Abstract The aim of the study was to find out how values and norms related to touch are perceived in the physiotherapist-patient relationship. 149 physiotherapists and 100 patients participated in the study. The questionnaire used in the survey was prepared in two versions, both containing the same 30 items describing the use of therapeutic touch from two perspectives. The respondents had to provide their answers on 6-point ordinal scales with the centre excluded. In our analyses we treated the applied research tool as a scale of fulfilment of touch-related norms in the case of therapists and, respectively, a scale of expectations of fulfilment of these norms in the case of patients. The reliability of the tool was checked with Cronbach’s α method. Factor analysis, Student’s t-test and one-way analysis of variance were used to develop the obtained results. In a therapeutic situation, the surveyed patients expect most of all that touch will express care. Physiotherapists are driven mainly by their professional competence in applying touch. A comparison of the obtained results on a scale depicting the fulfilment of norms underlying therapeutic touch has shown that the level of patients’ expectations concerning physiotherapists’ use of touch in therapy situations is lower than the physiotherapists’ declared level of fulfilling norms and values connected with this situation. The gender and age of physiotherapists were not found to differentiate axiological and normative declarations related to touch. Patients with higher education and women tend to express much higher expectations with respect to touch therapy.

PURPOSE:Restrictions related to the COVID-19 pandemic can negatively affect patients who require physiotherapy. This study aimed to analyze the consequences of limited physiotherapy on the functional state of children with neuromuscular diseases (NMD). In addition, the caregivers' well-being and caregiver opinions on physiotherapy were analyzed.METHODS:A questionnaire was shared with parents of children with NMD immediately after the COVID-19 lockdown. The survey included questions regarding the physical and mental condition of children and parents before the pandemic and during lockdown as well as their views on physiotherapy and telephysiotherapy. Statistical analysis was performed using the Wilcoxon Matched-Pairs Signed Ranks test, Spearman's Rank Correlation test, McNemar test, and Chi-square test.RESULTS:Parents of 235 children participated in the study. Results indicated that children devoted more time to physiotherapy before the pandemic than during the lockdown period, which was true for those living in cities and the countryside. The functional state of 50.2% of the children deteriorated during the lockdown, in the opinion of their parents. Significant correlations were found between limited physiotherapy time and the deterioration of children's functional condition, ability to maintain a standing position, and increased anxiety. The majority of parents reported increased levels of fear and anxiety (72.8%), fatigue (67.7%), and pain (53.2%). In-person physiotherapy was rated significantly higher than telephysiotherapy by parents.CONCLUSIONS:Limited access to physiotherapy and shorter therapy times may lead to functional deterioration in children with NMD, but this assumption needs to be objectively confirmed. According to the parents' opinions, telephysiotherapy is less beneficial than direct physiotherapy but may support therapy conducted directly by a physiotherapist. Results based on subjective parental opinions may be helpful in planning future projects.

BACKGROUND Not much is known about developmental motor disorders in the first year of life of children diagnosed with idiopathic scoliosis (IS). OBJECTIVE This study aimed to compare the occurrence of asymmetry or muscle tone disorders in the first year of life in adolescents with IS and their healthy counterparts. METHODS The parents of adolescents with IS and without scoliosis completed a survey on the occurrence of asymmetry, abnormal muscle tone, and physiotherapy in their children in the first year of life. Pearson's chi square test and Cramer's coefficient were used. RESULTS The final analysis included 527 surveys completed by parents of adolescents with idiopathic scoliosis (150) and without scoliosis (377). A significantly higher frequency of asymmetry (p= 0.001) and muscle tone disorders (p= 0.001) was noted in adolescents with idiopathic scoliosis. The results also revealed a significant association between scoliosis and asymmetry (p= 0.001), as well as muscle tone (p= 0.001). CONCLUSIONS Developmental asymmetry or improper muscle tone in the first year of life could be considered a potential factor in the development of scoliosis; however, this hypothesis should be confirmed in future studies. Infants diagnosed with developmental disorders require systematic observation.

Background: Neck and trunk muscle strength and relationship with motor function in individuals with spinal muscular atrophy (SMA) is not investigated well. Information on maximum muscle strength that children with SMA may develop considerably expands the possibilities of assessing the effectiveness of pharmacological treatment methods and therapeutic procedures. This study sought to assess neck and trunk muscle strength in patients with SMA and to compare it with values noted in healthy children. Methods: The study involved 56 individuals with SMA aged 5–16 not treated pharmacologically, including 9 patients with SMA type 1 (SMA1), 27 with SMA type 2 (SMA2), and 20 with SMA type 3 (SMA3). The control group included 111 healthy individuals aged 5–16. Neck and trunk muscle strength was assessed by means of a maximum voluntary isometric contraction method with the use of a handheld digital muscle tester MICROFET2. Moreover, relative strength was also calculated by standardising the maximum voluntary isometric contraction according to body mass. The Kruskal–Wallis test, Mann–Whitney U-test, and Spearman's rank correlation were used for statistical analysis. Results: The reliability of the neck and trunk muscle strength measurements with the handheld digital muscle tester was excellent with ICC > 0.9. The values of muscle strength in SMA groups were significantly lower than in the control group. The values of relative torque of the neck muscles expressed in percentage values calculated with regard to the control group were at the level of 47.6–51.6% in SMA1 group, 54.8–58.1% in SMA2 group and 80.6–90.3% in SMA3 group. The percentage values for upper and lower trunk muscle strength were at the level of 42.6–68.4% in SMA1 group, 56.9–75.4% in SMA2 group and 76.7–94.8% in SMA3 group. Conclusion: Handheld dynamometry provides reliable measures of neck and trunk muscle strength in SMA children. Neck and trunk muscle strength in children with SMA is lower than in healthy controls and depends on disease type, which confirms the theory based on clinical observations. Further, study is needed to investigate the effect of pharmacological treatment on the strength of the neck/trunk muscles, and relationship between neck and trunk muscle strength and motor capabilities.

The purpose of this study was to investigate the functional relationships between selected ranges of motion of the neck, upper and lower limbs, the strength of the neck and trunk muscles, postural parameters, and the motor function of children with SMA1 and SMA2-27 children, aged 6 months-15 years, with genetically confirmed spinal muscular atrophy type 1 (19 children) and 2 (8 children) undergoing pharmacological treatment. All children were examined, according to the methodology, including the motor function evaluation, measurement of selected ranges of motion, assessment of postural parameters, and measurement of neck and trunk muscle strength. The functional status of 15 children was assessed with the CHOP INTEND (CHOP group) scale and of 12 children with the HFMSE (HFMSE group). The results obtained showed that, in children examined with the CHOP scale, greater limitation of flexion in the shoulder joints was observed. As the deformation of the chest increased, the functional abilities of children deteriorated. In participants examined with the CHOP group, the ranges of neck rotation decreased with the increase of the chest deformity. In the HFMSE group, the ranges of head rotation showed a strong relationship with some parameters of muscle strength and the sum of the R coefficients. Participants showed many significant relationships between the range of motion in the neck and joints of the limbs, with more significant relationships in the CHOP group. The following conclusions were made: motor skills of children with SMA depend on muscle strength, range of motion, and deformities of the spine and chest; the development of scoliosis adversely affects the motor function, ranges of motion, and muscle strength; and movement ranges are related to motor skills and strength values.

Abstract Introduction Diastasis recti abdominis (DRA) is both a structural and a functional disorder. It is believed that the main cause of DRA is the extensive stretching of the abdominal wall resulting from pregnancy; yet the condition is also found in men and in children. There are several, seemingly mutually exclusive, DRA risk factors, such as the pathological abdominal muscle tension and chronic exercise deficits. The aim of the study was to determine the factors affecting the size of DRA in postpartum women. Material and methods The study involved 239 postpartum women. The study was conducted with the use of an online survey. The subjects completed the DRA test, the Beighton test and International Physical Activity Questionnaire. Results The analysis found DRA in majority of studied women (60.7%). The relationship between the BMI index and DRA was statistically significant (p = 0.01). The relationship between surgeries in the abdominal cavity and the DRA was statistically significant, too (p = 0.05). We showed that DRA correlates with other pelvic dysfunctions (p = 0.03). Conclusions The most significant risk factors for diastasis recti abdominis in postpartum women are abnormal BMI and surgeries to the abdominal cavity. Diastasis recti abdominis correlates with other dysfunctions, such as: spinal pain, urinary incontinence, peristaltic disorders, sexual disorders, abdominal hernia, groin hernia, lowering of the lesser pelvis organs. Further studies into DRA risk factors under close supervision of a physiotherapist are necessary.

Summary Introduction : The aim of the study was to evaluate whether our own twelve-week Sensorimotor Exercise Programme (SEP) affected FMS results in canoe slalom athletes. The Functional Movement Screen (FMS) is a tool for detecting asymmetries and movement range limitations in order to prevent sport injuries. The screen evaluates mobility and stability in seven fundamental movement patterns. Material and methods : The study population consisted of 16 athletes from the Canoe Slalom National Team of Poland who competed in three sports categories: kayak single, canoe single, canoe double. The athletes, 13 men and 3 women, undertook the FMS screen twice before the starting season. Between the first and the second screen the athletes undertook a twelve-week long sensorimotor training programme. Results : The result analysis showed a statistically significant difference in FMS results. The mean FMS screen result after twelve weeks of training increased from 16.6 points to 19.6 points. Conclusions : An adequately designed SEP can lead to an improvement in athlete movement patterns. The FMS screen allows for assessment of changes in athlete movement patterns after twelve weeks of SEP training.

BackgroundMusculoskeletal disorders are often observed in patients with spinal muscular atrophy (SMA). The aim of the study was to assess passive ranges of rotation in the cervical spine, chest deformity and pelvic obliquity in SMA patients, and to compare these results to the norms obtained in the group of healthy individuals. The second aim was to review these measurements and Cobb angle values for correlations in SMA patients.MethodsThe study included 74 patients with SMA and 89 healthy individuals aged 2 to 18years. Cervical Rotation (CR), Supine Angle of Trunk Rotation (SATR) and Pelvic Obliquity (PO) tests were carried out.ResultsCervical rotation ranges were significantly higher in the control group than in SMA patients (p<0.05). Differences between cervical rotation ranges to the left and to the right were significantly larger in SMA I and SMA II groups than in healthy individuals (p=0.000). Chest asymmetry and pelvic obliquity were bigger in SMA groups than in the control (p<0.05). Significant correlations between cervical rotation measurements, chest deformity, pelvic obliquity and Cobb angle were found in SMA individuals, depending on the type.ConclusionsThe results of the study suggest that CR, SATR and PO tests may assist in the assessment of SMA patients in addition to the radiographic evaluation of the spine. Biomechanical relationships between disorders located in various skeletal structures should be taken into account in the treatment of SMA patients. Special attention should be given to assessing postural parameters in non- sitters and sitters. Treatment of patients with SMA and associated musculoskeletal disorders requires a multi-specialist approach.

BACKGROUND:Alternating hemiplegia of Childhood (AHC) is a rare disease manifested by transient episodes of hemiplegia and other neurological disorders. Delayed motor development has been reported in patients with AHC, but detailed features of the motor impairment have not been described so far.AIM:The aim of the study was to evaluate gross motor function between attacks in a group of Polish patients with AHC.MATERIALS AND METHODS:The interictal gross motor function was assessed using the Gross Motor Function AHC scale, which consisted of 41 motor tasks. The study group consisted of 10 patients with AHC older than 2 years of age. The control group consisted of 30 age- and gender-matched subjects. The results achieved in each of the 41 tasks by the study subjects were compared to the results obtained with controls using the non-parametric Mann-Whitney U-test. In tasks 38-41, mean times were compared between the study subjects and controls.RESULTS:The study revealed gross motor function impairment in patients with AHC. The greatest differences compared to controls concerned such skills as standing on toes, walking on toes, walking on heels, as well as running and hopping on one leg and on alternate legs. Significant impairment of the motor function of the upper limbs was also found.CONCLUSIONS:The study confirmed motor function impairment between attacks in patients with AHC. The study findings may indicate the need to introduce individualised physiotherapy management of patients with AHC.

The majority of individuals with spinal muscular atrophy (SMA) experience progressive skeletal deformities which may affect the quality of life and mobility. To date, no studies have evaluated the reliability of tests assessing body posture and joint mobility in SMA patients. The purpose of this study was to assess the reliability of Cervical Rotation test (CR), Supine Angle of Trunk Rotation test (SATR), Hip Extension test (HE) and Pelvic Obliquity test (PO) developed to evaluate the musculoskeletal system in SMA individuals. Thirty individuals (12 girls and 18 boys) aged 4–15 with SMA type II (n = 24) and III (n = 6) confirmed by genetic examinations were qualified for the study. The participants were examined twice by three physiotherapists on the same day. The examination included four tests, i.e. CR, SATR, HE and PO tests aimed at assessing ranges of rotation in the cervical spine, chest deformities, ranges of hip extension and pelvis position while sitting. Statistical calculations were made with the use of statistical software IBM SPSS Statistics version 20. Reliability was assessed using the Intraclass Correlation Coefficient (ICC). Intraobserver reliability was excellent for CR (ICC range 0.839–0.911), SATR (ICC range 0.918–0.939 - the upper part of the sternum; ICC range 0.951–0.975 - the lower part of the sternum), HE (ICC range 0.988–0,991) and PO (ICC range 0.896–0.935) tests. The interobserver ICC reached the excellent values in CR (ICC range 0.912–0.920), SATR (ICC = 0.888 - the upper part of the sternum, ICC = 0.951 - the lower part of the sternum), HE (ICC range 0.922–0.923) and PO (ICC = 0.928) tests. CR, SATR, HE and PO tests are reliable and may be used for examining individuals with SMA. The application of these tests provides a possibility to detect early changes in the musculoskeletal system in children and adolescents and to assess the effectiveness of the implemented pharmacotherapy and rehabilitation.

Introduction: Obesity is a common health issue among children and adolescents leading to serious consequences later in life. There are reports on postural stability in children in relation to their nutritional status, but there are few studies involving a stabilometric platform. Aim: A comparison of postural stability in children with normal body mass and obese children. Material and methods: The stabilometric study involved 166 subjects. The postural stability evaluation was performed with the use of the Biodex Balance System platform. The following four postural stability tests were carried out: (1) eyes open, stable platform (SI0); (2) eyes open, level 4 unstable platform (SI4); (3) eyes open, level 4 unstable platform with the screen covered (SI4SC); (4) eyes closed, level 4 unstable platform (SI4EC), and the fall risk test (FRT). Results and Discussion: There were statistically significant differences found in the SI4, SI4SC, SI4EC, and FRT tests in all the inspected parameters. Only in the postural stability test on a stable platform (SI0) no differences were noted. The most marked differences between arithmetic means obtained for both groups were observed in the postural stability test on an unstable platform with closed eyes. Conclusions: Children with obesity are characterised by increased instability on a moving surface compared to children of normal body mass. Obese children experience the biggest problem when regaining balance with their eyes closed. It is advisable to include training on an unstable surface in physiotherapy programmes for obese children.

The aim of this study was to evaluate the classification system in sitting volleyball (SV) based on athletes' opinions on different competitive level. During World Sitting Volleyball Championships in 2014, 187 participants and 35 players in Polish and Lithuanian SV leagues participated in this study. They completed the survey regarding the current classification system in SV. The classification procedure was assessed as positive by 74% of elite athletes and 94.1% league athletes. Elite athletes see a need to include functional procedures, and in contrast to league athletes, they assessed the current classification system positively. Many of the players see a need to change the current classification system from medical to functional or mixed procedures. League athletes in contrast to elite athletes agree to include able-bodied people to compete on the court with people with physical impairments

Abstract Introduction Infancy is the key period in human development. Disorders in the motor development during the first year of life may affect the body posture, motor patterns and functioning in the period of childhood. The study objective was to assess the correlation between motor development in the first year of life and angle of trunk rotation, lumbopelvic-hip complex mobility and occurrence of joint hypermobility in children aged 3-9. Material and methods 120 healthy children aged 3 to 9 participated in the study. The study comprised a questionnaire and a clinical trial. The children in whom the questionnaire revealed abnormal motor development in the first year of life were included in the study group, and the other children were a control group. Then, a physiotherapist assessed the value of the trunk rotation angle with the use of a scoliometer, the lumbo-pelvic-hip complex mobility with the use of TPHA test, and the occurrence of joint hypermobility with the use of Beigthon test. Results Children with abnormal motor development in the first year of life were characterized by a statistically significantly higher value of the trunk rotation angle in the thoracic section and they had a higher asymmetry of rotational movement of the lumbo-pelvic-hip complex, as well as higher values in the Beighton test. Conclusions Abnormal motor development in the first year of life is a factor predisposing to increased values of the trunk rotation angle in the thoracic section, asymmetry of rotational movement of the lumbo-pelvic-hip complex, and joint hypermobility. Studies of other factors potentially leading to development of such disorders should be continued. Children with impaired development should be included in programmes of prophylaxis.

1. Abstract 1.1. Introduction: Rotational movements of the trunk and pelvis are visible during activities of daily living. To date, no researchers have assessed the reliability of any test used to examine rotational mobility of the lower trunk-pelvis complex. The aim of the study was to assess the reliability of the Trunk-Pelvis-Hip Angle test. 1.2. Materials and Methods: The study included healthy 41 adolescents aged 12-15 . Measurements were performed by three experienced physiotherapists. 1.3. Results: Reliability was excellent for three observers. Intraclass correlation coefficient ranged from 0.894 to 0.938 for intraobserver reliability. The interobserver intraclass correlation coefficient ranged from 0.888 to 0.900 . 1.4. Conclusion: The Trunk-Pelvis-Hip Angle test is a reliable measurement and may be used for examining the range of the lower trunk-pelvis rotation in adolescents. The test provides a new possibility in diagnosing the musculoskeletal system. 2. Keywords: Adolescents; Pelvis; Range of Rotation; Reliability; Spine; Trunk 3. Abbreviations TPHA test : Trunk-Pelvis-Hip Angle test TPHA left : Trunk-Pelvis-Hip Angle test on the left side of the body TPHA right : Trunk-Pelvis-Hip Angle test on the right side of the body

Aim: The aim of the study was to assess parental knowledge about the development and care of a child aged 0-12 months as well as to verify whether this knowledge is sufficient to detect potential abnormalities and thus allow for early intervention. Another aim of the study was to determine the effects of selected sociodemographic characteristics of respondents on their knowledge about the development and care of a child aged up to 1 year. Material and methods: A total of 99 parents (82 women and 17 men) with children aged 0-12 months were included in the study. The study was conducted using an author's online questionnaire. Two scales were the main dependent variables. One scale allowed for an assessment of respondents' knowledge about child development, while the other scale verified the knowledge about childcare. The obtained data were analysed statistically using the IBM SPSS Statistics version 20. The analysis of contingency tables used percentage profiles and the Pearson Chi-square independence test as well as Cramer's V association. The results were considered statistically significant at alpha = 0.05. Results: Statistical analysis of data points to an insufficient level of parental knowledge about the development and care of a small child. Factors such as education, place of residence and attending childbirth classes have a significant impact on this knowledge. Conclusions: Parental education on normal child development and childcare is necessary. This will help prevent many abnormalities by proper care as well as earlier detection of disorders and, consequently, early intervention.

Abstract Introduction. Physical fitness affects motor and intellectual development. Having a wide range of motor skills makes it possible to learn about the surrounding world and expand one’s knowledge. In the case of persons with intellectual disabilities, mastering gross and fine motor skills is the core of their development and functioning in society. The aim of the study was to analyse the relationship between physical fitness, gross and fine motor skills, and the level of functioning in schoolchildren with intellectual disabilities. Material and methods. The study involved 62 subjects whose age ranged from 9 to 24 years. Due to the large size and homogeneity of the group, the results of 26 subjects were considered in the analysis: 12 girls and 14 boys with moderate intellectual disability. Physical disability as well as gross and fine motor skills were measured with the BOT-2, TGMD- 2, and Eurofit Special tests. The level of functioning in society was assessed with a specially designed ICF-based questionnaire. Results. The study showed that girls had better motor skills than boys; this was reflected in the participants’ level of functioning as girls displayed a higher level of functioning. Boys, despite better physical fitness, were ranked on a lower level of functioning. Conclusions. A relationship was found between gross and fine motor skills and the level of functioning, assessed with BOT-2 and TGMD-2. No relationship was found between physical fitness, assessed with Eurofit Special, and the level of functioning. Instead of using assessment tools for general fitness, one should measure specific motor skills when assessing physical and motor development in children with intellectual disabilities.

The purpose of this exploratory study was to evaluate opinions of elite athletes, coaches and classifiers regarding the International Wheelchair Basketball Federation's (IWBF) functional classification system. We were also interested in the athletes' perspective regarding potential changes to the classification system. In addition, we compared the generalized opinions reported by the athletes to those of coaches and classification officers. This survey was administered during the Wheelchair Basketball Gold Cup (Amsterdam, 2006). Seventy-nine athletes, 50 men and 29 women, as well as 12 coaches and 14 classifiers completed the survey. The first part of the survey addressed demographic characteristics of the participants. The second part focused on their opinions regarding the current classification system. Based on the survey responses, athletes reported that the IWBF classification system is generally satisfactory. However, athletes as well as coaches and classification officers did report some specific concerns about this classification system. These concerns included changes in an athlete classification, athlete cheating and communication between classifiers and athletes. Athletes, coaches and classifiers, as the wheelchair basketball's primary constituent groups, have a vested interest in the evolution of the game and should be included in the evaluation and modifications to the functional classification system. This study has demonstrated that a classification specific survey could provide useful information and insight into the perspectives of these constituent groups.

Abstract Introduction: The menopausal syndrome affects 85-87% post-menopausal women. Typical symptoms include: hot flashes, heavy sweats, dizziness, increased body temperature, heart palpitations, depression, mood swings, distorted concentration, distorted memory and interrupted sleeping patterns. The literature on effects of physical activity on menopausal symptoms seems to be inconsistent. The aim of this study was to determine the relationship between intensified menopausal syndrome and undertaking physical activity. Material and methods: We studied 105 healthy menopausal women (aged 45 to 65). Their mean age was 52 SD 5.2. We used the survey method. The research tools were: questionnaire we devised, Kupperman index and Borg scale. Additionally, we devised: physical effort intensity index and physical activity variety index. To conduct the statistical analysis, we used STATISTICA programme. We set statistical significance at p<0.05. Results: We found a statistically significant relationship between the frequency of undertaking physical activity and the intensity of menopausal syndrome. More than a half of the subjects (54.3%) did physical exercise “often” or “regularly”, and they did not suffer from the “severe” form of menopausal syndrome. We found a significant relationship between the BMI and intensity of menopausal symptoms (p=0.04) and between the waist size and menopausal symptoms (p=0.001). Conclusions: The more intense, varied and frequent physical activity, the less intense menopausal symptoms. The subjects with normal BMI and waist narrower than 80cm had less difficult menopause. Physical activity reduces physical and psychological changes experienced in the climacteric.

Introduction: The Trunk-Pelvis-Hip Angle (TPHA) test is used for assessing the mobility of lumbo-pelvic-hip complex. The aim of the research was to assess the intraobserver reliability of the TPHA test in girls with and without idiopathic scoliosis and to compare the test values obtained by the girls in both groups.