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During cycling, prolonged compression by the bicycle saddle on the anatomical structures located in the perineum area occurs. An additional factor that may have a negative impact on organs located in the pelvic area may be a prolonged sitting position resulting in increased intraabdominal pressure. This situation has the potential to adversely affect pelvic floor function. Therefore, the aim of this study was to assess the incidence of lower urinary tract symptoms (LUTSs) in female competitive road cyclists and cross-country cyclists. The study included 76 female competitive road cyclists and cross-country cyclists and 76 women not practising competitive sport. The Core Lower Urinary Tract Symptom Score (CLSS) questionnaire was used to assess the lower urinary tract condition. Female competitive cyclists had a statistically significantly higher LUTSs score (95% CI: 3.12-4.2 vs. 2.31-3.16; p < 0.05) compared to women not practising competitive sports. Female cyclists had a statistically significantly higher overall CLSS score (95% CI: 3.99-5.61 vs. 2.79-3.97; p < 0.05). Female cyclists had a statistically significantly higher incidence and severity of urinary frequency (p < 0.05 and p < 0.02), urge (p < 0.001 and p < 0.02) and stress incontinence (p < 0.001 and p < 0.001), and pain in the bladder (p < 0.01 and p < 0.01), while physically inactive women recorded a statistically higher incidence of slow urinary stream (p < 0.01 and p < 0.04). A statistically significant association was recorded between the years of cycling and the number of hours per week spent on training and the number of symptoms and their severity. The number of natural births experienced by women involved in competitive cycling significantly affects the severity of LUT symptoms. Compared to women not practising competitive sports, competitive female cyclists are found to have a higher prevalence of LUTSs and a greater degree of severity. LUTSs in competitive female cyclists are negatively influenced by years of competitive career and weekly number of training hours and the number of natural births experienced.

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Tactile acuity is typically measured by a two-point discrimination test (TPD) and a two-point estimation task (TPE). In the back area, they are only conducted in the lumbar and cervical regions of the spine. Considering that such measurements have not been conducted in the sacral regions, the purpose of this study was to assess the inter- and intra-examiner reliability of the TPD and TPE at the level of the S3 segment. The study included 30 pain-free subjects aged 20-30 years. Tests were performed with a pair of stainless hardened digital calipers. The TPD was measured in two locations: 5 and 15 cm from the midline; for TPE both, points were located inside the measured area. Session 1 involved assessments by two examiners in 10-min intervals. Session 2 was measured by one examiner, at analogous intervals between tests. The TPD inter-rater reliability was excellent for mean measurements (ICC3.2: 0.76-0.8; ICC3.3: 0.8-0.92); the intra-rater reliability was excellent for mean measurements (ICC2.2: 0.79-0.85; ICC2.3: 0.82-0.86). The TPE inter-rater reliability was good to excellent for mean measurements (ICC3.2: 0.65-0.92; ICC3.3: 0.73-0.94); the intra-rater reliability for all studies (ICC2.1, ICC2.2, ICC2.3) was excellent (0.85-0.89). Two measurements are sufficient to achieve good reliability (ICC ≥ 0.75), regardless of the assessed body side.

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In order to determine the impact of a four-week cycle of Nordic Walking (NW) training on the physical fitness of people with chronic non-specific lower back pain and the impact of this form of activity on their self-assessment of health quality, the study included 80 men and women aged 29 to 63 years. The subjects were divided into two equal (40-person) groups: experimental and control. In both study groups the degree of disability in daily activities caused by back pain was assessed with the FFb-H-R questionnaire, the physical fitness was evaluated with the modified Fullerton test and the sense of health quality was assessed with the SF-36 questionnaire. The same tests were repeated after four weeks. In the experimental group NW training was applied between the two studies. During four weeks, 10 training units were carried out, and each training session lasted 60 min with a two-day break between each training. The four-week NW training resulted in a statistically significant sense of disability due to back pain (p < 0.001), significant improvement of physical fitness expressed by improvement in upper (p < 0.001) and lower (p < 0.01) body strength, upper and lower body flexibility (p < 0.001) and ability to walk a longer distance in a 6-min walk test (p < 0.001). The training participants also showed significant improvements in health quality in both physical (p < 0.001) and mental (p < 0.001) components. The four-week NW training has a positive impact on the physical fitness of men and women with chronic lower back pain. Participation in NW training also contributes to a significant reduction in the sense of disability caused by back pain and improvement in the self-assessment of health quality.

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The aim of this study was to compare the condition of the pelvic floor in women who are involved in regular recreational horseback riding, with both physically active women as well as women not undertaking any recreational physical activity. Taking into account horseback riding and physical activity, 140 healthy women aged 17 to 61 were divided into three groups: women practicing horseback riding (WPHR) (46 persons), physically active women (PAW) (47 persons) and women not physically active (WNPA) (47 persons). The Australian Pelvic Floor Questionnaire (APFQ) was used to measure the extent of pelvic floor dysfunctions in women from all three groups. The lowest average values were found in the group of women practicing recreational horseback riding, and the highest in the group of women not physically active (95% CI: 0.61-1.15 vs. 0.87-1.44 -bladder scores; 0.82-1.32 vs. 1.24-1.8-bowel scores; 0.07-0.33 vs. 0.08-0.35-prolapse of reproductive organs scores; 0.4-1.07 vs. 0.49-1.3-sexual function). Statistically significant intergroup differences were recorded only for the bowel function rate (p = 0.021). The overall pelvic floor dysfunction rate in the WPHR group was lower when compared with both control groups (95% CI: 2.15-3.62 vs. 2.34-3.54 in women from PAW group and vs. 3.0-4.56 in women from WNPA group). Based on this study, it can be concluded that all of the pelvic floor related symptoms, their frequency, and severity levels do not qualify recreational horseback riding as being a risk factor for developing pelvic floor dysfunction in women.

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To determine the impact of physical activity and fitness on the level of physical activity barriers (kinesiophobia) in women of perimenopausal age, the study included 105 women between the ages of 48 and 58. A Baecke questionnaire was used to evaluate physical activity and a modified Fullerton test was used to evaluate the fitness level. The level of kinesiophobia was assessed using the Kinesiophobia Causes Scale questionnaire. A low level of habitual physical activity has a negative impact on the values of Biological Domain (r = -0.581), Psychological Domain (r = -0.451), and on the Kinesiophobia Cause Scale total score (r = -0.577). Lower physical activity expressed by a lower score in the Fullerton test also has a negative impact on the level of kinesiophobia. Upper body flexibility (r = -0.434) has the strongest influence on the Biological Domain, whereas upper body strength (r = -0.598) has the greatest impact on the Psychological Domain. A low level of upper body strength also has the greatest impact on the Kinesiophobia Cause Scale total score (r = -0.507). Low levels of physical activity and fitness in women of perimenopausal age favour kinesiophobic attitudes and thereby increase the level of barriers against undertaking physical activity.

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STUDY DESIGN: Randomized controlled trial. INTRODUCTION: Two-point discrimination (2PD) test can be used to assess both clinical condition and the effects of therapy in carpal tunnel syndrome (CTS) patients. PURPOSE OF THE STUDY: To determine whether there are specific differences in 2PD between symptomatic and asymptomatic hands in CTS patients and to evaluate the impact of 2 therapy regimes on 2PD in patients with CTS. METHODS: Therapy for the neurodynamic mobilization group was based on manual therapy and neurodynamic techniques. Therapy for the electrophysical modalities group was based on red and infrared laser and ultrasound therapy using a contact method applied in the transverse ligament area. Therapeutic cycle consisted of 20 therapy sessions delivered at twice-weekly intervals. RESULTS: After therapy, 2PD in the symptomatic limbs in the neurodynamic mobilization and electrophysical modalities groups significantly improved (p < .001). However, there was no statistically significant difference between the treatment groups. CONCLUSIONS: Both therapy programs used in this study were beneficial for improving 2PD. LEVEL OF EVIDENCE: 2.

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BACKGROUND: Back pain represents one of the most common diseases across various populations of workers worldwide. This study analyzes the prevalence and severity of back pain, based on selected demographic variables, and the relationship with physical activity among school teachers. MATERIAL AND METHODS: The study included 998 professionally active teachers (840 females and 158 males) from the southern part of Poland. Validated psychometric tools, namely: 1) for evaluation of disability due to back pain - a Polish version of the Oswestry Disability Index (ODI) and Neck Disability Index (NDI), 2) for physical activity assessment - the Subjective Experience of Work Load (SEWL) as well as the authors' supplementary questionnaire, addressing demographic and anthropometric variables were used. RESULTS: There was no correlation between age and the NDI scores in females (r = 0.027), in contrast to males (r = 0.202; p ≤ 0.05). Statistically significant correlations (p ≤ 0.05) were reported between: age and the ODI, in both females (r = 0.219) and males (r = 0.180). No associations between the body mass index (BMI)-ODI, and BMI-NDI were found. In the case of women, disability related to low back pain (LBP) had a negative impact on the indicators of their activity during work, sports, and leisure time. In the case of men, the NDI and ODI scores did not differ, based on activity indicators. CONCLUSIONS: Our findings confirm that back pain represents a serious concern among teachers. Age appears to be a prognostic factor, while no association between the BMI and LBP has been revealed. The limitation of physical activity leads to more frequent back pain.

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AIM OF THE STUDY: To determine the effect of a 4-week Nordic walking training on the physical fitness of women of the perimenopausal age and self-assessment of the quality of their health. MATERIAL AND METHODS: Eighty-four women between 48 and 58 years of age were included in the study. Half of the group (42) was assigned to the control group and the other half was assigned to the experimental group. In both groups studied, physical fitness was evaluated using a modified Fullerton's test and a quality of life self-assessment SF-36 (Short Form of Health Status Questionnaire). Similar tests were repeated 4 weeks later. In the experimental group, a Nordic walking training was conducted between the two tests. During 4 weeks, 10 training sessions were performed, each session was 60 minutes long, and there was an interval of 2 days between the sessions. RESULTS: A 4-week Nordic walking training resulted in a significant improvement (p < 0.001) of physical fitness as demonstrated by an increased strength and flexibility of the upper and lower part of the body and the ability to walk a longer distance during a 6-minute walking test. Women participating in the training also showed a significant improvement in health in terms of both physical health (p < 0.001) and mental health (p < 0.001). CONCLUSIONS: A 4-week Nordic walking training has a positive effect on the physical fitness of the women in the perimenopausal age. Participation in training contributes also to a clearly higher self-assessment of the quality of health.

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BACKGROUND: Among the procedures used in the therapy of spinal pain syndromes one of the most frequently recommended is the cervical traction. The methods of performing the traction are varied. OBJECTIVES: It was decided to examine in the research whether the abduction and external rotation of the brachium, causing relaxation of the pectoral girdle muscles as well as the cervical spine, affects the quality and efficiency of traction in the patient's subjective assessment and the changes in the cervical spine range of motion. MATERIAL AND METHODS: Fifty subjects aged 20 to 42 were involved in the study, including 26 women and 24 men. The criterion of inclusion into the research project was the age between 20 and 40 years and the result of questionnaire containing the NDI scale for evaluation of the degree of dysfunction of the cervical spine, ranging in value between 5 and 14 points. The admitted group of 50 subjects was randomly divided into two experimental groups. The traction of the cervical spine was performed twice in both groups by means of the Saunders device. In the first group used the traditional positing, with the upper extremities placed along the torso, was adapted as first whereas in the second group the modified position was applied, in which the upper extremities were in the external rotation in abduction and with flexion in the cubital articulation, in other words the patients placed their hands next to head. In both cases the patient was in the supine position on a therapeutic table with a support roll under the knees. RESULTS: The evaluation of the cervical spine range of motion pointed, that in both position all the obtained differences proved statistical significance. The subjects taking part in the research claimed that the procedure performed by means of the traditional method was more pleasant. CONCLUSIONS: No significant difference was discovered in the effectiveness of the suggested positioning of the arms during performing the traction procedure of the cervical spine. The modified position caused greater sensation of discomfort than position with traditional arrangement of the arms.

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BACKGROUND: The excessive lateral pressure syndrome is a common complication following anterior cruciate ligament (ACL) reconstruction is. It may lead to premature wear of the articular surfaces of the femur and patella. The aim of the study was to assess the effectiveness of physiotherapy in the treatment of excessive lateral pressure syndrome after ACL reconstruction. MATERIAL AND METHODS: A total of 18 patients (4 women, 14 men) after arthroscopic ACL reconstruction were enrolled (age: 16 -54 years). The patients were randomly divided into two groups: experimental (Group E, 9 people), who attended therapy, and control (group C, 9 people). The distance between the lateral edge of the patella and the lateral condyle of femur was measured with an ultrasound scanner in both extremities. The experimental group patients attended 12 treatment sessions of the.Neurac method. A single session lasted 45 minutes. RESULTS: The baseline examination of both groups showed statistically significant excessive lateral pressure in the operated extremity in relation to the non-operated one in every angular position. At the same time, the quadriceps femoris of the operated extremity was found to be significantly weaker than its counterpart. On completion of the rehabilitation, statistically significant differences in quadriceps strength were recorded in the experimental group compared to the baseline examination while there were no significant differences in the control group. An intergroup comparison did not reveal any significant differences in quadriceps strength. There were also no significant differences in the severity of lateral pressure syndrome before and after the therapy in either group. CONCLUSIONS: 1. Rehabilitation improved quadriceps femoris, strength; it did not, however, decrease excessive lateral pressure syndrome. 2. The rehabilitation programme is not sufficient in conservative treatment of excessive lateral pressure syndrome.

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INTRODUCTION: It is estimated that about 80% of the general population occasionally experience spinal pain, with as many as 50% reporting pain in the cervical spine. The aim of this study was to determine the effectiveness of treatment of cervical spine pain with the Saunders traction device and transcutaneous electrical nerve stimulation (TENS) by assessing their impact on the cervical spine range of motion in the sagittal, coronal and horizontal planes. MATERIAL AND METHODS: A total of 39 patients aged 26 to 62 years took part in the study. All patients reported chronic cervical spine pain caused by overload and postural insufficiency. The participants were randomly divided into three experimental groups. The first group was treated with Saunders traction where the traction force was administered so that the patient would experience noticeable but painless traction. The second group received traction as well as classic transcutaneous electrical nerve stimulation, whereas the third group received only TENS. Each patient attended 10 treatment sessions not more than three days apart. Measurements of the range of motion were performed with the CROM instrument before and after the first session, after the fifth and tenth session and about three weeks after completion of rehabilitation. RESULTS: The study revealed the greatest ROM improvement in the coronal and horizontal planes and for the extension motion. CONCLUSIONS: The best therapeutic effect was obtained by combining traction with transcutaneous electrical nerve stimulation.

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INTRODUCTION: According to many authors, the access to public health service is obstructed for the intellectually handicapped people. To meet this argument Special Olympics created a program Healthy Sportsmen. This program relates to intellectually handicapped people all over the world and its aim is to diagnose selected clinical illnesses and create data bank of this social group. Additionally, it provides an opportunity for the 'young physicians' to improve their knowledge and skills in the area of practice with the handicapped. MATERIAL AND METHOD: The aim of the study was to answer the question: what is the parents' evaluation of the quality of the selected health services provided to children with different degree of intellectual handicap on the example of two voivodeships of southern Poland. 108 parents of intellectually disabled children took part in the study (51 women and 57 men): 71 respondents (66%) from the Silesian voivodeship and 37 (34%) from the Lesser Poland voivodeship. The study included the author's questionnaire in which 15 questions, concerning the opinions about selected medical services, were asked. RESULTS: In the opinion of parents' of the intellectually handicapped the access to dental services was evaluated at the lowest level. The attitude of the society towards the people with mental handicap, support and help offers from the Health Service units and the accessibility of the secondary health care were evaluated at similarly low level. The services provided by the primary care physicians and physiotherapists were evaluated at the highest level. CONCLUSIONS: There is a constant need to improve the methods of practice with the intellectually handicapped patients.

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