ObjectivesRheumatic diseases such as osteoarthritis and rheumatoid arthritis constitute the most frequent pathological states leading to the development of foot deformities, which reduce quality of life and cause disability. The aim of the present study was to compare the results of plantoconturographic examinations, obtained by means of a computer podoscope, in osteoarthritis and rheumatoid arthritis patients. Special attention was paid to the differences in the values of each parameter determining the level of foot function.Material and methodsThe study was performed in 94 female patients divided into two groups according to the type of disease. There were 54 patients with rheumatoid arthritis and 40 with osteoarthritis. The control group consisted of 34 healthy women. The plantographic assessment of static foot structure was carried out by means of a device for computer-aided foot examination.ResultsA fallen transverse arch of the right foot was statistically much more frequent in the rheumatoid arthritis patients than in osteoarthritis patients or the control group (p < 0.005 and p < 0.05, respectively). Significant differences in the values of the Wejsflog index were observed in the case of left foot between rheumatoid arthritis patients and the control group (p < 0.05). Similarly, there were statistically significant differences in the values of the hallux valgus angle (α) for the right foot between rheumatoid arthritis and osteoarthritis patients or control group (in both cases p < 0.05).ConclusionsRheumatic diseases predispose patients to disturbances of static foot function. The obtained results highlight the importance of diagnosing foot static disturbances in the prevention of destructive changes affecting the functioning of osteoarthritis and rheumatoid arthritis patients.

IntroductionRheumatoid arthritis (RA) is a chronic inflammation resulting in the involvement of all the structures constituting a joint. We determined the type and severity of foot deformities, determined the impact of the degree of disturbances of foot statics and the disease activity on the duration of the particular phases of gait, determined the impact of the maximum foot load and the percentage distribution of loads between the forefoot and hindfoot on the duration of the particular phases of gait, and established the link between observed disorders and the stage of rheumatoid arthritis.Material and methodsThe control group consisted of 41 healthy women. Rheumatoid arthritis patients, whose disease had been diagnosed based on the American College of Rheumatology (ACR) criteria, were divided into three groups. Group I consisted of 56 women, Group II of 28 patients in the first and second stage of RA, Group III of 28 patients in the third and fourth stage of the disease. We calculated the disease activity score (DAS28 index) and body mass index, and we conducted a pedobarographic examination.ResultsThe results obtained in our study revealed the disturbances of the parameters of foot statics in RA patients. We also detected a prolongation of gait phases, resulting from the disturbances of statics and the displacement of the maximum foot load both in static and dynamic conditions. Increased activity of the disease constituted an additional factor affecting the prolongation of gait phases.ConclusionsOur results confirm the usefulness of baropodometric examination as an important diagnostic tool in the evaluation of the locomotor system of RA patients.

Disturbed static foot function is one of the main causes of impaired quality of life, which may be related to the frailty syndrome of older adult patients with Rheumatoid Arthitis (RA). The aim of the study was to evaluate the relationship between parameters of static foot function disturbances and quality of life of older adult patients with RA. The study was performed among 102 patients with RA diagnosed according to the American College of Rheumatology (ACR) and EULAR 2010 criteria. Patients were divided into four subgroups depending on radiological evaluation according to the Steinbrocker classification. Plantoconturography examination was conducted using a podoscope with a 3D scanner and software for computer foot examination CQ ST2K. Quality of life of patients with RA was evaluated using the Arthritis Impact Measurement Scales-2 (AIMS-2). A statistically significant relationship between AIMS-2 and parameters of static foot function disturbances was observed. The study revealed correlations between parameters of disturbed static foot function and RA severity in comparison to disease duration. Our results indicate a relationship between static foot function disturbances and quality of life of patients with RA, not only in the area of physical activity, but also in the social an emotional domain. Study results indicate that plantoconturography and assessment of quality of life using AIMS-2 could be useful as a diagnostic and prognostic tool in RA.

Pulmonary arterial hypertension (PAH) is a chronic and progressive disorder with a poor prognosis associated with non-specific symptoms, including general weakness, shortness of breath on exertion, and decreased muscle strength and endurance. Despite recent significant progress in the field of PAH therapy, many patients are still characterized by a dynamic course of the disease, a significant reduction in physical performance, a constantly deteriorating quality of life, and limited activity in everyday life. Thus, the main goal of PAH therapy is to ensure an acceptable level of quality of life as early as possible in the course of the disease, reduce the progression of symptoms and, if possible, improve the prognosis, which is still poor. The perception of the importance of activity and exercise has changed significantly in recent years, and rehabilitation dedicated to PAH patients is now considered to be one of the new adjuvant treatment options. Currently, there is insufficient data on what form, frequency, and intensity of exercise are required for the best results. Nevertheless, exercise training (ET) is necessary in order to reverse the accompanying PAH impairment of exercise capacity and, without additional clinical risk, to maximize the benefits of pharmacotherapy. This review summarizes the current state of knowledge on the rehabilitation of PAH patients and presents the available rehabilitation models. In addition, it includes a ready-to-use, illustrated, safe home rehabilitation program with recommendations for its use. Utilizing ET as an adjuvant treatment option to improve the functional capacity and quality of life of patients may enhance the clinical effectiveness of therapeutic management and contribute to the improvement of the quality of care for patients suffering from PAH. The beneficial effect of exercise training on the development of symptoms improves the clinical course of the disease, and a lower incidence of adverse events can lead to a reduction in health care expenditure.

Zaburzenia wydolności statycznej stóp u pacjentów z reumatoidalnym zapaleniem stawów-współczesne metody diagnostyki i terapii New methods in diagnosis and therapy in case of disorder in static foot function in rheumatoid arthritis patients A An nn na a K Ku ur ry yl li is sz zy yn n-M Mo os sk ka al l, , K Ka at ta ar rz zy yn na a K Ka an ni ie ew ws sk ka a, , P Pa aw we eł ł K Ko on na ar rz ze ew ws sk ki i, , Z Zo of fi ia a D Dz zi ię ęc ci io oł ł Klinika Rehabilitacji Uniwersytetu Medycznego w Białymstoku

Introduction: Ailments located in the cervical spine are a serious clinical problem. The aim of the study was to evaluate the effectiveness of Postisometric Relaxation (PIR) and Classical Massage (CM) in analgesic therapy in patients with neck chronic increased muscle tension. Material and methods: The study was carried out in a group of 36 adults (mean age 49.5±8.59 years, 29 women) with neck increased muscle tension due to overload changes. Patients were randomly assigned into two groups. The therapy consisted of 10 PIR or CM procedures. VAS (Visual Analogue Scale), NDI (Neck Disability Index), SF-MPQ (McGill Pain Questionnaire-Short Form by Melzack) were used. The trigger points were assessed and the mobility of the cervical spine was measured. Results: A statistically significant reduction in pain was obtained in both groups (improvement in the PIR group: 70%±29, CM 55%±27). In the PIR group, trigger points were completely eliminated in 50% of subjects and in the CM group in 38.9%. There was a statistically significant reduction in the NDI in both groups (improvement in the PIR group 70%±26, CM 48%±29). In both groups, a statistically significant increase in the mobility of the cervical spine in all directions was observed (extension, lateral flexion and rotation were statistically significantly better in the PIR group). Conclusions: PIR and CM statistically significantly reduce pain, improve health, effectively eliminate trigger points and increase the mobility of the cervical spine. PIR better increases the range of extension, lateral flexion and rotation of the cervical spine.

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BackgroundRheumatic diseases such as osteoarthritis (OA) and rheumatoid arthritis (RA), constitute the most frequent pathological states leading to the development of foot deformities, which reduce the quality of life and cause disability.ObjectivesThe aim of the present study was to compare the results of plantoconturographic examination, obtained by means of a computer podoscope, in OA and RA patients. Special attention was paid to the differences in the values of each parameter determining the level of foot function.MethodsThe study was conducted on 94 female patients divided into two groups according to the type of disease. There were 54 patients with RA and 40 with OA. The control group consisted of 34 healthy women. The plantographic assessment of static foot structure was carried out by means of a device for computer-aided foot examination.ResultsA fallen transverse arch of the right foot was statistically much more frequent in the RA patients than in OA patients or the control group. Significant differences in the values of the Wejsflog index were observed between RA patients and the control group. Similarly, there were statistically significant differences in the values of the hallux valgus angle (α) for the right foot between RA and OA patients vs. the control group, as well as between OA patients and the control group.ConclusionsRheumatic diseases predispose patients to the disturbances of static foot function. The obtained results highlight the importance of diagnosing foot statics disorders in the prevention of destructive changes affecting the functioning of OA and RA patients.Acknowledgementfoot function, mobility, plantoconturography, RA patients, OA patientsDisclosure of InterestNone declared