Krakowskie Centrum Rehabilitacji

Traumatic brain injury (TBI) and cerebrovascular incidents (CVA) lead to numerous neurological deficits, including cognitive and emotional deficits. Transcranial direct current stimulation (tDCS) is gaining prominence as a method to help rehabilitate cognitive function and regulate emotions, offering a non-invasive and safe therapeutic approach. The aim of this paper is to analyze the current scientific data and own experiences according to the effectiveness of tDCS in the rehabilitation of patients after TBI and CVA with memory and emotion disorders. A literature review (2015–2024) was conducted, including clinical trials, meta-analyses, and systematic reviews (PubMed, Scopus, and Web of Science). The papers on the use of tDCS in the modulation of cognitive and emotional functions in neurological patients were analyzed. Particular attention was paid to the mechanisms of tDCS action, stimulation protocols (intensity, electrode location, treatment time), and clinical outcomes in terms of memory improvement, emotion regulation, and reduction of depressive symptoms. Studies indicate a beneficial effect of tDCS on neuronal plasticity and cognitive and emotional functions of patients after TBI and CVA. Combined therapy (tDCS and rehabilitation) shows greater effectiveness than traditional methods, leading to faster improvement of working memory, reduction of emotional lability and reduction of depression symptoms. It has also been shown that the effectiveness of tDCS depends on the location of electrodes and individual patient characteristics. The best results were obtained with protocols including 20–30 minute sessions at 1–2 mA intensity, conducted 5 times a week for 3 to 6 weeks. Anodal stimulation over dorsolateral prefrontal cortex (DLPFC) or motor cortex (M1) was the most commonly used method, resulting in significant improvement in both cognitive functioning and emotion regulation. tDCS treatments are a promising tool supporting neurorehabilitation of patients with memory and emotional disorders after brain injury. Combining tDCS with speech therapy may contribute to more effective restoration of cognitive and emotional functions. Further studies are needed to optimize stimulation parameters and standardize therapeutic protocols. (JNNN 2025;14(4):182–192)

Celem niniejszej pracy była ocena wpływu jednorazowej aplikacji oleju z lnianki siewnej (nazywanego również olejem rydzowym) na wybrane cechy skóry przedramion od strony przyśrodkowej, w tym stopień nawilżenia, przeznaskórkową utratę wody (TEWL) oraz elastyczność. W badaniu wzięło udział 20 zdrowych kobiet w wieku od 22 do 26 lat. Cechy skóry oceniano czterokrotnie: wyjściowo, po wykonaniu modelowego uszkodzenia bariery naskórkowej metodą tape stripping, a następnie po 1 godzinie od nałożenia badanego oleju na skórze uszkadzanej i nieuszkadzanej. Wykorzystano specjalistyczne urządzenia z certyfikacją do badań naukowych: korneometr, tewametr, kutometr i indentometr. Zaobserwowano istotny wzrost nawilżenia skóry po aplikacji oleju zarówno dla skóry uszkadzanej jak i nieuszkadzanej. Nie wskazano wpływu oleju z lnianki na funkcje barierowe naskórka (TEWL) ani parametry charakterysujące elestyczność oceniane kutometrycznie i identometrycznie. Wyniki badania potwierdzają, że olej rydzowy wykazuje szybkie działanie nawilżające. Nie obserwowano działania ograniczającego TEWL a obserwacja ta zbliża badany olej do olejów schnących. Brak wpływu na inne cechy biomechaniczne skóry, przy jednorazowej aplikacji nie definiuje braku takiego efektu dla wydłużonych protokołów stosowania, co jednak wymaga potwierdzenia empirycznego w kolejnych obserwacjach.

The aim of this study was to examine the occurrence of vocal fatigue in a group of teachers and to examine its possible connection with workload, i.e., inappropriate student behaviour and the need for professional recognition as sources of professional stress among these voice professionals. The study involved 74 participants (62 women and 12 men) aged 24 to 65 years – 40 of them employed in primary schools and 34 in secondary schools – who completed the Croatian version of the Vocal Fatigue Index (VFI-C) questionnaire and the Scale for Measuring Sources of Teacher Stress. The results showed the existence of a statistically significant positive correlation between the average results in all three categories of the VFI-C and all subscales of the Scale for Measuring Sources of Teacher Stress. A higher level of stress in teachers was associated with greater self-perceived presence of vocal fatigue symptoms. Compared to male teachers, female teachers reported statistically significantly higher stress caused by all observed sources and a higher overall experience of stress. This points to the importance of workload control and stress management in educational settings in reducing the risk of the occurrence of vocal fatigue symptoms among teachers, especially among female teachers.

The proper assessment of cognitive functioning is the subject of numerous scientific studies. Current behavioral methods essentially preclude this assessment in patients with disorders of consciousness (DOC). However, the development of eye-tracking technology (ETT) and the establishment of contact via this channel have created an opportunity to diagnose the cognitive function (CF) of DOC patients. The purpose of this study was to assess the level of CF of DOC patients for whom vision is the only channel of communication to introduce the CF assessment tool for DOC patients for whom vision remains the only channel for communication. The clinical multicenter study involved 31 DOC patients, whose attention, language functions, visual-spatial functions, personal orientation, memory, and abstract thinking were assessed three times (T1-T3) using the Cognitive Functions Assessment (CFA) scale, installed on the C-EYE X system. The collected data were compared with the CF assessment results obtained with the Coma Recovery Scale-Revised (CRS-R), and then statistically analyzed. There were no statistically significant differences between different time points. Patients scoring higher on the CRS-R receive higher values on the CFA. Statistically significant and moderate correlations were found between the total CFA and CRS-R scores. The results of the study indicate that the diagnosis of CF made with the use of the CFA allows for an accurate assessment of a wide spectrum of CF as well as makes their assessment independent of the experience of the examiner and the cooperation of the patient. The use of ETT, without reducing the quality of the examination, may reduce the workload of qualified personnel. The study was registered on the ClinicalTrials.gov clinical trials platform ID NCT05536921.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-025-27996-6.

Studies have shown that the narrative competence of children who stutter is similar to that of their peers who do not stutter. However, the communication attitudes of children who stutter may influence the development of their narrative skills. Given the lack of Polish research on this topic, there is a need to explore the narrative behaviours of Polish-speaking children who stutter. This study aimed to analyze narrative behaviors of children who stutter compared to children who do not stutter and to disseminate the acquired knowledge among speech-language therapists (SLTs) and parents. The research used a multiple-case method, supported by a focus group interview with parents. The results indicate that children who stutter may exhibit less favorable narrative behaviors than their peers without a stuttering experience. The focus group interview provided valuable insights into how the child’s immediate environment perceives and supports their communication skills. It allowed for the formulation of practical recommendations for SLTs and SLT students. Practical implications have been developed based on the obtained results.

IntroductionThoracic spine pain syndrome is far less common than lumbosacral or cervical pain. This pathology is often caused by work-related overload, especially sedentary work, lack of regular sport activities, and adopting incorrect postures. Thoracic spine pain may result, for instance, from degenerative joint lesions. In consequence, there is a reflex contraction of the soft, paraspinal tissues (muscles, fascia, ligaments). In this case, one of the treatment methods is spinal mesotherapy. The purpose of the present research was to evaluate the effectiveness and safety of thoracic spinal mesotherapy with collagen type I vs. lignocaine.Material and methodsA retrospective analysis of the results of the treatment of patients with chronic thoracic back pain syndrome using mesotherapy was performed. A total of 130 patients (49 men and 81 women; mean age: 49 ±9 years) were divided into 2 groups: group A (n = 65), treated with collagen type I, and group B (n = 65), treated with lignocaine 1%. Mesotherapy was performed weekly over 5 weeks. Patients were assessed using the Visual Analogue Scale (VAS) and Laitinen scales before the therapy, after the therapy, and after a 3-month follow-up visit.ResultsA statistically significant improvement was observed after the use of thoracic spinal mesotherapy both with collagen type I and lignocaine, on the VAS and Laitinen scales, with the collagen treatment having better results at the 3-month follow-up visit. No adverse effects were observed after the procedures.ConclusionsSpinal mesotherapy is an effective and safe method of treating chronic thoracic back pain syndrome using collagen type I and lignocaine. However, in an average observation, collagen mesotherapy seems to be more effective.

Prospective, randomized, controlled trials of intravenous immunoglobulin (IVIG) maintenance therapy in myasthenia gravis (MG) are lacking. In this trial, we evaluated the safety and efficacy of caprylate/chromatography-purified IVIG; (IGIV-C) in patients with generalized MG undergoing standard care. Sixty-two patients enrolled in this phase 2, multicenter, international, randomized trial (1:1 IGIV-C [2 g/kg loading dose; 1 g/kg every 3 weeks through week 21] or placebo). Efficacy was assessed by changes in Quantitative MG (QMG) score at week 24 versus baseline (primary endpoint) and percentage of patients with clinical improvement in QMG, MG Composite (MGC), and MG-Activities of Daily Living (MG-ADL) scores (secondary endpoints). Safety assessments reported all adverse events (AEs). The change in QMG at 24 weeks was -5.1 for IGIV-C and -3.1 for placebo (p = .187). Seventy percent of patients in the IGIV-C group had improvement in MG-ADL (≥2-point decrease) versus 40.6% in the placebo group (p = .025). Patients showing clinical improvement in QMG and MGC (≥3-point decrease) were 70.0% for IGIV-C versus 59.4% for placebo (p = .442) and 60.0% for IGIV-C versus 53.1% for placebo (p = .610). IGIV-C was well tolerated; serious AEs were similar between arms. Three of four MG exacerbations requiring hospitalizations occurred in the IGIV-C arm with one death. Several efficacy parameters showed numerical results greater than those seen in the placebo group. This was a small study and may have been underpowered to see significant differences. Additional studies may be warranted to fully determine the efficacy of IVIG maintenance therapy in MG.

The aim of the research was the review of the newest papers reporting the application of physiotherapy in scar treatment. Answers were searched to the following research-related questions: 1. Which techniques used in physiotherapy are effective in scar treatment? 2. Which tools used in physiotherapy are applied in scar treatment? 3. Was it possible to determine which approach had turned out to be the most efficient in scar treatment? The authors took advantage of the scientifically accepted medical databases online, such as: PubMed and Physiotherapy Evidence Database (PEDro). The inclusion criterion of the randomized clinical trial was based on the papers published between 2016 and May 2021. The papers on scar treatment reporting approaches different from those pertaining to physiotherapy were not included. Moreover, the papers written in languages other than English were not included either. 281 papers pertaining to this issue were found and 35 papers on physiotherapy approaches were selected. Finally, 9 papers were subjected to critical analysis. Most of the authors (n=3) reported using shockwave in their research. Next, laser treatment (n=2) or manual therapy (n=2) were applied. The fewest researchers used electrotherapy (n=1) and silicone gel (n=1).