{"references": ["Radomska Szko\u0142a Wy\u017csza w Radomiu", "Radom University in Radom", "Annual Reports of Education, Health and Sport 9781329876262", "Edited by", "Iwona Czerwi\u0144ska Pawluk Hanna \u017bukowska Wies\u0142awa Pilewska Mariusz Klimczyk Adam Szulc Walery Zuk\u00f3w", "htti)://ois.ukw.edu.i)l/index.i)hi)/iohs/index", "htti)://ioumal.rsw.edu.i)l", "htti)s://i)bn.nauka.gov.i)l/search?search&searchCategorv=WORK&filter.inJoumal=49068", "htti)s://i)bn.nauka.gov.i)l/search?search&searchCategorv=WORK&filter.inJoumal=36616", "htti)://elibrarv.ru/contents.asi)?titleid=37467", "Open Access", "Radomska Szko\u0142a Wy\u017csza w Radomiu", "Radom University in Radom", "Annual Reports of Education, Health and Sport 9781329876262", "Edited by", "Iwona Czerwi\u0144ska Pawluk Hanna \u017bukowska Wies\u0142awa Pilewska Mariusz Klimczyk Adam Szulc Walery Zuk\u00f3w", "htti)://ois.ukw.edu.i)l/index.i)hi)/iohs/index", "htti)://ioumal.rsw.edu.i)l", "htti)s://i)bn.nauka.gov.i)l/search?search&searchCategorv=WORK&filter.inJoumal=49068", "htti)s://i)bn.nauka.gov.i)l/search?search&searchCategorv=WORK&filter.inJoumal=36616", "htti)://elibrarv.ru/contents.asi)?titleid=37467", "Open Access", "Scientific Council", "pcl rm Ah* ten / IWriUuilVkmdi pet \u043b\u00bb Ah* mcd T \u0441\u041d\u0441\u0438\u0441\u042c\u0433\u043a\u0435 a|>\u00bbi\u00bb\u00ab\u00abhxia it bam \u043e pot \u043b* \u041b h* med V Ed*\u00bb ilbonc-. pt\\4 rm Ah* fee i l*>mki ihdmdi yr\u00abdC \u0433* Ah* med A GwhaAotlboncl pit\tVI\t\u00bfrwdoMkyitibamet", "pit \u043c Abb I \u00ab\u0410\u0443\u0440\u00bb ilbimei pet m AbbimdA GudpMiUnmcipitni Ah* med \u043a OiJy* abmeipot /\u00bb Ah* itW W 1\u042a\u0440\u0438 tfawi prt mAh* med V Mvn itbamci pot mAh* med ft S*d\u00ablkn il Wmci pet mAh* era \u041e C4od\u00ab\u00bbA.)t ilkranei. pit rm A h* eed t SmnanA il bm\u00bbc< pot m Ah* med 1. Shatmilbumcipet m Ah* med I ttm*i\u00bbe.\u0440<4 Ah* Yt N*waie\u00bbWmti pet Ah* M \u0413\u0442\u0430\u0410\u043e(Riimti.pot Ah* \u041a Pfmd tNmti pb A h* VI 7\u00abaAtTVAndi Amed 1 fksAauObines AI U Ibyi, ilVtmis A M rvnbtiaihdmdt A med M \u041b\u0442\u0442\u0443\u043f\u0410\u0430-\u0435\u042b\u0430 ifaimdi doc A\u00ab med V <1mm>ifbme\u00bb. Amd \u041a C>wmAilW*ds A med I C'nan&t hr*Yd slSdmdi A bod. & Delon*\u00bb ilbaaacs A md M Dtternmewnb ihdmdi A med M Ihpier-Dcra*-*\"** iNmli, A med \u041a bAeqrwAa iPdaoti A med I' K/umauA iMmtii A med \u043a \u041a\u043a\u0430* sPrlmti A1. Kwm* doc A A YLdn (Ibmti, AT. X* tlbami \u0410 \u041f MedK\u00bbH/ iPdmdL A md L DeUtMmdi", "Editorial Board", "St rim Admit* lYUobas Pmd iwid iSh\u00bb*uc \u041f\u043e\u00bb fend km lleem; \u2022 IVdmdt Akdmmr/ ftAm llSdmdX Iomm FrrAmki iTVdmdi Aiili Gdmni i)h*\u00abt*0 > I** Or)*\u00bb I lb mm i lldm \u0418\u00ab!\u00bb\u043a*\u0438\u043c\u00bb*| iTVdmdi IV-\u00ab11/d**. .Mmdi Sen. Immb* dbtmti TM>mil\u00abfm*lm \\W \u043c\u043b ifelmd! \u041b\u0435\u043c Sdt/tk \u2022 |4d*d>. Votl \u0427*\u0438\u042b| iPtdmd>.", ")ei) Nomci* iWda4>. Pw* \u043f\u042b\u043f\u0433\u0430\u0447\u0433 >PUmdt lAbAdsn Padcnh iMmdi *\u043a*\u0442\u0447 Pdmdj\u00bb ifcdmdc l**n ttod**\u00ab lOech \u042f\u0444\u0435\u042b\u043ak KmvM ftm* ilVdmdi kmwvd\u042b. \u041c\u043e\u0435\u043c Zemde cPodmdt Temmu 7\u00abAera*)e ilbmmi Wdef> Mm (bdmdl llmi Mm*a iPoimdi", "Ad\\i>or> Board", "tfwmi hdotdkilsdnli Wn |in*m itbmiri LMrldtbiMh lhem)i kermmrr Dm* ilsbndx Ylrmdm DodiAdbimei Kool tkemr iM\u00ab\u00bb*u>. Kwmet kathmmK/ tfldmiA, )ao koermc/ tiNdmdi Vmidm Komi* ilsdmdi \u0413 We.mj Mnned tPtdendc Yfabdv S.*u> ilbmx \u25a0 )\u0432\u043b \u0420\u043e\u0443\u044f*-I'.iWi Fipmaer h)*pe (Ibmi Riferl S/*blt iMmdv JAr IWhme iCMh KpcAbi", "Reviewers:", "pod rm Ah* fra 7- H*\u00abkdkiiMmdi km I'aedlY IbuHmdAoMk M\u00abD \u00bb ilbmnecpit m Ah* med W thpw (Pctmdipet m Ah* med 1 KarmrKtmti pst m Ah* med M kmie* ilknme.. pit m Ah* mnl Y Lmamk^ itbemrt pr*w( \u00ab\u0442\u043c\u0438 I ia* Marolnal tyobnMomrvofir Valy* *e*fi>1i \u00abamdaih W", "Ibhlhhlnj; llnuw; Radomska Sokoli Wy km n Radomiu. Radom I n\u0142trrdty In Radean Sir /.uhr/y cilrfo 2 24 tM Rjdom lei; *4* W JW 46 tt? imd orra idu, ul I\u2019rlnflnc llouw: Rjdomtiji SrLob Wy\u017csza n Kadoentai. Radem I nhmth In Radem Mr. /abrryeilet* 2 24-441 Radom Irl: \u00bbO iH 38J 6d 05 net* \u0432rm edaol", "ISBN 9781329876262", "Liczba znak\u00f3w: 716 000 (ze streszczeniami i ok\u0142adk\u0105). liczba grafik: 84 x 1 000 znak\u00f3w (rycza\u0142t) = 84 000 znak\u00f3w. Razem: Liczba znak\u00f3w: 800 000 (ze streszczeniami, ok\u0142adk\u0105 i grafikami) = 20,0 arkuszy wydawniczych.", "Number of characters: 716 000 (with abstracts). Number of images: 84 x 1000 characters (lump sum) = 84 000 characters. Total: Number of characters: 800 000 (with abstracts, summaries and graphics) = 20,0 sheet publications.", "DOI http://dx.doi.org/10.5281/zenodo.45634", "Content:", "Introduction\t5", "Miko\u0142ajewska Emilia. Incidence of neurogenic heterotopic ossifications in patients with neurological deficits = Wyst\u0119powanie neurogennych skostnie\u0144 oko\u0142ostawowych u pacjent\u00f3w neurologicznych, [in] Czerwi\u0144ska Pawluk Iwona Ed., \u017bukowska Hanna Ed., Pilewska Wies\u0142awa Ed., Klimczyk Mariusz Ed., Szulc Adam Ed., Zuk\u00f3w Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 7-14. ISBN 9781329876262. 304 p. \u00a9 The Author(s) 2013. This articles is published with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland.", "Miko\u0142ajewska Emilia. Use of orthopedic equipment in post-stroke patients as the element of rehabilitation = Wykorzystanie zaopatrzenia ortopedycznego w ramach rehabilitacji u pacjent\u00f3w po udarze m\u00f3zgu, [in] Czerwi\u0144ska Pawluk Iwona Ed., \u017bukowska Hanna Ed., Pilewska Wies\u0142awa Ed., Klimczyk Mariusz Ed., Szulc Adam Ed., Zuk\u00f3w Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013.15-22. ISBN 9781329876002. 304 p. \u00a9 The Author(s) 2013. This articles is published with Open Access at Annual Reports of Education, Health and Sport 9781329876002 of Kazimierz Wielki University in Bydgoszcz, Poland.", "Miko\u0142ajewska Emilia. Neurorehabilitation in pediatric stroke = Udar m\u00f3zgu u dzieci - post\u0119powanie w rehabilitacji neurologicznej, [in] Czerwi\u0144ska Pawluk Iwona Ed., \u017bukowska Hanna Ed., Pilewska Wies\u0142awa Ed., Klimczyk Mariusz Ed., Szulc Adam Ed., Zuk\u00f3w Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 23-31. ISBN 9781329876002. 304 p. \u00a9 The Author(s) 2013. This articles is published with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland.", "Gozhenko Anatoliy, Zuk\u00f3w Walery. Essays on the theory of disease, [in] Czerwi\u0144ska Pawluk Iwona Ed., \u017bukowska Hanna Ed., Pilewska Wies\u0142awa Ed., Klimczyk Mariusz Ed., Szulc Adam Ed., Zuk\u00f3w Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 32-50. ISBN 9781329876002. 304 p. \u00a9 The Author(s) 2013. This articles is published with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland.", "Samosiuk IZ, Chukhraeva EM, Samosiuk NI, Zukow W. Low-intensity physical factors in the treatment of and medical rehabilitation of patients with type 2 diabetes and their effects on lipid metabolism [in] Czerwi\u0144ska Pawluk Iwona Ed., \u017bukowska Hanna Ed., Pilewska Wies\u0142awa Ed., Klimczyk Mariusz Ed., Szulc Adam Ed., Zukow Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 51-60. ISBN 9781329876002. 304 p. \u00a9 The Author(s) 2013. This articles is published with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland.", "Miko\u0142ajewska Emilia, Miko\u0142ajewski Dariusz. Computational approach to neural plasticity of nervous system on system level = Podej\u015bcie obliczeniowe do neuroplastyczno\u015bci uk\u0142adu nerwowego na poziomie systemowym, [in] Czerwi\u0144ska Pawluk Iwona Ed., \u017bukowska Hanna Ed., Pilewska Wies\u0142awa Ed., Klimczyk Mariusz Ed., Szulc Adam Ed., Zukow Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 61-68. ISBN 9781329876002. 304 p. \u00a9 The Author(s) 2013. This articles is published with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland.", "Paprocki Micha\u0142, Piekut-Kaluba Katarzyna, Hagner-Derengowska Magdalena, Zukow Walery. Frequency of appearing of side distortions of the spine at students of studies postgraduate of direction physiotherapy exercises = Cz\u0119sto\u015b\u0107 wyst\u0119powania bocznych skrzywie\u0144 kr\u0119gos\u0142upa u student\u00f3w studi\u00f3w podyplomowych kierunku gimnastyka korekcyjna, [in] Czerwi\u0144ska Pawluk Iwona Ed., \u017bukowska Hanna Ed., Pilewska Wies\u0142awa Ed., Klimczyk Mariusz Ed., Szulc Adam Ed., Zukow Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 69-92. ISBN 9781329876002. 304 p. \u00a9 The Author(s) 2013. This articles is published with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland.", "Warmi\u0144ska Magdalena, \u0141oboda Dorota The physical activity and correct feeding elements a healthy lifestyle of chosen occupational groups = Aktywno\u015b\u0107 fizyczna i prawid\u0142owe \u017cywienie elementami zdrowego stylu \u017cycia wybranych grup zawodowych, [in] Czerwi\u0144ska Pawluk Iwona Ed., \u017bukowska Hanna Ed., Pilewska Wies\u0142awa Ed., Klimczyk Mariusz Ed., Szulc Adam Ed., Zukow Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 93-105. ISBN 9781329876262. 304 p. \u00a9 The Author(s) 2013. This articles is published with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland.", "Dolomatov SI, Zukow W, Atmazhov ID, Muszkieta R, Skaliy A. The use of biochemical indicators in human saliva for diagnostics periodontitis during pregnancy, [in] Czerwi\u0144ska Pawluk Iwona Ed., \u017bukowska Hanna Ed., Pilewska Wies\u0142awa Ed., Klimczyk Mariusz Ed., Szulc Adam Ed., Zukow Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 106-119. ISBN 9781329876262. 304 p. \u00a9 The Author(s) 2013. This articles is published with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland.", "Eksterowicz Jerzy, Napiera\u0142a Marek, Zukow Walery. Evaluation of the volume of consumption of chosen nutritients during training grouping together students from direction physical education = Ocena wielko\u015bci spo\u017cycia wybranych sk\u0142adnik\u00f3w od\u017cywczych podczas zgrupowania szkoleniowego student\u00f3w z kierunku wychowanie fizyczne, [in] Czerwi\u0144ska Pawluk Iwona Ed., \u017bukowska Hanna Ed., Pilewska Wies\u0142awa Ed., Klimczyk Mariusz Ed., Szulc Adam Ed., Zukow Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 120-131. ISBN 9781329876262. 304 p. \u00a9 The Author(s) 2013. This articles is published with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland.", "Makarewicz Ma\u0142gorzta, Dro\u017cd\u017c Iwona, Tuszy\u0144ski Tadeusz. The Effect of Some Bee Products on Microbiological Stability of Fresh Fruit Juices, [in] Czerwi\u0144ska Pawluk Iwona Ed., \u017bukowska Hanna Ed., Pilewska Wies\u0142awa Ed., Klimczyk Mariusz Ed., Szulc Adam Ed., Zukow Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 132-146. ISBN 9781329876262. 304 p. \u00a9 The Author(s) 2013. This articles is published with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland.", "Kalisz Karolina, Kalisz Zdzis\u0142awa, Hagner-Derengowska Magdalena, Zukow Walery, Trela Ewa. Assessment of balance in patients after stroke based on some scales and tests = Ocena r\u00f3wnowagi u pacjent\u00f3w po przebytym udarze m\u00f3zgu na podstawie wybranych skal i test\u00f3w, [in] Czerwi\u0144ska Pawluk Iwona Ed., \u017bukowska Hanna Ed., Pilewska Wies\u0142awa Ed., Klimczyk Mariusz Ed., Szulc Adam Ed., Zukow Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 147-180. ISBN 9781329876262. 304 p. \u00a9 The Author(s) 2013. This articles is published with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland.", "Dylewski Micha\u0142, Hagner-Derengowska Magdalena, Dylewska Monika, Zukow Walery, Hagner Wojciech. Possibilities of proprioceptive assessment in neurological patients using ZEBRIS system [in] Czerwi\u0144ska Pawluk Iwona Ed., \u017bukowska Hanna Ed., Pilewska Wies\u0142awa Ed., Klimczyk Mariusz Ed., Szulc Adam Ed., Zukow Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 181-190. ISBN 9781329876262. 304 p. \u00a9 The Author(s) 2013. This articles is published with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland.", "Babov KD, Gozhenko EA, Starchevskaya TV, Zukow W. To question about mechanism of action of ozone baths in patients with arterial hypertension = \u041a \u0432\u043e\u043f\u0440\u043e\u0441\u0443 \u043e \u043c\u0435\u0445\u0430\u043d\u0438\u0437\u043c\u0435 \u0434\u0435\u0439\u0441\u0442\u0432\u0438\u044f \u043e\u0437\u043e\u043d\u043e\u0432\u044b\u0445 \u0432\u0430\u043d\u043d \u0443 \u043f\u0430\u0446\u0438\u0435\u043d\u0442\u043e\u0432 \u0441 \u0430\u0440\u0442\u0435\u0440\u0438\u0430\u043b\u044c\u043d\u043e\u0439 \u0433\u0438\u043f\u0435\u0440\u0442\u0435\u043d\u0437\u0438\u0435\u0439, [in] Czerwi\u0144ska Pawluk Iwona Ed., \u017bukowska Hanna Ed., Pilewska Wies\u0142awa Ed., Himczyk Mariusz Ed., Szulc Adam Ed., Zukow Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 191-202. ISBN 9781329876262. 304 p. \u00a9 The Author(s) 2013. This articles is pubUshed with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland.", "Piechocka Anna, Trela Ewa, Nalazek Anna, Zukow Walery. Assessment of the effectiveness of the methods used in pain treatment dinic = Ocena skuteczno\u015bci metod stosowanych w poradni leczenia b\u00f3lu. [in] Czerwi\u0144ska Pawluk Iwona Ed., \u017bukowska Hanna Ed., PUewska Wies\u0142awa Ed., Klimczyk Mariusz Ed., Szulc Adam Ed., Zukow Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 203-223. ISBN 9781329876262. 304 p. \u00a9 The Author(s) 2013. This articles is pubUshed with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland.", "Lewandowska Magdalena, Trela Ewa, Nalazek Anna, Zukow Walery. Evaluation of nursing care among patients undergoing surgery for lumbar disc herniation cervical = Ocena opieki piel\u0119gniarskiej w\u015br\u00f3d pacjent\u00f3w operowanych z powodu dyskopatii szyjnej, [in] Czerwi\u0144ska Pawluk Iwona Ed., \u017bukowska Hanna Ed., PUewska Wies\u0142awa Ed., Himczyk Mariusz Ed., Szulc Adam Ed., Zukow Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 224-249. ISBN 9781329876262. 304 p. \u00a9 The Author(s) 2013. This articles is pubUshed with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland.", "Flegontova Veronica, Sheiko VitalU, Morfuntsov Vladimir, Yakovleva Ekaterina, Lvov Aleksandr. Immunologiczne i metaboUczne prze\u0142omy u zawodnik\u00f3w, uprawiaj\u0105cych zapasy Grecko-Rzymskie = Immune and metaboUc shifts in sportsmen going in for Greco-Roman wrestUng. [in] Czerwi\u0144ska Pawluk Iwona Ed., \u017bukowska Hanna Ed., PUewska Wies\u0142awa Ed., Himczyk Mariusz Ed., Szulc Adam Ed., Zukow Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 250-263. ISBN 9781329876262. 304 p. \u00a9 The Author(s) 2013. This articles is pubUshed with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland.", "StebUuk V., Podolsky A. Hemodynamic effects of audio-visual stimulation in the treatment for patients with arterial hypertension on the background of the syndrome of psycho-emotional stress, [in] Czerwi\u0144ska Pawluk Iwona Ed., \u017bukowska Hanna Ed., Pilewska Wies\u0142awa Ed., Himczyk Mariusz Ed., Szulc Adam Ed., Zukow Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 264-269. ISBN 9781329876262. 304 p. \u00a9 The Author(s) 2013. This articles is pubUshed with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland.", "K\u0119dziora Przemys\u0142aw, Lizis Pawe\u0142, Znojek-Tymborowska Justyna, Hagner-Derengowska Magdalena, Szczygielska-Babiuch Anna. Wp\u0142yw aktywnej rehabiUtacji na sprawno\u015b\u0107 samoobs\u0142ugi i lokomocji os\u00f3b po urazie rdzenia kr\u0119gowego = Influence of active rehabiUtation for self\u00acservice and locomotion efficiency at peoples past spinal cord injury, [in] Czerwi\u0144ska Pawluk Iwona Ed., \u017bukowska Hanna Ed., PUewska Wies\u0142awa Ed., Himczyk Mariusz Ed., Szulc Adam Ed., Zukow Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 270-282. ISBN 9781329876262. 304 p. \u00a9 The Author(s) 2013. This articles is pubUshed with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland.", "Novikov N., Tumansky V.A. \u0417\u0430\u043a\u043e\u043d\u043e\u043c\u0435\u0440\u043d\u043e\u0441\u0442\u0438 \u043f\u043e\u0432\u0440\u0435\u0436\u0434\u0435\u043d\u0438\u044f \u0438 \u0440\u0435\u043f\u0430\u0440\u0430\u0446\u0438\u0438 \u0441\u0442\u0440\u0443\u043a\u0442\u0443\u0440 \u0430\u044d\u0440\u043e\u0433\u0435\u043c\u0430\u0442\u0438\u0447\u0435\u0441\u043a\u043e\u0433\u043e \u0431\u0430\u0440\u044c\u0435\u0440\u0430 \u043f\u0440\u0438 \u043e\u0441\u0442\u0440\u043e\u043c \u0440\u0435\u0441\u043f\u0438\u0440\u0430\u0442\u043e\u0440\u043d\u043e\u043c \u0434\u0438\u0441\u0442\u0440\u0435\u0441\u0441-\u0441\u0438\u043d\u0434\u0440\u043e\u043c\u0435 = Injury and repair structures of air-blood barrier in acute respiratory distress syndrome, [in] Czerwi\u0144ska Pawluk Iwona Ed., \u017bukowska Hanna Ed., Pilewska Wies\u0142awa Ed., Himczyk Mariusz Ed., Szulc Adam Ed., Zukow Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 283-300. ISBN 9781329876262. 304 p. \u00a9 The Author(s) 2013. This articles is pubUshed with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland.", "Introduction", "We hope that a varied program of the Annual Reports of Education, Health and Sport", "will answer your expectations. We believe that the Annual Reports of Education, Health and Sport will contribute to raising the knowledge, skills and abilities of doctors, therapists, physiotherapists, nurses, psychologists, biologists, researchers, practitioners and health workers interested in rehabilitation, physiotherapy, tourism and recreation.", "Annual Reports of Education, Health and Sport, corresponding to the modem challenges of global health specialists collect articles from those areas of the leading centers of renowned foreign and domestic. Many of them present state of art in their field. This will be particularly valuable for young doctors in the specialization, and students.", "Welcome to familiarize yourself with this issue all relevant hazards and health, life and safety at work in tourism, recreation, rehabilitation, physiotherapy, nursing organization to work safely and missions in these conditions, the influence of environmental conditions on public health.", "Authors from abroad and the country will present an overview of contemporary challenges and solutions in these areas. The issue concerns the text of the wider work for human health, tourism, recreation, physiotherapy, nursing, wellness and rehabilitation, including the economics of health care.", "\u00a9 The Author(s) 2013.", "This articles is published with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland Open Access This articles is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.", "CE>", "Keywords: rehabilitation; neurorehabilitation; neurogenic heterotopic ossifications; quality of life.", "Abstract", "Aim: Neurogenic heterotopic ossifications (HO) are perceived rare, but important factor influencing both therapy\u2019 effectiveness and life quality of patients with neurological deficits.", "Material and Methods: One hundred patients with neurological deficits were assessed in the area of neurogenic heterotopic ossifications.", "Results: Number of patients with diagnosed neurogenic heterotopic ossifications were as follows:", "\u2022\t 3,33% in patents with spine cord injury (SCI),", "\u2022\t 4,29% in patients with traumatic brain injury (TBI).", "Conclusion: Despite neurogenic heterotopic ossifications seem be rare, ways of HO therapy and rehabilitation need for further research due to rather poor evidence provided so far.", "S\u0142owa kluczowe:\trehabilitacja;\trehabilitacja\tneurologiczna;\tneurogenne skostnienia", "oko\u0142ostawowe; jako\u015b\u0107 \u017cycia; Streszczenie", "Cel: Neurogenne skostnienia oko\u0142ostawowe s\u0105 rzadkim, lecz wa\u017cnym czynnikiem wp\u0142ywaj\u0105cym na efektywno\u015b\u0107 leczenia oraz jako\u015b\u0107 \u017cycia pacjent\u00f3w z deficytami neurologicznymi.", "Materia\u0142 i Metody: Stu pacjent\u00f3w z deficytami neurologicznymi zosta\u0142o zdiagnozowanych na obecno\u015b\u0107 neurogennych skostnie\u0144 oko\u0142ostawowych.", "Wyniki: Liczba pacjent\u00f3w ze zdiagnozowanymi neurogennymi skostnieniami oko\u0142ostawowymi wynios\u0142a:", "\u2022\t 3,33% w\u015br\u00f3d pacjent\u00f3w z uszkodzeniem rdzenia kr\u0119gowego,", "\u2022\t 4,29% w\u015br\u00f3d pacjent\u00f3w z traumatycznym uszkodzeniem m\u00f3zgu.", "Wnioski: Neurogenne skostnienia oko\u0142ostawowe wyst\u0119puj\u0105 rzadko, niemniej jednak sposoby ich leczenia i rehabilitacji wymagaj\u0105 dalszych bada\u0144 ze wzgl\u0119du na dotychczasowe ubogie dowody naukowe.", "1.\tIntroduction", "Heterotopic ossifications (HO) are defined as the abnormal formation of bone in soft tissues. Neurogenic HO are defined as \u201cformation of extra osseous bone in soft tissue surrounding peripheral joints in neurological patients\u201d [1]. Etiology of heterotopic ossification is often derived from pathological process initiated by traumatization of soft tissue. Concept of La Paz et al. joins HO in patients with central nervous system (CNS) deficits with dysfunction of proprioception [1]. Generally HO can be classified into:", "\u2022\t acquired forms - with not fully understood pathogenesis, observed with SCI, TBI, musculo\u00acskeletal trauma or injuries associated with burns,", "\u2022\t congenital forms [2, 3, 4, 5].", "Severe forms of HO can lead to severe disability, influencing patients function and quality of life. Because of it key aspects of HO treatment are:", "\u00b0 prevention,", "\u00b0 diagnosis, usually based on bone scintigraphy and/or other medical imaging techniques,", "\u00b0 therapy, usually local radiotherapy, nonsteroidal anti-inflammatory drugs, and surgical interventions [2, 3, 4, 5].", "\u00b0 possibilities of rehabilitation.", "PubMed (U.S. National Library of Health) database [6] was searched to identify relevant papers, significant evidences and directions of current research within heterotopic ossifications in neurological patients. Figure 1 shows the frequency of specified key words combinations.", "number of articles", "6 745\t3 088", "i 1 l l", "Frequency of specified key words", "6", "I 1 c", "\u25a1 c", "n_", "heterotopic\theterotopic\theterotopic\theterotopic\theterotopic\theterotopic\theterotopic\theterotopic\theterotopic\tneurogenic\tkey", "ossification\tossification\tossification\tossification\tossification\tossification\tossification\tossification\tossification\theterotopic\twords", "+ surgery\t+\t+\t+\tneurology\t+\tnursing\t+\tSCI\t+\tTBI\t+\tstroke\tossification", "rehabilitation physiotherapy", "0", "Fig. 1. Results of authors' investigation of the PubMed database (U.S. National Library of", "Medicine) [6].", "number\tNumber of articles with specified keywords depend on article type", "of articles\tTotal number of articles with keywords \u201cheterotopic ossifications\u201d + \u201cspine cord injury (SCI)\u201d: 55 |_ I", "Total number of articles with keywords \u201cheterotopic ossifications\u201d + \u201ctraumatic brain injury (TBI)\u201d: 25 |\t|", "Total number of articles with keywords \u201cheterotopic ossifications\u201d + \u201cstroke\u201d: 19", "15-", "review comparative clinical randomized letter study trial controlled trial", "Lack of:", "-\t historical articles,", "-\t editorials,", "-\t meta-analyses,", "-\t practical guidelines.", "article type", "2 12", "Fig. 2. Results of authors' investigation of the PubMed database (U.S. National Library of", "Medicine) [6].", "Aim of this study was to evaluate incidence of the neurogenic heterotopic ossifications in neurological patients.", "2.\tMaterial and Methods", "Investigated group consisted of one hundred neurological patients. The patients\u2019 profiles are presented in Table 1. Inclusion criteria were as follows:", ">\t age above 18 years,", ">\t diagnosis: Spine Cord Injury (SCI), Traumatic Brain Injury (TBI), stroke.", ">\t time after accident: since 4 weeks to 2 years.", "Inclusion of each patients was confirmed by medical records. Size and anatomical involvement of infarct varied depend on the patient.", "Table 1. Patients\u2019 overall profile.", "Number and percentage", "Kind of accident:", "Spine Cord Injury (SCI)\t30 (30 %)", "Traumatic Brain Injury (TBI)\t70 (70 %)", "Stroke\tNone", "Age [years]:", "Min\t33", "Max\t82", "SD\t13,22", "Mean\t59,92", "Median\t58", "Time after accident:", "4 weeks - 2 years\t100(100%)", "The results, where available, are expressed as mean, median, minimal value (min), maximal value (max) and standard deviation (SD). Statistical analysis of data was performed using the Statistica Software. A probability (p) value < 0.05 was considered as statistically significant.", "3.\tResults", "Results among 100 patients (100 %) involved in the study were as follows:", "Table 1. Results for whole group of patients", "Number of patients with diagnosed neurogenic heterotopic ossifications", "SCI\t1 (3,33%)", "TBI\t3 (4,29%)", "4.\tDiscussion", "Eleven articles in the area of neurogenic heterotopic ossifications were published since 1962 to 2012. Only seven of them can be perceived actual (were published within last ten years). The most actual clinical trial of Seipel et al. [7] showed:", "\u2022\t prevalence rate of neurogenic heterotopic ossification as 2,05%,", "\u2022\t increased risk factors in young male adults,", "\u2022\t most common site: hip,", "\u2022\t two or more ossifications: in 56,7% of patients, most of them with bilateral symmetric involvement of corresponding joint regions,", "\u2022\t size of ossifications: varied,", "\u2022\t progression in size: smaller in the case of small lesions [7].", "Article of da Paz et al. reports prevalence rate of neurogenic heterotopic ossification in patients with SCI as 25%, in 20% of these causing limitations in joint motion [1].", "More trials are provided generally in the area of heterotopic ossifications. In patients with SCI randomized controlled trials provide rather poor evidence in:", "\u2022\t HO prophylaxis using pulse low-intensity electromagnetic field [8],", "\u2022\t HO prevention with COX-2 selective inhibitor (rofecoxib) [9],", "\u2022\t HO prevention with indometacin [10].", "One of the most important reviews seems be comparison of HO treatment in patients with TBI and SCI provided by Aubut et al. [11]. Four databases (MEDLINE/Pubmed, CINAHL, EMBASE,", "11", "PsycINFO) were searched. Despite only 26 papers met inclusion criteria, this review provided significant view of treatment effectivity:", "\u00b0 in patients with TBI: surgical intervention as most effective treatment, lack of evidences in pharmacological prevention and treatment,", "\u00b0 in patients with SCI:", "\u25a0\t pharmacological treatments including bisphosphonates (most effective treatment), non\u00acsteroidal anti-inflammatory drugs - NSAIDs (most effective prevention), and Warfarin,", "\u25a0\t non-pharmacological treatments including pulse low-intensity electromagnetic field therapy, surgical excision, and radiotherapy [11].", "According to aforementioned review use of pulse low intensity electromagnetic field therapy is promised, but there is lack of follow up data. This can be significant guideline towards further research in the area of HO. Similar review of almost the same research group [12] concerning prevention and treatment of HO in patients with SCI provided the same results.", "There is a few articles concerning HO in post-stroke patients. HO are rather rare. Twelve cases studies cannot substitute for clinical trials or general reviews of studies. This lack of studies seem be very important, because significant stroke-survivors, including hemiplegic, need reliable and valid therapeutic approach [13].", "There is a few publications to compare my findings. Most of them concern therapy and rehabilitation in patients with diagnosed HO. My outcomes are similar to results of Seipel et al. [7].", "5.\tConclusion", "To summarize: neurogenic heterotopic ossifications seem be rare, but important factor influencing both therapy\u2019 effectiveness and life quality of patients with neurological deficits, especially SCI and TBI. Ways of HO therapy and rehabilitation need for further research due to rather poor evidence provided so far.", "Open Access", "This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.", "References", "1.\t da Paz A. C., Carod Artal F. J., Kalil R. K. The function of proprioceptors in bone organization: a possible explanation for neurogenic heterotopic ossification in patients with neurological damage. Med Hypotheses. 2007; 68(1): 67-73.", "2.\t Kiwerski J. E. Neurogenne skostnienia oko\u0142ostawowe [Neurogenic periarticular ossification (article in Polish)]. Balneol Pol 2008; 50(4): 283-287.", "3.\t Miko\u0142ajewska E. Skostnienia oko\u0142ostawowe - terapia kompleksowa: opis przypadku [Heterotopic ossifacations - complex therapy: case study (article in Polish)]. Praktyczna Fizjoterapia i Rehabilitacja 2012; 25: 50-53.", "4.\t Miko\u0142ajewska E. Skostnienia oko\u0142ostawowe u os\u00f3b po urazie czaszkowo-m\u00f3zgowym: mo\u017cliwo\u015bci terapii [Heterotopic ossifications in patients after craniocerebral trauma: possibilities of the treatment (article in Polish)]. Praktyczna Fizjoterapia i Rehabilitacja 2011; 19: 48-49.", "5.\t Gautschi O. P., Cadosch D., Bauer S., Filgueira L., Zellweger R. Heterotopic ossification - from the aetiology to the current management (article in German). Einfallchirurg. 2008; 111(7): 523-534.", "6.\t MEDLINE/PubMed (U.S. National Library of Medicine) http://www.ncbi.nlm.noh.gov/pubmed - access 13.03.2012.", "7.\t Seipel R., Langner S., Platz T., Lippa M., Kuehn J. P., Hosten N. Neurogenic heterotopic ossification: epidemiology and morphology on conventional radiographs in an early neurological rehabilitation population. Skeletal Radiol. 2012; 41(1): 61-66.", "8.\t Durovic A., Miljkovic D., Brdareski Z., Plavsic A., Jevtic M. Pulse low-intensity electromagnetic field as prophylaxis of heterotopic ossification in patients with traumatic spinal cord injury. VojnosanitPregl. 2009; 66(1): 22-28.", "9.\t Banovac K., Williams J. M., Patrick L. D., Levi A. Prevention of heterotopic ossification after spinal cord injury with COX-2 selective inhibitor (rofecoxib). Spinal Cord. 2004; 42(12): 707-710.", "10.\t Banovac K., Williams J. M., Patrick L. D., Haniff Y. M. Prevention of heterotopic ossification after spinal cord injury with indomethacin. Spinal Cord. 2001; 39(7): 370-374.", "11.\t Aubut J. A., Mehta S., Cullen N., Teasell R. W. A comparison of heterotopic ossification treatment within the traumatic brain and spinal cord injured population: An evidence based systematic review. NeuroRehabilitation. 2011; 28(2): 151-160.", "12.\t Teasell R. W., Mehta S., Aubut J. L. A systematic review of the therapeutic interventions for heterotopic ossification after spinal cord injury. Spinal Cord. 2010; 48(7): 512-521.", "13.\tGardner M. J., Ong B. C., Liporace F., Koval K. J. Orthopedic issues after cerebrovascular accident. Am J Orthop (Belle Mead NJ). 2002; 31(10): 559-568.", "This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.Org/licenses/by-nc/3.0/) which permits unrestricted, non- commercial use, distribution and reproduction in any medium, provided the work is properly cited.", "Miko\u0142ajewska Emilia. Use of orthopedic equipment in post-stroke patients as the element of rehabilitation = Wykorzystanie zaopatrzenia ortopedycznego w ramach rehabilitacji u pacjent\u00f3w po udarze m\u00f3zgu, [in] Czerwi\u0144ska Pawluk Iwona Ed., \u017bukowska Hanna Ed., Pilewska Wies\u0142awa Ed., Klimczyk Mariusz Ed., Szulc Adam Ed., Zuk\u00f3w Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013.15-22. ISBN 9781329876002. 304 p. \u00a9 The Author(s) 2013. This articles is published with Open Access at Annual Reports of Education, Health and Sport 9781329876002 of Kazimierz Wielki University in Bydgoszcz, Poland.", "Original Text published \u00a9 The Author (s) 2012. Miko\u0142ajewska Emilia. Use of orthopedic equipment in post-stroke patients as the element of rehabilitation = Wykorzystanie zaopatrzenia ortopedycznego w ramach rehabilitacji u pacjent\u00f3w po udarze m\u00f3zgu. Journal of Health Sciences. 2012;2(3):15-22. ISSN 1429-9623 / 2300-665X. Open Access Open Journal Systems of Radom University in Radom, Poland ISSN 1429-9623 / 2300-665X. 2012.", "USE OF ORTHOPEDIC EQUIPMENT IN POST-STROKE PATIENTS AS THE ELEMENT OF REHABILITATION", "Wykorzystanie zaopatrzenia ortopedycznego w ramach rehabilitacji u pacjent\u00f3w po udarze m\u00f3zgu", "Emilia Miko\u0142ajewska Rehabilitation Clinic, The 10th Clinical Military Hospital with Policlinic, Bydgoszcz, Poland", "\u00a9 The Author(s) 2012;", "This article is published with open access at Licensee Open Journal Systems of Radom University in Radom, Poland", "Corresponding Authors:", "Emilia Miko\u0142ajewska Rehabilitation Clinic,", "The 10th Clinical Military Hospital with Policlinic,", "Bydgoszcz, Poland", "E-mail: ", "Keywords: rehabilitation; ischemic stroke; assistive technology; orthopedic equipment; activities of daily living; quality of life.", "Abstract", "Aim: Orthopedic equipment is perceived improving all dimensions of quality of life: functional, psychological and social decreased as a result of stroke. Aim of this study was to evaluate of use of the most common orthopedic equipment in post-stroke patients.", "Material and Methods: Study involved twenty post-stroke patients. Assessment was performed in each patient based on the factual orthopedic equipment use.", "Results: Among post-stroke patients involved in the study 85% used orthopedic equipment at discharge. Only 3 patients (15%) were independent.", "Discussion: Orthopedic equipment seems significantly improve ADLs limitations and increase resulting independence, life quality, and effectivity of rehabilitation of stroke survivors. There is need for further studies in the area of orthopedic equipment use in post-stroke patients.", "S\u0142owa kluczowe: rehabilitacja; udar niedokrwienny; technologia wspomagaj\u0105ca; zaopatrzenie ortopedyczne; czynno\u015bci codziennego \u017cycia; jako\u015b\u0107 \u017cycia.", "Streszczenie", "Cel: Zaopatrzenie ortopedyczne mo\u017ce oddzia\u0142ywa\u0107 korzystnie na wszystkie wymiary jako\u015bci \u017cycia: funkcjonalny, psychiczny i spo\u0142eczny. Celem niniejszego badania by\u0142o okre\u015blenie przedmiot\u00f3w zaopatrzenia ortopedycznego najcz\u0119\u015bciej u\u017cywanych przez pacjent\u00f3w po udarze.", "Materia\u0142 i Metody: W badaniu wzi\u0119\u0142o udzia\u0142 dwudziestu pacjent\u00f3w po udarze. Ocena zosta\u0142a dokonana ka\u017cdorazowo na podstawie faktycznego u\u017cycia przedmiot\u00f3w\tzaopatrzenia", "ortopedycznego.", "Wyniki:\tW badanej grupie 85% pacjent\u00f3w wykorzystywa\u0142o przedmioty\tzaopatrzenia", "ortopedycznego przy wypisie z oddzia\u0142u rehabilitacyjnego. Jedynie 15% pacjent\u00f3w\tpo udarze nie", "potrzebowa\u0142o ich.", "Dyskusja: Zaopatrzenie ortopedyczne mo\u017ce znacz\u0105co poprawi\u0107 samodzielno\u015b\u0107, jako\u015b\u0107 \u017cycia oraz efektywno\u015b\u0107 rehabilitacji pacjent\u00f3w po udarze, znosz\u0105c lub zmniejszaj\u0105c\tograniczenia", "w wykonywaniu czynno\u015bci \u017cycia codziennego. Istnieje potrzeba dalszych bada\u0144 w tym zakresie.", "Introduction", "According to current knowledge total number of strokes in Poland exceeds 70 000 per year. As a result:", "-\t approximately 50 % of post-stroke survivors have limited independence - most of them need help in activities of daily living (ADLs) [1-7],", "-\t at least 22 % stroke survivors walks only with help of other people [8],", "-\t at least 26 % stroke survivors is dependent on other people in ADLs [8],", "-\t the most common functional limitations affect the most basic activities: bathing, dressing, housekeeping, mobility and communication abilities [9, 10].", "This situation significantly influences both independence and life quality of stroke survivors. Every attempt aiming at improve situation of post-stroke patients and their families/caregivers seem be precious. One of possible solutions is use of orthopedic equipment, kind of Assistive Technology (AT).", "Issue of effective provision of orthopedic equipment is successfully addressed by employing Human Activity Assistive Technology model (HAAT model) [11, 12]. HAAT model is useful both in design, evaluation, and selection of AT used by the patient, especially in extending ADLs abilities", "[12]\t. Basic components of HAAT model are as follows:", ">\t human - determined by patient\u2019s skills and abilities,", ">\t activity - desired/determined by patient\u2019s life role and assistance need to accomplish activity, consisting three basic performance areas (self-care, work/school, play/leisure),", ">\t context - setting/environment, physical context (e.g. temperature, light), social context (e.g. relationships), cultural context, etc.,", ">\t AT - as basis providing human performance improvement [12].", "This way conceptual integrated system of AT provision (considering potential AT solutions) for individual patient is completed by the patient (human), his/her activities, context/environment and AT.", "Aforementioned approach clearly expands Donabedian model of evaluating quality of care in rehabilitation (structure, process, and outcomes) in the areas specific to post-stroke neurorehabilitation and care provided by multidisciplinary therapeutic team using e.g. AT solutions", "[13].", "Aim of this study was to evaluate incidence of the most common orthopedic equipment in post-stroke patients.", "Material and Methods", "Investigated group consisted of twenty post-stroke patients. Inclusion criteria were as follows: age above 18 years, diagnosis: stroke (ischemic or hemorrhagic), and time after accident - from 6 weeks to 2 years. The inclusion of patients was each time confirmed by medical records. Size and anatomical involvement of infarct varied depend on the patient.", "The patients\u2019 profiles are presented in Table 1.", "Table 1. Patients\u2019 overall profile.", "Number and percentage", "Age [years]:", "Min\t48", "Max\t69", "SD\t6,6", "Mean\t58,45", "Median\t58", "Time after accident:", "6 weeks - 2 years\t20 (100 %)", "Assessment was performed in each patient based on the factual orthopedic equipment use at discharge from neurologic rehabilitation ward.", "The results, where available, are expressed as mean, median, minimal value (min), maximal value (max) and standard deviation (SD). Statistical analysis of data was performed using the Statistica Software. A probability (p) value < 0.05 was considered as statistically significant.", "Results", "Results among 20 patients (100 %) involved in the study were as follows: 85% of post-stroke patients used orthopedic equipment at discharge. Only 3 patients (15%) were independent.", "Table 2. Results for whole group of patients.", "Orthopedic equipment\tUse in post-stroke patients [%]", "Number of patients\tPercentage", "wheelchair\t7\t35", "crutch\t1\t5", "cane, including:\t9\t45", "one pod cane\t3\t15", "tripod cane\t6\t30", "Total\t17\t85", "Discussion", "A lot of classifications of orthopedic equipment had been created for various purposes, including ways and rules of ambulation, research, patients\u2019 education, and patients\u2019 safety. Despite strong efforts these classifications do not fully meet the needs of assistive technology researchers. For example three principal mobility device domains within mobility-related assistive technology device classifications:", "1.\t ambulation aids,", "2.\t manual wheelchairs,", "3.\t powered mobility devices [14].", "No doubts common taxonomy in the area of AT would be more useful. Post-stroke patients need individual selection of the orthopedic equipment and additional periodical control. Basic possible solutions are as follows:", "-\t wheelchairs (various kinds according to needs, e.g. hemi wheelchairs),", "-\t canes:", "- one pod canes,", "- tripod canes, quadripod canes,", "-\t crutches,", "-\t Ankle Foot Orthotics (AFOs) and Dynamic Ankle Foot Orthotics (DAFOs),", "-\t foot-drop braces,", "-\t knee braces,", "-\t shoulder orthoses,", "-\t elbow orthoses,", "-\t wrist and hand orthoses [15, 16, 17].", "Table 3. Use of the orthopedic equipment among post-stroke patients in Poland according to", "research of Blaszczyszyn [18].", "Orthopedic", "equipment\tUse in admission [%]\tUse at discharge [%]", "wheelchair\t5\t-", "crutch\t25\t33,33", "walker\t10\t-", "tripod cane\t-\t5", "Total\t40\t38,33", "Aforementioned (in table 3) values seem be low. Danish research of Sorensen et al. [19] showed, that use of assistive devices and/or environmental modifications among post-stroke patients were as follows:", "-\t at discharge: 75%,", "-\t six months after discharge: 81%,", "-\t follow-up (3-5 years later, 74% of the survivors were seen): almost 100%.", "Most frequently used AT were: wheelchairs, aids for walking, aids for bathing. There was observed significant increase in use aids for cooking/eating and reading/hearing/writing [19]. Gosman- Hedstrom et al. [20] compared assistive technology devices given to patients treated in a stroke unit and patients treated in a general medical ward. This research showed, that higher prescription of assistive devices during the first 3 months may be cost-effective, because AT costs are only small part of the total costs spend on post-stroke care and rehabilitation [20].", "Important evidence provided study of Wilson et al. [21]. Among 91 participants (e.g. post\u00acstroke) investigated group of patients was more likely to use equipment to maintain independence versus personal assistance, what causes slow (in two years) decline in patients\u2019 function [21]. From the other side use of AT may be helpful strategy in reducing fatigue in post-stroke patients [22].", "There were observed important methodological problem. Independent on healthcare system organization and level of financial support there were assessed (in the most common case) number of real used (or: owned) orthopedic equipment. This situation covers at least three another cases:", "\u2022\t patient needs the orthopedic equipment, but it is not prescribed (e.g. due to misdiagnosis - see also HAAT model),", "\u2022\t patient needs the prescribed orthopedic equipment, but financial issues do not allow to provide it (important in low-income countries),", "\u2022\t patients has prescribed the orthopedic equipment, but do not use it.", "This issue needs additional research. What more there is need for consistent use of terminology and measures to reflect correctly interactions between patient, equipment, and processes involved in rehabilitation [13]. Important part of it may be proposed user-centered design process of assistive technology increasing functionality of solutions for a wider variety of users [23]. Critical issues to ensure successful outcomes of AT interventions in post-stroke patients are perceived:", ">\t co-operation between medical staff and biomedical engineers [24],", ">\t correct assessment of the patient [25],", ">\t timely and evidence based fit and use of appropriate orthopedic equipment [25],", ">\t education of patients and their families/caregivers [25],", ">\t preventive strategies and safe techniques [25].", "Generally current evidences support high value of AT for post-stroke patients and suggests improvement in the area of fitting and provision as early as possible.", "Conclusions", "There is need to provide further studies in the area of orthopedic equipment use in post-stroke patients. It seems it can significantly improve ADLs limitations and increase resulting independence, life quality, and effectivity of rehabilitation of stroke survivors, influencing life quality of patients\u2019 families/caregivers.", "Open Access", "This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.", "References", "1.\tB\u0142aszczyk B., Czernecki R. Pr\u0119dota-Panecka H., Profilaktyka pierwotna i wt\u00f3rna udar\u00f3w m\u00f3zgu (article in Polish). Studia Medyczne 2008;9:71-75.", "2.\tCz\u0142onkowska A. Udar m\u00f3zgu - perspektywy leczenia w Polsce w\t\u015bwietle\tosi\u0105gni\u0119\u0107", "\u015bwiatowych (article in Polish). Polski Przegl\u0105d Neurologiczny 2005; 1:1 -7.", "3.\t Cz\u0142onkowska A. Osi\u0105gni\u0119cia w zakresie udaru m\u00f3zgu (article in Polish). Medycyna po Dyplomie 2005; supl. 17:5-11.", "4.\t Palasik W. Nowe tendencje w terapii udaru niedokrwiennego (article in Polish). Terapia 2006;1:4-8.", "5.\t Profilaktyka wt\u00f3rna udaru m\u00f3zgu. Rekomendacje grupy ekspert\u00f3w Narodowego Programu Profilaktyki i Leczenia Udaru M\u00f3zgu (recommendations in Polish). Neurol Neurochir Pol 2003; supl. 6:17-43.", "6.\t Muren M. A., Hiitler M., Hooper J. Functional capacity and health-related quality of life in individuals post stroke. Top Stroke Rehabil 2008; 15(l):51-58.", "7.\tMurtezani A., Hundozi H., Gashi S. et al. Factors associated with reintegration\tto\tnormal", "living after stroke. Med. Arh., 2009, 63(4): 216-219.", "8.\t Helgason C.M., Wolf PA. American Heart Association Prevention Conference IV: prevention and rehabilitation of stroke \u2014 executive summary. Circulation 1997, 96: 701\u00ac707.", "9.\t de Haan R. J., Limburg M., Van der Meulen J.H.P i wsp. Quality of life after stroke. Impact of stroke type and lesion location. Stroke 1995, 26: 402-408.", "10.\t Jaracz K., Kozubski W. Jako\u015b\u0107 \u017cycia chorych po udarze m\u00f3zgu w \u015bwietle bada\u0144 empirycznych (article in Polish). Aktualno\u015bci Neurologiczne 2002, 2: 35-45.", "11.\t Cook A., Hussey S. Assistive Technologies: Principles and Practice. St. Louis, Mosby 1995, pp. 46-65.", "12.\t Oishi M. M. K., Mitchall I. M., Machiel Van der Loos H. M. (eds.) Design and Use of Assistive Technology. Social, Technical, Ethical, and Economic Challenges. Springer, New York-Heidelberg 2010.", "13.\t Hoenig H, Lee J, Stineman M. Conceptual overview of frameworks for measuring quality in rehabilitation. Top Stroke Rehabil. 2010;17(4):239-251.", "14.\t Shoemaker L. L., Lenker J. A., F\u00fchrer M. J., Jutai J. W., Demers L., DeRuyter F. Mobility- related assistive technology device classifications: implications for outcomes research. Am J Phys Med Rehabil. 2009;88(12): 1020-1032.", "15.\t Miko\u0142ajewska E. Dob\u00f3r zaopatrzenia ortopedycznego po udarze: opis przypadku. Praktyczna Fizjoterapia i Rehabilitacja, 2011, 17: 22-23.", "16.\t Giermek K., Cie\u015bla W., Kubacki J., Rojczyk-Chmarek J. Orthopedic upper limb appliances in post-stroke patients used in prevention of shoulder pain syndrome. Medical Rehabilitation 2008; 12(1): 17-23.", "17.\t Miko\u0142ajewska E. Neurorehabilitacja. Zaopatrzenie ortopedyczne [Neurorehabilitation. Othopedic equipment] (book in Polish). Wydawnictwo Lekarskie PZWL, Warszawa 2009.", "18.\t B\u0142aszczyszyn M. Wyniki wczesnej rehabilitacji pacjent\u00f3w po udarze m\u00f3zgu - doniesienie wst\u0119pne. Zeszyty Metodyczno-Naukowe AWF Katowice 2008;20:177-189.", "19.\t Sorensen H. V., Lendal S., Schultz-Larsen K., Uhrskov T. Stroke rehabilitation: assistive technology devices and environmental modifications following primary rehabilitation in hospital - a therapeutic perspective. Assist Technol 2003; 15(l):39-48.", "20.\t Gosman-Hedstr\u00f3m G., Claesson L., Blomstrand C., Fagerberg B., Lundgren-Lindquist B. Use and cost of assistive technology the first year after stroke. A randomized controlled trial. Int J Technol Assess Health Care 2002;18(3):520-527.", "21.\t Wilson D. J., Mitchell J. M., Kemp B. J., Adkins R. H., Mann W. Effects of assistive technology on functional decline in people aging with a disability. Assist Technol 2009;21(4):208-217.", "22.\t Flinn N. A., Stube J. E. Post-stroke fatigue: qualitative study of three focus groups. Occup Ther Int 2010; 17(2):81-91.", "23.\t Stehle C., Albrecht-Buehler C. Developing more desirable products for stroke survivors. Top Stroke Rehabil 2008; 15(2): 109-117.", "24.\t Miko\u0142ajewska E., Miko\u0142ajewski D. Wheelchairs development from the perspective of physical therapists and biomedical engineers. Adv Clin Exp Med 2010; 19(6):771-776.", "25.\t Sivan M., Bhakta B. Restoring mobility: theories, technologies and effective treatments. Clin Med 2008;8(6):596-600.", "This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.Org/licenses/by-nc/3.0/) which permits unrestricted, non- commercial use, distribution and reproduction in any medium, provided the work is properly cited.", "Miko\u0142ajewska Emilia. Neurorehabilitation in pediatrie stroke = Udar m\u00f3zgu u dzieci - post\u0119powanie w rehabilitacji neurologicznej, [in] Czerwi\u0144ska Pawluk Iwona Ed., \u017bukowska Hanna Ed., Pilewska Wies\u0142awa Ed., Klimczyk Mariusz Ed., Szulc Adam Ed., Zuk\u00f3w Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 23-31. ISBN 9781329876002. 304 p. \u00a9 The Author(s) 2013. This articles is published with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland.", "Original Text published \u00a9 The Author (s) 2012. Miko\u0142ajewska Emilia. Neurorehabilitation in pediatric stroke = Udar m\u00f3zgu u dzieci - post\u0119powanie w rehabilitacji neurologicznej. Journal of Health Sciences. 2012;2(3):23-31. ISSN 1429-9623 / 2300-665X. Open Access Open Journal Systems of Radom University in Radom, Poland ISSN 1429-9623 / 2300-665X. 2012.", "NEUROREHABILITATION IN PEDIATRIC STROKE Udar m\u00f3zgu u dzieci - post\u0119powanie w rehabilitacji neurologicznej", "Emilia Miko\u0142ajewska", "Rehabilitation Clinic, The 10th Clinical Military Hospital with Policlinic, Bydgoszcz, Poland", "\u00a9 The Author(s) 2012;", "This article is published with open access at Licensee Open Journal Systems of Radom University in Radom, Poland", "Corresponding Authors:", "Emilia Miko\u0142ajewska Rehabilitation Clinic,", "The 10th Clinical Military Hospital with Policlinic,", "Bydgoszcz, Poland", "E-mail: ", "Keywords: neurorehabilitation; physiotherapy; children; stroke; clinical guidelines.", "Abstract", "Pediatric stroke prevalence in children population is estimated to 2-3/100 000 (per 100,000 children per year) including:", "1,2/100 000 for ischemic stroke,", "1,1/100 000 for hemorrhagic stroke.", "Problem of post-stroke children neurorehabilitation seems be underestimated. Issues associated with stroke risk factors, etiology, post-stroke treatment and rehabilitation in children may significantly differ when compared with adults. This situation needs separate research and dedicated clinical guidelines, because pediatric strokes are often associated with long-term disability.", "This article aims at investigating the extent to which the available opportunities in the area of rehabilitation and physiotherapy of post-stroke children are being exploited, including own concepts, research and observations.", "S\u0142owa kluczowe: rehabilitacja neurologiczna; fizjoterapia; dzieci; udar; wytyczne kliniczne. Streszczenie", "Cz\u0119stotliwo\u015b\u0107 wyst\u0119powania udaru u dzieci jest szacowana na 2-3 / 100 000 dzieci rocznie,", "w tym:", "1,2/100 000 dla udaru niedokrwiennego,", "1,1/100 000 dla udaru krwotocznego.", "Problem dzieci\u0119cej neurorehabiltiacji poudarowej wydaje si\u0119 niedoceniany. Kwestie zwi\u0105zane z czynnikami ryzyka udaru, jego etiologi\u0105, leczeniem i rehabilitacj\u0105 poudarow\u0105 mog\u0105 znacz\u0105co r\u00f3wnie\u017c si\u0119 od odpowiednik\u00f3w dla pacjent\u00f3w doros\u0142ych. Wymaga to odr\u0119bnych bada\u0144 i", "23", "specjalnie opracowanych wytycznych klinicznych, gdy\u017c udary u dzieci s\u0105 cz\u0119sto przyczyn\u0105 d\u0142ugoterminowych deficyt\u00f3w.", "Artyku\u0142 stanowi pr\u00f3b\u0119 oceny, do jakiego stopnia s\u0105 wykorzystywane obecne mo\u017cliwo\u015bci rehabilitacji i fizjoterapii dzieci po udarze, z uwzgl\u0119dnieniem w\u0142asnych koncepcji, bada\u0144 i obserwacji.", "Introduction", "Suitable medical treatment and rehabilitation as far as early and accurate diagnosis of stroke in children can in a significant way influence therapy outcome [1,2]. Results of the pediatric stroke can be various and severe:\tmotor disorders, seizures, cognitive disturbances, and", "neuropsychological disturbances. They depend on lesion location and size, its cause and age of the small patient [1].", "PubMed (U.S. National Library of Health) [3] database was searched to identify relevant articles. This research was limited to the English language articles and encompassed the period from 01.01.1991 to 31.12.2011. Fig. 1. shows keywords were used in the searches and frequency of specified keywords combinations.", "number of articles", "7818", "Frequency of specified key words", "3575", "2945", "1462", "329", "77", "14", "2", "stroke +\tpediatric\tstroke +\tpediatric\tstroke\t+\tpediatric\tstroke\t+\tpediatric", "children\tstroke\tchildren\t+\tstroke\tchildren\t+\tstroke +\tchildren +\tstroke", "therapy + therapy rehabilitation rehabilitation neuro-\t+\tneuro-", "key words", "rehabilitation rehabilitation", "number of articles", "1534\tNumber\tof\tarticles\tdepend\ton\tarticle\ttypes", "Total number of articles with the keyword \u201cstroke + children\u201d: 7818 I\tI", "Total number of articles with the keyword \u201cpediatric stroke\u201d: 2945 |\tj", "939", "631", "354", "473", "177\t\t\t165", "60", "108", "8 20", "8\t24", "6\t13", "case report", "clinical trial", "systematic", "review", "randomized", "controlled", "trial", "practice meta-analysis historical key words guideline\tarticle", "number of articles", "600", "400", "200", "Frequency of specified keyword", "Total number of articles with the keywords \u201cstroke + children\u201d: 7818 I\tI", "Total number of articles with keywords \u201cpediatric stroke\u201d: 2945\t|\t|", "(", "I", "r", "r", "1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 20092010 2011", "year", "Fig. 1. Results of investigation of the PubMed database (U.S. National Library of Medicine) [3].", "\u00dc", "Number of articles with keywords \u201cstroke + children\u201d and \u201cpediatric stroke\u201d seems be huge (respectively 7818 and 2945). What more there is observed significant increase in the articles\u2019 number since 1991. But there were observed also:", "1. a lot of case reports, reviews and clinical trials versus very few randomized controlled trials, practice guidelines, and meta-analyses,", "2. very few (< 5%) articles in the area of rehabilitation and physiotherapy of post-stroke children, despite these cases need dedicated long-term rehabilitation.", "Aforementioned observations show where research is concentrated now. This article aims at investigating the extent to which the available opportunities in the area of rehabilitation and physiotherapy of post-stroke children are being exploited, including own concepts, research and observations.", "Prevalence", "Assessing stroke incidence in children we should be aware, that diagnosis in these cases may be delayed due to low clinical suspicion and need to exclude mimics of stroke in childhood.", "Number of misdiagnosed cases is not known, mainly because of diagnostic problems with non-typical clinical picture.", "Table 1. Childhood stroke incidence [1, 2, 4, 5, 6].", "Stroke subtype\tIncidence (per 100,000 children per year)\tRemarks (per 100,000 children per year)", "Ischemic stroke\t1,2/100 000 (ranging from 1,2 to 7,8 depend on study)\t-", "Hemorrhagic stroke\t1,1/100 000 (ranging from 0,71 to 5,11 depend on study)\tspontaneous intraparenchymal hemorrhage (IPH)1: 0,8/100 000", "non-traumatic subarachnoid hemorrhage (SAH): 0,3/100 000", "Total incidence\t2-3/100 000", "(ranging from 2 to 13 depend on study)\tincidence rates in neonates: 1 per 5000 livebirths", "Hemorrhagic stroke in children", "In pediatric hemorrhagic stroke:", "-\t mortality is approximately 25% (ranging from 7% to 54%),", "-\t significant disability is present in 42% of survivors,", "-\t recurrence risk is estimated at 10 % [5].", "Etiology of hemorrhagic stroke in children is as follows: the most common are cavernoma (3-27%), coagulopathy (5-64%), intracranial tumor (2-22%), aneurysm (5-29%), drug use (17%), vasculopathy (17%), surgical complications (12%), hypertension (3-10%), and mild infection (10%) [5].", "Despite severity, there is lack of management or treatment guidelines [5, 7]. Diagnosis is based mainly on laboratory tests, computed tomography (CT), magnetic resonance imaging (MRI) and conventional cerebral angiography (CCA).", "1 traumatic IPH or hemorrhagic transformation of ischemic stroke are usually not considered hemorrhagic stroke [5, 6]", "26", "Main pediatric ischemic stroke causes are perceived heart diseases, inflammatory diseases, connective tissue diseases, haematologic disturbances, metabolic diseases, and genetic issues [1]. Several co-existing risks factors may be observed in selected cases.", "In pediatric ischemic stroke:", "1.\t complete recovery is observed in 13-40% of cases,", "2.\t seizures are observed in 20% of them,", "3.\t mortality seems be lower than in the adult patients,", "4.\t recurrences are observed in 2-40% of cases, depend on stroke cause [1].", "Diagnosis is based mainly on assessment of cariovascular system (e.g. electrocardiogram - ECG), laboratory tests (blood tests, urine tests, cerebrospinal fluid tests to eliminate inflammatory, metabolic, etc. causes), and medical imaging techniques: computed tomography (CT), magnetic resonance imaging (MRI, AMRI, MRA, MRV), conventional cerebral angiography (CCA) [1].", "Treatment of ischemic stroke in children should be provided in dedicated specialistic wards, because therapy and care in first hours after cerebrovascular accident significantly influence of further therapy and rehabilitation [1]. Use of neuroprotective and thrombolitic drugs is widely discussed as possible in selected cases, but generally results in children are unknown.", "N euro rehabilitation", "Treatment of post-stroke children guided by extrapolation from the adult literature is not always possible and effective [5]. Key topics for basic and clinical research in post-stroke children are perceived:", "\u2022\t Enhanced neuronal plasticity in developing brain, based mainly on neurogenesis, programmed cell death, and activity-dependent synaptic plasticity [8];", "\u2022\t Motor function improvement thanks to combination of physiotherapy with occupational therapy;", "\u2022\t Possible neurological complications such as neurocognitive sequelae, ototoxicity, seizure, peripheral neuropathy, deficits in cognitive function (learning, memory, attention, speed of information processing) [9];", "\u2022\t Possible orthopaedic complications such as spasticity (role of botulinum toxin injections), contractures, deformities both in the area of bones and spinal cord, gait abnormalities and upper limb function limitations [10];", "\u2022\t Impairment of children's emotional, social and school abilities.", "Children brain is characterized by greater potential and unique reorganizational skills, so neurorehabilitation possibilities in post-stroke children should be greater. This way quality of functional recovery is perceived better in pediatric population [11]. But current understanding of similarities and differences in post-stroke recovery between children and adults seems be not complete. No doubts we need for improvement of classic approaches to neurorehabilitation:", "\u00b0 traditional physiotherapy,", "\u00b0 basic approach based on NDT-Bobath Concept as the whole strategy of neurorehabilitation including way of clinical thinking and parents/caregivers involvement [12],", "\u00b0 later involved elements of Vojta method or constraint-induced movement therapy (CIMT) [13, 14].", "There is need to admit, that CIMT includes three key elements:", "-\t constraining use of the less-impaired upper extremity,", "-\t intensive, repetitive daily practice of motor movements with the impaired upper extremity for 2-3 weeks,", "-\t shaping of more complex action patterns as successive approximations of the target action", "[14].", "Mechanisms responsible for CIMT effectivity are perceived operant conditioning (as reversal of learned nonuse) and experience-driven cortical reorganization [14].", "According to the current research most of the functional recovery occurs within the first 2-3 months after stroke [11]. Average observed length of follow-up was 33.2 months (ranging from 1 to 120), but only 42.3% of children achieved full recovery [6]. There were observed good educational and mobility outcomes, but low-moderate range of communication, activities of daily living (ADLs), and socialization [15].", "Prognostic factors are perceived as follows:", "\u2022\t age,", "\u2022\t functional status in admission,", "\u2022\t lesions in both cortical and subcortical locations,", "\u2022\t systemic disease aetiology,", "\u2022\t seizures (incidence 57,7%),", "\u2022\t vascular abnormalities (incidence 50%),", "\u2022\t lethargy (incidence 42,3%),", "\u2022\t altered levels of consciousness (incidence 38,5%),", "\u2022\t hemiparesis (incidence 38,5%)", "\u2022\t neurological deficits at discharge [6].", "What more there was observed relationship between radiologically apparent extent of brain damage, degree of impairment, and functional outcome. Health of parents/caregivers was rated generally lower than it was expected [16].", "Clinical scales can be useful tool supporting assessment. The most common used scales are as follows:", "1.\t Pediatric Stroke Outcome Measure (PSOM),", "2.\t modified Pediatric Stroke Outcome Measure [17].", "3.\t Pediatric Stroke Activity Limitation Measure examining degree of difficulty experienced by the children in daily activities,", "4.\t Child Health Questionnaire assessing health-related quality of life,", "5.\t Short-Form 36 General Health Survey as useful tool for parent health assessment.", "To summarize rehabilitation in post-stroke children has great potential for significant long\u00acterm improvement. Both children and their parents/caregivers show wide-ranging health needs [16]. Medical staff, especially physiotherapists, need for widely accepted clinical guidelines and recommendations in the area of rehabilitation procedures and rehabilitative measures.", "Directions of further research", "Management strategies for neurological complications in post-stroke children are still emerging. Further research in the area of cellular and molecular etiology of these deficits can cause emerging of new therapies and their optimization. Evidences concerning post-stroke recovery in adults can be insufficient.", "Young age of patients need use of dedicated solutions such as biofeedback (including haptic), augmented reality or virtual reality systems [18]. These systems provide not only motivation and engagement of the child, but also allow for advanced control and another diagnostic tool for physiotherapist. Effective therapy of children usually needs to be associated with fun and play - this way child becomes the most difficult patients. No doubt all multidisciplinary therapeutic team should be aware issues unique to children and their families/caregivers.", "Wide discussed is use of clinical telerehabilitation to increase access to rehabilitation, better coordination of care, and education of parents/caregivers [19, 20]. Close co-operation between", "experienced physiotherapist, post-stroke children, and parents/caregivers is perceived rather difficult using distant telerehabilitation service, but it may play role of useful tool for control and education purposes. There is need for further research, especially in the area of dedicated diagnostic tools, e-learning programs and support tools for parents/caregivers based e.g. on the NDT-Bobath Concept.", "Conclusions", "Problem of post-stroke children neurorehabilitation seems be underestimated. Factors associated with stroke risk factors, etiology, post-stroke treatment and rehabilitation in children may significantly differ when compared with adults. This situation needs separate research and dedicated clinical guidelines, because pediatric strokes are often associated with significant long-term disability.", "Open Access", "This article is distributed under the terms of the Creative Commons Attribution Noncotmnercial License which permits any noncotmnercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.", "References", "-\tPilarska E. Eldar niedokrwienny u dzieci: czynniki ryzyka, objawy, leczenie, nast\u0119pstwa. Neurologia Dzieci\u0119ca, 2009; 18(36): 13-18.", "-\tLynch J. K., Hirtz D. G., De Veber G., et al. Report on the National Institute of Neurological Disorders and Stroke Workshop on Perinatal and Childhood. Stroke Pediatrics 2002; 109:116\u00ac123.", "-\tMEDLINE/PubMed (U.S. National Library of Medicine) http://www.ncbi.nlm.nih.gov/pubmed - access 16.06.2012", "-\tFullerton H. J., Wu YWV., Zhao S., Johnston S. C. 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Pediatric stroke recovery: a descriptive analysis. Arch Phys Med Rehabil 2009;90(4):657-662.", "-\t Miko\u0142ajewska E. Metoda NDT-Bobath w neurorehabilitacji os\u00f3b doros\u0142ych [NDT-Bobath metod in neurorehabilitation of adults] (book in Polish). Wydawnictwo Lekarskie PZWL, Warszawa 2011.", "-\t Liepert J. Evidence-based therapies for upper extremity dysfunction. Curr Opin Neurol 2010;23(6):678-682.", "-\t Brady K., Garcia T. Constraint-induced movement therapy (CIMT): pediatric applications. Dev Disabil Res Rev. 2009; 15(2): 102-111.", "-\t Hurvitz E., Warschausky S., Berg M., Tsai S. Long-term functional outcome of pediatric stroke", "survivors. Top Stroke Rehabil. 2004;ll(2):51-59.", "-\t Gordon A. L., Ganesan V., Towell A., Kirkham F. J. Functional outcome following stroke in children. J Child Neurol. 2002;17(6):429-434.", "-\t Lo W., Zamel K., Ponnappa K.. et al. The cost of pediatric stroke care and rehabilitation. Stroke 2008;39(1): 161-165.", "-\t Galvin J., McDonald R., Catroppa C., Anderson V. Does intervention using virtual reality improve upper limb function in children with neurological impairment: a systematic review of the evidence. Brain Inj 2011 ;25(5):435-442.", "-\t Gregory P., Alexander J., Satinsky J. Clinical telerehabilitation: applications for physiatrists. PM R. 2011;3(7):647-656.", "-\t Miko\u0142ajewska E., Miko\u0142ajewski D. Neurological telerehabilitation - current and potential future applications. J Health Sci 2011; 1(4):7-14.", "This is ail open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.Org/licenses/by-nc/3.0/) which permits unrestricted, non- commercial use, distribution and reproduction in any medium, provided the work is properly cited.", "Gozhenko Anatoliy, Zuk\u00f3w Walery. Essays on the theory of disease, [in] Czerwi\u0144ska Pawluk Iwona Ed., \u017bukowska Hanna Ed., Pilewska Wies\u0142awa Ed., Klimczyk Mariusz Ed., Szulc Adam Ed., Zuk\u00f3w Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 32-50. ISBN 9781329876002. 304 p. \u00a9 The Author(s) 2013. This articles is published with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland.", "Original Text published \u00a9 The Author (s) 2012. Gozhenko Anatoliy, Zuk\u00f3w Walery. Essays on the theory of disease. Journal of Health Sciences. 2012;2(4):7-25. ISSN 1429-9623 / 2300-665X. Open Access Open Journal Systems of Radom University in Radom, Poland ISSN 1429-9623 / 2300-665X. 2012.", "ESSAYS ON THE THEORY OF DISEASE 1 2 Anatoliy Gozhenko , Walerij Zukow", "'State Enterprise Ukrainian Research Institute for Medicine of Transport, Odessa, Ukraine", "2Radom University, Radom, Poland", "\u00a9 The Author(s) 2012;", "This article is published with open access at Licensee Open Journal Systems of Radom University in Radom,", "Poland", "Keywords: theory; disease.", "Abstract", "Authors dared to depart from the classical principles of this writing, so as not to distract the reader from the logic of question set forth numerous references to other authors, despite their importance. Understand that it will not provide full scientific picture of the problem, but it will introduce you to their views on the theoretical foundations of pathology and present them clearly and simply. We assume our task to be fulfilled if you pay attention and make sure that the knowledge of the basic theoretical concepts of pathology is of great practical importance for the whole of medicine and every medical practitioner.", "Finally, the theoretical basis of rehabilitation on the one hand is the idea that recovery is incomplete, as the structural and functional damage in the body of the disease (the system) is limited . The first step in this is to determine the maximum functionality of the body (system). This information is subsequently justifies subsequent rehabilitation strategies: restoration of structural and functional features body (stem cell therapy, gene therapy, graft, organ), or stimulation sanogenetic mechanisms of the body - interorgan, intersystem compensation.", "In Overall, each practitioner, starting to diagnose and especially the treatment of the disease should be clear that the disease is a complex adaptive process in the body damage (pathology). This damage, which begins with the disease, there is always the result of interactions between the active and reactive causes the body. Moreover, all recorded in the patient's changes are always part of this device, so always play a protective role, but they are in most cases damaging, ie serve as vehicles for self-development of the disease. Therefore, all the effects of the disease should increase safety, adaptive its capabilities, while reducing the likelihood of secondary pathogenic damaging effect.", "Skillfully guided in this complex process of vital activity, doctor his actions to help the body to adapt itself to support its activities, to reduce the degree of impairment, damage and, finally, as to restore the adaptive capabilities of the organism, that is, ensure its recovery.", "Each disease (nosology), in each patient the etiology, pathogenesis, sanogenesis have their own characteristics, but they are all based on the general principles of functioning of the body in health and disease, which are described by the theory of concepts and mechanisms of disease.", "Every step in the knowledge of the disease to the physician is a personal revelation of this fact, and the patient base of effective diagnosis and treatment.", "Introduction", "Decision to write this book arose in response to an understanding of how being ignored in a doctor, and even the scientific community theoretical questions pathology. Meanwhile, it is their knowledge can equip modern doctor strategic principles of diagnosis and treatment of diseases.", "Authors dared to depart from the classical principles of this writing, so as not to distract the", "reader from the logic of question set forth numerous references to other authors, despite their", "importance. Understand that it will not provide full scientific picture of the problem, but it will introduce you to their views on the theoretical foundations of pathology and present them clearly and simply. We assume our task to be fulfilled if you pay attention and make sure that the knowledge of the basic theoretical concepts of pathology is of great practical importance for the whole of medicine and every medical practitioner.", "Chapterl. Theory of medicine: teaching and medical practice", "First want to remind you of the two fundamental postulates of modem medicine.", "First - the human body, being structurally and functionally heterogeneous system between a whole. Hence, for pathology, when the primary damage (broken) one or the other body in the disease process includes the entire organism - the sick people, the changes inherent in the disease are systemic, even inter-system, ie, organismic. Hence, to treat disease, not only direct medical efforts to eliminate certain organ or systemic disorders.", "Second - not sick people in general, but the specific genetic individual man, which explains the important postulate traditional domestic medicine - should be treated the patient, not the disease. These provisions are a common outcome of theory and clinical practice. And, last, essentially, the paradigm of domestic medicine.", "Both provisions determine systemic, holistic and at the same time, an individual approach to the disease and the patient at all stages of medical practice.", "However, the training of doctors to practice in the highest medical school today is organized in such a way that the end of the university doctor in theory does not fully prepared for the implementation of their practice on the basis of these and other general theoretical position.", "Let's organizational structure of didactic teaching in universities. In the first and second courses, future doctors are studying a healthy person, based on an analytical approach: a separate study the morphology, physiology, biochemistry and biophysics of the body. This is taken in teaching medical schools due to extreme complexity of the human body to understand that in general, without any analysis of its individual components is virtually impossible. In the third year taught a number of subjects, including general theoretical fundamental importance pathological anatomy, pathological physiology and pharmacology. For it is their study focused on the formation of ideas about the theoretical foundations of the disease and the principles of treatment. Occupies a special place among them physiopathology designed to give an idea of the etiology, pathogenesis and disease outcome. This integrative position pathophysiology resulting in its classical definition, as a philosophy of medicine. However, the very pathological physiology as an academic discipline is heterogeneous and divided into the following sections: nosology, model disease processes,", "pathophysiology of organs and systems, clinical pathophysiology - each of which has its own learning tasks [1, 2, 3].", "Start pathology, disease ie those states prevention diagnosis and treatment which aims to all practical medicine, begins with studying the section nosology.", "This very short section of pathophysiology precedes the study of specific diseases, ie mechanisms of the etiology, pathogenesis and sanogenesis all clinical nosology. It's certainly true is historically sequenced to precede the study of specific diseases, examining the general principles of the origin and development of the disease in general. However, the practice of teaching, personal experience indicates significant difficulties in implementing this approach. Mainly, in our opinion, is the contradiction between the need to study and understanding of the general principles of pathology without knowledge of the specific mechanisms and specific diseases. The psychological effect of this is to change students' motivation to the reorientation of the study only the specific pathology of certain diseases.", "Study the theoretical foundations of the last completed by the end of the third year, and then studied the subsequent clinical information until the end of high school. But by that time, the main provisions of nosology or simply forgotten, or do not relate to a specific pathology, ie \"they do not work.\" It seems that they almost do not need a clinical practice, or even for research in the field of medicine. At best, there are only some general theoretical phantoms educational level. Consciously legitimate medical theory of disease are rarely used by doctors and even scientists. The latter says that in the scientific press virtually no work on the development of theory of disease, and the debate on these issues, conferences episodic, and little attention to him, even at conventions and conferences pathophysiology.", "But, if these or other matters of medical theory does not used in sufficient amounts, in practice, not in demand, so they are not needed, whether to study them, or teach them?", "Thus, the question of whether there should be theory of disease in medicine, despite its paradoxical nature is now quite acceptable. To answer this question it is advisable to consider the key elements that will form the basis for the theory of medicine.", "Chapter 2. Disease: definition, biological essence and significance for practical medicine", "Explicit and numerous differences in disease of the body of qualitative and quantitative indicators of health have long been encouraged to determining overall nature of the disease. Moreover, the long history of doctors and scientists have unsuccessfully searched for disease", "\"something\" is not inherent in the new state of health. Just over 100 years ago, medicine has come to recognize that the human element in their morphological, biochemical processes and functions qualitatively identical to a healthy one. This basic conclusion is today the theoretical basis of diagnosis. Indeed, that's been going on for 30-40 years, we are not looking at illnesses of certain qualitative differences at the level of the constituent elements of the body (morphological, physiological, biochemical). However, it is equally obvious conclusion is that the sick person is different from the healthy quality, ie health and illness are qualitatively different states, which are the properties, characteristics of the whole organism. Search of the qualitative criterion of the body in the end ended up having such a level, the degree of adaptation to constantly changing environmental conditions, which is the main condition for the existence of the body, ie life. Adaptive structural and functional features of the human body allows him to maintain his consistency, independence from large, diverse, ever-changing environment. However, these devices are not limitless possibilities. In historical terms, the human body, which was formed in certain environmental conditions for tens of thousands of years as a complex biological system is quite stable, thanks to the emergence and development of the functional systems that provide adaptation to the real factors of the environment while maintaining a relatively stable state of its internal environment. Therefore, the body is adapted only to the influences and factors and parameters that affect it during evolution. Consequently, the resulting mechanisms of adaptation (adaptation) are not unlimited in power.", "Realistically, these mechanisms can adapt to such parameters, which took place in the evolution and functional reserve of strength is typically less than two times.", "Should be stressed that it is absolutely clear is the state of originally quite revolutionary, because they really make a theoretical basis for diagnosis and treatment. First, it became clear that all the differences between the patient from a healthy person are only quantitative. Last saved by medicine attempts to find a qualitatively new morphological structure and function in patients, but only pointed to the need to consider quantitative differences. Second, it became clear that the first and the main manifestation of the disease is reduced degree of adaptation of organisms to the influences of the environment. It must be emphasized that this postulate is the basis of the principle of functional diagnostics, to detect when the disease to humans imposed certain functional load. And, in this way not only identify the disease in the height of the stage, but also the start, and even in prenosological periods.", "Was eventually formulated a provision stating that the disease in the general biological terms is a form of human life at damage [1, 2, 3].", "In terms of social health disease - a limitation in the individual (subjective discomfort, restrictions on the forms of life) and social - disability.", "Thus, the disease can be treated as a special state of adaptation to the environment, therefore, a sick person also adapts. Arisen in the course of evolution adaptive mechanisms genetically had programed and transmitted hereditarily. Thus, the device is the basic principle of life, and the condition is common to both health and life.", "Meanwhile, the main difference between health and disease is the same device, the exact degree, the level of this device. Indeed, the sick and healthy people adapt to the environment, however, the health of the body adjusts within limits evolutionarily formed through appropriate mechanisms to adapt. For example, the most frequent temperature fluctuations healthy man adapts within, say -40 \u00b0C +50 \u00b0C, sustaining life in a certain time frame, then the disease, almost any, time and temperature limits of adaptation are reduced. Consequently, the disease is life, but with a more limited device compared with health. These limitations begin with emotional state (mood, etc.), reducing the adaptation to the environment, to physical activity and, consequently, to the social and productive activities, ie to work. Adapt to the physical limitation of the environmental conditions, the decrease of oxygen partial pressure, temperature fluctuations environment parameters of the electromagnetic field, radiation effects, water, and salt and nutritional stress. In connection with this, I believe that there is no need to separately allocate social aspects because it is a direct result of physiological limitations.", "Foregoing allows us to offer the following definition of the disease, \"disease - a human life is damaged, compensation is due to genetically predetermined adaptive response provides human adaptation environmental, limited in comparison with the healthy state.", "\"Consequently,the disease occurs in response to damage to the body and allows the adaptation to it, ie living with the disease. In conclusion, once again it must be emphasized that, based on the understanding of the disease, the practice of medicine in the diagnosis focuses on the search for quantitative (morphological, functional and biochemical) differences in the disease, which is characterized by the adaptation of the body, and in the treatment of it is directed not so much against with pathological phenomena, and to support the correction of adaptive mechanisms, ensure adaptation to the environment.", "Chapter 3. Etiology. Mechanisms of disease", "Any damage the human body should be something called. Pathophysiology section, which examines the emergence of diseases called etiology. Aitia - reason, logos - teaching, ie literally the science of the causes of diseases. Today, however, this definition sounds a bit different \"The", "etiology - the study of the causes and conditions of the disease.\" More than two thousand years of experience in academic medicine allows us to say with confidence that every disease has a material cause, although this situation became apparent a little over a hundred years ago. Until the mid-19th century there were many diseases with unknown causes. Moreover, this applies primarily to infectious diseases, which were most frequent in the population, mass, constituting the main cause of mortality of patients.", "Situation changed dramatically in the 19th century, revolutionary in the understanding of the etiology of disease has occurred with the discovery of bacteria and viruses, predetermining materialist approach to understanding of this group of diseases. Although bacteriocarrier and several other identified phenomena shook the doctrine of the causes of disease, but it is fast enough - no more than 20 years was supplemented by a second element - the conditions of disease. In historical terms, it should be noted that the exaggeration of the role of reason led to monocauzalizmus theory, according to which the disease need only one cause. The denial of such a limited approach and the need to address the conditions led to exaggeration of conditions and the role of theory conditionalism respectively. These oscillations have been overcome and now every practitioner looking for the cause of the patient and takes into account the conditions, as the material that either promote or hinder the development of the disease. However, despite these theoretical contributions of nearly a century of experience in medicine has not lowered interest in clarifying and understanding the etiology of diseases. This is due to the need etiotropic treatment and especially prevention. Meanwhile, a statement of reasons and conditions, in many cases, does not explain why in some cases there are, and in some not. The climax of the etiology of many diseases of misunderstanding was the emergence of such an interpretation as polietiologic disease: hypertension, allergies, etc. This allowed IV Davydovski almost half a century ago, noted that the etiology is still the weakest part of medicine [4]. In our opinion the years, little has fundamentally changed in the theory of etiology. Therefore, in those cases where a specific etiology is not clear, it is possible to explain everything so that the disease can cause a variety of causes and conditions. However, in this case, the specific reasons for the action seems to disappear, and either we must continue the search for a cause of the disease - an example is the history of studying the etiology of peptic ulcer disease and stomach ulcers.", "Meanwhile detection etiological role Helicobacter pylori, in many ways was the end interpretations of polyetiology this disease. And the same example heliobacterial etiology of peptic ulcer showed the complexity of the phenomenon - to this day there are heated debates about the role of heliobacterial infection, because its presence in the stomach fails to guarantee the development of the disease. What is due to the complexity and difficulty of the current theories of etiology? In our", "opinion this is due to the fact that in this case, despite the recognition of the role of the environment in causing disease, priority is given to only one reason. Its effect and causes the disease by inducing damage. That damage is the trigger mechanism of the disease, which is followed by the reaction to it, a way of life in terms of damage.", "Meanwhile, in our view of the fault may be due to several mechanisms [5].", "First mechanism is the direct cause of the damaging effect. An example is the mechanical trauma, thermal burns, chemical burns, ie first of all this action is intense mechanical, physical and chemical factors that cause the destruction of organs and tissues, affecting primarily the cells. By conditions include specification of these factors and to a small extent particular reactions, which are least affected by the implementation of the direct damaging effect, causes. Consequently, at a certain intensity of one or another reason, regardless of the other terms of damages. This, at first glance, the most understandable mechanism between etiology is much rarer and causes fewer diseases.", "Second mechanism is indirect damage, ie on the mechanism of self-harm. The reason, in this case acting on the body, it causes reactions that, in turn, cause damage to organs and tissues, in fact it is a mechanism of self-harm, which only runs external cause. The most striking example is the allergic reaction. Antigen (allergen), getting into the internal environment of the body, does not cause direct damage, it does not have such properties. Moreover, a number of people it causes allergic reactions, and other people they do not occur, which also indicates that the direct damaging effect allergens do not have. However, if a number of conditions that lead to increased sensitivity to the allergen (sensitization) of the body, re-entry is accompanied by its reaction with immunoglobulins, in the case of immediate-type allergic reactions to the then upcoming activation of mast cells, which are fixed to the immunoglobulin E and subsequent release of cells of biologically active agents, mediators of allergy. It is from their number and determine the nature and extent of tissue disorders - redness, swelling, pain, tears, salivation, bronchospasm, etc. up to the development of anaphylactic shock. Thus, although the damage occurs at the time of the cause, that is, readmission allergens, but the damaging effect mechanisms have reactions to these effects, in fact the reaction of protection.", "Third mechanism disregulation is the etiology of diseases. According to this mechanism, apparently, develops hypertension, autonomic dysfunction may have some mental illness. In this case, the initial damage (action?) Is minimal and not ill, due to an almost complete compensation by adaptive responses that are triggered by a series of regulatory changes. Subsequently, however, lead to changes in the regulation disregulation disorders that cause has significant problems (damage). The latter seems like otstrochennym injury time, while the first violation is disregulation state. This", "mechanism is formulated on the basis of the etiology of the teachings of GN Kryzhanowski disregulation disease and needs further study [6].", "In general, we can summarize that the etiology is the study of the mechanisms of the disease, in which the interaction of causes and the body, which is what the influenced by the way of damages, which should be considered as part of the beginning of starting any disease [5].", "It should be emphasized that the role of reason and the body in the process of interaction may be different. Effects (factors) are environmental causes of the disease, when their parameters (characteristics) beyond evolutionarily familiar, and therefore those which formed the physiological adaptation mechanisms devices. Mechanisms of self-harm is triggered when a result of genotypic or phenotypic changes physiological adaptive responses vary or decrease, the body is in a state of flux, so that the interaction with the environment or the protection of the reaction are insufficient and these effects become pathological, example is infectious complications of AIDS, hypothermia in patients with hypothyroidism, etc. or excessive reactions expressed adaptation condition hiperreaction cause less protection and adaptation, with a reduction in how much damage appliances and even death of the organism - anaphylactic reactions and shock. It is important to stress that the body responds to these pressures (injury) will not only protect the specificity of the reaction (devices), but also with the common stereotypes of mechanisms, such as the development of the general adaptation syndrome (stress). This, in turn, explains the emergence of the theory polyetiology diseases where different causes produce the same type of disease as a result of self\u00acharm occurring to the standard mechanism of injury as a result of their hyperactivity.", "Consequently, the physician in establishing the origin (etiology) of the disease should not only look for the cause as the effect of its of a factor, even with the conditions of their actions, and even more needs to be configured to the need for understanding and interaction with the body to cause the establishment of the role of each, the causes and the body, the damage is a beginning, ie etiology of the disease.", "Chapter 4. Pathogenesis", "Thus, damage is the beginning of the disease, but it does not have all the disease. The latter is the primary lesion, with all subsequent amendments, a great variety of reactions of the organism, which is a disease of the adaptation of the organism in terms of damage. Considering the disease but the steady state and dynamic process that takes a different time, which can sometimes take years or decades, we apriori assume that this is not a mechanical set of lesions and reactions to it, but a dynamic process. The process involves the development, however, in this case to define the driving force of the development of the disease. Certainly, the relationship and the exact dependence on the", "etiology of the disease suggests that this effect may be the driving presence and permanent effect on the body causes. This would seem the most logical mechanism of the disease as a result of the constant presence and action of the cause was the most rare and insignificant. Among such diseases except that you can include some parasitic diseases, and the classic example is in the pathophysiology of scabies, when the disease is fully predetermined action causes - scabies mite. His action causes the disease removal - recovery. However, even the most parasitic diseases are more complex processes where the damage by parasites of the human body combined with the emergence of secondary damage arising in the course of disease, complicating the course and outcome of the disease. A second possible explanation of the dynamics of the disease process is the presence and action in the body causes, but this interaction necessarily connected with the body. Moreover, it is the interaction of changes in the dynamics of the disease, mainly due to changes in the body that alter the character and even the form of the human interaction with the cause. These diseases are much more, and, above all, is a chronic infectious disease. Usually striking example is tuberculosis. Indeed, if in the course of treatment can be achieved by reorganization of the body tubercle bacillus, it is possible to speak of recovery from tuberculosis which would not be a significant impact of the disease, up to cardiopulmonary diseases. At the same time, depending on the condition of the body, especially his immunity, the disease can manifest itself in many different clinical forms of primary miliary tuberculosis to etc. However, it appears that more disease develops in this type of relationship with the etiology, the interaction causes to the body, with the emergence of the primary damage appears only in the form of the first push, and subsequently develop the disease without cause, only by the mechanism of self-development. An example is any stressinduction disease - myocardial infarction mechanism noncoronary necrosis, hypertension, glomerulonephritis, and other important finding considering the role of etiology (cause) of the disease is in the position that in addition to exceptional role of etiology, where to start any disease , human disease subsequently developed to a great extent, and in many cases, completely on their own, so they self-developing. These mechanisms of disease pathogenesis have been called. The term pathogenesis (pathos - disease) suggests that the disease is regarded as a process, not a set of violations originally arose as a result of interaction with the cause. However, in a detailed analysis of the problem immediately raises the key question of what is the driving mechanism for the development of disease (pathogenesis) in cases when the cause ceases to act, what is more and more pathological changes in the body. The pattern of this question becomes even more obvious when we examine the initial stages of the development process. So, due to the mechanisms of etiology, is the occurrence of injury, primary, source, the key component of the disease. This in turn leads to the development of a number of reactions to eliminate damages and compensation arising functional", "disorders. Compensatory response is adaptation to injury, and this ensures the adaptation of the organism, although usually on a smaller range than normal, in health, but is sufficient for the (continuing) life. Moreover, each of the reactions are inherently adaptive, ie protective. There is no reaction in response to injury, initially inherently pathological. In this case, if the reactions of protection can compensate for the damage, and the cause of action has stopped, then the disease must end, happen recovery. Thus develop severe disease, such as altitude sickness. However, the practice of medicine suggests that many of the diseases become chronic and develop a long period, sometimes for life. Moreover, it is interesting that their development is really dependent on the primary damage is more significant than it is, the greater the likelihood of chronic disease. However, in almost all cases, the primary defensive reactions compensate the damage, although often not completely. In cases where compensatory mechanisms are inadequate and even a limited adaptation does not occur, the disease ends in death. However, clinical observations suggest that in the course of the disease appear more and more violations, which often determine the severity of the disease, its outcomes. In the analysis of this question is to determine the key mechanisms of secondary disorders (damage) in the development of the disease. Rather quickly found that they are not directly caused by the cause. Analysis of this problem, in the end, led to a key concept pathophysiologists pathogenesis - unity mechanisms of damage and protection in the dynamics of the disease. It was found that in all cases the pathogenesis is likely that each protective and adaptive response of the organism can become damaging, ie becomes a source of secondary fractures (damage) in the body of a patient. Such a possibility is realized in cases where there is a significant, over-activation of defense reactions. Therefore, the higher, harder, protection, the greater the likelihood of further damage.", "So in theory of medicine appeared, and then giving way to the concept of the unity and struggle of opposites reactions and damage protection as a basic mechanism of self-development, self-movement of the disease [7]. Consider from this point of the disease. Consequently, if the etiology of the disease is that the interaction with the organism causes leading to the primary injury, in response to which the body includes adjustment reactions to injury, the reaction of protection to which there is compensation arising irregularities. The higher the protection, the greater the likelihood that they themselves produce new defense reaction, secondary (pathogenic) injury, self\u00acharm. In response to a trigger other responses to the protective nature of the orientation that compensate for previous violations, but they can also be damaging. In this primary, Causal violations can be fully compensated, liquidated, and the cause of subsequent violations are the only proper response and protective mechanisms. In this case, the disease occurs later in most cases, regardless of the causes and mechanisms of their occurrence. The most striking example of this is", "an autoimmune disease in which the initial antigen challenge (infectious or noninfectious) during the subsequent stages of the disease is not present, and the disease progresses (glomerulonephritis, hepatitis, etc.).", "Consequently, the pathogenesis of the disease is the mechanism of self-development as a process of inter-related and interdependent, consecutive reactions, each of which, having emerged as an adaptive protection, she also becomes damaging, causing the following protective reaction with similar dynamics, as a subsequent link pathological process. Subsequent analysis of the dynamics of pathological processes has shown that not all parts of it are equal. It turned out that some parts of pathogenesis are crucial for the further development of pathological processes. Such a link in each pathological been called the main component of the pathogenesis, because it determines how the further development of the disease. In this connection, the definition of such a link is an important pathophysiological and clinical challenge. This is already the classical concept of the pathophysiology, yet causes a number of issues. The main one is that, in principle, any link shaping circuit (pathogenesis), the disease is to predetermine future and, therefore, its elimination (normalization) should lead to a \"fault\" chain of pathogenesis. Between the experimental data and clinics do not allow to accept. The answer to the question can be found in the following well-known concept of pathogenesis - the role of general and local in pathogenesis. It has long been the perception of the fact, however was not a local disease process (local damage) in the disease process in one way or another always involves the whole body. The physiological basis of the development of the disease is that the human body is not a set of separate organs and systems operating in isolation, but is a functional whole; changes in its parts are always accompanied by coupled reactions of adaptation (of protection). The pathology of this means that in the process of compensation of damage not only involves the local area, but also the overall number of mechanisms. However, realizing that the defensive reactions can always be damaging, pathological, it can be concluded that the disease is not only the development of a single pathological process may occur at the same time a network of interconnected, interacting processes, aimed at adapting than one organ or system of the body and as a whole to the pathogenic effects of the environment. For the first time this idea was clearly expressed in the Guide to the pathophysiology of AI Zaichik and LP Churilov [8], this is also about the types of branched pathogenesis writes and AV Ataman, pointing to the two species - the divergence and convergence [10]. Certainly, the role of compensation of damage to different branches of the pathological processes in the network of pathological processes, different in their effect on the dynamics of the disease. Consequently, the main pre-empting the disease process, and includes the most important, ie main elements. Mainly because the dynamics of the disease, the role of the individual units, even the basic pathological", "process is often changing, and therefore the main link is not always constant throughout the illness. At each stage of the disease may be their basic pathogenesis. On the complex dynamics of the pathogenesis and the set shows the classical notion of a vicious circle. It turned out that she pathogenetic chain is not always a linear developmental process. Often, starting from a certain level, she later returned to him, causing even more damage, ie is as if the closure of the pathological process in terms of the type, and as with disturbances in the body increases, this group was called vicious. This is further evidence of the complex space-time configuration of pathogenesis.", "Thus, the disease is extremely complex organism's adaptation to the environment involving many parts (organs and systems) to the dynamic self-developing process protection (device), also causes the formation of multiple violations dynamic state of the temporary arrangements [9]. It should be noted that in this case, not all the mechanisms of the pathogenesis of available clinical observation, or they appear to have a generalized form of adaptation, while these external manifestations of hidden complex and diverse pathogenic mechanisms for the general is not a collection of private (parts). So firmly established in the pathophysiology of the concept of the internal mechanisms of pathogenesis and their external (clinical) dimensions.", "So now identified the basic mechanisms of pathogenesis and patterns that allow us to understand the dynamics of the disease, their internal logic. In general, we can say that the modem paradigm of the disease should be considered as self-development and self-movement of pathology as a way to achieve the adaptation of the organism in terms of damage and pathogenesis (disease), is the only possible form of the organism's adaptation to the environment, evolution shaped and genetically fixed. However, the pathological process is not the only form of response of organisms and the development of pathology. Previously, we have pointed out that the severity of the disease depends on the extent of the primary injury, because it determines the need for the inclusion of any compensatory responses and expression and, consequently, the future dynamics of disease in cases where the damage is insignificant and often locally , the answer can not develop a process, one or more of the reactions, which are referred to as a pathological reaction. Completion of the pathological process, however, the availability of sufficient permanent disabilities (limitations) of functions leads to a pathological condition characterized by low dynamics or even its total absence.", "Chapter 5. Periods and disease outcome", "Is usually in the development of the disease can be divided into three main periods: the latent, for infectious disease incubation, the period of clinical manifestations, and outcome during the height of the disease or to a chronic disease [7]. The overall result of acute (rarely chronic) disease is: complete or incomplete recovery, death. The presence of various diseases almost", "43", "identical periods also suggests that there are common principles for the development of various diseases.", "Latent period of the disease is characterized by the fact that in most cases this is not yet the damage occurs, or the extent of its insufficient, due to the fact that cause the body does not react. So, with infectious diseases entering the infectious agent in the body, depending on its pathogenicity is often not accompanied by any clinical symptoms as long as there is no damage. However, in this period of change begins in the body due to the fact that the antigenic determinants of the bacteria or virus develop antibodies or sensitized lymphocytes, and earlier included a nonspecific reaction of phagocytosis. It is formed by the interaction of the immune response to viruses cause or bacteria, and are often damaged by the mechanisms (self-harm), ie by the second mechanism etiology of diseases, which, along with the destruction of a foreign agent (cause), there is damage, which is accompanied by significant clinical findings in the second period of the disease. As a rule, therefore, is developing most of the diseases, which are particularly acute infectious diseases. Another cause of the latent period of the disease, which is typical for most chronic diseases, is that the development of the minimum damage that can not be detected by themselves clinically develop reactions protection, adaptation leads to almost complete indemnification of, and thus to preserve the ability to maintain required level of adaptation, at least in terms of conventional stationary loads on the human body, and only increase damage, which reaches the limit adaptability protective reactions, leads to the manifestation of functional impairment with a particular clinical picture the main period of the disease, or protective reaction reaching its maximum become damaged.", "Outcome, in turn, depend on the ratio of the amount of damage (primary and in the development of pathological processes) and compensatory abilities protective reactions. Heavy damage in which defense mechanisms do not provide compensation, lead quickly to death. So, in case of significant damage (violations) arising under the influence of the interaction of the body and causes, the extent of which can not be compensated for by the reactions of protection, the last reaching maximum intensity, causing secondary damage in the body. Thus, as an initial injury (disorder) can not compensate for the combination of it with the severity of secondary pathology, adaptation of the body can be achieved only in a very limited range, and the degree of its steadily decreasing, damage (damage) are increasing, which could eventually lead to impossibility of adaptation followed by death. In the second case, if the primary disorders compensated by the reactions of protection, the pathological process is developing in the direction of increasing (normalization) adaptive capacity, leading to recovery. Depending on the degree of normalization of primary disturbances (etiotropic) begins with the restoration of damaged or complete recovery from", "illness when the adaptive ability of the body are restored completely, or in some cases, particularly after acute infectious disease with the formation of immunity, even with their increase. However, often, certain injuries lead to violations, especially morphological, which are normally compensated by the existence of the body only through the reserve capacity of the organs and tissues interorgan interconnection and compensation recovery occurs, but is not complete. Hallmark of his is to reduce the maximum adaptability. Thus, the incomplete recovery is always due to the fact that the primary etiotropic damage is accompanied by destruction of tissue (organ) - bringing the number of structural and functional units of its decrease.", "Chapter 6. Sanogenesis", "To one of the most important theories of clinical medicine is sanogenesis. Sanitas - health, genesis - origin, development, ie mechanisms of recovery. The logic of medical thinking really takes the assertion that recovery of man, of course, is due to the inclusion of certain recovery mechanisms, etc. Meanwhile, the domestic theoretical medicine is one of the most debated issues. Although more than 30 years, Professor SM Pavlenko was formulated the sanogenesis as the mechanism of recovery [10] theoretical idea has not progressed in that time a single step, in fact it was subjected to withering criticism position was rejected by a majority of pathophysiology. What caused such hostility among theorists of medicine? So, historically happened that this time has finally firmly established in the pathophysiology of assumptions on the driving mechanism of the development of pathological processes - the unity of damaging and protective mechanisms of pathogenesis. It became clear that each defense mechanism is potentially damaging. Along with the really fundamental, it automatically raised the question that if in the pathogenesis of so organically combined damage and protection, whether at the same allocate out pathogenesis, more pathological processes, some of its mechanisms, which are the only mechanisms of recovery, this is extremely protective. It seemed, in this case, it goes without collapsing the fundamental principle of pathology, ie, Unity damage and protection, and thus the possibility to explain the mechanism of the disease its self-motion, self pathogenesis.", "However, by the end of XX century, there is a need, based on the fundamental concepts of the pathogenesis deepen and expand the current understanding of the disease. This was due to the practical needs of the health services. It was necessary to define the concept of premorbid conditions, to clarify the mechanisms underlying the recovery, rehabilitation, etc. Ask areas such as adaptation, regenerative, rehabilitation medicine. For their understanding and development of not only the concept of the unity of injuring and protective mechanisms. As in the period of rehabilitation or recovery, with preventive treatment is often damaging effects may be absent.", "Moreover, methods of treatment related to a method of promoting adaptive capacity in healthy individuals, and yet they can not always be attributed solely to the effects valeological because in many cases, rehabilitation is a method of promoting regenerative capacity of the body after an illness with symptoms of incomplete recovery.", "Should pay attention to the fact that prominent pathologists in the XIX century, turned to the theory of these matters. An excellent example is the work of Professor VV Podvysotski he published in 1894, \"On the reserve forces of the body and the importance of them to fight the disease.\" In it, he writes that \"in a living organism to recognize the existence of a number of replacement forces in two ways: ready and growing again, the newly formed\" [13]. Detailed analysis of the development of disease from the perspective of inclusion and education of new spare forces VV Podvysotsky concludes that, \"... that the guarantee of recovery from illness, success in combating it is first and foremost in the reserve of energy, which can detect all life ... \". In fact, our great predecessor, draws our attention to the complexity of the disease, the fact that along with the development of pathological processes and includes many security, which are themselves often do not cause damage, but have significant influence on the mechanisms of the disease, contributing to recovery. However, beyond the development of the doctrine of the disease characterized by a primary care theorists to the pathologic process as the basis of the disease, rather than to a protective adaptive mechanism of the body [11].", "It was only in the mid 70's by Professor SM. Pavlenko attempted theoretical basis of mechanisms of recovery. Formulated the concept of sanogenesis \"sanogenesis - a dynamic process of protective-adaptive mechanisms (physiological and pathological nature) arising under pre\u00acexisting disease that develops throughout the disease process and aimed at restoring the body's self\u00acregulation\" [10].", "However, this position was taken solely as a new division of disease mechanisms at exceptionally damaging or protective (sanogenetic), which was the main reason of official denial sanogenesis as an important theoretical trend in pathophysiology. Subsequently, despite the complete rejection by most theorists of having only protective, ie sanogenetic mechanisms in clinical medicine have become more and more use of the term sanogenesis and began to study the mechanisms of recovery. Such a mismatch between the needs of clinical and theoretical position could not last long and, indeed, by the end of the 20th century appeared again attempts to justify the presence of sanogenetic mechanisms. Moreover, the reason will not only serve the needs of practical medicine. Thus, in pathological processes are having difficulty understanding the mechanisms of recovery only from a position of unity and struggle of opposites. After all, if we agree that the primary mechanism of recovery will only reduce the amount of damage, as a", "consequence of the fall and the severity of protection, which will also reduce the subsequent damage. Consequently, it may cause a kind of \"attenuation\" of the pathogenesis, but it is not clear how one should recover the level of adaptation, without additional protection, but do not damage the mechanism. All the more impossible for such a treatment is increasing the degree of an organism adapted after an illness, previously cited example of improving immunity after acute infectious diseases, such as influenza. We have previously shown that the main cause erroneous interpretation of the disease pathogenesis is the identification of all with a single pathological process [9]. If in the human disease would develop only a single disease process, which would be consistent and interconnected, mutual functional triples defense and damage as a change of the same pathogenesis, then no other including sanogenetic mechanisms simply could be. However, in our opinion, the disease is much more complex space-time structure. First, the pathogenesis is not home very much linear, but a much more complex linear network character. At the same time, along with the main direction of development of the pathological process, there are many \"side\" processes. In essence, each link can cause a reaction response of conjugated systems, which fully complies with the principle of response body as a complex integrated system, ie interacting subsystems. Moreover, most of these reactions is adaptive and \"unload\" the basic system that is broken, damaged. This provides the necessary (possible) level of adaptation of the patient with those injuries that occur in organs and tissues. However, not all adaptive response protection reach such intensity to cause damage, but they can induce other mechanisms of adaptation (of protection). Such an \"unloading\" of the basic pathological circuit in turn reduces the degree of activation of defense mechanisms, and thus the severity of damage.", "Protection mechanisms and circuit protective-adaptive reactions, which are not themselves be regarded as damaging sanogenetic, and the process of adaptation, with systems offering compensation is to be determined as sanogenesis. Thus, the structure and dynamics of the disease involves both the pathogenesis and sanogenesis. Consequently, recognition of the complex and diverse mechanisms sanogenetic not only enhances our understanding of the disease, but, most importantly, is an important part of clinical, including mainly rehabilitation medicine. On the last VV Podvysotsky said: \"The great mass of therapeutic agents that are offered at various times to treat diseases remain intact and strengthened only by those whose action is ... to strengthen the weakened defense and emergency forces of the body ...\" [11].", "Chapter 7. Meaning of the modern theory of disease to clinical medicine", "Foregoing ideas about the nature of the disease were the result of the hard work of theoretical medicine, and especially pathophysiology. However, the criterion of truth is the clinical", "practice. Practitioner in his clinical judgment and action based on an adequate theoretical understanding of the nature of the disease can achieve the most effective results in their clinical practice. General theoretical ideas are needed to work with the doctor of the individual patient at all stages of healing on the prevention, diagnosis, treatment and rehabilitation. So, when planning preventive measures for any disease, we must remember that they are designed to provide solutions to two points. First, due to the fact that every disease has a cause, it is necessary to prevent the possibility of the action and the degree of influence of etiological factors on the human body.", "Secondly, based on the understanding of the mechanisms of etiology, must act on the human body in such a way as to prevent interaction with the etiologie factors, or to reduce the body's response to the limits of physiological adaptation, ie adjust the form and degree of adaptive responses, because there are reasons not condition the result of its action, a lot depends on the response of the organism. So, historically, became traditional preventive measures to enhance immune defense, particularly hardening, and then the immunization, which provides for the formation of protective immune and non-immune reactions. Subsequently have been actively used in the prevention of stress relieving activities, hypoxic training, etc.", "The concept of role in the etiology of diseases of the reasons is the theoretical basis of causal treatment, and that is either exclusively aimed at eliminating the causes (scabies), or at the same time takes into account the state of the organism in causal treatment (antibiotics) - their bacteriostatic effects in combination with the use of immunostimulatory drugs. Extremely important in the pathogenesis of disease development is the theoretical basis of pathogenetic therapy, which can be combined with causal when the cause is present throughout the disease, or used independently, including the self-development of the disease if there is already without cause. Based on the role of the individual in the pathogenesis of a disease the doctor in the first place plans to act on the main link in the pathogenesis, strives to avoid a vicious circle. However, applying etiotropic and pathogenetic therapy, the physician should not forget about the possible impact on the disease by stimulating sanogenetic mechanisms - it is usually restorative therapy, metabolites, vitamins, etc. Hence, the object of treatment (correction) is not only a body or system that are damaged or violated, and the entire body, not just involved in the pathogenesis, but in sanogenesis.", "Finally, the theoretical basis of rehabilitation on the one hand is the idea that recovery is incomplete, as the structural and functional damage in the body of the disease (the system) is limited . The first step in this is to determine the maximum functionality of the body (system). This information is subsequently justifies subsequent rehabilitation strategies: restoration of structural and functional features body (stem cell therapy, gene therapy, graft, organ), or stimulation sanogenetic mechanisms of the body - interorgan, intersystem compensation.", "In Overall, each practitioner, starting to diagnose and especially the treatment of the disease should be clear that the disease is a complex adaptive process in the body damage (pathology). This damage, which begins with the disease, there is always the result of interactions between the active and reactive causes the body. Moreover, all recorded in the patient's changes are always part of this device, so always play a protective role, but they are in most cases damaging, ie serve as vehicles for self-development of the disease. Therefore, all the effects of the disease should increase safety, adaptive its capabilities, while reducing the likelihood of secondary pathogenic damaging effect.", "Conclusions", "Skillfully guided in this complex process of vital activity, doctor his actions to help the body to adapt itself to support its activities, to reduce the degree of impairment, damage and, finally, as to restore the adaptive capabilities of the organism, that is, ensure its recovery.", "Each disease (nosology), in each patient the etiology, pathogenesis, sanogenesis have their own characteristics, but they are all based on the general principles of functioning of the body in health and disease, which are described by the theory of concepts and mechanisms of disease.", "Every step in the knowledge of the disease to the physician is a personal revelation of this fact, and the patient base of effective diagnosis and treatment.", "Open Access", "This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.", "References in transliteration", "1.\t Zajko NN. 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Odesa. 2006. 5-7.", "References in ogirinal", "1.\t \u0417\u0430\u0439\u043a\u043e HH. \u041f\u0430\u0442\u043e\u043b\u043e\u0433\u0438\u0447\u043d\u0430 \u04441\u0437\u044e\u043b\u043e\u043f\u044f. \u0420\u0435\u0434. \u0417\u0430\u0439\u043a\u043e \u041d\u041d, \u0411\u0438\u0446\u044c \u042e\u0412. \u041c. \u041c\u0435\u0434-\u043f\u0440\u0435\u0441-\u0448\u0444\u043e\u0440\u043c. 2006. 635 \u0441.", "2.\t \u041b\u0438\u0442\u0432\u0438\u0446\u043a\u0438\u0439 \u041f\u0424. \u041f\u0430\u0442\u043e\u0444\u0438\u0437\u0438\u043e\u043b\u043e\u0433\u0438\u044f \u0442. 1. \u0420\u0435\u0434. \u041b\u0438\u0442\u0432\u0438\u0446\u043a\u0438\u0439 \u041f\u0424. \u041c. \u0413\u042d\u041e\u0422\u0410- \u041c\u0435\u0434. 2002. 751 \u0441.", "3.\t \u0420\u0435\u0434. \u0410\u0434\u043e \u0410\u0414, \u0410\u0434\u043e MA, \u041f\u044b\u0446\u043a\u0438\u0439 \u0412\u0418 \u0438 \u0434\u0440. \u041f\u0430\u0442\u043e\u043b\u043e\u0433\u0438\u0447\u0435\u0441\u043a\u0430\u044f \u0444\u0438\u0437\u0438\u043e\u043b\u043e\u0433\u0438\u044f. \u041c. \u0422\u0440\u0438\u0430\u0434\u0430. X. 2002. 616 \u0441.", "4.\t \u0414\u0430\u0432\u044b\u0434\u043e\u0432\u0441\u043a\u0438\u0439 \u0418\u0412. \u041f\u0440\u043e\u0431\u043b\u0435\u043c\u0430 \u043f\u0440\u0438\u0447\u0438\u043d\u043d\u043e\u0441\u0442\u0438 \u0432 \u043c\u0435\u0434\u0438\u0446\u0438\u043d\u0435 (\u044d\u0442\u0438\u043e\u043b\u043e\u0433\u0438\u044f). \u041c. \u041c\u0435\u0434\u0433\u0438\u0437. 1962. 175 \u0441.", "5.\t \u0413\u043e\u0436\u0435\u043d\u043a\u043e \u0410\u0418. \u042d\u0442\u0438\u043e\u043b\u043e\u0433\u0438\u044f \u0432 \u0441\u0432\u0435\u0442\u0435 \u0441\u043e\u0432\u0440\u0435\u043c\u0435\u043d\u043d\u044b\u0445 \u043f\u0440\u0435\u0434\u0441\u0442\u0430\u0432\u043b\u0435\u043d\u0438\u0439 \u043e \u043c\u0435\u0445\u0430\u043d\u0438\u0437\u043c\u0430\u0445 \u0432\u043e\u0437\u043d\u0438\u043a\u043d\u043e\u0432\u0435\u043d\u0438\u044f \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u0439. \u0411\u044e\u043b\u0435\u0442\u0435\u043d\u044c VII \u0447\u0438\u0442\u0430\u043d\u044c iM. \u0412\u0412 \u0428\u0434\u0432\u0438\u0441\u043e\u0446\u044c\u043a\u043e\u0433\u043e: \u043d\u0430\u0443\u043a. \u043a\u043e\u043d\u0444. 22 - 23 \u0442\u0440\u0430\u0432\u043d\u044f 2008 \u0440. \u0422\u0435\u0437\u0438 \u0434\u043e\u043f. \u041e\u0434\u0435\u0441\u0430. 2008. 27-28.", "6.\t \u041a\u0440\u044b\u0436\u0430\u043d\u043e\u0432\u0441\u043a\u0438\u0439 \u0413\u041d. \u0414\u0438\u0437\u0440\u0435\u0433\u0443\u043b\u044f\u0446\u0438\u043e\u043d\u043d\u0430\u044f \u043f\u0430\u0442\u043e\u043b\u043e\u0433\u0438\u044f. \u0420\u0435\u0434. \u041a\u0440\u044b\u0436\u0430\u043d\u043e\u0432\u0441\u043a\u0438\u0439 \u0413\u041d. \u041c\u043e\u0441\u043a\u0432\u0430. 2002. 96 \u0441.", "7.\t \u0410\u0434\u043e \u0410\u0414. \u0412\u043e\u043f\u0440\u043e\u0441\u044b \u043e\u0431\u0449\u0435\u0439 \u043f\u0430\u0442\u043e\u043b\u043e\u0433\u0438\u0438. \u0420\u0435\u0434. \u0410\u0434\u043e \u0410\u0414. \u041c. Medicine. 1985. 240 \u0441.", "8.\t \u0417\u0430\u0439\u0447\u0438\u043a \u0410\u0418. \u041e\u0431\u0449\u0430\u044f \u043f\u0430\u0442\u043e\u043b\u043e\u0433\u0438\u044f. \u0420\u0435\u0434. \u0417\u0430\u0439\u0447\u0438\u043a \u0410\u0418, \u0427\u0443\u0440\u0430\u043d\u043e\u0432 \u041b\u0418. \u0421\u0430\u043d\u043a\u0442-\u041f\u0435\u0442\u0435\u0440\u0431\u0443\u0440. \u042d\u041b\u0411\u0418. \u0421.\u041f\u0431. 2005. 655 \u0441.", "9.\t \u0413\u043e\u0436\u0435\u043d\u043a\u043e \u0410\u0418. \u041f\u0430\u0442\u043e\u0433\u0435\u043d\u0435\u0437 \u0438 \u0441\u0430\u043d\u043e\u0433\u0435\u043d\u0435\u0437 \u0432 \u0441\u043e\u0432\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0439 \u0442\u0435\u043e\u0440\u0438\u0438 \u0431\u043e\u043b\u0435\u0437\u043d\u0438. \u0411\u044e\u043b\u0435\u0442\u0435\u043d\u044c VI \u0447\u0438\u0442\u0430\u043d\u044c \u00bf\u043c. \u0412\u0412 \u0428\u0434\u0432\u0438\u0441\u043e\u0446\u044c\u043a\u043e\u0433\u043e, \u043f\u0440\u0438\u0441\u0432\u044f\u0447\u0435\u043d\u0438\u0445 \u0434\u043e 150-\u04401\u0447\u0447\u044f \u0437 \u0434\u043d\u044f \u043d\u0430\u0440\u043e\u0434\u0436\u0435\u043d\u043d\u044f: \u043d\u0430\u0443\u043a. \u043a\u043e\u043d\u0444. 31 \u0442\u0440\u0430\u0432\u043d\u044f - 1 \u0447\u0435\u0440\u0432\u043d\u044f 2007 \u0440. \u0422\u0435\u0437\u0438 \u0434\u043e\u043f. \u041e\u0434\u0435\u0441\u0430. 2007. 8-11.", "10.\t \u041f\u0430\u0432\u043b\u0435\u043d\u043a\u043e \u0421\u041c. \u041d\u043e\u0437\u043e\u043b\u043e\u0433\u0438\u044f. \u0423\u0447\u0435\u0431\u043d\u0438\u043a. \u0420\u0435\u0434. \u041f\u0430\u0432\u043b\u0435\u043d\u043a\u043e \u0421\u041c. \u041c. 1947. 63 \u0441.", "11.\t \u041f\u043e\u0434\u0432\u044b\u0441\u043e\u0446\u043a\u0438\u0439 \u0412\u0412. \u041e \u0437\u0430\u043f\u0430\u0441\u043d\u044b\u0445 \u0441\u0438\u043b\u0430\u0445 \u043e\u0440\u0433\u0430\u043d\u0438\u0437\u043c\u0430 \u0438 \u043e \u0437\u043d\u0430\u0447\u0435\u043d\u0438\u0438 \u0438\u0445 \u0432 \u0431\u043e\u0440\u044c\u0431\u0435 \u0441 \u0431\u043e\u043b\u0435\u0437\u043d\u044c\u044e. \u0420\u0435\u0434. \u041f\u043e\u0434\u0432\u044b\u0441\u043e\u0446\u043a\u0438\u0439 \u0412\u0412. \u0421.\u041f\u0431. 1901. 18 \u0441.", "12.\t \u0413\u043e\u0436\u0435\u043d\u043a\u043e \u0410\u0418. \u0421\u0430\u043d\u043e\u0433\u0435\u043d\u0435\u0437: \u0422\u0435\u043e\u0440\u0438\u044f \u0438 \u043f\u0440\u0430\u043a\u0442\u0438\u043a\u0430. \u0411\u044e\u043b\u0435\u0442\u0435\u043d\u044c V \u0447\u0438\u0442\u0430\u043d\u044c \u00bf\u043c. \u0412\u0412 \u0428\u0434\u0432\u0438\u0441\u043e\u0446\u044c\u043a\u043e\u0433\u043e: \u043d\u0430\u0443\u043a. \u043a\u043e\u043d\u0444. 25 - 26 \u0442\u0440\u0430\u0432\u043d\u044f 2006 \u0440. \u0422\u0435\u0437\u0438 \u0434\u043e\u043f. \u041e\u0434\u0435\u0441\u0430. 2006. 5-7.", "This is an open access article licensed under the terms of the Creative Commons Attribution Non -Commercial License (http://creativecommons.Org/licenses/by-nc/3.0/) which permits unrestricted, non- commercial use, distribution and reproduction in any medium, provided the work is properly cited.", "Samosiuk IZ, Chukhraeva EM, Samosiuk NI, Zuk\u00f3w W. Low-intensity physical factors in the treatment of and medical rehabilitation of patients with type 2 diabetes and their effects on lipid metabolism, [in] Czerwi\u0144ska Pawluk Iwona Ed., \u017bukowska Hanna Ed., Pilewska Wies\u0142awa Ed., Klimczyk Mariusz Ed., Szulc Adam Ed., Zuk\u00f3w Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 51-60. ISBN 9781329876002. 304 p. \u00a9 The Author(s) 2013. This articles is published with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland.", "Original Text published \u00a9 The Author (s) 2012. Samosiuk IZ, Chukhraeva EM, Samosiuk NI, Zukow W. Low-intensity physical factors in the treatment of and medical rehabilitation of patients with type 2 diabetes and their effects on lipid metabolism. Journal of Health Sciences. 2012;2(4):27-37. ISSN 1429-9623 / 2300-665X. Open Access Open Journal Systems of Radom University in Radom, Poland ISSN 1429-9623 / 2300-665X. 2012.", "LOW-INTENSITY PHYSICAL FACTORS IN THE TREATMENT OF AND MEDICAL REHABILITATION OF PATIENTS WITH TYPE 2 DIABETES AND THEIR EFFECTS ON", "LIPID METABOLISM", "IZ Samosiuk1,2, EM Chukhraeva1, N1 Samosiuk1, W Zukow3", "National Medical Academy of Postgraduate Education, named PL Shupyk, Kiev, Ukraine department of Health Sciences of Radom University, Radom, Poland department of Health of University of Economy, Bydgoszcz, Poland", "\u00a9 The Author(s) 2012;", "This article is published with open access at Licensee Open Journal Systems of Radom University in Radom,", "Poland", "Abstract", "Background. The beginning of the third millennium was marked by rapid increase in the number of patients with diabetes mellitus (diabetes). Not infectious epidemic of the XXI century named disease (29), which in 2010 hurt 285 million people. The vast majority of patients - patients is diabetes type 2 (diabetes 2).", "Objective. Clinical studies on the impact of low intense physical factors on lipid metabolism in patients with type 2 diabetes.", "Material and methods. The complex examination and treatment of 90 patients with diabetes 2 in the department of medical rehabilitation, physiotherapy and balneology NMAPE named PL Shupyk - Kyiv city clinical hospital of invalids of the Great Patriotic War (IGPW) (Endocrinology Branch). Patients proceeded to the planned rehabilitation, including the women was 55 (61.1%), men - 35 (38.9%), whose average age was respectively 78,5 \u00b1 4,7 y. and 79,6 \u00b14,1 y. This was a contingent of patients due to the specific hospital where patients are treated mainly elderly and senile age. Results. Using of magneto-laser-ultrasonic therapy in combination with exposure to electromagnetic radiation of mm-band (EHF-puncture) on lipid metabolism of patients with type 2 diabetes (a total of 90 patients) are given. Patients were randomly divided into 2 groups: first one (n = 40) received general (basic) therapy. The second one (n = 50) received magneto-laser-ultrasonic therapy + EHF puncture according to developed methodology. The possibility of positive influence of physical factors on lipid metabolism of patients DM 2 that is stored after a course of combined treatment for 6 months has been proved (catamnestic observations).", "Conclusion. Priority in the choice of therapy should be DM2 safety and efficacy of treatment, and, therefore, to study the characteristics of modern physical factors in diabetes two to prevent complications, treatment and medical rehabilitation of such patients is an important medical and social challenge.", "Key words: diabetes, physical therapy, lipid metabolism.", "Streszczenie", "Wst\u0119p. Pocz\u0105tek trzeciego tysi\u0105clecia cechowa\u0142 szybkim wzrostem liczby pacjent\u00f3w z cukrzyc\u0105. Nie zaka\u017ana epidemia XXI wieku o nazwie cukrzyca w 2010 dotyczy 285 milion\u00f3w ludzi. Zdecydowana wi\u0119kszo\u015b\u0107 pacjent\u00f3w jest chorych na cukrzyc\u0119 typu 2", "Cel pracy. Badania kliniczne nad wp\u0142ywem niskointensywnych czynnik\u00f3w fizycznych na metabolizm lipid\u00f3w u chorych na cukrzyc\u0119 typu 2.", "Materia\u0142 i metody. Kompleksowe badanie i leczenie 90 pacjent\u00f3w z cukrzyc\u0105 2 na Wydziale rehabilitacji medycznej, fizjoterapii i balneologii Akademii imeni PL Shupyk w Kijowie w Szpitalu Klinicznym Inwalid\u00f3w Wielkiej Wojny Ojczy\u017anianej (IGPW). Pacjenci przyst\u0105pili do planowanej rehabilitacji, w tym kobiety by\u0142o 55 (61,1%), m\u0119\u017cczy\u017ani - 35 (38,9%), kt\u00f3rych \u015bredni wiek wynosi\u0142 odpowiednio 78,5 \u00b1 4,7 r. i 79,6 \u00b14,1 r. By\u0142o to uwarunkowane pacjent\u00f3w ze wzgl\u0119du na specyfik\u0119 szpitala, gdzie pacjenci s\u0105 leczeni g\u0142\u00f3wnie os\u00f3by starsze", "Wyniki. Korzystanie z terapii magneto-lasero-ultrad\u017awi\u0119kowego w po\u0142\u0105czeniu z polem elektromagnetycznym pozytywnie wp\u0142ywa na metabolizm lipid\u00f3w u pacjent\u00f3w cukrzyc\u0105 typu 2. Wnioski. Leczenie i rehabilitacj\u0105 medyczna pacjent\u00f3w z cukrzyc\u0105 typu 2 mo\u017ce by\u0107 wspomagana fizjoterapi\u0105 magneto-lasero-ultradziwi\u0119kow\u0105 z wymiernym pozytywnym efektem leczniczym.", "S\u0142owa kluczowe: cukrzyca, fizykoterapia, metabolizm lipid\u00f3w.", "Introduction", "The beginning of the third millennium was marked by rapid increase in the number of patients with diabetes mellitus (diabetes). Not infectious epidemic of the XXI century named disease (29), which in 2010 hurt 285 million people. The vast majority of patients - patients is diabetes type 2 (diabetes 2). Social significance of diabetes is caused by its complications, high disability and premature death of patients (22a, 24).", "Patients with diabetes two live 10-15 years less than people without diabetes (2, 9, 11, 17). These authors stress that elderly people with obesity (BMI > 30 kg / m ) the risk of diabetes significantly increased compared with those with normal BMI.", "Diabetes 2 - systemic, chronic progressive disease caused by the presence of insulin resistance (IR), secretory defective P-cells with hyperinsulinemia, which leads to the emergence and progression of atherosclerosis, cardiovascular disorders in these patients and thus increase mortality (20, 21, 23-27).", "It is known that the central link diabetes 2 is IR, which is accompanied by compensatory hyperinsulinemia and a number of metabolic disorders: abnormal glucose tolerance (AGT), obesity, dyslipidemia and hypertension (7).", "Increased insulin content in blood plasma and the level of free fatty acids with altered glucose tolerance leading to accumulation of fat reserves and an increase in spontaneous lipolysis (8, 12). Increased utilization of fatty acids in the liver and hyperinsulinemia increase the synthesis triglicerids, cholesterol, LDL, etc., that is disturbed lipid metabolism.", "Thus, the violation of glycemic control, hyperinsulinemia, insulin resistance or AGT, dyslipidemia - are major factors in the development of complications of diabetes 2 and disability of patients.", "When correcting dyslipidemia very important ratio triglycerides / HDL, as these two components at two diabetes is closely linked (21, 28).", "To correct dyslipidemia in diabetes two important all available methods, which may include:", "\u2022\t change in lifestyle, which includes control body weight, adequate physical activity, sensible (the patient adequate) nutrition;", "\u2022\t different options pharmacological treatment (statins, niacin, fibrates, glitazones, antagonists kanabioid receptors, inhibitors of protein, transporting cholesterol esters; combination therapy, etc.),", "\u2022 non-medication methods other than diet and exercise therapy have to provide various", "options for physiotherapy, acupuncture, herbal medicine, etc. (2a, 2b, 6, 13).", "Analyzing the literature data it should be noted that most sugar lowering medications, including insulin, as well as hypolipidemic drugs are not without drawbacks and prolonged use of their effectiveness is reduced, and there are also some serious complications.", "Achieve and maintain normoglicemia, eliminating the major metabolic disorders to prevent various complications, it is accepted approach to therapy of patients with diabetes, and despite the presence of multiple drugs for the treatment of diabetes 2 full control of metabolic disorders and preserve the functional activity of beta-cells of the pancreas remains elusive to medical therapy (11, 16a)'", "So, you need a search for new medicines and non-pharmacological options and techniques in the treatment of diabetes 2, including methods of physiotherapy (FT).", "Objective: Clinical studies on the impact of low intense physical factors on lipid metabolism in patients with type 2 diabetes. Material and methods", "The complex examination and treatment of 90 patients with diabetes 2 in the department of medical rehabilitation, physiotherapy and balneology NMAPE named PL Shupyk - Kyiv city clinical hospital of invalids of the Great Patriotic War (IGPW) (Endocrinology Branch). Patients proceeded to the planned rehabilitation, including the women was 55 (61.1%), men - 35 (38.9%), whose average age was respectively 78,5 \u00b1 4,7 y. and 79,6 \u00b14,1 y. This was a contingent of patients due to the specific hospital where patients are treated mainly elderly and senile age. More detailed clinical and demographic characteristics of patients with diabetes 2, which were under our observation are given in Table. 1.", "To obtain objective data on the effectiveness of low intensive physical factors in the treatment and medical rehabilitation of patients with diabetes 2 and their effects on lipid metabolism, all patients (n = 90) randomized were divided into 2 groups, depending on the used medical and rehabilitation facilities.", "The first (n = 40) - received basal therapy used in the Endocrinology outpatient IGPW: health food diet with the use of number 9, dosed exercise therapy, electrophoresis of drugs, massage, oral sugar lowering (preferably sulfonylurea and biguanide drugs), by necessity - other drugs (depending on the comorbidity). In observation excluded patients who received insulin.", "The second (n = 50) - received magnetic laser ultrasoun therapy (MLUST) the developed method (Patent of Ukraine for useful model number 1167) in combination with basic therapy and EHF-puncture (top - provides low-impact electromagnetic radiation mm band (LIEMR-MMD) in acupuncture points (AP), auricule points.", "Algorithm procedures for diabetes 2 was as follows:", "In one session provided MLUST impact on the projection of the pancreas, segmental areas of innervation and solar plexus.", "If necessary stimulation performed segmental innervation zones of the kidneys and the projection of the same kidney. 2 hours held EHF-puncture in the following AP: E (III) 36; F (XII) 3; RP (IV) 2, 3; J (XIV) 12, 6.", "The next day (a day in the second session) impact made by these factors (MLUST) projection of liver segmental innervation zone and its projection C8-Th3 segments of the spinal cord. Thus the impact of ultrasound and magneto laser radiation to these areas is carried out simultaneously and this combination has therapeutic synergy.", "2-3 hours held UHF - puncture.", "The overall rate of combined physiotherapy 2 diabetes consisted of a 14-21 session, if possible 2-3 courses per year.", "Developed a combined method of FT with diabetes in treatment and rehabilitation complex was conducted against the background sugar lowering therapy and other medications. It carried out the necessary control of blood biochemical parameters (blood glucose, glycated hemoglobin, blood lipids and others), electrophysiological examinations and others. If under the influence of physical factors recorded decrease in blood glucose levels, the decision to lower doses of drugs or sugar lowering complete their withdrawal.", "In Table 1 shows the basic data that characterized the clinical demographics of patients with diabetes 2, which were under our observation with regard to the distribution group. Classification of patients the course of diabetes 2 (severity of illness, state compensation, etc.) was carried out according to Ministry of Health of Ukraine \u2116 356 from 22.05.2009 y.", "All patients observed on a single program, which included a thorough clinical examination with a mandatory minimum of laboratory-biochemical, instrumental and electrophysiological examinations.", "Laboratory and biochemical studies, but the general blood and urine tests included the study of carbohydrate and lipid metabolism, the functional state of the liver and kidneys.", "The study of carbohydrate metabolism was carried out according to MOH of Ukraine \u2116 356 of 22.05.2009 y., which include mandatory Indicators fasting glycemia and postprandial glycemia (2 hours after meals) and glycated hemoglobin (NbAlc, %). Laboratory and biochemical examinations included the determination of lipid abnormalities: total cholesterol (TCH), triglycerides (TG), cholesterol, low density lipoproteids (LDL) cholesterol, high density lipoproteids (HDL) was calculated index of atherogenic (IA).", "Well studied (for the indications ) the level of enzymes ALT and AST, the concentration of creatinine, urea, C reactive protein and sialic acid, etc.. Examined daily in the urine sugar concentration, the presence of glycosuria, acetonuria, macro-and microalbuminuria.", "Basic laboratory and biochemical studies were conducted in a certified laboratory of the Kiev City Clinical Hospital IGPW.", "Routine studies were ECG, blood pressure (BP), heart rate; selectively performed MRI, ACT, radiography, and electroencephalography electroneuromiography more.", "The results and their discussion", "In real piece of work contains studies on the influence of physical factors on lipid metabolism in patients with diabetes 2.", "Earlier, we published work on the application of EHF-puncture in experimental diabetes streptozocynes (14) and in the clinic (6).", "In Table 2 provides the actual material impact of treatment and rehabilitation complexes in lipid abnormalities in patients with diabetes 2.", "Table 1. Clinical and demographic characteristics of patients with type 2 diabetes who were under our observation.", "Main indicators\tGroups surveyed", "First (n = 40)\tSecond (n = 50)\tAll", "Abs.", "number.\t%\tAbs.", "number.\t%\tAbs.", "number.\t%", "Sex\tMale\t15\t37.5\t20\t40\t35\t38.9", "Female\t25\t62.5\t30\t60\t55\t61.1", "Age (years)\t61-75\t6\t15\t8\t16\t14\t15.6", "76-90\t34\t85\t42\t84\t76\t84.4", "Disease", "duration", "(years)\t<5\t11\t2.5\t\t2\t2\t2.2", "5-10\t3\t7.5\t2\t4\t5\t5.6", ">10\t36\t90\t47\t94\t83\t92.2", "Severity of illness\tMild\t9\t22.5\t12\t24\t21\t23.3", "Average\t20\t50\t24\t48\t44\t48.9", "Severe\t11\t27.5\t14\t28\t25\t27.8", "State", "compensation\tCompensation\t9\t22.5\t15\t30.0\t24\t26.7", "Subcompensation\t16\t40.0\t17\t34.0\t33\t36.6", "Decompensation\t15\t37.5\t18\t36.0\t33\t36.7", "Body Mass Index", "(kgm2)\t<25\t7\t17.5\t9\t18\t16\t17.8", "29-30\t20\t5050\t25\t\t45\t50.0", ">30\t13\t32.5\t16\t32\t29\t32.2", "Table 2. Influence of applied medical complex on lipid abnormalities in patients with type 2 diabetes (M \u00b1 m).", "Investigated", "parameters\tControl group (n = 20) Practically healthy persons\tGroups of surveyed", "first (n = 25)\tA%\tsecond (n = 30)\tA%", "Total Cholesterol, mol/1\t5,97 \u00b10,16\t1) 6,71 \u00b1 0,24\t\t7,19 \u00b10,2", "2)6,03 0,22\u00b1\t-10,2\t\u00b15,680,31\t21,1", "3)6,08 0,31\u00b1\t-9,4*\t\u00b15,230,27\t28,0", "4)6,04 0,23\u00b1\t-9,0 *\t\u00b15,240,3\t27,2", "TG, mol /1\t1,81 \u00b10,13\t1)2,21 0,49\u00b1\t-\t\u00b12,230,18", "2)2,0 0,43\u00b1\t-9,9*\t\u00b11,950,16\t12,6", "3)2,1 0,3 8\u00b1\t-5,0 *\t\u00b11,870,15\t16,2", "4)2,0 0,35\u00b1\t-9,5 *\t\u00b11,730,14\t22,5", "LDL Cholesterol, mol/1\t3,05 \u00b10,14\t1)4,5 0,31\u00b1\t\u2014\t\u00b14,990,30", "2) 3,8 \u00b1 0,28\t-15,6\t\u00b1 0,283,42\t-31,5", "3)3,79 0,31\u00b1\t-15,8\t\u00b12,960,17\t-42,7", "4)3,78 0,29\u00b1\t-16,0\t\u00b13,020,19\t-39,5", "HDL Cholesterol, mol/1\t1,45 \u00b1 0,04\t1) 1,21 0,08\u00b1\t-\t\u00b11,190,1", "2) 1,32 \u00b1 0,09\t\u00b19,0 *\t\u00b10,091,38\t\u00b115,

Radomska Szkoła Wyższa w Radomiu Radom University in Radom Annual Reports of Education, Health and Sport 9781329876262 Edited by Iwona Czerwińska Pawluk Hanna Żukowska Wiesława Pilewska Mariusz Klimczyk Adam Szulc Walery Zuków htti)://ois.ukw.edu.i)l/index.i)hi)/iohs/index htti)://ioumal.rsw.edu.i)l htti)s://i)bn.nauka.gov.i)l/search?search&searchCategorv=WORK&filter.inJoumal=49068 htti)s://i)bn.nauka.gov.i)l/search?search&searchCategorv=WORK&filter.inJoumal=36616 htti)://elibrarv.ru/contents.asi)?titleid=37467 Open Access Radomska Szkoła Wyższa w Radomiu Radom University in Radom Annual Reports of Education, Health and Sport 9781329876262 Edited by Iwona Czerwińska Pawluk Hanna Żukowska Wiesława Pilewska Mariusz Klimczyk Adam Szulc Walery Zuków htti)://ois.ukw.edu.i)l/index.i)hi)/iohs/index htti)://ioumal.rsw.edu.i)l htti)s://i)bn.nauka.gov.i)l/search?search&searchCategorv=WORK&filter.inJoumal=49068 htti)s://i)bn.nauka.gov.i)l/search?search&searchCategorv=WORK&filter.inJoumal=36616 htti)://elibrarv.ru/contents.asi)?titleid=37467 Open Access Scientific Council pcl rm Ah* ten / IWriUuilVkmdi pet л» Ah* mcd T сНсисЬгке a|>»i»««hxia it bam о pot л* Л h* med V Ed*» ilbonc-. pt\4 rm Ah* fee i l*>mki ihdmdi yr«dC г* Ah* med A GwhaAotlboncl pit VI ¿rwdoMkyitibamet pit м Abb I «Аур» ilbimei pet m AbbimdA GudpMiUnmcipitni Ah* med к OiJy* abmeipot /» Ah* itW W 1Ъри tfawi prt mAh* med V Mvn itbamci pot mAh* med ft S*d«lkn il Wmci pet mAh* era О C4od«»A.)t ilkranei. pit rm A h* eed t SmnanA il bm»c< pot m Ah* med 1. 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A ft Mmkmntr tbdmdl A med к Tick (Mmdl Editors-in-Chief Anatoliy Go/hcnko Walcn Zukow Co-editors Railodan Muukk-ta Maivk Napicrala Associate Editors Iwona C/.crwinska Pan In к Marius/ Klimcxyk Miroslaua Cicslicka Adam S/ulc Secretary Burtlomicj Nicspod/inski © The Author(s) 2012-2013. IWi elliiw ti p*Xd»d и* Орт Vr«w at Animal U^erli * I duration llrblh md Yfat ef Medomda VikateVlytan « Wadmdn Ihli tUdm t atmrdly b Wedmn Ptimd < lpm Амет Ш« mthbo h thdiihbrd tmdw 0» torn» * the СехИотСтштт Withmfm Ymreemnold lioeno nboh psu*» mi nenremmmiełmr. dtmtkmlen. emiiopedmtienb my mrAimc pmldodlb orlfhkkl mthcris» md mor ar* ordMad cc^ CD©® AMithmlrn Im mad ambbr tb ««k b lb maimn ifrdlad hj the hoIm m Итмг (be ml b mi nay Itml ommdt that Ihn owdai te ym m \ma mraflhr nmii. Wmmwrild Immey net melhlawml lb r—niritd pefm#4 Мт» A*» Ifym *trr trmvfonn. я bdld i^m rkf* nmk. son mat tMithpelhrimAbif wmt anti imd»« (bcamrer 4n*ai Imm te ltd« me. Ilertar btm mlkra tpnai m dm. IWm «(Игра *H m dm at Ihr m*1 f*h*tin IretMlomi tpmn I »•* * okorhmir laWInr). I dll a i hdrdn he It*» m*n mtm ot Ib mmąutm U Ulnar a ~papt * 1лтт\Ш If«* (1М*т j»d *|da ln«|| (>r*w( «тми I ia* Marolnal tyobnMomrvofir Valy* *e*fi>1i «amdaih W Ibhlhhlnj; llnuw; Radomska Sokoli Wy km n Radomiu. Radom I nłtrrdty In Radean Sir /.uhr/y cilrfo 2 24 tM Rjdom lei; *4* W JW 46 tt? imd orra idu, ul I’rlnflnc llouw: Rjdomtiji SrLob Wyższa n Kadoentai. Radem I nhmth In Radem Mr. /abrryeilet* 2 24-441 Radom Irl: »O iH 38J 6d 05 net* вrm edaol ISBN 9781329876262 Liczba znaków: 716 000 (ze streszczeniami i okładką). liczba grafik: 84 x 1 000 znaków (ryczałt) = 84 000 znaków. Razem: Liczba znaków: 800 000 (ze streszczeniami, okładką i grafikami) = 20,0 arkuszy wydawniczych. Number of characters: 716 000 (with abstracts). Number of images: 84 x 1000 characters (lump sum) = 84 000 characters. Total: Number of characters: 800 000 (with abstracts, summaries and graphics) = 20,0 sheet publications. DOI http://dx.doi.org/10.5281/zenodo.45634 Content: Introduction............................................................................................................................... 5 Mikołajewska Emilia. Incidence of neurogenic heterotopic ossifications in patients with neurological deficits = Występowanie neurogennych skostnień okołostawowych u pacjentów neurologicznych, [in] Czerwińska Pawluk Iwona Ed., Żukowska Hanna Ed., Pilewska Wiesława Ed., Klimczyk Mariusz Ed., Szulc Adam Ed., Zuków Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 7-14. ISBN 9781329876262. 304 p. © The Author(s) 2013. This articles is published with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland. Mikołajewska Emilia. Use of orthopedic equipment in post-stroke patients as the element of rehabilitation = Wykorzystanie zaopatrzenia ortopedycznego w ramach rehabilitacji u pacjentów po udarze mózgu, [in] Czerwińska Pawluk Iwona Ed., Żukowska Hanna Ed., Pilewska Wiesława Ed., Klimczyk Mariusz Ed., Szulc Adam Ed., Zuków Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013.15-22. ISBN 9781329876002. 304 p. © The Author(s) 2013. This articles is published with Open Access at Annual Reports of Education, Health and Sport 9781329876002 of Kazimierz Wielki University in Bydgoszcz, Poland. Mikołajewska Emilia. Neurorehabilitation in pediatric stroke = Udar mózgu u dzieci - postępowanie w rehabilitacji neurologicznej, [in] Czerwińska Pawluk Iwona Ed., Żukowska Hanna Ed., Pilewska Wiesława Ed., Klimczyk Mariusz Ed., Szulc Adam Ed., Zuków Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 23-31. ISBN 9781329876002. 304 p. © The Author(s) 2013. This articles is published with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland. Gozhenko Anatoliy, Zuków Walery. Essays on the theory of disease, [in] Czerwińska Pawluk Iwona Ed., Żukowska Hanna Ed., Pilewska Wiesława Ed., Klimczyk Mariusz Ed., Szulc Adam Ed., Zuków Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 32-50. ISBN 9781329876002. 304 p. © The Author(s) 2013. This articles is published with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland. Samosiuk IZ, Chukhraeva EM, Samosiuk NI, Zukow W. Low-intensity physical factors in the treatment of and medical rehabilitation of patients with type 2 diabetes and their effects on lipid metabolism [in] Czerwińska Pawluk Iwona Ed., Żukowska Hanna Ed., Pilewska Wiesława Ed., Klimczyk Mariusz Ed., Szulc Adam Ed., Zukow Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 51-60. ISBN 9781329876002. 304 p. © The Author(s) 2013. This articles is published with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland. Mikołajewska Emilia, Mikołajewski Dariusz. Computational approach to neural plasticity of nervous system on system level = Podejście obliczeniowe do neuroplastyczności układu nerwowego na poziomie systemowym, [in] Czerwińska Pawluk Iwona Ed., Żukowska Hanna Ed., Pilewska Wiesława Ed., Klimczyk Mariusz Ed., Szulc Adam Ed., Zukow Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 61-68. ISBN 9781329876002. 304 p. © The Author(s) 2013. This articles is published with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland. Paprocki Michał, Piekut-Kaluba Katarzyna, Hagner-Derengowska Magdalena, Zukow Walery. Frequency of appearing of side distortions of the spine at students of studies postgraduate of direction physiotherapy exercises = Częstość występowania bocznych skrzywień kręgosłupa u studentów studiów podyplomowych kierunku gimnastyka korekcyjna, [in] Czerwińska Pawluk Iwona Ed., Żukowska Hanna Ed., Pilewska Wiesława Ed., Klimczyk Mariusz Ed., Szulc Adam Ed., Zukow Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 69-92. ISBN 9781329876002. 304 p. © The Author(s) 2013. This articles is published with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland. Warmińska Magdalena, Łoboda Dorota The physical activity and correct feeding elements a healthy lifestyle of chosen occupational groups = Aktywność fizyczna i prawidłowe żywienie elementami zdrowego stylu życia wybranych grup zawodowych, [in] Czerwińska Pawluk Iwona Ed., Żukowska Hanna Ed., Pilewska Wiesława Ed., Klimczyk Mariusz Ed., Szulc Adam Ed., Zukow Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 93-105. ISBN 9781329876262. 304 p. © The Author(s) 2013. This articles is published with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland. Dolomatov SI, Zukow W, Atmazhov ID, Muszkieta R, Skaliy A. The use of biochemical indicators in human saliva for diagnostics periodontitis during pregnancy, [in] Czerwińska Pawluk Iwona Ed., Żukowska Hanna Ed., Pilewska Wiesława Ed., Klimczyk Mariusz Ed., Szulc Adam Ed., Zukow Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 106-119. ISBN 9781329876262. 304 p. © The Author(s) 2013. This articles is published with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland. Eksterowicz Jerzy, Napierała Marek, Zukow Walery. Evaluation of the volume of consumption of chosen nutritients during training grouping together students from direction physical education = Ocena wielkości spożycia wybranych składników odżywczych podczas zgrupowania szkoleniowego studentów z kierunku wychowanie fizyczne, [in] Czerwińska Pawluk Iwona Ed., Żukowska Hanna Ed., Pilewska Wiesława Ed., Klimczyk Mariusz Ed., Szulc Adam Ed., Zukow Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 120-131. ISBN 9781329876262. 304 p. © The Author(s) 2013. This articles is published with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland. Makarewicz Małgorzta, Drożdż Iwona, Tuszyński Tadeusz. The Effect of Some Bee Products on Microbiological Stability of Fresh Fruit Juices, [in] Czerwińska Pawluk Iwona Ed., Żukowska Hanna Ed., Pilewska Wiesława Ed., Klimczyk Mariusz Ed., Szulc Adam Ed., Zukow Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 132-146. ISBN 9781329876262. 304 p. © The Author(s) 2013. This articles is published with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland. Kalisz Karolina, Kalisz Zdzisława, Hagner-Derengowska Magdalena, Zukow Walery, Trela Ewa. Assessment of balance in patients after stroke based on some scales and tests = Ocena równowagi u pacjentów po przebytym udarze mózgu na podstawie wybranych skal i testów, [in] Czerwińska Pawluk Iwona Ed., Żukowska Hanna Ed., Pilewska Wiesława Ed., Klimczyk Mariusz Ed., Szulc Adam Ed., Zukow Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 147-180. ISBN 9781329876262. 304 p. © The Author(s) 2013. This articles is published with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland. Dylewski Michał, Hagner-Derengowska Magdalena, Dylewska Monika, Zukow Walery, Hagner Wojciech. Possibilities of proprioceptive assessment in neurological patients using ZEBRIS system [in] Czerwińska Pawluk Iwona Ed., Żukowska Hanna Ed., Pilewska Wiesława Ed., Klimczyk Mariusz Ed., Szulc Adam Ed., Zukow Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 181-190. ISBN 9781329876262. 304 p. © The Author(s) 2013. This articles is published with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland. Babov KD, Gozhenko EA, Starchevskaya TV, Zukow W. To question about mechanism of action of ozone baths in patients with arterial hypertension = К вопросу о механизме действия озоновых ванн у пациентов с артериальной гипертензией, [in] Czerwińska Pawluk Iwona Ed., Żukowska Hanna Ed., Pilewska Wiesława Ed., Himczyk Mariusz Ed., Szulc Adam Ed., Zukow Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 191-202. ISBN 9781329876262. 304 p. © The Author(s) 2013. This articles is pubUshed with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland. Piechocka Anna, Trela Ewa, Nalazek Anna, Zukow Walery. Assessment of the effectiveness of the methods used in pain treatment dinic = Ocena skuteczności metod stosowanych w poradni leczenia bólu. [in] Czerwińska Pawluk Iwona Ed., Żukowska Hanna Ed., PUewska Wiesława Ed., Klimczyk Mariusz Ed., Szulc Adam Ed., Zukow Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 203-223. ISBN 9781329876262. 304 p. © The Author(s) 2013. This articles is pubUshed with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland. Lewandowska Magdalena, Trela Ewa, Nalazek Anna, Zukow Walery. Evaluation of nursing care among patients undergoing surgery for lumbar disc herniation cervical = Ocena opieki pielęgniarskiej wśród pacjentów operowanych z powodu dyskopatii szyjnej, [in] Czerwińska Pawluk Iwona Ed., Żukowska Hanna Ed., PUewska Wiesława Ed., Himczyk Mariusz Ed., Szulc Adam Ed., Zukow Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 224-249. ISBN 9781329876262. 304 p. © The Author(s) 2013. This articles is pubUshed with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland. Flegontova Veronica, Sheiko VitalU, Morfuntsov Vladimir, Yakovleva Ekaterina, Lvov Aleksandr. Immunologiczne i metaboUczne przełomy u zawodników, uprawiających zapasy Grecko-Rzymskie = Immune and metaboUc shifts in sportsmen going in for Greco-Roman wrestUng. [in] Czerwińska Pawluk Iwona Ed., Żukowska Hanna Ed., PUewska Wiesława Ed., Himczyk Mariusz Ed., Szulc Adam Ed., Zukow Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 250-263. ISBN 9781329876262. 304 p. © The Author(s) 2013. This articles is pubUshed with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland. StebUuk V., Podolsky A. Hemodynamic effects of audio-visual stimulation in the treatment for patients with arterial hypertension on the background of the syndrome of psycho-emotional stress, [in] Czerwińska Pawluk Iwona Ed., Żukowska Hanna Ed., Pilewska Wiesława Ed., Himczyk Mariusz Ed., Szulc Adam Ed., Zukow Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 264-269. ISBN 9781329876262. 304 p. © The Author(s) 2013. This articles is pubUshed with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland. Kędziora Przemysław, Lizis Paweł, Znojek-Tymborowska Justyna, Hagner-Derengowska Magdalena, Szczygielska-Babiuch Anna. Wpływ aktywnej rehabiUtacji na sprawność samoobsługi i lokomocji osób po urazie rdzenia kręgowego = Influence of active rehabiUtation for self­service and locomotion efficiency at peoples past spinal cord injury, [in] Czerwińska Pawluk Iwona Ed., Żukowska Hanna Ed., PUewska Wiesława Ed., Himczyk Mariusz Ed., Szulc Adam Ed., Zukow Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 270-282. ISBN 9781329876262. 304 p. © The Author(s) 2013. This articles is pubUshed with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland. Novikov N., Tumansky V.A. Закономерности повреждения и репарации структур аэрогематического барьера при остром респираторном дистресс-синдроме = Injury and repair structures of air-blood barrier in acute respiratory distress syndrome, [in] Czerwińska Pawluk Iwona Ed., Żukowska Hanna Ed., Pilewska Wiesława Ed., Himczyk Mariusz Ed., Szulc Adam Ed., Zukow Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom 2013. 283-300. ISBN 9781329876262. 304 p. © The Author(s) 2013. This articles is pubUshed with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland. Introduction We hope that a varied program of the Annual Reports of Education, Health and Sport will answer your expectations. We believe that the Annual Reports of Education, Health and Sport will contribute to raising the knowledge, skills and abilities of doctors, therapists, physiotherapists, nurses, psychologists, biologists, researchers, practitioners and health workers interested in rehabilitation, physiotherapy, tourism and recreation. Annual Reports of Education, Health and Sport, corresponding to the modem challenges of global health specialists collect articles from those areas of the leading centers of renowned foreign and domestic. Many of them present state of art in their field. This will be particularly valuable for young doctors in the specialization, and students. Welcome to familiarize yourself with this issue all relevant hazards and health, life and safety at work in tourism, recreation, rehabilitation, physiotherapy, nursing organization to work safely and missions in these conditions, the influence of environmental conditions on public health. Authors from abroad and the country will present an overview of contemporary challenges and solutions in these areas. The issue concerns the text of the wider work for human health, tourism, recreation, physiotherapy, nursing, wellness and rehabilitation, including the economics of health care. © The Author(s) 2013. This articles is published with Open Access at Annual Reports of Education, Health and Sport. RSW. Radom Poland Open Access This articles is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. CE><©<2) Attribution — You must attribute the work in the manner specified by the author or licensor (but not in any way that suggests that they endorse you or your use of the work). Noncommercial — You may not use this work for commercial purposes. Share Alike — If you alter, transform, or build upon this work, you may distribute the resulting work only under the same or similar license to this one.

Czerwińska Pawluk Iwona Ed., Żukowska Hanna Ed., Pilewska Wiesława Ed., Klimczyk Mariusz Ed., Szulc Adam Ed., Zukow Walery Ed. Annual Reports of Education, Health and Sport 9781329876262. RSW. Radom. 2013. ISBN 9781329876262. 304 p.