Primjena duhovno-tjelesnih tehnika kod osoba s multiplom sklerozom

The objectives of the study were to assess the prevalence of mind-body practice by persons with multiple sclerosis (MS) and analyze the relationship of age, sex, clinical course of MS, level of incapacity, and time elapsed from MS diagnosis. The study included 120 patients with MS who underwent inpatient rehabilitation at the Lipik Hospital for Medical Rehabilitation in the period from May 1, 2015 to October 10, 2015. For the purposes of the study, a semi-structured questionnaire on the current usage of mind-body procedures was applied. Closed ended questions referred to the use of the following procedures: meditation, deep-breathing exercises, hypnotherapy, yoga, biofeedback, chiropractic, massage, reflexology, bioenergy, and magnetic therapy. The studied patients were divided into two groups according to whether they practiced or did not practice mind-body procedures. Comparison of the variables was performed using Student’s t-test and a Pearson correlation test. At the time of the study, 37 (30.8%) MS patients reported currently practicing one or more mind-body procedures. Respondents most commonly were practicing meditation (n=13; 10.8%), followed by massage (n=10; 8.3%), acupuncture (n=7; 5.8%), bioenergy healing (n=7; 5.8%), magnetic therapy (5; 4.2%), chiropractic (n=5; 4.2%), yoga (n=3; 2.5%), tai chi (n=2; 1.7%), and reflexology (n=1; 0.8%). There was no statistically significant difference according to age (p=0.520), sex (p=0.448), EDDS score (p=0.489), disease duration (p=0.963) and disease course (p=0.932) between the groups of respondents practicing and those not practicing mind-body procedures. Regarding the widespread use of various mind-body procedures, there is a need to actively monitor MS patients in order to provide them with guidance when using these procedures.Cilj istraživanja je bio utvrditi učestalost primjene duhovno-tjelesnih tehnika kod osoba s multiplom sklerozom (MS) i analizirati povezanost primjene tih tehnika s dobi, spolom, kliničkim tijekom MS, stupnjem onesposobljenosti i vremenom proteklim od postavljanja dijagnoze MS. Studijom je bilo obuhvaćeno 120 oboljelih koji su pohađali stacionarnu rehabilitaciju u Specijalnoj bolnici za medicinsku rehabilitaciju Lipik u periodu od 1.5.2015. do 10.10.2015.godine. U svrhu studije upotrijebljen je semi-strukturirani upitnik. Strukturiranim pitanjima ispitala se primjena sljedećih tehnika: meditacije, vježbi dubokog disanja, hipnoterapije, joge, biofeedbacka, kiropraktike, masaže, refleksologije, bioenergije i magnetoterapije. Ispitanici su podijeljeni u dvije skupine, ovisno o tome jesu li ili nisu primjenjivali duhovno-tjelesne tehnike. Usporedba varijabli učinjena je pomoću Studentovog t- testa i Pearsonovog testa korelacije. U vrijeme istraživanja 37 (30,8%) ispitanika primjenjivalo je jednu ili više duhovno-tjelesnih tehnika. Ispitanici su najčešće primjenjivali meditaciju (n=13; 10,8%), potom masažu (n=10; 8,3%), akupunkturu (n=7; 5,8%), bioenergiju (n=7; 5,8%), magnetoterapiju (5; 4,2%), kiropraktiku (n=5; 4,2%), jogu (n=3; 2,5%), tai chi (n=2; 1,7%) i refleksologiju (n=1; 0,8%). Između skupine koja je primjenjivala i koja nije primjenjivala duhovno-tjelesne tehnike nije nađena statistički značajna razlika u odnosu na dob, spol, EDSS zbroj, trajanje bolesti i klinički tijek bolesti. S obzirom na učestalu primjenu različitih duhovno-tjelesnih tehnika, potrebno je aktivno praćenje oboljelih od MS kako bi se mogle učiniti smjernice za liječenje navedenim tehnikama

Sindrom nemirnih nogu kod oboljelih od multiple skleroze – iskustva bolesnika liječenih u specijalnoj bolnici za medicinsku rehabilitaciju u lipiku

The study included 60 patients with multiple sclerosis (MS) hospitalized at our institution from September 1 to December 31, 2014. Th e aim of the study was to assess the prevalence of restless legs syndrome (RLS) in MS patients and RLS relationship with patient age, sex, degree of disability, form of MS, time elapsed from MS diagnosis and use of antidepressants. The diagnosis of RLS was made according to the criteria set by the International Restless Legs Syndrome Study Group. Of the 60 patients, 24 (40%) met the criteria for the existence of RLS. In the group of patients with RLS, there was a significantly higher proportion of women and those that were taking antidepressants. Th ere were no statistically significant between-group differences according to age, duration of illness, degree of disability and clinical course of MS. In the study, 37.5% of patients that met the criteria for RLS diagnosis had not informed the neurologists about their difficulties. The high prevalence of RLS and the fact that a large proportion of patients did not inform the neurologists about their difficulties related to RLS point to the need of an active approach to diagnosis and treatment.U studiji je obuhvaćeno 60 oboljelih od multiple skleroze (MS). Svi su bili hospitalizirani u našoj ustanovi od 1. rujna 2014. do 31. prosinca 2014. Cilj rada je bio istražiti učestalost sindroma nemirnih nogu (RLS) i odrediti međusobnu povezanost RLS-a s dobi ispitanika, spolom, stupnjem onesposobljenosti, oblikom MS, vremenom proteklim od postavljanja dijagnoze MS i uzimanjem antidepresiva. Dijagnoza RLS-a postavljena je sukladno kriterijima Međunarodne studijske grupe za sindrom nemirnih nogu (IRLSSG). Od ukupno 60 ispitanika njih 24 (40%) ispunilo je kriterije za postojanje RLS-a. U skupini ispitanika s RLS utvrđena je statistički značajno veća zastupljenost žena i onih koji uzimaju antidepresive. Nije nađena statistički značajna razlika između skupina u odnosu na životnu dob, trajanje bolesti, stupanj onesposobljenosti i klinički tijek MS. Od 24 bolesnika koji su ispunili kriterije za dijagnozu RLS-a njih 37,5% nije obavijestilo neurologa o prisutnim smetnjama. Visoka učestalost RLS-a i činjenica da velik udio oboljelih ne iznosi nadležnom neurologu smetnje iz okvira RLS-a zahtijevaju aktivan pristup u dijagnostici i liječenju

Pseudobulbarni afekt kod oboljelih od multiple skleroze

The aim of the study was to determine the prevalence of pseudobulbar affect (PBA) in patients with multiple sclerosis (MS) and to analyze the link between PBA and patient age, sex, clinical course of MS, disease duration and degree of disability. The study was conducted on 79 MS patients that underwent inpatient rehabilitation at the Lipik Special Hospital for Medical Rehabilitation in the period from August 15, 2014 to February 15, 2015. PBA is a term used for an emotional disinhibition syndrome characterized by sudden and involuntary episodes of crying or laughing which are not in proportion to the stimulus applied or occur without stimulus. The condition can be present in patients with various neurological disorders, such as amyotrophic lateral sclerosis, Alzheimer’s disease, Parkinson’s disease, patients having recovered from stroke, or following traumatic brain injury. The estimated prevalence in patients with MS ranges from 10% to 46.2%. As a measuring instrument in the study, we used the Center for Neurologic Study-Lability Scale (CNS-LS), where a sum ≥17 denoted positive finding. The total number of respondents was 79, of which 33 (41.8%) met the CNS-LS criteria for the diagnosis of PBA. There was no statistically significant correlation between PBA, age and degree of disability, although PBA was more common in women and in patients with a secondary progressive form of the disease. We found that 42.4% of respondents with positive CNS-LS criteria for PBA did not inform their neurologist on the presence of sudden mood changes. The high frequency of PBA and the fact that a significant proportion of patients did not inform the neurologist on their affective disturbances call for an active approach to diagnosis and treatment.Cilj rada je bio odrediti učestalost pseudobulbarnog afekta (PBA) kod oboljelih od multiple skleroze (MS) i analizirati povezanost PBA s dobi bolesnika, spolom, kliničkim oblikom MS, trajanjem bolesti i stupnjem onesposobljenosti. Studija je obuhvatila 79 oboljelih od MS koji su u razdoblju od 15. kolovoza 2014. do 15. veljače 2015. provodili stacionarnu rehabilitaciju u Specijalnoj bolnici za medicinsku rehabilitaciju Lipik. PBA je naziv za sindrom dezinhibicije emocionalne ekspresije obilježen iznenadnim i nevoljnim epizodama plača ili smijeha koje nisu u razmjeru s primijenjenim podražajem ili se javljaju bez njega. Može biti prisutan kod oboljelih od različitih neuroloških bolesti poput amiotrofične lateralne skleroze, Alzheimerove bolesti, Parkinsonove bolesti, kod osoba nakon preboljelog moždanog udara i nakon traumatskog oštećenja mozga. Procijenjena učestalost kod oboljelih od MS kreće se od 10% do 46,2%. Kao mjerni instrument u istraživanju koristili smo ljestvicu CNS-LS (Center for Neurologic Study-Lability Scale), pričem je zbroj ≥17 značio pozitivan nalaz. Ukupan broj ispitanika bio je 79, od kojih je 33 (41,8%) ispunilo kriterije CNS-LS za dijagnozu PBA. Nije nađena statistički značajna povezanost između PBA, dobi i stupnja onesposobljenosti, dok je PBA bio češći kod žena i oboljelih od sekundarno progresivnog oblika bolesti. Utvrđeno je da 42,4% ispitanika s pozitivnim kriterijima CNS-LS za PBA nije obavijestilo neurologa o prisutnim naglim promjenama u raspoloženju. Visoka učestalost PBA i činjenica da značajan udio oboljelih ne iznosi neurologu smetnje u afektivnoj sferi zahtijeva aktivan pristup u dijagnostici i liječenju

PHYSICAL FITNESS OF THE HEALTH WORKERS IN LIPIK SPA

UVOD: Rezultati istraživanja Hrvatske zdravstvene ankete 2003. na 12000 osoba starijih od 18 godina su pokazali da je ukupno nedovoljno tjelesno aktivno 35,8% ispitanika (oko 44% muškaraca i 32% žena) u Hrvatskoj. U radu je procijenjena tjelesna aktivnost fizioterapeuta i specijalista fizikalne medicine i rehabilitacije u Toplicama Lipik i komparirana sa tjelesnom aktivnošću stanovnika Hrvatske. CILJ RADA: Cilj je bio ispitati sklonost redovitom vježbanju i tjelesnim aktivnostima, kao čimbenika zdravog stila života, zdravstvenih djelatnika Toplica Lipik koji vježbanje redovno sugeriraju pacijentima ili klijentima. MATERIJAL I METODE: Istraživanje je uključilo 46 ispitanika, zdravstvenih djelatnika u Toplicama Lipik. Korišten je standardizirani upitnik o stupnju tjelesne aktivnosti. REZULTATI S DISKUSIJOM: Anketirano je 46 djelatnika, uz primjenu standardiziranog upitnika, 14 muškaraca i 32 žene, prosječne životne dobi 36,43 (u rasponu od 20-63) godine. 17 ispitanika je veoma aktivnih, 18 aktivnih, 6 umjereno aktivnih i 5 neaktivnih. Rezultati istraživanja ukazuju da je 76% ispitanika aktivno ili vrlo aktivno. Najveći postotak veoma aktivnih i aktivnih 90% (18) je među ispitanicima od 20-29 godine života, 62% (8) ih je u dobi od 30-39 godine, 80% (4) starosti od 40-49 godine, 71% (5) od 50-59 godine života, dok među starijima od 60 godina nema aktivnih i veoma aktivnih. ZAKLJUČAK: Ova skupina ispitanika je iznad prosječno aktivna u odnosu na ostalu populaciju u Hrvatskoj. Tjelesna aktivnost zdravstvenih djelatnika Toplica Lipik bila je ovisna o njihovoj životnoj dobi i sugerira zdrav stil života ispitanika.INTRODUCTION: The results previous investigation Croatian Health Questionnaire that included 12000 participans older then 18 years and was conducted 2003. suggested that 35,8% participans (about 44% men and 32% women) in Croatia was not enough physical active.This study focused on obtaining relevant information about the level of physical activity among physiotherapists and physicians – specialists of physical and rehabilitation medicine in Lipik Spa and compare with physical fitness in Croatia. AIM OF THE PAPER: The main aim oft this study was to estimate familiarization the health workers in Lipik Spa with regular gym and physical activity in their own lifes because they usually suggest physical fitness to their patients or clients. MATERIALS AND METHODS: This study included 46 participans, health workers in Lipik Spa. The standardiset questionnaire was applied. RESULTS AND A DISCUSSION: 46 respondents (14 men, 32 women), the average age 36,43 (in range from 20 to 63) years were included and assessted by the standardised questionnaire. 17 subjects was very active, 18 active, 6 moderate active and 5 inactive. The results suggest that 76% of the respondents are active or very active. The most very active and active 90% (18) were subjects from 20-29 years old; 62% (8) was in the group from 30 to 39; 80% (4) from 40-49; 71% (5) from 50-59 years. In the group elderly then 60 years there was no active or very active subjects. CONCLUSION: This group of the participans is active above average when compared to the general population of Croatia. Physical fitness the health workers in Lipik Spa was mostly dependent of their life-age

Depression in patients with multiple sclerosis

Cilj rada: Cilj rada je bio odrediti učestalost depresije kod oboljelih od multiple skleroze (MS) i analizirati povezanost depresije sa spolom bolesnika, dobi, kliničkim oblikom MS, trajanjem bolesti, uzimanjem antidepresiva i stupnjem onesposobljenosti. Ispitanici i metode: Studija je obuhvatila 102 oboljelih od MS koji su u razdoblju od 15. svibnja 2015. do 15. rujna 2015. provodili stacionarnu rehabilitaciju u Specijalnoj bolnici za medicinsku rehabilitaciju Lipik. Prikupljeni su podaci o spolu i dobi ispitanika, stupnju onesposobljenosti, kliničkom obliku MS, uzimanju antidepresiva i vremenu proteklom od postavljana dijagnoze MS. Dijagnoza depresivnog sindroma postavljena je pomoću upitnika PHQ-9. Ispitanici su podijeljeni u dvije skupine, ovisno o prisutnosti ili odsutnosti depresivnog sindroma. Rezultati: Ukupan broj ispitanika bio je 102, od kojih je 31 (30,4%) ispunilo kriterije za dijagnozu depresivnog sindroma, a 10 njih (32,3%) uzimalo je antidepresive. Nađena je statistički značajna povezanost između prisutnosti depresivnog sindroma i višeg stupnja onesposobljenosti (P = 0,028), dok nije nađena između prisutnosti depresivnog sindroma u odnosu na spol (P = 0,429), životnu dob (P = 0,652), trajanje bolesti (P = 0,549) i klinički tijek bolesti (P = 0,326). Zaključak: Visoka učestalost bolesnika pozitivnih na testu probira na depresiju i činjenica da samo tre-ćina njih uzima antidepresive zahtijeva aktivan pristup u dijagnostici i liječenju depresije kod oboljelih od MS.Objective: The aim of the study was to determine the prevalence of depression in patients with multiple sclerosis (MS) and to analyze the link between depression and patient sex, age, clinical course of MS, disease duration, antidepressant intake, and degree of disability. Patients and methods: The study was conducted on 102 MS patients that had undergone inpatient rehabilitation at the Lipik Hospital in the period from May 15, 2015 to September 15, 2015. Data on patient age, sex, degree of disability, clinical course of MS, antidepressant use, and time elapsed from MS diagnosis were collected. The diagnosis of depressive syndrome was made using the Patient Health Questionnaire-nine (PHQ-9). Study patients were divided into two groups according to the depressive syndrome absence or presence. Results: The total number of respondents was 102, of which 31 (30.4%) met the criteria for depressive syndrome diagnosis. 10 (32.3%) out of the 31 patients were taking antidepressants. There was a statistically significant positive correlation between the presence of depressive syndrome and higher level of disability (P = 0.028), whereas there was no correlation between the presence of depression and sex (P = 0.429), age (P = 0.652), disease duration (P = 0.549), and disease course (P = 0.326). Conclusion: The high rate of patients screened positive for depression and the fact that only one-third of these patients were taking antidepressants call for an active approach to diagnosis and the treatment of depression in MS patients

Bolni sindromi u oboljelih od multiple skleroze – iskustva bolesnika liječenih u Specijalnoj bolnici za medicinsku rehabilitaciju u Lipiku

In the study, we evaluated 61 multiple sclerosis patients hospitalized at our hospital in the period from October 1, 2013 to February 15, 2014. The aim of the study was to investigate pain syndromes associated with the underlying disease. Pain in the month preceding assessment was reported by 90% of patients. Most patients suffered from low back pain (52%) and musculoskeletal pain (39%), followed by neck pain (31%), painful tonic spasm (26%), neuropathic extremity pain (23%) and pain due to spasticity (21%). Other types of pain were present in less than 20% of patients. A total of 67% of patients were taking analgesics; the most frequently used were nonsteroidal antiinflammatory drugs, while drugs against neuropathic pain were taken by a smaller number of patients. The high incidence of pain syndromes pointed to the importance of regular physical therapy procedures.U studiji je obuhvaćen 61 oboljeli od multiple skleroze. Svi su bili hospitalizirani u našoj ustanovi od 1. listopada 2013. do 15. veljače 2014. Cilj rada je bio istražiti bolne sindrome pridružene osnovnoj bolesti. Bolovi su bili prisutni u 90% ispitanika. Najveći broj oboljelih imao je bolove u leđima (52%) i mišićno-zglobno-koštane bolove (39%), nakon čega slijede bolovi u vratu (31%), bolni tonički spazmi (26%), neuropatski bolovi u ekstremitetima (23%) i bolovi uslijed spasticiteta (21%). Drugi tipovi bolova bili su prisutni u manje od 20% oboljelih. Analgetike je uzimalo 67% ispitanika, najčešće nesteroidne antireumatike, dok je lijekove protiv neuropatskih bolova uzimao manji broj bolesnika. Visoka učestalost bolnih sindroma ukazuje na važnost redovitih postupaka fizikalnih terapija