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The purpose of the research was to evaluate the efficiency of body balance regulation in the elderly and verify whether physical activity in adolescence could influence later physical efficiency. Research was carried out on 62 persons aged between 65 and 96 years of age. Fifty people declared that they undertook physical activity in adolescence, while 12 reported no activity. Stabilographic examinations were performed during trials with open and closed eyes on a horizontally situated platform tilted forward and backward. The centre-of-pressure (COP) path length, sway range area and centre-of-pressure velocity (COP velocity) were assessed. The safety margin when a person leans forward and backward was evaluated as well. On a horizontally situated platform, exclusion of visual control in most of the examined participants resulted in a significant increase in values of examined parameters. Tilting the platform caused in both groups an increase in values of all the parameters. These changes were more visible when a trial with eyes closed was performed and the group of active people obtained better results. These people were also able to use the support area more effectively when changing the position of the body. It was found that body balance disorder affects more often elderly people who were less active in adolescence and that with age visual balance control dominates the proprioceptive one. This means that physical activity directed towards, among other things, forming and improving the body balance regulation system is needed at an early age. [ABSTRACT FROM AUTHOR]

Background: Back pain is common among people working in the sitting position. Quality of the sitting position depends among others on the standard of work station. Dental units are built on the basis of contemporary ergonomic workplace concepts, while medical assistant workstations are typically computer office workstations. The purpose of the study was pain estimation in association with the identification of the spine arrangements during sitting work with better and worse ergonomic adjustment., Material and Methods: The study involved 80 women working in the sitting position suffering from pain - 40 dentists working on dental units with a higher ergonomic potential and 40 medical assistants working on stations with lower ergonomic potential. The study included interviews, pain assessment and working spine arrangements analysis using the ultrasonographic measurement system., Results: There were exceeds of work parameters in particular segments of the spine observed in all examined persons. The relationship between pain intensity and work parameters as frontal bending amplitude of lumbar spine segment, transversal amplitude of cervical spine segment and transversal amplitude of lumbar spine segment were observed in the group of dentists. There was observed the relationship between pain severity and the values of sagittal bending amplitude of cervical spine segment and thoracic spine segment in the group of medical assistants. Other determinants of pain also have been identified., Conclusions: Exceeded values of work parameters were observed amongst subjects working both at the higher and the lower ergonomic potential work stations. The working postures of people working in the sitting position are similar only to their external characteristics. Pain depends on working position. The pain intensity is determined by other factors: length of professional experience, duration of the pain, the number of working hours per week, body mass index (BMI). Med Pr 2018;69(5):509-522., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

Background: Cerebral palsy (CP) leads to varying degrees of movement restrictions, imposing on the parents (especially mothers) a number of additional responsibilities. The burden of long-term care for a disabled child can lead to severe pain in various locations and of various intensity. Therefore, it is important to identify their risk factors and provide training for parents of CP children to educate them how to offer care not only to aid rehabilitation of their child, but also to avoid hazards to their own health. The aim of this study was to evaluate the prevalence of back pain and its underlying causes in mothers of children with cerebral palsy., Material and Methods: The study enrolled 179 mothers of CP children aged 3-18 years. The intensity, frequency and functional consequences of the pain were described according to the criteria formulated by Jackson and Moskowitz. The children's functional status was assessed on the basis of their medical records, the GMFCS (Gross Motor Function Classification System) scale and an interview with their mothers. Pain intensity in the mother was compared with the functional status of the child and the level of his/her independence as well as other factors related to the daily care of a child with cerebral palsy. The nonparametric chi-square (x2) test was used for the statistical analyses, with the level of significance at p <0.05., Results: Most of the mothers caring for a CP child on a daily basis suffered from back pain of various location and intensity. The intensity of the pain was determined by the child's locomotor skills and independence level, the necessity of lifting the child several times a day, the number of additional tasks performed by the mother and the age and body weight of the child. At the same time, pain intensity was independent of maternal age, the possibility of having a replacement caregiver and (lack of) prior instruction on appropriate behaviours in their daily care for the disabled child., Conclusions: 1. Long-term daily care of children with cerebral palsy promotes the development of back pain in their mothers. 2. The incidence and intensity of pain depends primarily on the child's functional status and independence level, body weight, age, the need for repeatedly lifting the disabled child throughout the day and the number of additional tasks performed by the mother.

Background: Work-related musculoskeletal disorders in physiotherapists working with children are due to the failure to apply the principles of ergonomics in their daily practice, which is often caused by the necessity of working in forced positions. Health hazards are even bigger because of the disproportion of body weight and height between the patient and the therapist. The aim of the study was to evaluate positions of the spine at work among physiotherapists involved in child neurorehabilitation and their impact on the occurrence of back pain., Material and Methods: The study enrolled 84 physiotherapists between the ages of 28-55 years involved in child neurorehabilitation whose seniority in the profession ranged from 2 to 33 years. The physiotherapists were interviewed about their work and its negative consequences. The 6-degree Jackson and Moskowitz scale was used to determine the level of pain intensity. Three-dimensional positions of the spine were recorded under natural working conditions using a SonoSens Monitor 8 ultrasonic measuring system. The recorded data was compared with the so-called "profile for ergonomic operation of the spine". The idea behind the study was to find the relation between pain intensity, duration and location on the one hand, and working positions of the spine and other data from the interview on the other. The statistical analysis was based on Spearman's rank correlation coefficient, analysis of variance with single classification, post hoc analysis (Tukey test) and the chi-square test (%2). The level of statistical significance was established at p < 0.05., Results: All subjects reported 1-4° pain. The intensity of pain increased with age, profession seniority, duration of the history of pain and duration of a sense of fatigue persisting after work. Pain intensity correlated with the length of time the spine was placed in unergonomic positions - especially in excessive lateral flexion in the thoracic segment and rotation in the cervical, thoracic and lumbar segments., Conclusions: 1. Positions of the spine in physiotherapists involved in neurorehabilitation of children are unergonomic and back pain is common in these therapists. 2 There is a correlation between working techniques and the prevalence of pain in physiotherapists.

Background: The aim of the study was to assess postural habits in young, healthy people, identify correlations between postural errors and pain and attempt to modify bad habits., Material and Methods: 144 people, aged 18-23 were enrolled. The intervention consisted of 4 stages: Stage 1 - identification of postural habits, description of responses to stress, back pain frequency and intensity (Jackson & Moskowitz); Stage 2 - correction of habitual position with the help of a physiotherapist, briefing about ergonomic everyday behaviours and consequences of continued non-ergonomic behaviours, Stage 3 - follow-up examination: self-assessment of changes, evaluation of the effects of modifications, determination of causes for discontinuing the behaviour modification programme, where applicable; and Stage 4 - final examination, assessment of results. Correlations were sought between inappropriate postural behaviour in various positions and between non-ergonomic postural behaviour and pain location and response to stress. Statistical analysis was carried out with Excel and Statistica v. 7.1. A non-parametric χ(2) test was used at p<0.005., Results: All participants presented poor postural patterns in the standing, sitting and recumbent position. Back pain was reported by half of the participants. Statistically significant relationships between pain and habitual positions were noted with regard to the cervical and lumbar spine and also for abdominal pain as a response to stress in people with excessive thoracic kyphosis. Behaviour modifications caused or intensified lumbar pain or thigh muscle pain. Positive outcomes included better urination and/or defecation and greater comfort in assuming the different positions and performing activities of daily living in these positions. Some examinees discontinued behaviour modification during the first month after the initial instruction and the majority did so over the next three months., Conclusions: 1. Non-ergonomic postural behaviours are common among young people. 2. Changing the body position does not eliminate the impact of the inappropriate habit. 3. An attempt to modify non-ergonomic postural behaviours usually results in pain, which may act as a demotivating factor. 4. Discomfort associated with the modification of habitual postural behaviours is reduced after 3-4 months of regular training.

Background: Postural alignments, secondary curves of spine and tendency to unequal body weight distribution are the compensatory mechanisms in scoliosis, eventually leading to disturbances in the regulation of body posture. The pathological pattern of incorrect posture, evokes a vicious circle of causes and effects, which probably includes alterations in body weight distribution to both feet., Objective: To examine the role of equal weight loading of both feet in posture regulation among children and adolescents with low-degree scoliosis., Methods: A total of 115 participants, aged 7-19 years, were divided into three groups: low degree scoliosis (10-26⁰ Cobb; n = 56), scoliotic posture (5-9⁰; n = 29), and without lateral spine curvature (n = 30). Three measurements of body arrangement and the weight distribution on feet were simultaneously taken using the photogrammetry and the podographic platform: in a free standing position, while attempt to correct body arrangement and with equal loading of both feet., Results: Unequal weight distribution was observed in free standing position in patients with scoliosis. Attempts to correct body arrangement worsened existing disproportion, especially in the left-side curvatures. Equal feet loading lead to the body disarrangement, even among non - scoliotic subjects., Conclusions: In subjects with low degree scoliosis the compensatory changes in the spatial arrangement of the body are usually accompanied by asymmetric distribution of foot pressure and the active attempt to correct the curvature enhances this asymmetry. Attempts to maintain symmetrical distribution of body weight result in significant deterioration of the posturometric parameters even in non-scoliotic subjects.

Objectives: The most frequent manner of attending childbirth imposes on midwives assuming poor body position affecting the musculoskeletal system. Long professional experience does not mitigate the negative effects. The adopted movement habit, as well as the type, number and frequency of actions influence the body posture. The aim of the study was to identify ergonomic threats of basic occupational midwives activities and how particular spinal segments arrangements while attending childbirth using the same technique in senior midwives differ from those of junior ones. It was also checked whether pain influences the working position assumed by midwives., Materials and Methods: Examinations were conducted in 95 midwives aged 21-50 (X = 29.25 ± 9.34): 51 graduates of BSc midwifery who worked 680 h in delivery rooms during obligatory practical classes and apprenticeship and 44 senior midwives with professional experience of 7-27 years (X = 14.84 ± 5.98). The study was threefold. The spinal alignment while performing work activities associated with attending childbirth was assessed using the OWAS system and the SonoSens Monitor, the center of gravity projection on basal plane--using the AccuGait AMTI stabilometric platform. The measurements were taken during a simulation of attending childbirth (on examination model). A survey was conducted aimed at identifying spinal pain., Results: Midwives' working postures require unnatural body alignments. Postural instability in the working position and no maximal usage of basal plane were observed. The work overload may afflict the musculoskeletal system, which was confirmed by different pain discomforts in 67.3% of the examinees., Conclusions: Spinal alignment while attending childbirth is individually differentiated and in every case non-ergonomic. Identifying explicitly spinal overloads is difficult, but the most prevalent ones affect lumbar and cervical regions altogether. Spinal pain is frequently noted, both in junior and senior midwives, and is characteristic for midwives working in maximal movement ranges.

Background: Abnormal body alignment may lead to the development of spinal overload syndromes, nerve root irritation, pain, impaired ventilation, and compromise of exercise capacity., Objective: The aim of the study was to find out whether low degree scoliosis impairs breathing, reduces exercise capacity and produces back pain over time., Material and Methods: Respiratory function, exercise capacity (PWC170) and pain intensity (Jackson and Moskowitz regimen) were assessed in 39 adults aged 19 to 38 years diagnosed with low degree scoliosis (10-280) several years ago. A group of 43 controls with no scoliosis in adolescence was also examined., Results: There was no progression of the curvature after the treatment in the scoliosis group. Spirometric parameters in this group were slightly lower than in the controls, although there was no evidence of the restrictive type of respiratory disorder, which was found in only 5.1% patients. PWC170 test results were significantly lower (by about 20%) than in controls, and 84.6% of the subjects reported intermittent, occasional, or frequent pain, mostly lumbar and associated with the work performed. In 12.8% of cases, the pain interfered with breathing. In about half of the group, pain occurred after exertion and caused limitation of activity, while in the remaining subjects it did not affect daily activities., Conclusions: 1) low degree scoliosis generally did not cause restrictive impairment of ventilation; 2) adults with established low degree scoliosis demonstrated impaired exercise capacity, in the form of reduced PWC170 scores; 3) the presence of low degree scoliosis at school age was associated with back pain in adulthood.

An upright body posture cannot be maintained passively for reasons including a high location of the centre of gravity (COG) and a small support area. Proper alignment of body parts is maintained automatically, tending towards a pattern encoded in the CNS. A particularly important role in posture regulation is played by the short muscles of the back, which respond to being stretched with a contraction. During the early phase of scoliosis, the CNS automatically corrects abnormalities, but over time habituation occurs and the CNS treats them as something normal. Any attempt to restore proper body alignment is treated as an error and CNS automatically restores this abnormal pattern. With a prolonged deviation in body part alignment, CNS treats it as a defect and runs compensatory mechanisms to restore the balance of the body as a whole. Balance is ensured by postural compensation, but this does not restore proper body part alignment. In the treatment of scoliosis, it is important both to slow down progression and to prevent the development of abnormal postural habits, which are part of a vicious circle even without progression. Secondary prevention is therefore needed in all patients. Passive observation limits the possibilities for prevention and contradicts the principle of early implementation of rehabilitation. Depending on the size of the angle of curvature, recommended treatments of scoliosis comprise observation, corset bracing, and surgery. Physiotherapy is often treated as an unconventional and ineffective treatment. Often, the biggest problem is transferring the resulting correction to automatic maintenance of a correct posture in the vertical position. The aim of this paper was to discuss the conservative treatment of scoliosis with regard to difficulties maintaining the correct alignment of the body parts in the vertical position that accompany scoliosis.

Background: Pain-related abnormalities of the economy of walking are the most important factor adversely affecting overall physical activity of patients with chronic lower limb ischaemia. These patients are routinely managed conservatively, with the aim of improving pain-free claudication distance. The aim of this study was to examine the impact of HiToP on the functional status of the lower limbs in such patients and look for possible flow dynamics correlates in peripheral microcirculation in the lower limbs., Material and Methods: The study involved 68 patients aged 40-70 years, who were randomly assigned to Group A (experimental) and Group B (control). Study procedures included a treadmill test to determine the claudication distance and the measurement of blood flow in lower limb peripheral microcirculation using laser Doppler flowmetry. The intensity of lower limb pain was also determined. Patients from the experimental group were subjected to a series of HiToP sessions. The control group received mock HiToP (placebo)., Results: The claudication distance and maximum walking distance were significantly prolonged only in the HiToP group. With regard to microcirculation flow dynamics, only mean flow values increased substantially, but this was again only observed in the group treated with HiToP., Conclusions: HiToP makes it possible to improve lower limb function, as evidenced primarily by improved claudication distance, maximum walking distance and improved blood flow parameters in cutaneous microcirculation.

Background: The effects of faulty postures include disturbances of the symmetric distribution of compressive and tensile forces acting on both sides of the body axis and the emergence of harmful shear forces. The torques of antigravity muscles also change unfavourably. This may lead to the development of a repetitive strain syndrome, stenosis of intervertebral foramina, compression of nerve roots and back pain. The development of back pain syndromes is significantly affected by the performance of various work-related tasks in non-ergonomic positions. The aim of the study was to investigate the association between back pain syndromes and the quality of body posture, especially in the context of work ergonomics., Material and Methods: The study enrolled 125 persons: 39 adults with a childhood history of scoliosis, 39 midwives, and 47 physiotherapists. Body posture was assessed in all participants. In midwives and physiotherapists, body position during the performance of work-related tasks was also evaluated. The frequency and severity of pain was assessed with the Jackson-Moskowitz measure., Results: The study revealed that over 80% of the participants suffered from spinal pain. In most cases, the pain was intermittent and was felt in the lumbar spine. The occurrence of pain among midwives and physiotherapists was not directly dependent on the predominant type of abnormal spinal position assumed during the performance of occupational tasks or the quality of body posture. The complaint was also reported by ca. 85% of persons with a history of scoliosis., Conclusions: An incorrect body posture (especially scoliosis) and performance of work-related tasks in non-ergonomic positions increase the probability of back pain.

Objectives: In Poland, physiotherapy is offered at three types of school: medical universities, universities of physical education, and schools that do not specialise in either the medical sciences or physical education. This study explored the knowledge of students who were completing their physiotherapy studies about working in Poland and other countries of the European Union (EU), and about their vocational plans. Students were asked, through self-assessment, about aspects of the professional skills they had gained., Design: Quantitative questionnaire-based study of students in three university settings., Setting: Eleven university-level schools in Poland offering studies in physiotherapy and representing three orientations: medical sciences (MS), physical education (PE) and other universities (OU)., Participants: The study sample comprised of 954 third-year Bachelor programme students., Results: The differences in university profiles did not influence the vocational plans of the students, with more than 70% (668/954) declaring that they would look for work outside Poland: 76% (725/954) in the UK and 69% (658/954) in Germany. Most students stated that finding work as a physiotherapist is difficult in Poland (686/954,72%) and easy in other EU countries (763/954, 80%). Differences in university profiles had an effect on the students' assessments of their professional skills, as students from universities without a long-standing tradition of training in physiotherapy declared that they were less well prepared to work as physiotherapists; the difference was statistically significant for 12 of the 16 domains examined (P<0.05)., Conclusions: In the light of these results, an increased influx of Polish physiotherapists, trained according to European standards, into EU countries, especially the UK and Germany, is to be expected in the near future. The physiotherapists will predominantly be graduates of medical and sports-oriented state universities. It appears advisable to launch, under the auspices of an EU programme, an integrated employment information system for physiotherapists that would offer updated information on current demand in individual EU countries.

In acquired scoliosis, the degree of the curve is initially low and its type becomes apparent only after it has progressed. The characteristics of scoliosis include an abnormal spatial arrangement of individual body segments, which the central nervous system (CNS) interprets as a defect and automatically launches compensatory mechanisms. Neglecting low-degree scoliosis poses a two-fold danger. It usually leads to the development of structural changes, while the child gets used to the abnormal body arrangement, thus reinforcing the poor postural habits. The basic aim of early rehabilitation is to manage the compensatory mechanisms and prevent the development of adverse secondary changes, rehabilitation in scoliosis being no exception.Some cases of scoliosis require surgery. The point is to minimise the changes resulting from the progression of scoliosis. The role of corrective exercises seems to be significant here. However, views on the usefulness of such exercises are sometimes extremely varied, even though both favourable and sceptical opinions are not fully supported by the literature. However, a number of reports indicate that corrective exercises are useful. , The selection and of corrective exercises and how they should be performed are another question. A number of methods of conservative treatment of scoliosis have been devised. Currently, none of them is considered a comprehensive regimen since each patient requires an individual approach. The most difficult aspect is to ensure that local correction translates to the automatic maintenance of the corrected body posture in a standing position. This is facilitated by corrective exercises supported with biofeedback. , The aim of this paper is to elucidate this complex issue that often leads to divergent and improper attitudes to the conservative treatment of scoliosis.

Background: Maintaining functional fitness is an important problem in elderly people. Effective balance control is one of its main aspects. Evaluation and diagnosis of the weakest link in balance control (especially in this age group) facilitates appropriate prevention and rehabilitation. The goal of this study was to determine the role of the optic teleceptor and proprioception in maintaining body stability of elderly people., Material and Methods: Balance control effectiveness and body stability was examined in 43 elderly people aged 65 and over by exposure to changing stimuli affecting tele- and proprioception. The participants were given false suggestions as to the vertical and horizontal planes of reference, and the position of the base was changed in different directions. Stabilographic parameters were acquired using an AccuGait platform. The results were compared with a control group of 53 healthy people under 30 years old. All study data were subjected to a statistical analysis., Results: Proprioceptive impulsation coming from the base was the key factor in body balance control. The results show a higher risk of falls in elderly people, especially during backwards inclination., Conclusions: Changing spatial points of reference and position of the base activate body balance regulation mechanisms. The efficiency of these mechanisms in maintaining body stability is lower among elderly people, which indicates a need to implement appropriate prophylactic programmes in this age group.

Background. Compensation for abnormal alignment of body parts in scoliosis may occur above or below the pelvis. This manifests as dislocation of body parts or changes in the angular composition of the lower limbs. Compensation for unbalanced body arrangement through changes in pelvic tilt and lower limb joints are typically reflected in the gait pattern of the person with scoliosis. The aim of our research was to determine whether and how improper body arrangement in the frontal plane is reflected in the gait pattern of children and youth with lower degree scolioses. Material and method. Children and youth with scolioses of varying grade were examined. In addition to photogrammetric body posture examination, three-dimensional gait analysis was performed during particular gait phases. For each examined child the results of this analysis were compared to the posture parameters. Results. Varying signs of gait asymmetry were observed in the whole group of children and youth with scoliosis. The symptoms were connected with both general gait attributes (unisommetry and unisochrony) and further gait markers. The most obvious changes were observed in pelvis rotation during the swing phase and excessive pelvis elevation during the mid-stance phase. These deviations did not correlate significantly with the results of the static examination. Conclusions. The gait asymmetries observed in children and youth with low-grade scoliosis are non-specific, and probably depend on the individual capabilities of each person to compensate for deficiencies.

Background. A review of the literature indicates that exercises strengthening the dorsal extensor muscles occupy a significant place in the program of posture reeducation. These exercises are usually performed in positions other than vertical. It has not been proven, however, that the strength of these muscles in children with scoliosis is insufficient to hold the spine in an upright position. As a result of evolution, the human being walks upright, against gravity. In normal conditions, then, the strength of the antigravitational muscles would seem to be the most important. The purpose of our research was to investigate the strength of the antigravitational muscles and the long dorsal muscles in a group of children with scoliosis. Material and methods. 51 children were tested in a special stand for the measurement of maximum force in these muscle groups, during isometric contraction for 10 seconds. The examinations were performed using a "MikroFET 2" device in cooperation with a computer and the "Hercules 2000" software. Results. The initial results showed considerable individual differentiation in the strength of the antigravitational and dorsal extensor muscles among the study population. The differentiation was decidedly greater in relation to the antigravitational muscles. With some isolated exceptions the strength of these muscles was greater than the strength of the dorsal extensors. Interestingly, there was no significant correlation with the children's age or the degree of spinal curvature. Conclusions. The strength of the afore-mentioned muscles appears to be of secondary importance for maintaining the correct posture.