4 college of Family Physicians in Poland 5 department of Family medicine, chair of internal diseases and gerontology, jagiellonian university medical college in krakow, Poland 6 academy of Physical Education in katowice, Poland 7 Polish society of Family medicine, Poland 8 department of Family medicine, wroclaw medical university, Poland A -study design, B -data collection, C -statistical analysis, D -data interpretation, E -manuscript Preparation, F -literature search, G -Funds collection the purpose of these guidelines is to attract attention to the need for systemic corrections in the existing health care model to become an effective tool for improving health. the intention of the authors is to present the assumptions of a new approach of physiotherapeutic treatment standards for patients with motor disorders in back pain syndromes: cervical, thoracic and lumbar--sacral, at the primary health care level. the current management provides care for this group of primary care patients mainly through pharmacotherapy and/or by referring them to an appropriate specialist outpatient clinic. in the latter situation, the waiting time from the appearance of pain to first contact with the physiotherapist in Poland is several months. in many patients, the symptoms of back pain are uncomplicated and require a few simple low-cost physiotherapeutic procedures (massage, simple physical therapy and kinesis therapy). in such cases, physiotherapeutic treatment should be based on the simple assessment of the patient's condition and planning therapy on this basis. this can be achieved by performing a functional examination and palpation assessment to determine which muscles and ligaments are responsible for pain. this evaluation provides a basis for establishing a physiotherapeutic strategy based on massage, physical therapy and kinesitherapy. in addition, simple instruction on self-massage, self-physiotherapy and self--kinesitherapy should be provided, as well as the need for orthotic supplies and other technical assistance ought to be considered. the potential effects of such a form of primary care activation include: increase of the possibility to have influence, using directed simple physical factors, on a particular motion system disorder by the patient himself/herself, support of the rehabilitation process performed by a physiotherapist in the primary care and specialist outpatient clinic setting and shaping conscious pro-health attitudes in primary care patients. Key words: primary care physician, physiotherapy, back pain syndromes. Summary
4 college of Family physicians in poland 5 Department of Family medicine, chair of internal Diseases and Gerontology, jagiellonian university medical college in krakow, poland 6 academy of physical Education in katowice, poland 7 university of computer science and skills, lodz, poland 8 polish society of Family medicine, poland 9 Department of Family medicine, wroclaw medical university, poland A -study Design, B -Data collection, C -statistical analysis, D -Data interpretation, E -manuscript preparation, F -literature search, G -Funds collection the objective of these guidelines in the scope of physiotherapy in primary healthcare is to suggest simple, uncomplicated and more cost-effective physiotherapeutic activities in patients experiencing pain due to painful shoulder syndrome. a general practitioner should decide whether the treatment undertaken within primary healthcare, including the process of physiotherapy, is effective and sufficient, or whether it requires more advanced activities, such as advanced diagnostics and further specialist treatment. the authors of the recommendations, apart from massage, also include procedures in the scope of kinesiotherapy, physiotherapy and orthopedic equipment. according to the authors, the aim of recovering the correct spatial system, called structural homeostasis, in the shoulder girdle, is, first of all, normalization of muscle tension and then inclusion in a rehabilitation program covering the methods to recover and consolidate the correct models of motor activity. the starting point for determining a rehabilitation program should be the ability to prepare a simple assessment of the patient's condition. this may result from a palpation examination to determine the incorrect distribution of resting tension in the area of the muscles and tendons engaged in the pathology and causing pain. the authors believe that such a solution contains the key to reducing the costs of treatment, providing access to physical therapists and quick assistance in the scope of improvement of a patient's clinical condition. at the same time, they emphasize the need to correct the previous healthcare model, so that it becomes a more effective tool in maintaining health. SummaryISSN 1734-3402, eISSN 2449-8580 this is an open access article distributed under the terms of the creative commons attribution-noncommercial-sharealike 4.0 international (cc by-nc-sa 4.0). license (http://creativecommons.org/licenses/by-nc-sa/4.0/). kassolik k, Rajkowska-labon E, tomasik t, Gieremek k, Dobrzycka a, andrzejewski w, kiljański m, kurpas D. Recommendations of the polish society of physiotherapy, polish society of Family medicine and college of Family physicians in poland in the scope of physiotherapy in painful shoulder syndrome in primary healthcare. Fam Med Prim Care Rev 2018; 20(3): 277-290, doi: https://doi.org/10.5114/ fmpcr.2018.78274.
WprowadzenieMasaż wibracyjny wywiera wpływ na rodzaj czucia głębo-kiego, zwany propriocepcją. Propriocepcję defi niuje się jako wyspecjalizowaną funkcję czuciową obejmującą zmysł orientacji ułożenia części własnego ciała, ich ruchu (kinestezja) i czucie wibracji. Receptory zapewniające propriocepcję -mechanoreceptory -ulokowane są w mięśniach i ścięg-nach. Dostarczają one także mózgowi informacji o tonusie mięśniowym. Za czucie wibracji odpowiadają duże, kuliste ciałka Vatera-Paciniego, obecne głównie w głębokich warstwach skóry, w ścięgnach, torebkach stawowych i okostnej. Włókno nerwowe otoczone jest wielowarstwowym, koncentrycznym układem spłaszczonych komórek Schwanna, pomiędzy którymi znajduje się płyn tkankowy [1,2]. Masaż wibracyjny ręcznyMasaż ręczny znany jest od tysięcy lat. Jednym z istotnych elementów masażu klasycznego jest technika wibracyjna [3]. Masażysta wykonuje ruchy "trzęsące" ręką powodując wibrację tkanki podskórnej. Najczęściej celem tego typu masażu jest zmniejszenie obrzęku tkanki. Działanie techniki wibracyjnej jest podobne do wpływu innego elementu składowego masażu -oklepywania. Wibracja ręczna stosowana jest też w celu drenażu drzewa oskrzelowego IntroductionVibratory massage affects deep sensibility called proprioception. Proprioception is defi ned as a specialised sensibility function covering the sense of the relative position of neighbouring parts of the body, their movement (kinesthesia) and sensing vibration. The receptors providing proprioception -mechanoreceptors -are located in muscles and tendons. They supply the brain with all the information about muscular tonus. Large, spherical Vater-Pacini corpuscles are responsible for vibration sensibility and they are present in deep skin layers, tendons, articular capsules and periosteum. Nervous fi bres are surrounded by multilayer, concentric system of Schwann cells between which tissular liquid is be found [1,2]. Manual vibratory massageManual massage has been known for thousands of years. One of important elements of classical massage is gentle vibration [3]. A massage therapist performs on the skin's surface rapid tapping movements with his/her hand causing vibration in subcutaneous tissues. The vibration technique's effects are similar to another element of massage -percussing. Manual vibration is also used for drainage of the bronchial tree in people with Słowa kluczowe: fi zjoterapia, masaż wibracyjny, trening, rehabilitacja, sport. Masaż wibracyjny dla wspomagania treningu sportowego i fi zjoterapii Abstract:Recently many new devices used for vibratory massage have become available on the Polish market. Manuals usually lack information concerning frequency and intensity of the vibration to be used. Scientifi c papers on application and effects of vibratory massage are hard to fi nd in Polish references. The authors of this paper gathered the available reports on using vibratory massage in sports, biological renewal and physiotherapy.
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