Aleksandra Truszczyńska

Akademia Wychowania Fiycznego im. Jergo Kukuczki w Katowicach, Catowice, Silesian Voivodeship, Poland

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Publications (18)6.45 Total impact

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    ABSTRACT: Back pain in Air Force fast jet pilots has been studied by several air forces and found to be relatively common. The objective of the study was to determine the prevalence and degree of the pain intensity in the cervical, thoracic and lumbar spine, subjective risk factors and their effect on the pilots' performance while flying high maneuver aircrafts and the consequences for cognitive deficiencies. The study was designed as a retrospective, anonymous questionnaire survey, collecting data on the age, aircraft type, flying hours, pain characteristics, physical activity, etc. The study was participated by 94 pilots aged 28-45 years (mean age: 35.9±3.3 years), actively flying fast jet aircrafts Su-22, Mig-29 and F-16. The estimates regarding the level of the subjective back pain were established using visual analogue scales (VAS). The values of the Cochran and Cox T-test for heterogeneous variances are as follows: for the total number of flying hours: F = 2.53, p = 0.0145, for the pilot's age: F = 3.15, p = 0.003, and for the BMI factor F = 2.73, p = 0.008. Our questionnaire survey showed a significant problem regarding spinal conditions in high performance aircraft pilots. The determination of the risk factors may lead to solving this problem and help eliminate the effect of the unfavorable environment on piloting jet aircrafts. Experiencing back pain during the flight might influence the mission performance and flight safety. The costs of pilots education are enormous and inability to fly, or even disability, leads to considerable economic loss. More research on specific prevention strategies is warranted in order to improve the in-flight working environment of fighter pilots.
    International Journal of Occupational Medicine and Environmental Health 03/2014; · 1.31 Impact Factor
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    ABSTRACT: The osteoarthritis of the hip dominant symptom is pain that leads to disability and to postural and gait disorders. The aim of this study was to analyze postural stability and its impact on disability and pain. The study population consisted of 60 patients and control group of 30. Group 1 (n = 30) included patients with unilateral coxarthrosis, aged 56.2 (±12.3) years, BMI 25.17 (±2.87) kg/m2. There were 16 men (53.3%). The mean age of patients in group 2 (n = 30) with bilateral coxarthrosis was 62.3 (±12.1) years; the mean BMI was 24.87 (±2.06) kg/m2. There were 15 men in this group (50%). The patients were evaluated using the WOMAC, the Harris Hip Score, VAS and the Biodex Balance System. Both study groups had stability index results different than the control group. There was a significant correlation between the stability indexes and BMI. VAS correlated with the M-L plane variance. In group 2, there were significant differences related to disability for the disability scales for all measured parameters. Balance disorder is a basic parameter found in coxathrosis. There is a statistically significant correlation between balance disorders and BMI, VAS and functional scales.
    Acta of bioengineering and biomechanics / Wroclaw University of Technology 01/2014; 16(1):45-50. · 0.33 Impact Factor
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    ABSTRACT: Background. Patients who undergo total hip arthroplasty (THA) find it difficult to return to work. Objectives. Analysis of factors influencing return to work after THA. Assessment of patients' quality of life and its impact on their attitude to work. Material and methods. We studied patients operated on for degenerative hip disease at the Department of Orthopaedic Surgery of Medical Centre of Postgraduate Education in Otwock between 2007 and 2012. The total number of the patients was 400; however, we chose only those patients who were younger than 65 and still in employment. The study population consisted of 54 of these patients. The mean patient age was 55.89 (±7.424). There were 29 men (57.3%) and 25 women (46.3%). Results. 32 patients (59.3%) returned to work. There was a statistically significant difference regarding the attitude to work and return to work. An overwhelming majority of the patients who returned to work - 31 out of 32 (96.6%) - liked their jobs. The 12 patients (22.22%) who did not return to work declared their intention to apply for a disability pension. The patients who returned to work assessed their physical health as better than the patients who did not return to work. Conclusions. 1. 40.7% of patients after THA did not return to preoperative employment. The reasons for not returning were not medical, because elimination of pain and an increased range of motion made return to work possible. 2. The perception of the quality of physical and psychological health among patients with THA who returned to work was significantly better than among those who did not return.
    Ortopedia, traumatologia, rehabilitacja. 10/2013; 15(5):459-67.
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    ABSTRACT: Background. Total hip arthroplasty involves division of the joint capsule, which can cause receptor damage, affecting postural stability and increasing the risk of falls. The aim of this study was to determine whether postural stability can be disturbed by total hip arthroplasty from a postero-lateral approach. Material and methods. Static balance was quantified with the use of a two plate tensometric platform in a study group of 16 patients (8 women and 8 men) with unilateral hip osteoarthritis, mean age 57.13 (± 10.7) years, height of 173.38 (± 9) cm, weight 90.21 (± 16.9) and BMI of 30.07 (± 2.87) kg/m2. Results. Postural balance improved after surgery, with a statistically significant decrease in the length of the sway path in the AP plane and a strong trend towards significance in the medio- lateral plane. The maximum deflection of the COP from the 0 in the Y direction was reduced. The average velocity of movement of the COP along the Y-axis was significantly reduced, and velocity along the X-axis in mm/s was reduced with a strong trend towards significance. Conclusions. 1. THA from a postero-lateral approach did not lead to a deterioration of postural stability in the early postoperative period. 2. Balance parameters, including path length and the average velocity of the COP in the antero-posterior plane, improved in a statistically significant manner. 3. The maximum extension of the COP in the frontal plane decreased with a strong trend towards significance.
    Ortopedia, traumatologia, rehabilitacja. 10/2013; 15(6):567-73.
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    ABSTRACT: The return to work of patients who undergo spinal surgery poses important medical and social challenge. 1) To establish whether patients who undergo spinal stenosis surgery later return to work. 2) To establish the patient's attitude towards employment. 3) To assess the quality of life of the patients and its influence on their attitude to work. The study population consisted of 58 patients aged from 21 to 80 years (the mean age was 52.33±14.12). There were 29 women (50%) and 29 men (50%) in the group. The patients' quality of life was measured by the use of the WHOQOL-BREF instrument. Individual interviews were conducted 3 to 8 months (a mean of 5.72 months ±1.6) after the surgery. 1) Although 13 patients (22.3%) returned to work, 44 (75.9%) did not, these being manual workers of vocational secondary education. 2) Almost half of the patients (27 patients, i.e. 44%) intend to apply for disability pension, 16 patients (27.6%) consider themselves unfit to work, 22 patients (37.9%) do not feel like working again. 3) The quality of life of the patients decreased. Domain scores for the WHOQOL-BREF are transformed to a 0-100 scale. The mean physical health amounted to 60.67 (±16.31), the mean psychological health was 58.78 (±16.01), while the mean social relations with family and friends were 59.91 (±20.69), and the mean environment 59.62 (±12.48). 1) A total of 75% of the patients operated for lumbar spinal stenosis do not return to their preoperative work. Difficulties in returning to work and decreased quality of life are associated with female sex, lower-level education, hard physical work and low income. 2) Physical health, psychological health, social relations and environment decreased to the mean of approximately 60. 3) The quality of life of the patients who did return to work was similar to that of healthy people.
    International Journal of Occupational Medicine and Environmental Health 07/2013; · 1.31 Impact Factor
  • Neurologia i neurochirurgia polska 01/2013; 47(2):189-194. · 0.49 Impact Factor
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    ABSTRACT: Back pain poses a serious clinical problem in some cases, because under the clinical symptoms of back pain might be other hidden diseases. The aim of this study was to present difficulties in diagnosis and treatment of various diseases of the spine and 2. description to the flagship division, based on the traffic lights. The clinical material is based on a group of 20 patients with diagnostic and therapeutic difficulties, among 1825 patients treated due to low back pain. Diagnosis was based on clinical examination and various imaging techniques. In the case of cancer biopsy was performed, and in specific and nonspecific infections of the spine treated surgically toward the microscopic examination of tuberculous granulation tissue or inflammatory. The diagnosis of osteoporotic fractures was based on the digital 3D CT. The studied group of 20 patients were divided according to color flag system. Among the analyzed patients 14 received red flag, 5 yellow and 1 black. The red flag has received seven patients with spinal infection, 3 patients with cancer and two with osteoporotic fracture, and 2 patients with low back pain due to an aortic aneurysm. Yellow flag received 5 patients with compensation claims. 1. In patients with back pain, diagnostic examinations should be administered according to a particular order. Clinical and radiographic examinations are basic tools which should be supplemented by the modern techniques of MRI and CT. 2. Histopathological evaluation of tissue preparations facilitates the diagnosis of an infection or tumour. 3. Classification according to colored flags are useful in clinical practice. It describes the degree of risk of serious illness and difficulties in therapy.
    Ortopedia, traumatologia, rehabilitacja. 06/2012; 14(3):215-27.
  • Aleksandra Truszczyńska, Piotr Walczak, Kazimierz Rapała
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    ABSTRACT: The aim of this article was to present transient peripartum femoral head osteoporosis. This very rare condition occurred twice in our patient-a woman in her 30s. The cases described in the literature were mostly unilateral, with bilateral hip involvement noted much less frequently. In our patient, transient osteoporosis occurred in the third trimester of her first pregnancy in the right hip, her second pregnancy was uncomplicated, and in the third trimester of the patient's third pregnancy, osteoporotic changes were noted in the left hip joint. The patient breastfed her first and third babies only 3wk each. She breastfed her second baby for 4mo. The diagnostic workup was based on the clinical examination and radiographic/magnetic resonance imaging, which revealed bone marrow edema, and the dual-energy X-ray absorptiometry scans. The treatment consisted in core decompression of the femoral head (foragé), unloading of the hip using crutches as well as administration of calcitonin and calcium supplements. Complete recovery of the femoral heads was achieved. The follow-up time was 7yr.
    Journal of Clinical Densitometry 06/2012; · 1.71 Impact Factor
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    ABSTRACT: Low back pain in pilots of military helicopters is widely discussed in the world literature. Vibrations and improper seat configuration cause that cervical, thoracic and lumbar spine might be exposed to overloading. The aim of the study was to determine the incidence and intensity of pain in the spine as well as to identify subjective risk factors of back pain and its effect on the pilot's actions while flying a helicopter. 112 pilots, aged 25-56 years (mean age: 34.8 ± 6.3 years), actively flying helicopters, participated in the questionnaire survey. The questionnaire containing five groups of questions, elaborated by the authors, was used. 70% of the pilots reported pain complaints. Pain was localized in different parts of the spine. Uncomfortable body posture during prolonged flights resulting from the lack of lumbar support exerted the highest effect on pain provocation. This questionnaire survey enabled to determine the prevalence of pain, its type and intensity. Knowledge on low back pain imposes the necessity to eliminate the negative environmental effect on helicopter pilotage. Elimination of risk factors is possible through appropriate physical exercises and adjustment of pilots' seats. The authors plan to conduct--in the future--detailed annual examinations among pilots with back pain and, based on the results, to elaborate a prophylactic program containing simple forms of isometric and isotonic training involving paravertebral and deep abdominal muscles designed specifically for pilots of military helicopters.
    International Journal of Occupational Medicine and Environmental Health 06/2012; 25(3):258-64. · 1.31 Impact Factor
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    ABSTRACT: The paper presents the case of a 73-year-old patient with a history of tuberculosis of the hip in childhood who received an Exeter total hip prosthesis. Tuberculosis recurred 58 years after primary infection and 9 years after THA. The authors analyzed the available literature, which described only a few case reports, because Mycobacterium tuberculosis infections of a joint implant after THA are extremely rare. They are frequently the result of local reactivation of the pathogen or, less commonly, an overlooked diagnosis of tuberculosis at the time of endoprosthesis implantation. Proper diagnostic work-up of infection is particularly difficult because synovial fluid cultures are usually negative. In addition, a coexisting Staphylococcus aureus infection may obscure the clinical presentation. In post-THA patients, complete anti-TB treatment is recommended. Particular caution should be observed in patients from regions with high TB morbidity or with a history of pulmonary and operated joint tuberculosis.
    Ortopedia, traumatologia, rehabilitacja. 04/2012; 14(2):189-96.
  • Kazimierz Rąpała, Aleksandra Truszczyńska
    Polish Journal of Surgery. 01/2010; 82(4):233-242.
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    ABSTRACT: Advances in digital computed tomography prompted the authors to use this technique to measure correlations between the lumbar spinal canal and the dural sac. The aim of the study was to: 1. Evaluate the value of surgical decompression of neural structures using digital computed tomography. 2. Establish mathematical correlations between the surface area of the dural sac and the narrowed spinal canal before and after the operation. MATERIAL AND METHODS. The analysis involved 33 patients who underwent lumbar stenosis surgery. Complete clinical records and imaging examination reports were available for this group of patients. 1. Statistically significant differences in spinal canal height at L4 and L5 were found between the control group (N) and the surgically treated group before and after surgery. L4: Reference--16.85 mm, before surgery--14.10 mm; after surgery--15.8 mm. L5: Reference--17.77 mm, before surgery--15.79 mm; after surgery--15.83 mm. 2. Statistically significant differences were found in the ratio of the surface area of the spinal canal and vertebral body surface area at L4 and L5 between the control group (N) and the operated group before surgery. L4: Reference--19.5%, before surgery--17.7%, after surgery--20.3%. L5: Reference--19.37%, before surgery--14.25%; after surgery--17.93%. 3. Statistically significant differences were found in the ratio of the surface area of the dural sac to the spinal canal surface area at L4 and L5 between the control group (N) and the operated group before surgery. L4: Reference--69.84%, before surgery--51.82%, after surgery--67.36%. L5: Reference--70.31%, before surgery--61.40%; after surgery--69.46%. 1. The ratio of the surface area of the spinal canal to the vertebral body surface area at L4 and L5 after surgery was statistically comparable to the value obtained for a normal spine. 2. The ratio of the surface area of the dural sac to the spinal canal surface area at L4 and L5 after surgery was statistically comparable to the value obtained for a normal spine.
    Ortopedia, traumatologia, rehabilitacja 01/2010; 12(2):120-35.
  • Kazimierz Rapała, Piotr Walczak, Aleksandra Truszczyńska
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    ABSTRACT: INTRODUCTION: Chronic use of steroids in acute lymphoblastic leukemia is a significant supportive therapy. Whereas steroids have adverse effect on vessels leading to avascular osteonecrosis of femur head (ANFH). The aim of the study was to present a ANFH of three young persons diagnosed too late that ended with implantation of total hip arthoplasty (THA). DESCRIPTION OF CASES AND RESULTS: Authors described chemotherapy of acute lymphoblastic leukemia according to established program. The fight for patient's life finished with success, but with side effect--ANFH. It was not diagnosed in an early period, because diagnosis was based only on X-ray of the hips. According to literature pain in the hip accompanying negative X-ray, should be supplemented with MRI, which allows confirmation of oedema of femur head bone marrow. Only early decompression in I degree of ANFH according to ARCO classification may stop a further progress of disease. Pain, impairment of gait, and necrosis covering over 30% of head was an indication for THA. CONCLUSION: THA of hip among young people is allowed when joints are completely destroyed and painful.
    Chirurgia narzadow ruchu i ortopedia polska 01/2010; 75(2):121-5.
  • Kazimierz Rąpała, Piotr Walczak, Aleksandra Truszczyńska
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    ABSTRACT: The authors present the advantages and disadvantages of the Denis and AO classifications based on a review of classical and recent literature concerning the evolution of classification of thoracolumbar spine conditions. The newest classification of fractures proposed by Vaccaro (TLICS - Thoracolumbar Injury Classification Severity Score) is discussed in detail. Special attention is given to instability in these fractures. The principles of modern operative treatment are briefly discussed. Short transpedicular segmental stabilization and immobilization is a commonly accepted approach in unstable fractures with neurological deficits.
    Ortopedia, traumatologia, rehabilitacja. 01/2010; 12(5):385-400.
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    ABSTRACT: Introduction. The problem of lumbar stenosis has been analysed at length in the literature as the number of patients with low back pain of this aetiology continues to increase. The aim of this study was:1. to carry out a prospective study assessing the dimensions of spinal canal on the basis of CT data and to compare patient data with a control group.2. to determine if the sagittal and transverse dimensions and surface area of the spinal canal are sufficiently sensitive and robust measures of spinal canal stenosis at L3, L4 and L5 levels. Material and methods. The investigational group consisted of 176 patients (93 men, 83 women). A total of 528 vertebral levels were evaluated and compared with a control group consisting of 42 persons. Digital CT scans were obtained with a precision of 0.01 mm and 0.01 mm(2). A discriminative function algorithm was used to classify cases according to the level of stenosis.Results. The mean sagittal dimension at L3 was 13.26 mm and the mean transverse dimension was 23.36 mm, with a surface area of 244.39 mm(2). At L4, the mean sagittal dimension was 14.12 mm, the mean transverse dimension was 24.60 mm, and the surface area was 267.70 mm(2). At L5, the mean sagittal dimension was 14.76 mm, the mean transverse dimension was 31.38 mm, and the surface area was 303.99 mm(2). The most important factors influencing the quality of classification were height, width and surface area. Student's t test with a significance level at p=0.05 revealed statistically significant differences. The accuracy of classification in discriminative analysis was 92.66%. Conclusions. The proposed indicators of the sagittal and transverse dimensions and surface area of the spinal canal were useful in assessing quantitative changes with this investigational technique. The sagittal dimension had the greatest sensitivity in the evaluation of stenosis.
    Ortopedia, traumatologia, rehabilitacja 02/2009; 11(1):14-28.
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    ABSTRACT: The study of lumbar spine pathology requires adequate preparation and knowledge of the normal structure of this part of the spine. The main goal of the study was to assess spinal canal morphology with computed tomography. The sagittal and interpedicular dimensions and surface area were considered the most important measurements. An additional goal was to assess the shape of the spinal canal and intervertebral joint angles. Computed tomography was used to assess the lumbar spinal canals of 42 people to an accuracy of 0.01 using a special console for digital analysis. The mean sagittal dimension showed minor differences and ranged from 15.75+/-0.886 at the L3 level to 17.77+/-1.619 at the L5 level. The mean interpedicular dimension was significantly different between the levels, increasing from 24.75+/-2.173 at L3 to 34.57+/-3.332 at L5. Similar results were obtained as regards the mean surface area of the spinal canal. The surface area was 277.2+/-36.15 mm2 at the L3 level, compared to 297+/-9.90 mm2 at L4 and 386.5+/-50.55 mm2 at L5. The spinal canal shape at the L4-L5 level was triangular or trefoil in all 42 patients. No significant differences were found between the angles of right and left intervertebral joints. Our results do not differ from those described in literature. A sagittal dimension over 15 mm, and an interpedicular dimension of more than 25 mm are characteristic of a normal spinal canal. The results constitute reference data for further studies concerning lumbar stenosis.
    Ortopedia, traumatologia, rehabilitacja 01/2009; 11(2):156-63.
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    ABSTRACT: The development of diagnostic imaging facilitates evaluation of spinal anatomy, but there is no full correspondence between morphologic and pathologic changes observed in radiographic studies and clinical findings. The aim of the study was to: 1. Evaluate the degree of signal intensity and degenerative changes of intervertebral discs in the lumbar spine on MRI. 2. Estimate interrater reliability of classification of pathology between experienced and inexperienced medical doctors. The sample consisted of 89 persons aged between 18 and 21 years. MRI scans of the lumbar spine were evaluated by the use of a console for digital analysis by three medical doctors with different levels of experience. Evidence of dehydration of intervertebral disc was found in 3.37%-4.49% at the L4-L5 level, and in 13.48%-15.73% of cases at the L5-S1 level. Interrater reliability ranged from full agreement at levels where degenerative changes are rarely observed to fair and poor agreement at L4-L5 and L5-S1. Intrarater reliability showed full agreement on higher levels to good and very good at l4-l5 and l5-S1 levels. Interrater reliability concerning the degree of degenerative changes was 0.6 for Th12 to L4, but was poor at L4-L5 and L5-S1. Intrarater reliability ranged from full agreement at higher levels to poor at L3-L4-L5 and moderate at L5-S1. 1. Asymptomatic intervertebral disk changes were found in 30% of the study participants. 2. Evaluation of the degree of degenerative changes of intervertebral discs requires specialist training and experience.
    Ortopedia, traumatologia, rehabilitacja. 13(4):343-51.
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    ABSTRACT: Publications concerning the shape of the spinal canal and degenerative changes in the intervertebral joints have not described this issue in full detail to date, especially with regard to the causes of pain syndromes associated with degenerative changes in intervertebral joints. The aim of the study was to assess the shape of the spinal canal and joint surface angles at L3, L4 and L5. The study involved 176 patients with clinical and radiological evidence of spinal canal stenosis confirmed by computed tomography. Morphometric measurements were conducted to a precision of 0.01 degrees . At the level of L4-L5, a triangular spinal canal was found in 66 patients, and a trefoil spinal canal in 71. The results demonstrate that, in the group of 176 patients with spinal canal stenosis, mean differences between right and left angles were 11.37 degrees at the L3 level, 9.40 degrees at the L4 level, and 11.57 degrees at the L5 level. In the control group, mean differences were 2.15 degrees at the L3 level, 2.26 degrees at the L4 level, and 2.98 degrees at the L5 level. Statistically significant differences between the groups were found for p= 0.05 at each level (L3, L4, L5). The level of significance of angular differences at these levels warrants the conclusion that there is joint incongruence that may give rise to degenerative changes. While the most common pathomechanism underlying degenerative changes is vertebral sinking in the course of disc disease and emerging intervertebral instability, abnormal intervertebral angles can also lead to instability that gives rise to degenerative changes.
    Ortopedia, traumatologia, rehabilitacja 11(3):222-32.