Physiotherapy according to the BeBo Concept as prophylaxis and treatment of urinary incontinence in women after natural childbirth

Pelvic floor muscle dysfunctions can lead to urinary incontinence, a condition which often affects women both during pregnancy and after childbirth. As a result of this, certain exercises are recommended during and after pregnancy to prevent and treat this incontinence, and the BeBo Concept is one of these methods used to prevent pelvic floor muscle dysfunction. The aim of the present study was to evaluate the effects of a 6-week course of physical therapy according to the BeBo Concept on the improvement of perineal muscle strength and endurance as well as urinary continence in women after their first vaginal delivery. The study was conducted on a group of 56 women who were randomly assigned to the exercise (n = 30) or control (n = 26) group. The exercising group participated in a 6-week physical therapy program according to the BeBo Concept. Pelvic floor muscles were assessed using the perineometer and palpation Perfect Test. UDI6 and ICIQ-SF questionnaires were used to obtain information about the symptoms of urinary incontinence, evaluate the frequency, severity and impact of urine leakage on the quality of life. In all women after natural childbirth, regardless of treatment, it was observed that measured parameters improved, but the improvement was slightly more explicit in those who participated in the Bebo Concept exercise group (e.g. ICIQ-SF exercise group p = 0.001, control group p = 0.035). Due to its positive impact on the pelvic floor, this exercise program should be recommended to women after natural childbirth.

Estimation of selected parameters in stabilographic image depending on physical activity level in children and adolescents

Introduction: Balance is an extremely important component of everyday human functioning. Assessment of body balance in children can be not only a diagnostic tool, but also information about the maturation of the balance system, diversity in terms of age and sex, as well as factors affecting balance and its development. In practice, maintaining body balance is a dynamic process, consisting in "continuous loss and regaining balance". According to scientific reports, in addition to age, psychosomatic status, the development of specific sensory-motor capabilities and strategies is also influenced by the type of sport. Objective: The aim of the study was to assess balance in a group of children and adolescents with different levels of sports activity. Material and methods: The study comprised 64 children and adolescents aged 10 to 13. The group was divided into: Group 1 (15 girls and 17 boys) regularly physically active, and Group 2 (17 girls and 15 boys) not undertaking any physical activity. All participants were assessed regarding postural stability using a CQStab2P stabilometric platform. Four tests were carried out for each participant: standing on both feet, on the left and right limb, and free standing with an additional task. The following parameters were analysed: SP (Sway Path) MA (Mean Amplitude) and MF (Mean Frequency). Results: In the majority of cases, the variables indicated statistically significant differences from normal distribution – except for MA-R (on the right lower limb) and MF-T (standing on both feet with additional task). In the case of the SP-L indicators (on the left lower limb), SP-B (standing on both feet), SP-T, MA-B and MA-T, the advantage of low results was observed in the examined sample (distribution accuracy) and clear concentration near the average (leptocurticity of distribution). In the case of the trial to stand on the right lower limb, training subjects obtained statistically significantly higher SP results than those non-training. During the standing test, the length of MA was recorded as statistically significantly lower than in other conditions. In addition, the SA index, when trying to stand on the right lower limb, was statistically significantly higher in relation to the length of the radius when standing on the left limb. Training participants had a higher average radius compared to those not training. Conclusions: Physical training positively affects the results of posturographic examination. Non-training girls have a statistically significantly lower level of SP compared to boys not training and training girls.

Assessing the impact of certain exercises on the spatial head posture

OBJECTIVES

The head constitutes 6% of the total body weight, which is linked to the cervical spine and all other joints through the kinematic chain by various muscles. The forward head posture is one of the most common postural disorders and seems to be especially dangerous. The goal of the work was to assess the impact of 4 weeks of training neck and nape muscles on the head posture.

MATERIAL AND METHODS

The subjects were 20 participants, who performed neck exercises for 20 days. The head posture in a sagittal and frontal plane was assessed photogrammetrically twice: before and after the exercises. The following have been used for the assessment: craniovertebral (CV) angle, head tilt angle (HT), and frontal head tilt angle (FHT).

RESULTS

After a 20-day program of neck and nape exercises the values of specific angles were compared. The results indicated significant changes in the head posture. In the sagittal plane: the average value of the CV angle before the training was 47.17°, and 50.82° after the training; the average value of the HT angle before the exercises was at 20.99°, and 24.31° after. In the frontal plane the average value of the FHT angle before the exercises was at 2.71°, and after 20 days of training the average value of this angle decreased to 2°.

CONCLUSIONS

The results demonstrate that a short, home-based targeted exercise program can improve head posture. Int J Occup Med Environ Health. 2019;32(1):43-51.

Evaluation of transverse abdominal muscle thickness and the quality of life in patients undergoing rehabilitation due to disc-root conflict in the lumbo-sacral spine treated surgically using the spinal disc resection method

Purpose: The aim of the study was to determine the relationship between the changes in abdominal transverse muscle thickness (TrA) after therapy that included elements of reeducation of central stabilisation, and pain reduction as well as quality of patients’ life after intervertebral disc resection of lumbar spine. Material and methods: The study group consisted of 30 patients (17 women and 13 men) aged 28-87 (58 ± 15) participating in a rehabilitation stay. All subjects underwent intervertebral disc resection (LS level) within the years 2012-2016. All subjects included in the study underwent ultrasound evaluation of the thickness of the TrA muscle, evaluation of activation ratio, percentage change in muscle thickness, evaluation of the quality of life with SF-36, assessment of pain components on the VAS scale and level of disability using the Barthel index. All the subjects were referred to a 3-week therapy programme combined with motor control re-education including deep muscle training. The tests were performed before and after the physiotherapy on the basis of the original exercise programme. Results and conclusions: The percentage of TrA muscle thickness change in the first exam was 15.84 ±0.1%, and 16.09 ±0.13% after treatment. There were no statistically significant differences between the measurements. In the assessment of quality of life, patients in the first exam reached the score of 113.23 ±28.07 points, whereas in the second one - 85.1 ±27.05 points. The difference between the results was statistically significant (p<0.001). Pain components on the VAS scale were assessed at 4.3 ±0.83 points on average in the former exam, and 2.83 ±1.04 points in the latter one. The difference in measurements was statistically significant (p<0.001). The assessment of the level of disability using the Barthel scale with an average score of 93.66 ±8.4 points, conducted in the first exam, indicated that the studied persons were characterised by full efficiency. The original therapy, carried out among subjects operated on due to disc-root conflict of the LS spine, has a positive effect on the thickness of the TrA muscle both in contraction and at rest, and also reduces the level of pain while improving quality of life.

Changes in the contraction ratio of transversus abdominis and quality of life in patients after total hip replacement and three-compartment knee arthroplasty with implant posterior stabilization

Core stability is a reference term for the performance of the deep trunk muscles, which provide functional stability of the lumbopelvic area and control the human body in static and dynamic positions. The study group consisted of 30 patients between the age of 42 and 76 years (mean=61.4) after total hip arthroplasty (total hip replacement, Group I) and total knee arthroplasty (three-compartment arthroplasty with posterior stabilization of the implant - Group II). In 18 (60%) patients, hip endoprosthesis was performed, whereas in 12 (40%), three-compartment knee endoprosthesis with posterior stabilization has been implanted. In the study group, Rehabilitative Ultrasound Imaging (RUSI) of the transversus abdominis muscle thickness was conducted at rest and in contraction, the transversus abdominis activation ratio was specified, the SF-36 Life Quality Questionnaire was applied and a three-week treatment cycle was performed. The tests were carried out twice, i.e. before and after treatment. In the group of patients after total hip replacement, the transversus abdominis (TrA) contraction ratio before the beginning of the exercise programme was 0.79±0.06, and after its completion 0.9 ±0.02. The observed difference was statistically significant at p<0.001. In the group of patients after three-compartment knee arthroplasty, the TrA contraction ratio before the beginning of the exercise programme was 0.78±0.09, and after its completion0 0.91±0.02. The difference of these values was statistically significant at the level of p<0.05. The results of the SF-36 questionnaire in both groups indicate improvement in physical functioning. The observed difference was statistically significant at p<0.001. The performed three-week physiotherapy treatment in conjunction with deep muscle training increases the thickness of the TrA muscle during rest and contraction testing, and increases the transversus abdominis contraction ratio in Rehabilitative Ultrasound Imaging in the study groups. Furthermore, improvement in the level of physical functioning was observed within the studied groups.

Selected life quality variables of women treated surgically due to intertrochanteric femur fractures in the aspect of nursing and rehabilitation standards

Introduction: The aim of presented study was to evaluate selected quality of life indicators for women treated surgically due to intertrochanteric femur fractures in terms of implementation of physiotherapeutic and nursing standards. Clinical Hospital in Krakow (5WSK) within the period from January 2015 to December 2016. At that time, 145 women with intertrochanteric femur fracture were admitted to the hospital. The age of the patients ranged between 58 and 92 years, with an average of 83.6 years. The following questionnaires and score scales were used to assess the quality of life: Short Pfeiffer Mental Status Questionnaire (SPMSQ), Instrumental Activities of Daily Living (IADL) scale, SF-36 Quality of Life Questionnaire, Barthel scale, HOOS scale, Geriatric Depression Scale (GDS) by Yesavage, the author’s questionnaire on rehabilitation care problems related to urinary tract infections, bed sores, pneumonia, gastrointestinal disorders, gastrointestinal infections and thromboembolic complications as well as survival rate. Results and conclusions: 1. The quality of life of women operated because of intertrochanteric femoral fractures using an intramedullary Gamma nail had deteriorated in both short and long-term observation. 2. Maintenance and individualization of nursing standards and rehabilitation in women treated surgically due to intertrochanteric femoral fractures had a positive effect on the overall process of their treatment. 3.The level of physical activity declared by women operated due to intertrochanteric femur fracture prior to the occurrence of these fractures, has a signifi cant effect on their functional results in short and long-term observation. The higher the level of physical activity of these patients before the fracture, the more favourable was the functional outcome. 4. The level of mood and self-acceptance of the disease in women treated surgically for this fracture had signifi cant impact on the process of their nursing as well as rehabilitation, and on functional status in short and long-term follow-up. The higher the level of mood and self-acceptance of the disease in these women, the better the process of their nursing, rehabilitation and the functional outcome.

Stabilometric indicators as an element of verifying rehabilitation of patients before and after reconstruction of anterior cruciate ligament

PURPOSE

The aim of the study was to evaluate effectiveness of rehabilitation in patients before and after rACL, based on stabilographic indicators.

METHODS

The research group was comprised of 31 men aged 20-57 with anterior cruciate ligament injury, qualified for reconstruction surgery. A measurement of static stabilometric indicators and muscle strength was taken twice for each patient - before surgery and after 6 months. To assess stabilographic indicators the stabilographic platform was used and to asses muscle strength a dynamometer was used. In order to assess knee function the Lysholm scale and VAS scale were used.

RESULTS

The rehabilitation programme improved static stability of the knee in the frontal plane, which is manifested by a significant shortening of the SPML path length. Rehabilitation proceedings should focus on improving static stability of the knee joint in the sagittal plane, because the results obtained indicate only a slight shortening of the SPAP length. The results of the Lysholm and VAS scales point to a positive influence of the applied rehabilitation.

CONCLUSION

Inclusion into rehabilitation diagnostic tools to assess stabilometric indicators enables for effective verification of rehabilitation proceedings focused on restoring body posture control before and after the rACL.

Evaluation of relationship between the results of selected tests for muscle strength assessment of the hip abductors

PURPOSE

The assessment of hip joint abductor muscle strength is most often carried out using a dynamometric test. However, both in clinical practice and literature, evaluation is performed by means of the single-leg half-squat or the amount of abduction movements performed in the hip joint. In this context, the question arises whether the results of individual tests are convergent. The aim of the study is to evaluate the relationship between strength of the hip abductor muscle measured by dynamometer, the single-leg-squat and the number of repetitions of the movements in time.

METHODS

A group of 35 students (20 women and 15 men) between 20 and 24 years old participated in the study. Each student was subjected to three tests assessing the condition of the hip and associated abductor muscles. Those included: assessment of hip joint abduction muscle strength in a dynamometric study, assessment of the number of abdomen movements performed lying on the side and standing, during a 30-second interval, and the single-leg-squat test.

RESULTS

Based on the tests conducted, a significant relationship was observed between the muscle strength measurement results for the left and right side in the dynamometric study and the number of hip abduction repetitions in 30 seconds and the single-leg-squat test.

CONCLUSIONS

The obtained results indicate a significant relationship between the results of all the tests. In practice, this means that the tests can be used interchangeably.

Assessment of the influence of jogging on the shape of female foot arches

INTRODUCTION

Both walking and its faster, running, consist of cyclical subsequent phases of swing and support; however, they differ in their time proportions as well as magnitude of acting forces. There is a lack of studies concerning the long-term consequences of repeated jogging cycles on the function of feet and, above all, on their permanent impact on the shape of foot arches.

OBJECTIVES

The objective of this study was to answer the question whether regular jogging changes the shape of the transverse and medial longitudinal arches of the feet.

MATERIAL AND METHODS

The research material consisted of 96 women with an average age of 26.57, and included 50 actively jogging women, and 46 of non-joggers. The study was performed with the use of EMED-SF force platform. The plantar surface of the foot was divided into 10 regions according to Cavanagh, for which peak pressure and contact time were established. Two indicators were defined: metatarsal bone pressure distribution pattern acc. to Kantali, and longitudinal arch index acc. to Cavanagh.

RESULTS

The data obtained revealed more frequent occurrence of the greatest pressure under the centrally located metatarsal heads (lack of functional foot transverse arch) among the female joggers, compared with the non-joggers. Moreover, the findings indicate the higher frequency of medial longitudinal foot arch flattening among female runners, with a great deal of consistency between both feet, whereas results for the control group show asymmetrical medial arch shapes with right foot propensity to normal arch shape and left foot tendency for excessive arch.

CONCLUSIONS

The observed differences in feet arch shapes between female joggers and non-joggers indicate the influence of jogging on feet functional adaptations.

The influence of anterior cruciate ligament reconstruction on accelerometric gait analysis

ACL injuries – next to damage to the collateral ligaments, menisci of the knee – are the most common injuries of the knee joint and very often require surgical treatment. The main aim of the treatment is to restore normal gait pattern. The objective of this study was to determine the influence of reconstructed ACL on selected gait parameters by using an accelerometer system. The study involved 34 people aged 18-54 who were divided in two groups. The first group consisted of 20 people after ACL reconstruction, aged 19-54 years old (mean 29). The second group consisted of 14 healthy people between the age of 18-45 (mean 25.36). Gait analysis in normal and fast rate was performed using the CQMotion Electronik System, MEMS type. Differences in the results were observed in the first group. In 75% of people during normal walking and in 95% during fast walking, a 5% difference between the healthy limb and the limb after ACL reconstruction was observed. The gait rate had influence on acceleration value which was observed in RMS values in both of the groups. The RMS value was different, depending on the gait rate. Accelerometric gait analysis shows that the differences in comparing rate values between limbs are not so great, however, the gait pace has influence on some gait parameters. parameters.

Assessment of fundamental movement patterns and risk of injury in male soccer players

Introduction. The aim of the study was to assess the functional status of male soccer players in different age groups who played on different surfaces. Methods. The study included 45 soccer players aged 13-35 years. Among them, 15 were junior players, 15 were players of the senior Silesia-Opole 3rd league (SL), and 15 were senior players in the futsal Extra Class league (SF). The functional status and basic motor skills were assessed according to the results obtained in seven motor tasks included in the Functional Movement Screen™ (FMS) test. Results. The mean total scores in the FMS test were statistically significantly higher among both senior futsal and senior 3

Characteristics of static and dynamic loading of the plantar surface of the foot in women with hallux valgus deformity

Hallux valgus is one of the most common foot deformations, which occurs twice as frequently in women than in men. The aim of the study was to evaluate the feet soles pressure distribution pattern of young women with hallux valgus deformity. The study sample consisted of 23 young women (21-27 years). Among the participants, 14 demonstrated the presence of single- or double-sided hallux valgus (study group – a total of 22 feet with hallux valgus) and 15 women had the correct angle of the big toe for one or both feet (control group – a total of 23 feet without deformation). The research tool was the Podoscan 2D platform and the FreeMED force platform (Sensor Medica, Italy). Using the FreeStep Professional software on the plantocontourograms of the feet, the angle of hallux valgus was determined (ALFA angle). In statics the following parameters were assessed: maximal fore- and rear-foot loading, percentage loading of forefoot and the Weissflog indicator, and in dynamics (gait): the percentage loading of forefoot and medial part of the foot, the value of maximum foot pressure and the passage point of the center of pressure line. There were no differences between the study and control group regarding loading of the fore- and rear-foot or pressure distribution pattern on the lateral and medial side of the foot, however, statistically significant differences were observed in the value of the Weissflog indicator and the exit place of the center of pressure line. 1. Hallux valgus deformity changes the foot rollover pattern, in which instead of the big toe as the main place to transfer forces during the fi nal support phase, the increased load is transferred through the second foot ray. 2. hallux valgus promotes fl attening of the transverse arch of the foot. 3. changes in foot pressure pattern observed in the group of women with hallux valgus are not dependent on the valgus angle. Masłoń A., Czechowska D., Szczygieł E., Golec J. Characteristics of static and dynamic loading of the plantar surface of the foot in women with hallux valgus deformity. Med Rehabil 2016; 20(2): 5-12. DOI: 10.5604/01.3001.0009.4804

Assessment of adaptive changes of feet pressure distribution pattern amongst randomly selected group of female joggers

BACKGROUND

Both walking and running contain the same cyclical movement phases; however, they differ greatly in time proportions, as well as magnitude of acting forces. The objective of this study was to ascertain that the regular jogging activity induced the adaptive modifications of foot pressure distribution pattern in fore-aft and lateral-medial dimensions during walking for female joggers.

METHODS

The research base consisted of 96 women between 20 and 50 years of age, and included 50 female active joggers, and 46 of female non-joggers. The study was performed with the use of an EMED-SF force platform. Two parameters describing the plantar surface of the foot loading were established, namely force time integral (FTI) and pressure time integral (PTI). Two indicators were defined: percentage medial impulse acc. to Bowen and metatarsals and toes loading ratio acc. to Nagel.

RESULTS

Our study showed lower PTI and FTI for the both feet big toes in the female joggers group. What is more, our research results indicate that regular jogging increases loading of metatarsus and lateral side relatively to toes and medial side, respectively.

CONCLUSIONS

The observed differences in foot pressure distribution patterns in both groups included in the current study proved the substantial influence of jogging on adaptive functional changes of walking pattern.

Head position influence on stabilographic variables

PURPOSE

Head constitutes 6% of our body weight and significantly influences human body motor system mechanics. From physiological point of view, it should be located at extension of body middle line. Its location being modified results in many consequences in motor system. Our research was aimed at assessing the influence of head position on human body balance stabilographic variables.

METHODS

The research was made on a group of 62 patients: 45 women and 17 men, aged from 40 to 60 yrs, 46 yrs on average. Head position in sagittal and frontal plane was assessed with photogrammetric method. Chosen stability parameters were estimated with dynamometric platform PEL 38 and computer software TWIN 99.

RESULTS

The results confirmed correlations between existing stabilographic values and head position in frontal plane only. Head position, when changed in this plane, increased the amplitude ( p = 0.001) and average speed of body gravity center trembilng ( p = 0.002). There were no significant relations found in sagittal plane ( p > 0.05).

CONCLUSIONS

Our results show that the head position influences stabilographic variables. Its change in frontal plane decreases body posture stability to the largest extent.

Analysis of body composition among children and adolescents - a cross-sectional study of the Polish population and comparison of body fat measurement methods

OBJECTIVE

The first aim of the present study was to analyze the body composition of Polish children ages 7-17 years old to add to the current body of literature. The second aim was to compare two body fat measurement methods (bioimpedance vs. Slaughter equation) on the abovementioned population.

METHODS

Height (cm) and weight (kg) of 308 (161 males and 147 females) participants, ages 7-17, were measured, and body mass index (BMI) scores were calculated. Skinfold thickness (SFT) was measured for the triceps, subscapular, abdominal, suprailiac, thigh, and medial thigh skin folds on the left side of the body. Fat mass, fat percentage in the whole body (%BF), fat-free mass, and total body water were assessed using bioelectrical impedance analysis (BIA).

RESULTS

In the present sample, 29.5% of males were overweight, and 11.3% of these were obese. Among females, 27.2% were classified as overweight, and 6.8% of these were obese. Males had a higher total body water (median=27.25 vs. 24.8 kg, p<0.001) and fat-free mass (median=37.25 vs. 33.90 kg, p<0.001), while females showed a higher total body fat percentage (median=22 vs. 14.55%, p<0.001) and fat mass (median=9.1 vs. 5.9 kg, p<0.001). %BF calculated using Slaughter equations overestimated those obtained by BIA in both genders (p<0.0001).

CONCLUSIONS

The percent of youths classified as overweight and obese has increased in Krakow (Poland). Calculation of body fat percent derived from bioimpedance provides better estimates than the use of Slaughter equations, which tended to overestimates the values.