STRESZCZENIEWstęp. Do le gli wo ści bó lo we szyj ne go od cin ka krę go słu pa sta no wią jed ną z naj częst szych do le gli wo ści w ob rę bie ukła du ruchu. Ce lem pra cy by ła oce na sku tecz no ści i wpły wu ma sa żu lecz ni cze go na za kre sy ru cho mo ści pa cjen tów z bó la mi szyj ne go odcin ka krę go słu pa.Ma te riał i me to dy. Ba da niem ob ję to gru pę 60 osób w wie ku 37 -82 la ta (śr.: 62,8±9,86 lat) le czo nych z po wo du bó lów szyjne go od cin ka krę go słu pa w Za moj skiej Kli ni ce Re ha bi li ta cji Wy ższej Szko ły Za rzą dza nia i Ad mi ni stra cji. Ba da nych pa cjen tów po dzie lo no na dwie gru py: w pierw szej gru pie (30 osób) za sto so wa no za bie gi z za kre su fi zy ko te ra pii i ki ne zy te ra pii; w dru giej gru pie (30 osób) do dat ko wo zle co no ma saż lecz ni czy. Do oce ny sku tecz no ści re ha bi li ta cji za sto so wa no po miar cy fro wym in klino me trem Sa un ders`a, Wskaź nik Spraw no ści w Bó lach Krę go słu pa Szyj ne go (Neck Di sa bi li ty In dex -NDI) oraz ska lę bó lu VAS.Wy ni ki. Obie ba da ne gru py pod wzglę dem Wskaź ni ka NDI i Ska li VAS przed (NDI: p=0,56; VAS: p=0,231) i po re ha bi li ta cji (NDI: p=0,203; VAS: p=0,401) nie ró żni ły się istot nie sta ty stycz nie. Po słu gu jąc się kwe stio na riu szem NDI i Ska lą VAS po re ha bi li ta cji stwierdzo no istot nie sta ty stycz nie zmniej sze nie bó lu (p<0,001) po pra wę spraw no ści i funk cjo no wa nia (p<0,001) w obu ba da nych gru pach. W ba da niu in kli no me trem Saun ders'a u pa cjen tów z ma sa żem uzy ska no istot ną sta ty stycz nie po pra wę w za kre sie zwięk sze nia ru chomo ści: zgię cia (p=0,022), zgię cia w pra wo (p=0,018), zgię cia w le wo (p=0,003).Wnio ski. 1. Ma saż lecz ni czy wpły wa na zwięk sze nie za kre sów ru cho mo ści. 2. Sku tecz ność ma sa żu lecz ni cze go jest po rów -ny wal na do sku tecz no ści re ha bi li ta cji opar tej je dy nie na fi zy ko te ra pii i ki ne zy te ra pii.Słowa kluczowe: masaż leczniczy, ból odcinka szyjnego, inklinometr Saundersa, Wskaźnik Sprawności w Bólach Kręgosłupa Szyjnego (NDI) SUMMARYBackground. Neck pain is one of the most common musculoskeletal ailments. The aim of this study was to evaluate the effectiveness and impact of therapeutic massage on the range of motion in patients with neck pain.Material and methods. The study involved 60 patients aged 37-82 years (mean age: 62.8 ± 9.86 years) treated for neck pain at the Rehabilitation Department of Zamość University of Management and Administration. The patients were divided into two groups: one (30 persons) received kinesiotherapy and physiotherapy, and the other group (30 persons) additionally received therapeutic massage. The effectiveness of rehabilitation was assessed with a Saunders digital inclinometer, the Neck Disability Index (NDI) and a Visual Analogue Scale (VAS).Results. Both groups did not differ significantly in terms of NDI and VAS scores at baseline (NDI: p = 0.56, VAS: P = 0.231) and after rehabilitation (NDI: p = 0.203; VAS: P = 0.401). The NDI questionnaire and VA...

Biliary fistula and gallston ileus are rarely found. The diagnosis is difficult. Gallstone ileus requires urgent and appropriate surgical therapy. Enterolitotomy remains the gold standard of operative treatment for gallstone ileus, but additional procedures of one-stage cholecystectomy and repair of fistula are necessary. Some researchers advise first to resolve the gallstone ileus and then to perform the elective operation for gallstone disease in more ideal circumstances. Our case had clinical evidence of ileus, which was confirmed by radiological exam. Ultrasonographic examination performed before operation did not confirm the presence of gallbladder; it did not detect a large stone located in the intestine. The patient, a 75-year-old woman, was operated on. During the procedure it was shown that the second part of the duodenum was involved in a scar and displaced to the hepatic hilus. There was no gallbladder; it was probably destroyed by a long-lasting vesicoduodenal fistula. Cholangiography also did not detect the gallbladder. Biliary passage through the common bile duct was sufficient. The hole in the duodenum wall was sutured, and Kehr drain was inserted into the common bile duct. The gallstone was removed by incision of the intestine down to the obstruction. The postoperative period was complicated by a small suppuration of the laparotomy wound. Vesicoduodenal fistula present for a long time can lead to atrophy of the gallbladder. The one-stage procedure seems to be appropriate if biliary fistula and gallstone ileus are found.

Introduction: Breast cancer constitutes 10.9% of all new cases of tumours registered in the Polish National Cancer Registry. Post-mastectomy lymphoedema of the upper limb is the most common post-operative complication. The aim of the study was to evaluate the effectiveness of selected physiotherapeutic methods in the treatment of post-mastectomy lymphoedema. Material and methods: The study included 90 post-mastectomy patients in Stalowa Wola, Zamość and Tyczyn in the period from January 2014 to July 2016. The patients participated in two-week outpatient physiotherapy. In order to assess the effectiveness of lymphoedema treatment, circumferences of upper extremities were measured before and after physiotherapy. The results were then statistically analysed. Results: The majority of the subjects had undergone mastectomy within a period shorter than 5 years before. It was noted that the post-mastectomy upper limb had a significantly smaller circumference after physiotherapy than before physiotherapy (p<0.001). The study revealed no differences in the measurements of arm circumference with regard to the time since the mastectomy was performed. According to the patients, manual lymphatic drainage was the most effective type of physiotherapy treatment (p=0.04). Statistical analysis revealed significantly smaller arm circumferences after physiotherapy than before physiotherapy in patients treated 2-3 times (p=0.001) compared to patients who underwent either fewer or more treatments at the same time. Conclusions: 1. Two-week physiotherapy treatment proved to be the most effective in reducing lymphoedema in the arm area. 2. The period since the performance of the mastectomy had no impact on the effectiveness of lymphoedema treatment. 3. According to the post-mastectomy patients, manual lymphatic drainage was the most effective type of lymphoedema treatment. 4. Applying 2-3 physiotherapeutic procedures at the same time showed the best results.

Postural stability of the body depends on many factors. One of them is physical activity. It is especially important in the case of sports or professional work, which combine mobility with the accuracy of a shot in a standing position. The smaller the body fatigue, the more accurate the shot. The aim of the study was the assessment of the impact of physical effort on the center of gravity deflection and length of the COP (center of pressure) path, as well as the reaction of ground forces in people who do not engage in systematic physical activity. The study group included 139 people (23.1 ± 5.2 yr; M: 46.8%; F: 53.2%). The test consisted of performing a static test twice, shooting at the target in a multimedia shooting range. Group X performed the Harvard test between the static tests. Group Y made no effort. The reaction parameters of the ground forces were assessed using the Zebris PDM-L Platform. In Group X performing the Harvard test, an increase in the average COP, VCOP, and 95% confidence ellipse area was noted. The path length and the average velocity of COP speed increased. There were no differences in Group Y (p > 0.05). Physical effort significantly affected the postural stability of the studied people, increasing the average parameters assessing balance when adopting static firing position.

No abstract