Tomasz Kuligowski

Bio: Tomasz Kuligowski is an academic researcher. The author has contributed to research in topics: Degenerative disc disease & Lumbar. The author has an hindex of 2, co-authored 12 publications receiving 19 citations.

Manual Therapy in Cervical and Lumbar Radiculopathy: A Systematic Review of the Literature.

Abstract: The aim of this study was to describe and update current knowledge of manual therapy accuracy in treating cervical and lumbar radiculopathy, to identify the limitations in current studies, and to suggest areas for future research. The study was conducted according to PRISMA guidelines for systematic reviews. A comprehensive literature review was conducted using PubMed and Web of Science databases up to April 2020. The following inclusion criteria were used: (1) presence of radiculopathy; (2) treatment defined as manual therapy (i.e., traction, manipulation, mobilization); and (3) publication defined as a Randomized Controlled Trial. The electronic literature search resulted in 473 potentially relevant articles. Finally, 27 articles were accepted: 21 on cervical (CR) and 6 in lumbar radiculopathy (LR). The mean PEDro score for CR was 6.6 (SD 1.3), and for LR 6.7 (SD 1.6). Traction-oriented techniques are the most frequently chosen treatment form for CR and are efficient in reducing pain and improving functional outcomes. In LR, each of the included publications used a different form of manual therapy, which makes it challenging to summarize knowledge in this group. Of included publications, 93% were either of moderate or low quality, which indicates that quality improvement is necessary for this type of research.

Analyzing thermoregulation processes in early school-age girls and boys through thermography

Abstract: The research assessed thermoregulation processes in early school-age children. Thermal maps of the subjects’ bodies were compared before and after general physical exercise and after post-exercise restitution to establish differences between the sexes. The research involved 40 students aged 7, including 20 boys. The subjects participated in interval training which maintained the pulse at 60–80% HRmax. Measurements of body surface temperatures were taken in 12 fields with ThermoVision FLIR SYSTEM T335 camera before exercise, immediately after exercise and after 15 min of restitution. Statistical analysis was based on the Shapiro–Wilk test to verify the normality of variables, multivariate analysis of variance, Student’s t test for independent samples and Duncan’s post hoc test. The level of statistical significance was established at p < 0.05. Analysis of the results showed a difference in the distribution of surface body temperatures in boys and girls depending on the studied area. The highest values were recorded in the trunk area, and the lowest in the lower-limb area. Statistical analysis demonstrated that in both groups there was a statistically significant decrease in post-exercise temperatures. The results revealed greater efficiency of thermoregulation processes during restitution in girls, because the values obtained in all measurement fields in Test 3 were higher than the pre-exercise values. In Tests 2 and 3, differences between the sexes were reported mainly in the upper-limb area.

Mobilisation efficacy in young patients with different stages of degenerative disc disease.

Abstract: Background Lumbar vertebrae carry the greatest load from the spinal column, often leading to several pathologies, including degenerative disc disease (DDD), potentially disturbing spinal movement patterns. Mobilisation increases hypomobile segment mobility, however there is little evidence on mobilisation in patients suffering from different types of DDD. Objective To assess the efficacy of mobilisation in young patients with DDD, as diagnosed by MRI. Methods Thirty patients (24-35 years) participated in this study, and were divided into two groups, based on progression levels of DDD diagnosed by MRI (protrusion-PRO/extrusion-EXT). Twenty sessions of sustained stretch mobilisation (grade III) were applied to both groups over four weeks. Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), straight leg raise (SLR), passive lumbar extension (PLE) and lumbar range of motion (ROM) assessed outcome variables. Three trial stages were investigated: pre-therapy (1), post-therapy (2) and follow-up (3). Results Age (p= 0.007) and NRS (p= 0.002) were significantly different before therapy. Patient outcomes were significantly improved for all parameters in both groups, except SLR which improved in the EXT group only (p= 0.043). Conclusions Applied treatments improved patient outcomes and were statistically significant in both groups, however, better outcomes were observed in the EXT group during follow-up. Mobilisation was a safe and effective procedure for the treatment of DDD.

Effectiveness of Traction in Young Patients Representing Different Stages of Degenerative Disc Disease.

Abstract: Background Low back pain (LBP) currently ranks among the most frequent musculoskeletal pathologies, and the average age of those affected is constantly decreasing. One of the causes of LBP is lumbar disc herniation (LDH). If untreated, it causes disability and leads to socio-economic problems. Traction techniques are a popular method of treating this condition. The stage of LDH (protrusion, extrusion) in young people appears to determine patients' clinical status, necessitating diversification of treatment methods with regard to the type of damage. Material and methods The study enrolled 37 people aged 22-35. The subjects underwent radiological evalu-ation (MRI), which constituted the basis for assigning them to one of two groups: a protrusion group (PRO) or an extrusion group (EXT). During the experiment, the patient was in the supine position while the therapist administered three-dimensional traction using a manual therapy belt. The Oswestry questionnaire, MRC scale, NRS, SLR test, PLE test and measurements of lumbar segment mobility were used for clinical evaluation. Statistica 12.5 was used to perform statistical calculations. Results An analgesic effect was noted with regard to the following two parameters in both groups: ODI (PRO 28 → 14 and EXT 30 → 28, p l0.01) and NRS (PRO 6 → 2 and EXT 6 → 3, p l0.01). The subjects improved clinically, with regard to PLE (EXT 22% → 0%, p l0.04) and SLR (PRO 100% → 29%, p l0.01, and EXT 100% → 57%, p l0.01). Conclusions 1. The type of intervertebral disc damage determines the functional status of young people with degenerative disc disease. 2. The study demonstrated and confirmed a positive effect of traction on the functional status of subjects with lumbar disc herniation. 3. Traction techniques are safe and can be successfully used in the treatment of LDH.

The initial effects of different rates of lumbar mobilisations on pressure pain thresholds in asymptomatic subjects

Abstract: Introduction: Lumbar mobilisations are commonly used in clinical practise to reduce pain and increase function. Mobilisations to the cervical spine have been shown to reduce pain using pressure pain thresholds (PPT). Yet there is no evidence to confirm that this happens in the lumbar spine. Furthermore there is little known about the effects of different treatment doses on the amount of hypoalgesia produced. It is unknown if changing the rate of application of mobilisations has an effect on hypoalgesia. The aim of this study was to investigate the immediate effects of lumbar posteroanterior mobilisations performed at different rates on PPT. Pressure pain thresholds were measured in a number of locations in order to assess the extent of the analgesic response. Method and Results: A repeated measures single blind, randomised-trial was conducted on 30 asymptomatic subjects (22 female and 8 males). Pressure pain thresholds were measured at 4 sites in the upper and lower quadrants, before and after the application of lumbar spine posteroanterior mobilisations performed at 2Hz, 1Hz and quasi-static. The results demonstrated an immediate and significant improvement in PPT measures (P< 0.000) irrespective of the rate or site tested. The effects were both local and widespread. There was no significant difference between the rates of mobilisations on PPT. Conclusion: This study provides new experimental evidence that lumbar spine posteroanterior mobilisations produce an immediate and significant widespread hypoalgesic effect, regardless of the rate of mobilisation. Further research is now needed to investigate the effect on a patient population with low back pain.

Respuestas termorreguladoras de niños en el ejercicio en ambiente de calor

Abstract: OBJETIVO: Revisar las posibles peculiaridades en los mecanismos biologicos referentes a las respuestas termorreguladoras y sudoripara especificas en el ejercicio realizado por ninos en ambiente de calor. FUENTES DE DATOS: Se realizo una revision de 47 articulos publicados entre 1960 y 2011 en las bases de datos electronicas MedLine y SciELO Brasil, con el uso de los siguientes descriptores: "ninos", "calor", "sudoracion", "termorregulacion", "glandula sudoripara" y "ejercicio", siendo usados aisladamente o en combinacion, ademas de una tesis doctoral sobre el tema. SINTESIS DE LOS DATOS: En pre-puberes, la tasa de sudoracion durante el esfuerzo es menor en comparacion a los adultos. Ninos poseen caracteristicas termorreguladoras diferenciadas, presentando un debito de sudor por glandula mucho menor. La mayor razon entre area de superficie y masa corporal hace que los ninos absorban mas calor durante el ejercicio bajo estres termico, elevando el riesgo de presentar sintomas de hipertermia. El mayor flujo de sangre para la piel contribuye con un mejor control de la homeostasis termica de ninos. El menor tamano de la glandula, la menor sensibilidad colinergica, los niveles bajos de catecolaminas circulantes durante el esfuerzo y la falta de hormona androgenica explican la ocurrencia de la baja eliminacion de sudor en el ejercicio realizado por ninos. CONCLUSIONES: Ninos exhiben glandulas sudoriparas inmaturas. Asi, la practica de actividad fisica combinada a altas temperaturas no es bien tolerada por el publico infantojuvenil, que presenta mayor vulnerabilidad a las lesiones termicas. En el calor, se debe tener un control riguroso de la ingestion de liquidos y una monitoracion atenta de las condiciones climaticas para mayor seguridad en la practica de ejercicios.

Cognitive telerehabilitation in neurological patients: systematic review and meta-analysis.

Abstract: Telerehabilitation (TR) seems to be an encouraging solution for the delivery of cognitive treatments in patients with neurological disorders. This study was aimed to analyze and synthesize the evidence on the efficacy of cognitive TR interventions in patients with neurological diseases, compared with conventional face-to-face rehabilitation. From a total of 4485 records, 9 studies met the inclusion criteria for qualitative analysis. At the end of the process, 7 studies remained for quantitative analysis. By comparing TR with face-to-face treatments for cognitive impairments, we assessed improvements in global cognitive domain (Mini Mental State Exam) (MD = -0.86; 95% CI -2.43, 0.72, I2 = 0%), in learning and memory domains (SMD = 0.26, 95% CI -0.22, 0.74, I2 = 24%), in verbal fluency (SMD = 0.08, 95% CI -0.47, 0.62, I2 = 0%), and in executive functions (i.e., problem-solving, central processing speed and working memory) (SMD = 0.38, 95% CI 0.06, 0.71, I2 = 0%). In all the included studies, improvement in the performance of the TR groups was comparable to that achieved through face-to-face intervention. Significant differences between those two modalities of providing treatments were observed for working memory and total executive function comparison, in favor of TR. The results of this study can sustain the efficacy of TR and its application for the treatment of neurological patients, especially when treated for executive function impairments.

Regions of interest selection and thermal imaging data analysis in sports and exercise science: a narrative review.

Abstract: OBJECTIVE Infrared thermography (IRT) is a non-invasive, contactless and low-cost technology that allows recording of the radiating energy that is released from a body, providing an estimate of its superficial temperature. Thanks to the improvement of infrared thermal detectors, this technique is widely used in the biomedical field to monitor the skin temperature for different purposes (e.g. assessing circulatory diseases, psychophysiological state, affective computing). Particularly, in sports and exercise science, thermography is extensively used to assess sports performance, to investigate superficial vascular changes induced by physical exercise, and to monitor injuries. However, the methods of analysis employed to treat IRT data are not standardized, and hence introduce variability in the results. APPROACH This review focuses on the methods of analysis currently used for thermal imaging in sports and exercise science. MAIN RESULTS Firstly, the procedures employed for the selection of regions of interest (ROIs) from anatomical body districts are reviewed, paying attention also to the potentialities of morphing algorithms to increase the reproducibility of thermal results. Secondly, the statistical approaches utilized to characterize the temperature frequency and spatial distributions within ROIs are investigated, showing their strengths and weaknesses. Moreover, the importance of employing tracking methods to analyze the temporal thermal oscillations within ROIs is discussed. Thirdly, the capability of employing procedures of investigation based on machine learning frameworks on thermal imaging in sports science is examined. SIGNIFICANCE Finally, some proposals to improve the standardization and the reproducibility of IRT data analysis are provided, in order to facilitate the development of a common database of thermal images and to improve the effectiveness of IRT in sports science.

Temperature Distribution of Selected Body Surfaces in Scoliosis Based on Static Infrared Thermography

Abstract: The purpose of the research was to assess the usefulness of thermography as a complementary method in musculoskeletal dysfunction, with particular emphasis on scoliosis. The children, aged 7–16, were classified into one of two groups: the study group—children with scoliosis (n = 20), and the reference group—healthy children (n = 20). All children underwent anthropometric tests, body mass index determination, four pictures each with a FLIR T1030sc HD thermal imaging camera, and measurement of spinal rotation with a scoliometer (Gima, Italy). There is a temperature differential (about 4 °C) within the upper and lower body in children. In healthy children, differences in temperature of contralateral areas of the body do not exceed 0.5 °C. Thermography is a useful and noninvasive method of assessing muscular tension disbalance in the course of scoliosis. In the case of scoliosis, the areas of the body with a significant thermal asymmetry of the surface are the upper back, thighs, and back of the lower legs. Due to the high positive correlation of the spinal rotation angle with the amount of thermal asymmetry, the areas that should be subjected to a detailed thermal assessment in the supplementary diagnosis of scoliosis using thermovision are the upper back, chest, thighs, and back of the lower legs.