STRESZCZEnIEWstęp. W le cze niu dys funk cji kom plek su bar ko we go co raz czę ściej wy ko rzy stu je się ró żne za bie gi z za kre su tera pii ma nu al nej. Ce lem pra cy by ła pró ba spraw dze nia, czy te ra pia ma nu al na wpły wa na po pra wę za kre su ru cho mości sta wu ra mien ne go oraz zmniej sze nie do le gli wo ści bó lo wych u pa cjen tów z prze wle kłym uszko dze niem sto żka ro ta to rów sta wu ra mien ne go.Ma te riał i me to dy. Ba da nych po dzie lo no lo so wo na dwie 15-oso bo we gru py ba da ną i po rów naw czą. Oby dwie gru py pod da no stan dar do we mu sko ja rzo ne mu le cze niu, na któ re skła da ły się: TENS, so no te ra pia oraz ki ne zy te ra pia. Gru pę ba da ną pod da no do dat ko wo au tor skie mu pro gra mo wi skła da ją ce mu się z wy bra nych ele men tów ró żnych tech nik sto so wa nych w te ra pii ma nu al nej. Oce nia no zmia ny za kre sów ru cho mo ści sta wu ru chu oraz, za po mo cą skali VAS, zmia ny stop nia na si le nia ob ja wów bó lo wych pod czas wy ko ny wa nia te stów czyn no ścio wych. Uzy ska ne wyni ki pod da no ana li zie sta ty stycz nej.Wy ni ki. W gru pie ba da nej uzy ska no szyb sze i istot niej sze zmniej sze nie do le gli wo ści bó lo wych oraz istot niej sze zwięk sze nie za kre su ru cho mo ści sta wu we wszyst kich ba da nych za kre sach ru chów.Wnio sek. Włą cze nie te ra pii ma nu al nej do kom plek so we go, stan dar do we go po stę po wa nia fi zjo te ra peu tycz ne go w re ha bi li ta cji pa cjen tów z prze wle kłym uszko dze niem sto żka ro ta to rów sta wu ra mien ne go istot nie pod no si sku teczność le cze nia.Sło wa klu czo we: te ra pia ma nu al na, uszko dze nie sto żka ro ta to rów, fi zjo te ra pia SUMMARY Background. Various manual therapy procedures are increasingly more often being used in the treatment of shoulder complex dysfunctions. The objective of the present study was to investigate whether manual therapy can improve the range of motion in the glenohumeral joint and alleviate pain in patients with chronic rotator cuff injuries.Material and methods. The participants were randomly assigned to an experimental group and a control group of 15 patients each. Both groups received a standard combination therapy involving TENS, ultrasound therapy and kinesiotherapy. Additionally, the experimental group took part in a treatment programme designed by the authors composed of selected elements of various manual therapy techniques. Outcome evaluation focused on changes in the range of motion in the glenohumeral joint and changes in pain intensity (VAS scale) during the performance of functional tests. The results were subjected to statistical analysis.Results. More rapid and more significant pain reduction and more significant improvement in the range of motion of the glenohumeral joint across all movements tested were obtained in the experimental group.Conclusion. The inclusion of manual therapy in standard comprehensive physiotherapy applied in the rehabilitation of patients with chronic rotator cuff injuries of the glenohumeral joint sig...

Diabetes is a common disorder that leads to the musculoskeletal symptoms such as the shoulder arthritis. The involvement of peripheral nervous system is one of the troublesome for the patients as it provokes chronic sensory symptoms, lower motor neuron involvement and autonomic symptoms. In the course of the disease there has been several types of neuropathies described. A 41-year-old male patient was admitted to the internal medicine department because of the general weakness, malaise, polydypsia and polyuria since several days. The initial blood glucose level was 780mg/dl. During the first day the continuous insulin infusion was administered. On the next day when he woke up, the severe pain in the right shoulder with limited movement, right upper extremity weakness and burning pain in the radial aspect of this extremity appeared. On examination right shoulder joint movement limitation was found with the muscle weakness and sensory symptoms in the upper limbs. The clinical picture indicated on the right shoulder arthritis and the peripheral nervous system symptoms such as the right musculocutaneous, supraspinatus, right radial nerve and left radial nerve damage. We present a first case report of simultaneous, acute involvement of the shoulder joint and multiple neuropathy in a patient with newly diagnosed type 2 diabetes, presumably in the state of ketoacidosis.