Parastomal hernia is described as the most common complication in patients with ostomy. It is reported that its incidence varies from 3% to 39% for colostomies and 0 to 6% for ileostomies. Surgical repair remains the treatment of choice. There are three types of surgical treatment - fascial repair, stoma relocation and repair using prosthetic mesh via a laparoscopic or open approach. Recently there have been several meta-analyses and systematic reviews aiming to compare the results of surgical treatment, and the authors agreed that the quality of evidence precludes firm conclusions. To describe the novel concept of parastomal hernia repair - HyPER/SPHR technique (hybrid parastomal endoscopic re-do/Szczepkowski parastomal hernia repair) and its early results in 12 consecutive cases. Twelve consecutive patients were operated on due to parastomal hernia using the new HyPER hybrid technique between June 2013 and May 2014. The patients' condition was evaluated during the perioperative period, 6 weeks and then every 3 months after surgery. After 6 weeks of follow-up we have not observed any mesh-related complications. All 12 patients were examined 3 months and 6 months after repair surgery for evaluation. No recurrence, stoma site infection or stoma-related problems were found. None of the patients complained of pain and none of them needed to be hospitalized again. Reported quality of life on a 0-10 scale after 6 weeks of follow-up was 8 (range: 7-10). The HyPER procedure for treatment of parastomal hernias proposed by the authors is a safe and feasible surgical technique with a high patient satisfaction rate and a low number of complications. The hybrid procedure seems to be a promising method for parastomal hernia repair.

Infants with Down syndrome (DS) who are admitted to rehabilitation centers are several weeks old, and the tests that they undergo are often not specific enough to highlight the main developmental disorders in the first postnatal trimester. The aim of this study was to assess the possibility of using the Test of Infant Motor Performance (TIMP) to examine motor development of children with DS. Using the TIMP, 141 infants, including 64 infants with DS, with a mean age of 9.4 weeks, were examined. The control group represented 77 infants without developmental disorders, with a mean age of 10.0 weeks. The results show that children with DS achieve lower TIMP scores in comparison with children without developmental disorders. The TIMP is a sensitive measure of delayed motor development in infants with DS and can be used to confirm the need for therapy.

Aging population, increases the number of major abdominal surgery (MAS) performed in the elderly. Main goal of physiotherapy after that surgery is prevention postoperative complications and reduction of functional limitation. The aim of the study was to asses functional status elderly people after MAS during early postoperative physiotherapy. In a prospective randomized study involved 34 patients scheduled for elective MAS, aged 65+. Patients were randomly assigned to receive PNF or conventional physiotherapy. The study included forced spirometry (FVC, FEV1, PEF) and functional tests (gait speed, up&go). Measurements were performed before surgery and the fourth day after surgery. Also analyzed age, sex, BMI and the level of postoperative independence (postoperative independence scale SAP). Kolmogorow- Smirnow test was used to check normal distribution, t-Student was used to check whether two sets of data differ significantly, and r-Pearsons for correlations testing. p values <0.05 were considered significant. After surgery the time of gait speed test and up and go test was significant longer in comparison to preoperative value. FVC%, FEV1%, PEF% values was decrease. In the PNF group was found significantly higher postoperative independence(SAP) and shorter length of stay in hospital compared to conventional physiotherapy group. Results of SAP and functional tests were significantly positive correlated. Major abdominal surgery decrees efficiency of walking and lung ventilation after 65 year old in early postoperative period. Some techniques of the PNF concept used in improving older patients after the MAS may favourably affect the postoperative increase independence and reduce the time of hospitalization.

The operation to restore the continuity of the gastrointestinal tract is another surgical intervention in a given patient, which directly translates into an increased risk of complications during and after surgery. That is why proper qualification is important for the operation to restore the continuity of the gastrointestinal tract in terms of performance and efficiency of the anal sphincter apparatus, among other things.was to evaluate the effect of restoring physiological defecation routes on the sphincter function and to observe the parameters of anorectal manometry in patients before and after surgery to restore the continuity of the gastrointestinal tract.The study included 29 patients scheduled for restoration of the continuity of the gastrointestinal tract, 12 women and 17 men. The average age in the group was 62 years. Anorectal manometry was performed both before surgery as well as one month and three months afterwards in all patients. The average time to have a stoma was 12 months.The resting pressure in the anal canal (MRP) three months after the restoration of the continuity of the gastrointestinal tract increased by 30.4%. The maximum systolic blood pressure in the anal canal (MSP) increased by 22.2%. The value of recto-anal inhibitory reflex (RAIR) decreased by 19.2%. The length of the high pressure zone in the anal canal (HPZL) increased by 27%. The study results of visceral rectal sensation thresholds decreased by 23.3% for the sensation threshold, and 14.4% for the pressure threshold.Restoring the continuity of the gastrointestinal tract improves the anal sphincter function which is evident in the parameters of anorectal manometry. The restoration of passage improves the sphincter function, and these changes are statistically significant.

Background: Diabetic foot ulcers (DFUs) affect millions worldwide, significantly increasing the risk of amputation, mortality, and reduced quality of life. While conventional interventions such as specialized footwear and podiatric care can mitigate ulceration risks, they do not address the biomechanical factors contributing to ulcer recurrence. Emerging evidence suggests that lower limb exercises may play a role in secondary DFU prevention. This scoping review aims to synthesize available research on home-based lower limb exercise programs for individuals with diabetes mellitus, focusing on feasibility, adherence, and their impact on foot biomechanics and ulcer prevention. Methods: A search was conducted across six electronic databases (PubMed, Web of Science, Cochrane Library, EBSCO, Scopus, and ScienceDirect) for studies published between January 2014 and December 2024. Eligible studies included those assessing home-based lower limb exercises in diabetic individuals, with interventions lasting at least four weeks. Studies focusing on supervised exercises, pharmacological interventions, or non-diabetic populations were excluded. Results: Nine studies met the inclusion criteria, featuring a range of home-based exercise interventions, such as muscle strengthening, stretching routines, proprioceptive training, functional mobility exercises, and range-of-motion activities. These interventions demonstrated notable effectiveness, leading to improved foot biomechanics, more even plantar pressure distribution, enhanced balance, and reduced ulcer recurrence (in some cases). One study, for instance, reported a significant decrease in ulcer recurrence, with only 16% of participants in the intervention group experiencing relapse compared to 72% in the control group after 24 weeks. Adherence rates varied across studies but were generally higher when programs included structured guidance through educational booklets, mobile applications, or consistent phone follow-ups ranging from 41% to 92.5%. Nonetheless, the findings tend to be tempered by methodological differences between studies and a lack of robust long-term follow-up data. Conclusions: Home-based lower limb exercises show promise in improving foot function and preventing DFU recurrence. Further research is needed to standardize protocols, enhance adherence, and confirm long-term effectiveness.

Streszczenie: Wstęp: Podeszły wiek jest istotnym czynnikiem ryzyka chorób jelita grubego wymagających leczenia chirurgicznego. Celem fizjoterapii po dużych operacjach brzusznych jest zapobieganie powikłaniom i redukowanie ograniczeń funkcjonalnych. Celem badania było określenie związku pomiędzy poziomem aktywności fizycznej a stanem funkcjonalnym i sprawnością wentylacyjną płuc we wczesnym okresie pooperacyjnym. Materiał i metody: 34 pacjentów zakwalifikowanych do planowej dużej operacji brzusznej w wieku 65+ przydzielono losowo do grupy usprawnianej metodą z wykorzystaniem elementów koncepcji PNF lub grupy usprawnianej tradycyjnie. Spirometrię natężoną (FVC, FEV1, PEF) i testy funkcjonalne (prędkość chodu, wstań i idź) wykonywano przed operacją i w czwartej dobie po operacji. Analizowano poziom aktywności fizycznej, wiek, płeć, BMI oraz poziom pooperacyjnej samodzielności (SAP). Do analizy wyników zastosowano test Kołmogorowa-Smirnowa, test t-Studenta dla prób zależnych oraz analizy korelacji r-Pearsona. Przyjęto poziom istotności p<0,05. Wyniki: W teście prędkości oraz wstań i idź nastąpiło wydłużenie czasu wykonania po operacji w porównaniu do poziomu przed operacją. W FVC %, FEV1 %, PEF % nastąpił spadek wartości. W grupie osób z wysoką aktywnością nie odnotowano istotnych statystycznie zmian wartości dla tych pomiarów. Osoby o wysokim poziomie aktywności miały istotnie wyższy wynik na skali SAP niż osoby o średnim lub niskim poziomie aktywności. Wnioski: Duże operacje brzuszne w istotny sposób pogarszają funkcję wentylacyjną płuc oraz sprawność i prędkość chodu chorych po 65 roku życia, we wczesnym okresie pooperacyjnym. Wysoka przedoperacyjna aktywność fizyczna starszych pacjentów zakwalifikowanych do dużych operacji brzusznych, korzystnie wpływa na funkcję wentylacyjną płuc oraz poziom pooperacyjnej samodzielności, sprawności i niezależności w chodzie w okresie szpitalnym.