BackgroundOrthognathic surgery (OGS) is associated with extensive surgical intervention within the soft and hard tissues of the facial region of the skull leading to inflammatory reactions. The presence of postoperative swelling indicates the accumulation of exudate or transudate; both these fluids occur in surgery. Massive swelling is a significant problem, because the tension of tissues intensifies pain sensations. The aim of the study was to evaluate the effectiveness of the kinesio taping method (KT) in patients after orthognathic surgery in the area of the facial skull in terms of eliminating postoperative swelling.Material/methodsThe study of the impact of kinesiology tape applied after orthognathic surgery to the craniofacial area on the elimination of swelling was performed in sixteen patients who suffered from this complication after bilateral sagittal split osteotomy.ResultsThe swelling was shown to be reduced after KT; within the same study the differences were statistically significant between the left and right sides and for the same side (p<0.05). The application of the lymphatic kinesio taping method led to the reduction of tension in the affected area and restoration of proper lymphatic circulation in the region covered by swelling. This allows for the improvement of the blood and lymph microcirculation and activation of self-healing processes.ConclusionsThe analysis of the impact of the practical use of the lymphatic KT on complications after orthognathic surgery revealed that it had a beneficial effect on the reduction of swelling. The use of the KT method seems promising because it is simple to carry out, not traumatic, economical and rarely causes undesirable allergies.

Chronic obstructive pulmonary disease (COPD) is characterized by a decline of lung function and symptoms such as chronic bronchitis and emphysema leading from lung tissue destruction. Increased activity of matrix metalloproteinases (MMPs) and an imbalance between MMPs and their tissue inhibitors (TIMPs) are considered as factors influencing the pathogenesis of COPD. We investigated the role of genetic polymorphism and expression level of MMP-9 and concentration of its complexes with TIMPs in the development of COPD among Polish patients. We analyzed SNP in the promoter region of MMP-9 gene (rs3918242) using PCR-RFLP method among 335 COPD patients and 309 healthy individuals. Additionally, 60 COPD patients and 61 controls were tested for copy number variants (CNV) of MMP-9 (by quantitative real-time PCR) and serum levels of MMP-9 and its complexes with TIMP1 and TIMP2 (using ELISA). All subjects were analyzed for lung function using spirometry (FEV1% and FEV1/FVC parameters). We observed that allele and genotype frequencies of the SNP rs3918242, as well as the number of gene copies, were similar in COPD patient and controls groups. Serum levels of MMP-9 and MMP-9/TIMP1 complex were significantly higher in COPD patients in comparison to controls groups, although independently of analyzed gene polymorphisms. Additionally, the significant inverse relationships between parameters of lung function (FEV1% and FEV1/FVC) and proteins level were found in ridge regression models, especially we found that FEV1% decreased when MMP-9 level increased in controls and patients with COPD group. In conclusion, we found that COPD patients were predisposed to produce more MMP-9 and MMP-9/TIMP1 complex than healthy individuals. This phenomenon is probably associated with the disease-related lung environment but not with genetic features of the MMP-9.

Aim: This study aimed to evaluate the effects of dysphagia therapy in patients in the early post-stroke period. Clinical rationale: Dysphagia can be one of the consequences of stroke. This problem often leads to complications in the early stages of stroke, including aspiration pneumonia. Although individual reports on dysphagia exist in the literature, no comprehensive guidelines for dysphagia therapy are available. Material and methods: This randomised controlled trial included 60 patients with swallowing difficulties after ischaemic stroke (30 each in the study and control groups; age range: 55-65 years) who were admitted to a hospital stroke subunit. Patient rehabilitation period covered 15 days (seven days a week), with therapy for the first 10 days provided during patient hospitalisation and then outpatient physiotherapy during the subsequent five days. The procedure, including providing education about safe food and liquid consumption to patients and their caregivers, was performed in both patient groups. An original dysphagia treatment method was employed in the study group. Statistical average, standard deviation, and statistical error before and after therapy were determined in the study and control groups. The significance of differences in results between the study and control groups was assessed using the Mann-Whitney U test. Results: The applied therapy for dysphagia improved the swallowing function and selected motor functions of patients after stroke. In the study group, ineffective (delayed) and absent swallowing reflex was observed in 13 patients (44%) before therapy and in one patient (3%) after therapy. The rate of effective swallowing reflex increased from 57% to 97%. Statistically significant differences in swallowing reflex were observed between the study and control groups after therapy (p = 0.00001). Conclusions: A comprehensive therapy for dysphagia is effective and can reduce serious complications of swallowing disorders in clinical practice. Clinical implications: The results of this study could improve the clinical treatment of dysphagia.

Forms of rehabilitation for patients after COVID-19 are gaining interest. The purpose of this study was to investigate and compare an innovative in-hospital pulmonary rehabilitation programs augmented with training elements performed in virtual reality. This randomized controlled study included 32 patients enrolled in post-COVID-19 rehabilitation at a Public Hospital in Poland. The rehabilitation models included exercise capacity training on a cycle ergometer, breathing and general fitness workout, resistance training, and relaxation. The forms of training and relaxation differed between the groups: the experimental group employed virtual reality, and the control group used a traditional form of therapy. Exercise tolerance was assessed using a 6 min walk test (6 MWT), while psychological parameters were evaluated using the Hospital Anxiety and Depression Scale (HADS) and the brief World Health Organization Quality of Life Scale (WHOQOL-BRIEF). The analysis of the post-rehabilitation results showed a statistically significant improvement in both groups regarding depression (VR: 6.9 (3.9) vs. 4.7 (3.5), p = 0.008; CG: 7.64 (4.5) vs. 6.6 (4.8), p = 0.017) and anxiety (VR: 8.6 (4.6) vs. 5.6 (3.3), p < 0.001; CG: 9.57 (6.0) vs. 8 (4.8), p = 0.003). No statistically significant improvements in quality of life were noted in both groups. Moreover, the analysis showed a statistically significant improvement in the exercise capacity in both groups after completion of the rehabilitation program, expressed as a distance in the 6 MWT, as well as a statistically significant improvement in dyspnea in the VR group. To conclude, the analysis of the preliminary data revealed that a 3-week hospital-based pulmonary rehabilitation program for COVID-19 patients led to an improvement in exercise tolerance as well as a reduction in the symptoms of anxiety and depression. The virtual reality-based form of training delivery, despite its attractiveness, did not significantly affect patients’ performance.

The current spread of SARS-CoV-2 indicates a long-term fight against the widespread and exponential increase in morbidity and mortality across the globe. A variety of non-pharmacological strategies to mitigate and suppress virus transmission have been investigated and introduced. Currently, emerging studies focus mostly on the management of hospital-treated patients in the acute phase of the disease, including the legitimacy of using physiotherapeutic procedures. However, current literature lacks guidelines for rehabilitation related to maintaining continuity and universality of the therapy after the end of the acute phase of the disease and discharge from hospital. The authors suggest implementing an immediate rehabilitation program in post-infection patients as data from previous epidemics of respiratory-related viral diseases shows that COVID-19 survivors should be expected to have impaired lung ventilation function, and reduced exercise tolerance and muscular weakness, and prolonged return to work and participation. It should be assumed that only the introduction of immediate recommendations for the implementation of rehabilitation procedures based on simple and well-known tests, as well as their obligatory regime, can contribute to the reduction of respiratory disability leading, in a short time, to infections recurrence and, in the long run, to a lower quality of life and socioeconomic burden on the population. This article presents a respiratory rehabilitation program for COVID-19 survivors, recommended by the Polish Society of Physiotherapy. This program was approved by the Polish Minister of Health and implemented as a pilot program at the Hospital of the Ministry of the Interior and Administration in Głuchołazy, Poland. Med Pr. 2021;72

BackgroundThe six-minute walk test (6MWT) is considered to be a simple and inexpensive tool for the assessment of functional tolerance of submaximal effort. The aim of this work was 1) to background the nonlinear nature of the energy expenditure process due to physical activity, 2) to compare the results/scores of the submaximal treadmill exercise test and those of 6MWT in pulmonary patients and 3) to develop nonlinear mathematical models relating the two.MethodsThe study group included patients with the COPD. All patients were subjected to a submaximal exercise test and a 6MWT. To develop an optimal mathematical solution and compare the results of the exercise test and the 6MWT, the least squares and genetic algorithms were employed to estimate parameters of polynomial expansion and piecewise linear models.ResultsMathematical analysis enabled to construct nonlinear models for estimating the MET result of submaximal exercise test based on average walk velocity (or distance) in the 6MWT.ConclusionsSubmaximal effort tolerance in COPD patients can be effectively estimated from new, rehabilitation-oriented, nonlinear models based on the generalized MET concept and the 6MWT.

BackgroundNumerous recommendations from pulmonary scientific societies indicate the need to implement rehabilitation programs for patients after COVID-19. The aim of this study was to propose an innovative comprehensive intervention based on a hospital-based pulmonary rehabilitation program for individuals with post-acute sequelae of COVID-19.MethodsIt was decided to evaluate two forms of hospital rehabilitation: traditional and one provided through virtual reality. Preliminary results are based on a group of 32 patients (20 female and 12 male), of average age 57.8 (4.92) years in the period of 3–6 months after the initial infection. Primary outcomes included analysis of lung function, exercise performance and stress level. A 3-week, high-intensity, five-times per week pulmonary rehabilitation program was designed to compare the effectiveness of a traditional form with a VR-led, novel form of therapy.ResultsThe analysis of the results showed a statistically significant improvement in both groups with regard to exercise performance expressed as 6MWT distance. Moreover, a statistically significant decrease in dyspnoea levels following the 6MWT was also noted in intergroup comparison, but the between-group comparison revealed non-statistically significant changes with low effect size. Regarding lung function, the analysis showed essentially normal lung function at baseline and a non-statistically significant improvement after the completion of the rehabilitation program. The analysis of the stress level showed a statistically significant improvement in both groups within the inter-group comparison, yet the between-group comparison of deltas values showed a non-significant difference with low effect size.ConclusionA 3-weeks inpatients pulmonary rehabilitation program led to improvement of the exercise performance of people with post-acute sequelae of COVID-19, but not lung function. Furthermore, the program was shown to reduce patients' stress levels. A comparison of the traditional form of rehabilitation to the novel form using VR, shows similar effectiveness in terms of exercise performance and stress levels.

Physiotherapy in patients after laparoscopic cholecystectomy (CHL) is impeded by postoperative pain which causes a decline in patients' activity, reduces respiratory muscles' function, and affects patients' ability to look after themselves. The objective of this work was to assess the influence of Kinesio Taping (KT) on pain level and the increase in effort tolerance in patients after CHL. The research included 63 patients after CHL. Test group and control group included randomly selected volunteers. Control group consisted of 32 patients (26 females, 6 males), test group consisted of 31 patients (22 females, 9 males). Both groups were subjected to complex physiotherapy, and control group had additional KT applications. Before surgery, during and after physiotherapy, patients were given the following tests: 100-meter walk tests, subjective pain perception assessment, and pain relief medicines intake level assessment. The level of statistical significance for all tests was established at P < 0.05. Statistical analysis showed a significant decrease in the time required to cover a 100-meter distance and a decrease in pain perception presented by significantly lower painkillers' intake in the test group in comparison with the control group. The improvement in clinical condition observed in the research indicates the efficiency of KT as a method complementing physiotherapy in patients after laparoscopic cholecystectomy.