Background: Balance disorders are one of the main symptoms in parkinson's Disease (PD)—patients have a tendency to fall, related traumas and also a significant restriction of mobility. Numerous tools may be used to evaluate the balance, but it is difficult to choose the proper one. The aim of this review was to compare simple diagnostic tools for PD and emphasize those characterized by a high reliability and sensitivity. Methods: The global literature search was conducted in PubMED, Scopus, Science Direct, Web of Science, Cochrane, and Google Scholar for publications in English and Polish. Results: According to the literature some scales and functional tests in which clinimetric properties had been assessed in PD population were selected and described. Conclusion: Basing on current knowledge, psychometric properties, and clinical experience, the authors suggest the BESTest with its shortened versions and the Fullerton Advanced Balance Scale to be used for comprehensive balance assessment of parkinson's disease patients. These tests are easy in administration, not time-consuming and provide a professional diagnosis allowing to plan individual therapy for the patient being examined.
The COVID-19 pandemic causes increased mental stress and decreased mobility, which may affect people with Parkinson’s disease (PD). The study aimed to investigate the secondary impact of the COVID-19 pandemic on the level of activity, quality of life (QoL) and PD-related symptoms. The respondents completed an online survey in Polish in the period from December, 2020 to June, 2021. The questionnaire was completed by 47 participants aged 43 to 90 years (mean 72.1 ± 1.3 years). A total of 94% reported reduced contact with family and friends. Over 90% remained active during the pandemic. However, 55% of people with PD showed subjectively lower level of activity then before the pandemic. Moreover, 36% of the respondents felt afraid to visit a doctor and reported problems with access to medication. Subjective QoL reduction was reported by 80%, and 83% declared worsening of PD symptoms. The post pandemic deterioration of motor symptoms in people with PD did not affect their QoL. However, the deterioration of contacts and feelings of isolation had a significant impact on the decline in quality of life (p = 0.022 and p = 0.009, respectively) and the presence of anxiety (p = 0.035 and p = 0.007, respectively). These results may indicate than greater importance of social and mental factors than fitness and health-related factors in the QoL self-assessment of the people with PD.
There are no official recommendations regarding physiotherapy for encephalitis patients. However, such patients, depending on their condition, have to undergo rehabilitation preceded by a detailed functional examination. The paper describes the physiotherapy treatment of a 28-year-old female after acute encephalitis. She suffered three-limb palsy with preserved movement in the right ankle joint. The patient was admitted to a clinic that offers respiratory therapy, where she underwent a comprehensive rehabilitation process. The initial and final functional assessment was conducted based on the International Classification of Functioning, Disability and Health. The therapy aimed to enable social contacts by learning to communicate with the environment, taking advantage of learned motor skills and adapting the body to maintain a sitting position. The goals were implemented with gradual upright standing, electrostimulation of paralyzed muscles, orofacial therapy, methods of respiratory acceleration and the use of communication technologies. As a result of the physiotherapy, the patient can communicate with the environment more efficiently and showed a more assertive attitude towards the disease and greater motivation to exercise and socialize. This paper supports the importance of a rehabilitation program adapted to the needs of a patient with severe disabilities and encourages more studies in this area.
It has been observed that in some people in the acute phase of ischemic stroke (IS) there is a tendency to shift the body weight towards the side more affected by the disease and a tendency to spontaneous movements of the upper and/or lower limbs (not covered by the neurological syndrome). The purposes of this study were: to define the kind of behavior observed, and to select symptoms which can predict its occurrence. Participants (n = 222) hospitalized due to first-time IS were assigned to three groups. A: 78 patients with no lateralization of the neurological syndrome (lateralization of the neurological syndrome—LoNS); B: 109 patients with LoNS; O+ group: 35 patients, who at the beginning of hospitalization presented, apart from LoNS, characteristic motor symptoms performed by the less affected side. Patients underwent therapy depending on the neurological symptoms. If the patient showed potential symptoms of a new phenomenon, overactivity of the less affected side (OLAS), a trial therapy (focused on this behavior) was used to confirm it. The predictive symptoms, selected among these from the index day, for the occurrence of OLAS in sitting were distinguished: asymmetry in supine posture and simple, repetitive movements of the nonparetic upper extremity.
Aim. This prospective study aimed to assess the diversity of diagnoses in patients hospitalized in the neurology department, in whom the occurrence of dizziness was the presenting complaint during qualification for hospitalization, based on a joint assessment performed by a doctor and a physiotherapist and the implementation of treatment, including physiotherapy. Material and Methods. The study included consecutive patients selected from 2155 individuals hospitalized between 2018 and 2020 in the Neurology Unit who reported dizziness as the presenting complaint. Results. 100 patients (the mean age 58.68±16.57) were qualified for the study: 53 men (the mean age 59.47±15.44) and 47 women (the mean age 57.79±17.88). In the overwhelming number of cases, dizziness was associated with a vascular incident. However, cases of vertigo were also reported. Conclusion. A variety of diagnoses were made in patients hospitalized in the neurological department in whom the occurrence of dizziness was the presenting complaint during qualification for hospitalization.
The observation of persons in the acute phase of ischemic stroke (IS) allowed to select a group of patients whose spontaneous motor activity stood out from the typical clinical picture of the hemiplegia syndrome. It has been noticed that these persons have presented tendency to shift the body weigh toward more affected side and the tendency to move the upper and / or the lower limb (not covered by the neurological syndrome) in simple, repetitive patterns. The purposes of this study were: to define noted kind of behavior, and to select symptoms which can predict the occurrence it. Persons (n=222) hospitalized due to first-time IS were as-signed to 3 groups. A: 78 persons with no lateralization of the neurological syndrome (LoNS). B: 109 persons with LoNS, O+: 35 persons, who at the beginning of hospitalization presented, apart from LoNS, charac-teristic motor symptoms. Persons underwent therapy depending on the neurological symptoms. If the pa-tient demonstrated the potential symptoms for overactivity of the less affected side (OLAS), to confirm it, trial therapy was performed. The predictive symptoms, selected among these from the index day, for the occurrence OLAS in sitting were distinguished: asymmetry in supine and simple, repetitive movements of nonparetic upper extremity.