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Open access

Piotr Czyżewski, Ireneusz Hałas, Renata Kopytiuk, Janusz Domaniecki and Marek Szczepkowski


Introduction: The rib broken are most frequent damages of chest. They cause strong pain, and make difficulties in breathing and changing position of body. Uncomplicated breakdowns are cured by analgesics drugs. One of physical methods for pain decreasing in musculoskeletal dysfunctions is kinesiotaping. The aim of this study was assessment of effectiveness Kinesiology Taping method after rib broken and their influence on pain reduction and breathing parameters.

Material and methods : In this study take part 14 patients after broken one or few ribs from General and Colorectal Surgery Clinic Bielanski Hospital in Warsaw.

Breathing parameters was controlled by forced vital capacity(FVC), forced expiratory voluntary in first second(FEV1) and peak expiratory flow (PEF). Pain was asses by visual analogue scale (VAS) separately for three situations: deep breathing, provoked coughing and changing body position from supine to seating. Next K-Active Tape® apply on skin over the broken rib. After 15 minutes breathing parameters and pain level assessing was repeated.

Results: There were difference between pain level before and after K-Active Tape® apply in three different situations. It shown difference in value of average points VAS in changing body position from supine to seating (p= 0,015), provoked coughing (p= 0,022) and deep breathing (p= 0,023). It means that pain was significantly decrees. Analysis of average value breathing parameters indicate upward trend FVC, FEV1 and PEF after Kinesiology Taping application, but it wasn’t statistically significant.

Conclusions: Kinesiology Taping is safety, supplementary method for heeling posttraumatic ribs condition. Apply lymphatic and ligament techniques using K-Active Tape® could be effectiveness method of reduction pain after ribs broken. It’s necessary to continue research on effectiveness Kinesiology Taping after ribs broken with extend methodology.

Open access

Tomasz Zieliński, Piotr Czyżewski and Marek Szczepkowski


The operation to restore the continuity of the gastrointestinal tract is another surgical intervention in a given patient, which directly translates into an increased risk of complications during and after surgery. That is why proper qualification is important for the operation to restore the continuity of the gastrointestinal tract in terms of performance and efficiency of the anal sphincter apparatus, among other things.

The aim of the study was to evaluate the effect of restoring physiological defecation routes on the sphincter function and to observe the parameters of anorectal manometry in patients before and after surgery to restore the continuity of the gastrointestinal tract.

Material and methods. The study included 29 patients scheduled for restoration of the continuity of the gastrointestinal tract, 12 women and 17 men. The average age in the group was 62 years. Anorectal manometry was performed both before surgery as well as one month and three months afterwards in all patients. The average time to have a stoma was 12 months.

Results. The resting pressure in the anal canal (MRP) three months after the restoration of the continuity of the gastrointestinal tract increased by 30.4%. The maximum systolic blood pressure in the anal canal (MSP) increased by 22.2%. The value of recto-anal inhibitory reflex (RAIR) decreased by 19.2%. The length of the high pressure zone in the anal canal (HPZL) increased by 27%. The study results of visceral rectal sensation thresholds decreased by 23.3% for the sensation threshold, and 14.4% for the pressure threshold.

Conclusions. Restoring the continuity of the gastrointestinal tract improves the anal sphincter function which is evident in the parameters of anorectal manometry. The restoration of passage improves the sphincter function, and these changes are statistically significant.

Open access

Piotr Czyżewski, Janusz Domaniecki, Aneta Dąbek and Renata Kopytiuk


Wstęp: Podeszły wiek jest istotnym czynnikiem ryzyka chorób jelita grubego wymagających leczenia chirurgicznego. Celem fizjoterapii po dużych operacjach brzusznych jest zapobieganie powikłaniom i redukowanie ograniczeń funkcjonalnych. Celem badania było określenie związku pomiędzy poziomem aktywności fizycznej a stanem funkcjonalnym i sprawnością wentylacyjną płuc we wczesnym okresie pooperacyjnym.

Materiał i metody: 34 pacjentów zakwalifikowanych do planowej dużej operacji brzusznej w wieku 65+ przydzielono losowo do grupy usprawnianej metodą z wykorzystaniem elementów koncepcji PNF lub grupy usprawnianej tradycyjnie. Spirometrię natężoną (FVC, FEV1, PEF) i testy funkcjonalne (prędkość chodu, wstań i idź) wykonywano przed operacją i w czwartej dobie po operacji. Analizowano poziom aktywności fizycznej, wiek, płeć, BMI oraz poziom pooperacyjnej samodzielności (SAP). Do analizy wyników zastosowano test Kołmogorowa-Smirnowa, test t-Studenta dla prób zależnych oraz analizy korelacji r-Pearsona. Przyjęto poziom istotności p<0,05.

Wyniki: W teście prędkości oraz wstań i idź nastąpiło wydłużenie czasu wykonania po operacji w porównaniu do poziomu przed operacją. W FVC %, FEV1 %, PEF % nastąpił spadek wartości. W grupie osób z wysoką aktywnością nie odnotowano istotnych statystycznie zmian wartości dla tych pomiarów. Osoby o wysokim poziomie aktywności miały istotnie wyższy wynik na skali SAP niż osoby o średnim lub niskim poziomie aktywności.

Wnioski: Duże operacje brzuszne w istotny sposób pogarszają funkcję wentylacyjną płuc oraz sprawność i prędkość chodu chorych po 65 roku życia, we wczesnym okresie pooperacyjnym. Wysoka przedoperacyjna aktywność fizyczna starszych pacjentów zakwalifikowanych do dużych operacji brzusznych, korzystnie wpływa na funkcję wentylacyjną płuc oraz poziom pooperacyjnej samodzielności, sprawności i niezależności w chodzie w okresie szpitalnym.

Open access

Aneta Dąbek, Agnieszka Adamiec, Witold Rekowski and Piotr Czyżewski


Introduction: The menopausal syndrome affects 85-87% post-menopausal women. Typical symptoms include: hot flashes, heavy sweats, dizziness, increased body temperature, heart palpitations, depression, mood swings, distorted concentration, distorted memory and interrupted sleeping patterns. The literature on effects of physical activity on menopausal symptoms seems to be inconsistent. The aim of this study was to determine the relationship between intensified menopausal syndrome and undertaking physical activity.

Material and methods: We studied 105 healthy menopausal women (aged 45 to 65). Their mean age was 52 SD 5.2. We used the survey method. The research tools were: questionnaire we devised, Kupperman index and Borg scale. Additionally, we devised: physical effort intensity index and physical activity variety index. To conduct the statistical analysis, we used STATISTICA programme. We set statistical significance at p<0.05.

Results: We found a statistically significant relationship between the frequency of undertaking physical activity and the intensity of menopausal syndrome. More than a half of the subjects (54.3%) did physical exercise “often” or “regularly”, and they did not suffer from the “severe” form of menopausal syndrome. We found a significant relationship between the BMI and intensity of menopausal symptoms (p=0.04) and between the waist size and menopausal symptoms (p=0.001).

Conclusions: The more intense, varied and frequent physical activity, the less intense menopausal symptoms. The subjects with normal BMI and waist narrower than 80cm had less difficult menopause. Physical activity reduces physical and psychological changes experienced in the climacteric.

Open access

Piotr Czyżewski, Marek Szczepkowski, Janusz Domaniecki and Aneta Dąbek


Aging population, increases the number of major abdominal surgery (MAS) performed in the elderly. Main goal of physiotherapy after that surgery is prevention postoperative complications and reduction of functional limitation.

The aim of the study was to asses functional status elderly people after MAS during early postoperative physiotherapy.

Material and methods. In a prospective randomized study involved 34 patients scheduled for elective MAS, aged 65+. Patients were randomly assigned to receive PNF or conventional physiotherapy. The study included forced spirometry (FVC, FEV1, PEF) and functional tests (gait speed, up&go). Measurements were performed before surgery and the fourth day after surgery. Also analyzed age, sex, BMI and the level of postoperative independence (postoperative independence scale SAP). Kolmogorow- Smirnow test was used to check normal distribution, t-Student was used to check whether two sets of data differ significantly, and r-Pearsons for correlations testing. p values <0.05 were considered significant.

Results. After surgery the time of gait speed test and up and go test was significant longer in comparison to preoperative value. FVC%, FEV1%, PEF% values was decrease. In the PNF group was found significantly higher postoperative independence(SAP) and shorter length of stay in hospital compared to conventional physiotherapy group. Results of SAP and functional tests were significantly positive correlated.

Conclusions. Major abdominal surgery decrees efficiency of walking and lung ventilation after 65 year old in early postoperative period. Some techniques of the PNF concept used in improving older patients after the MAS may favourably affect the postoperative increase independence and reduce the time of hospitalization.

Open access

Piotr Czyżewski, Dominika Hryciuk, Aneta Dąbek and Marek Szczepkowski


Early physiotherapy is an important part of the comprehensive treatment of patients after major abdominal surgery (MAS). Accelerated mobilization should be safe and requires the use of appropriate techniques. Most of the physiotherapists and surgeons recommends using abdominal belts. Opponents claim that belts have an adverse effect on lungs ventilation.

The aim of the study was to determine the effect of abdominal belt on lung ventilation efficiency in the early period after MAS.

Material and methods. The study involved 20 patients after MAS. Including 9 women and 11 men, aged between 40 to 90 years (x̅ 66.7). In the scheduled 7 patients and urgent 13. All of them were in the early period after surgery. Dynamic spirometry was performed twice in the postoperative period. For the first time wearing a belt, and then without the belt in the same group. Evaluated the forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF). For the analysis uses the Wilcoxon matched-pairs test and Spearman’s rank correlations. P values <0.05 were considered significant.

Results. The value of the ventilation indicators measured wearing abdominal belt were slightly lower than the values evaluated without the belt. The results are shown in percent predicted for age and gender, FEV wearing belt 52%, without belt 53%; FEV1 59% vs 61%; PEF 46% vs 51%. There were no statistically significant differences

Conclusions. There were no significant negative influence of abdominal belt on lungs ventilation in early period after MAS. There was no correlations between age, body mass index and changes in ventilation indicators.