Osteoarthritis (OA) is a common health problem leading to pain, limitation in physical function, a decrease in the quality of life and disability. OA affects 60–70% of the population above 65 years of age all over the world, and is associated with a high cost of healthcare. The main method of treatment of OA, apart from pharmacotherapy and surgery, is comprehensive rehabilitation. Advances in medical technology have resulted in the possibility of using computer-assisted interventions in rehabilitation. The present narrative review is aimed at investigating the effectiveness of virtual reality (VR) in the rehabilitation of elderly patients with knee or hip osteoarthritis, including patients after arthroplasty. This literature review based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was carried out in five databases: PubMed, Medline, Web of Science, Scopus and PEDro. It includes ten randomized controlled trials focused on the application of games and biofeedback in the rehabilitation of patients with knee and hip osteoarthritis. There are no conclusive reports that interventions based on VR are more effective than standard physical therapy. Moreover, evidence regarding patients after total hip arthroplasty (THA) is very scarce. The effectiveness of VR-based rehabilitation is unclear, although interventions based on VR are promising in view of pain management, postural and proprioception training. However, this evidence is not sufficient to create clinical guidelines and further high-quality studies are needed.
The present review is aimed at the effectiveness of virtual reality (VR) and exergames in the prevention of falls among the elderly. Falls become a significant problem in the aging population and lead to psychological, social, and physical impairment. Prevention of falls is crucial to the well-being of the elderly population and is one of the challenges of contemporary rehabilitation. Recently, in view of the threat of the SARS-CoV-2 pandemic, contactless methods of rehabilitation, including telerehabilitation, appear as valuable rehabilitation tools. This review is based on the PRISMA guidelines and was carried out in five databases: PubMed, Medline, Web of Science, Scopus, and PEDro. Twenty-one randomized controlled trials, focused on the application of VR and exergames in the prevention of falls, were included. This review suggests that VR training in rehabilitation appears to be a promising complement to traditional techniques of physiotherapy to improve specific physical outcomes. VR and exergames could be considered as a complement of standard physiotherapy and its possible continuation at home for elderly. However, further high-quality studies, with carefully designed protocols and proper blinding, are needed.
Temporomandibular disorders (TMD) consist of a group of symptoms such as: pain of temporomandibular joints, masticatory muscles or surrounding tissues, dysfunctions of TMJs’ mobility, and crepitation. The Hypermobility Joint Syndrome (HJS) manifests in the flaccidity of joint structures, an increase in the range of joint motion, and occurs more often in the young and women. The aim of this study was to present the occurrence of HJS among patients with myogenic TMD and disc displacement with reduction. The secondary goal was to assess the effectiveness of physiotherapy directed to TMD with coexisting HJS. The study involved 322 patients with symptoms of TMD. HJS was diagnosed using the Beighton Scale, which confirmed its occurrence in 26 cases. 79 subjects (7 males and 72 females; mean age, 33.9 ± 10.4 years) were selected and divided into two groups: HJS + TMD (n = 26; 2 males and 24 females; mean age, 27.1 ± 9.4 years) and TMD (n = 53; 5 males and 48 females; mean age, 37.4 ± 9.2 years). These patients completed 3-week physiotherapy management. Before and after physiotherapy, the myofascial pain severity on Numeric Pain Rating Scale, linear measurement of maximum mouth opening, and opening pattern, were assessed. To demonstrate differences between the results, the level of significance for statistical analysis was set at α = 0.05. A statistically significant improvement was obtained in decreasing myofascial pain in both groups. Coordination of mandibular movements was achieved in both groups. Generalized joint hypermobility occurred among patients with TMD. Physiotherapy directed to TMD was effective in reducing myofascial pain and restoring TMJ’s coordination also in patients with HJS.
Background: Arthrogryposis multiplex congenita (AMC) is a rare congenital disorder characterized by the occurrence of polyarticular contractures. Temporomandibular disorders (TMD) affect 25% of patients with arthrogryposis. Clinical Presentation: In this case report, the authors describe rehabilitation of a child between 8 and 24 months of age with AMC accompanied by Pierre-Robin Sequence. Physiotherapy directed to the TMJ included manual therapy, food intake training, and sensory training. Conclusion: Increase in the mobility of the TMJ and improvement in food intake, swallowing, speech, and breathing were achieved. Further research is necessary for investigating the effects of the proposed protocol of physiotherapy on a larger number of children with AMC and co-occurrence of TMD.
Streszczenie: Wstęp: Staw kolanowy jest jednym z najczęściej zajętych przez artropatię hemofilową, a zabieg alloplastyki stawu kolanowego jest leczeniem z wyboru w przypadku zaawansowanych zmian zwyrodnieniowych. Celem pracy było przedstawienie kompleksowego postępowania fizjoterapeutycznego, ze szczególnym uwzględnieniem terapii manualnej, u pacjenta z artropatią hemofilową w przebiegu hemofilii typu A, u którego została wykonana alloplastyka stawu kolanowego.Metodyka: Mężczyzna, lat 49, po zabiegu alloplastyki stawu kolanowego lewego, z artropatią hemofilową w przebiegu hemofilii A, został poddany 6-tygodniowej rehabilitacji. U pacjenta zastosowano metody terapii manualnej, ćwiczenia usprawniające oraz fizykoterapię. Oceny postępów rehabilitacji dokonano, stosując: kwestionariusz WOMAC, test Timed Up and Go (TUG test), pomiar goniometryczny zakresu ruchu stawów kolanowych, ocenę siły mięśni zginaczy i prostowników kolana w skali Lovetta, ocenę dolegliwości bólowych w skali VAS.Wyniki: Uzyskano wzrost siły mięśniowej oraz poprawę zakresu ruchu stawu kolanowego. W wyniku terapii poprawie uległa stabilność dynamiczna oraz stan funkcjonalny pacjenta (TUG test poprawa o 35%, skala WOMAC o 32%). Dolegliwości bólowe uległy zmniejszeniu z 9 na 3 w skali VAS. Uzyskano wydolny chód. Usprawnianie przebiegło bez powikłań.Wnioski: Fizjoterapia, w tym terapia manualna, u pacjenta z artropatią hemofilową po zabiegu alloplastyki kolana, jest postępowaniem skutecznym i bezpiecznym.
Background: Work on the Act on the Profession of Physiotherapist had been conducted since the 1990s. However, it was not until October 2015 that the legal regulations were eventually introduced, following which physiotherapists gained professional independence and became a profession of public...