A retrospective study of surgical treatment of spinal injuries with rehabilitation program

Introduction: Traumatic injuries of the spinal column are among the most devastating injuries in orthopedics. The primary goals of rehabilitation of these injuries are prevention of secondary complications, maximizing physical functioning and reintegration into the community. Rehabilitation after spinal injury reqires multidisciplinary team approach. Team members include, but are not limited to, physical therapists, occupational therapists, nurses, psychologists, health care managers and social workers, with each member having role and responsibility in their area of expertise. This study aimed to determine the difference in the occurrence of spinal injuries according to gender, age, cause of injury, neurological phenomenon in injured patients, the treatment and physical procedures used in the early stages of rehabilitation.Methods: The study was conducted as a retrospective and comparative at the Department of Orthopedics and Traumatology of Clinical Center University of Sarajevo. Medical records of 100 patients, treated at from January 1st 2007 till June 30th 2008, were processed and data about outpatient protocols and surgery protocols analyzed.Results: The results obtained from the data showed greater proportion of women (56%) compared to men (44%). Most patients were in the age group between 41 and 60. Injuries were most often due to falls from height and make 32%, fall from a tree 25%, traffic accidents 12% (²=17.94, p=0.0061). 88% of patients were without neurologic events, while the neurological disturbances occurred 12% (χ²=3.397, p=0.3343). 56% of patients with spinal injuries were treated surgically, while 41% were treated conservatively (χ ²=7.264, p= 0.00153). 73% patient had physical therapy program of early rehabilitation exercises, with at least at least only a massage in 4% of patients X² = 6.573, p = 0.04270).Conclusion: The adoption of national protocols is necessary for future treatment of patients with spinal fractures

Effects of strength, stretching and balance home exercise program on quality of life of people with knee osteoarthritis

Introduction: The aim of this study was to assess effects of strength, stretching and balance home exercise program (moderate intensity, performed once a day, five times a week) on quality of life of people with knee osteoarthritis. Methods: Participants with knee osteoarthritis performed physical therapy for a period of two weeks at the Department for Physical Medicine and Rehabilitation. The study group (n=30) continued to perform exercise program at home while the control group (n=30) did not continue the exercise program. The participants in the study group performed strength, stretching and balance exercises of moderate intensity, once a day, five times a week, for a total of eight weeks. The Short Form-36 Health Questionnaire (SF-36) was used to examine the effects of exercise program. Results: There was no the difference between the average value of quality of life in all examined areas (physical functioning, role limitations due to physical problems, role limitations due to emotional problems, vitality/energy, mental health, social functioning, physical pain, perception of general health) at the beginning of the study between the study group and control group (p>0.05 in all eight areas). The difference between the average value of quality of life at the beginning and end of the study was statistically significantly higher in the study group compared to the control group (physical functioning p=0.0001; role limitations due to physical problems p=0.0001; role limitations due to emotional problems p=0.0001; vitality/energy p=0.0001; mental health p=0.0001; social functioning p=0.0001; bodily pain p=0.0001; perception of general health p=0.0001). Conclusion: Home exercise program consisting of strength, stretching and balance exercises, of moderate intensity, performed once a day, five times a week is effective in improving quality of life of people with knee osteoarthritis

The Algorithm for overload syndrome prevention: Osgood-Schlatter's syndrome (OSD) as an overload syndrome caused by early inclusion of children in sports and excessive physical activity (sports and recreation)

Introduction: Osgood-Schlatter’s syndrome (Osgood-Schlatter disease [OSD]) is caused by an accumulation of repeated microtraumas and is classified as a type of chronic injury called “overload syndrome“. It is considered that the root causes of OSD are accelerated growth as well as excessive sports and recreational activity. Currently, more than 50% of children of school age are involved in sports activities. In this study, 40 external risk factors were analyzed. Considering that frequent medical examinations, expensive rehabilitation, time-consuming sports activities, and school obligations result in major socio-economic and financial consequences, a need to work on a preventive program was recognized. The aim of this study was to determine external risk factors and to develop an algorithm for the prevention of injuries caused by overload syndrome through a detailed analysis of Osgood-Schlatter’s syndrome concerning aerobic and anaerobic sports (football, basketball, karate, and taekwondo). Methods: The research has been conducted on 200 patients who were previously diagnosed with Osgood-Schlatter’s syndrome. The participants were divided into two groups, each containing 100 patients, first group – aerobic sports (football and basketball) and the second group – anaerobic sports (karate and taekwondo). Personal information, anthropometric measurements, complete medical, and sports history were taken from the patients. A clinical examination was conducted by the researcher himself. This clinical study was prospective, comparative, analytical, and descriptive. The research was conducted in the Public Center for Sports Medicine of Canton Sarajevo. Software used for statistical data analysis was SPSS for Windows (version 20.0, SPSS Inc., Chicago, Illinois, USA) and Microsoft Excel (version 13 of Microsoft Corporation, Redmond, WA, USA). Results: Patients experienced the first symptoms of OSD at 4 years (football) and 6 years (taekwondo). About 60% of patients who trained in anaerobic sports and 38% of patients who trained in aerobic sports trained other sports more often as well. The research showed that a higher percentage of patients who trained anaerobic sports trained multiple sports at the same time (karate 88%, and taekwondo 82%) compared to patients who trained aerobic sports (football 68%, and basketball 76%). Patients who trained in anaerobic sports were also more likely to engage in recreational activities (58.3%) compared to patients who trained in aerobic sports (41.7%). On average, the number of hours per week which patients spent actively training (primary sport, additional sports activity, and recreational sport) was 17.2 h for basketball players, 16.8 h for taekwondo trainees, 16.7 h for caratists, and 15.7 h in case of football players. About 32% of football players, 24% of basketball players, 12% of karate trainees, and 18% of taekwondo trainees did not engage in additional sports or recreational activities. Only 36% of patients who trained in aerobic sports and 37% of patients who trained anaerobic sports respected the planned rest days, and in both groups, some subjects trained for 12 months. Conclusion: The research showed that patients who trained in anaerobic sports more frequently trained more than one sport at the same time and spent more hours doing recreational activities compared to patients who trained in aerobic sports. By analyzing weekly physical activity, it was concluded that the rest is limited. Future research aims to identify risk factors so that children, parents, and trainers can be educated to work on prevention through teamwork

The Osgood-Schlatter's Syndrome (OSD) and Involvement of Children of Young Age in Sports

Introduction: Two findings can be highlighted from recent medical research, first children of a young age are involved in organized sports activities more frequently than ever and second the first symptoms of Osgood-Schlatter disease (OSD) have been reported in children at the age of 5.5 years. The latest research has shown that children from ages 10 to 12 years have already been actively involved in sports activities for 5–7 years. In recent years, the practice of young children training to master sports has become a trend. Said exposes young children who are training intensively to various external risk factors such as social isolation, addiction, frequent injuries, and syndrome of overload. Enablers of this behavior are commonly parents and coaches who notice the child’s abilities stand out from those of other children in the group and find that such talent requires intensive sport-specific training. The purpose of this study was to determine the average age of the patients and the average age when the first symptoms of the disease appeared as well as to provide an analysis of the average duration of children being actively involved in sports activities before the first symptoms of OSD appeared. Methods: The research has been conducted on 200 patients who were previously diagnosed with Osgood-Schlatter’s syndrome. The participants were divided into two groups each containing 100 patients, first group –aerobic sports (football and basketball) and the second group –anaerobic sports (karate and taekwondo). Personal information, anthropometric measurements, complete medical, and sports history were taken from the patients. A clinical examination was conducted by the researcher himself. The study was prospective, clinical, comparative, analytical, and descriptive. The research was conducted in Public Center for Sports Medicine of Canton Sarajevo. Software used for statistical data analysis was SPSS for Windows (version 20.0, SPSS Inc., Chicago, Illinois, USA) and Microsoft Excel (version 13 of Microsoft Corporation, Redmond, WA, USA). Results: The average age when the patients started with intensive training was highest with basketball players (7.8 years) following with karate trainees (6.8 years). Basketball players had statistically the lowest duration of being actively involved in sports activities before the first symptoms of OSD appeared (5.4 years). No statistically significant difference in the average duration of training was discovered between the test groups. The average age when knee pain or swelling under the knee first appeared was at the age of 11.4 years with players of aerobic sports and 11.8 years with players of anaerobic sports. Furthermore, no statistically significant difference was found between test groups and subgroups. Before the first appearance of knee pain, the taekwondo patients had been in training the longest (4.7 years) and basketball players the least amount of time (3.4 years). Conclusion: By conducting retrospective analysis, it has been concluded that children had started training at the age of 3 or 4 years and had encountered the first symptoms of OSD at the ages of 4 years (football) and 6 years (taekwondo). Research showed that the early involvement of children in sports and their early specialization in sports are both external risk factors that have a dominant influence on OSD development

Effect of physical therapy in daily life and work activities for people with chronic cervical pain syndrome

Introduction: Cervical pain syndrome (CPS), or pain in the neck, is defined as a set of symptoms that limit performing movements in the upper part of the back and last more than 1 day. When the mentioned symptoms last for more than 12 weeks, we talk about chronic CPS. It often represents the condition that results from disability. It is associated with poor posture, work in sitting position, stress, and long-lasting and repetitive movements. The aim of the study was to examine the effect of physical therapy on the degree of disability, pain intensity, and daily life and work activities of persons with chronic CPS.Methods: The research was conducted in the health spa center “Reumal” Fojnica from June 2020 until July 2020. It included 50 subjects of both genders, more than 18 years old, and of all occupations, treated with physiotherapy procedures (transcutaneous electrical nerve stimulation, magnetotherapy, therapeutic ultrasound, and kinesitherapy in the form of McKenzie exercises). In addition, a pre- and post-treatment study analyzed the condition of the respondents at the first examination and the control examination after completion of treatment.Results: By analyzing the results, we established that of the total number of respondents, 74% were female, and the average age was 57.36 years. At the end of the study, the degree of disability caused by neck pain was significantly lower (p < 0.05) than the degree of disability before the therapy. Discomfort caused by symptoms of CPS that occurred and interference with work before the therapy was significantly lower (p < 0.05) after the treatment program. Therapeutic procedures have reduced the pain intensity and improved the activities of everyday life.Conclusion: The treatment with physical therapy procedures effectively reduces the degree of disability and pain intensity and improves people’s daily life and work activities with chronic CPS

The importance of social support for elderly people

Introduction: Social support is not a one-way relationship but is based on the connections people have with other people, groups, and the wider community. This study aimed to assess the perception of social support by people in the third age and to investigate the correlation of social support with the sociodemographic characteristics of the respondents. Methods: A quantitative cross-sectional study was conducted with 147 elderly people who actively use the services of the Center for Health Promotion and Improvement “Generacija” in Sarajevo. The Multidimensional Scale of Perceived Social Support (MSPSS) was used to assess social perceptions. Results: The results show a weak negative relationship between age and the total scale (r = −0.199, p = 0.05), with older people having lower scores on the total scale. A significant relationship was found between the subscale other factors and age (r = −0.202, p = 0.05). The evaluation of the performance of daily activities correlates weakly with the evaluation of the friend’s subscale (r = 0.186, p = 0.05). The friend’s subscale correlates significantly with the quality of social life (r = 0.227, p = 0.05). The subjective assessment of the quality of social life after arriving at the center showed a correlation with the overall scale score (r = 0.182, p = 0.05) and especially with the friend subscale (r = 0.219, p = 0.05), with the increase in social life and the subscales examined in both cases. Conclusion: Users of the “Generacija” center rate social support on the MSPSS with high scores, with users receiving the most support from family. The sociodemographic characteristics of the respondents have an impact on the perception of social support by the users of the Center for Health Promotion and Improvement “Generacija,” more specifically; they were statistically significantly influenced by age, the way of performing daily activities, the quality of social life and the quality of social life after arrival at the Center

Importance of clinical examination in diagnostics of Osgood-Schlatter Disease in boys playing soccer or basketball

Introduction: Osgood–Schlatter disease is an irritation of the patellar tendon at the tibial tubercle. Sports with jumps, running, and repeated contractions of knee extension apparatus are considered to be importantexternal risk-factors which could cause Osgood–Schlatter disease.Objectives of the study are to draw attention to the importance of clinical examination in diagnostics of Osgood–Schlatter disease in boys playing soccer or basketball.Methods: The research included data obtained from 120 boys, average age of 14 years. Examinees were split into two groups, one with young athletes which regularly have soccer or basketball trainings and thesecond one with boys who do not participating in sports. We performed anthropological measurements and clinical examinations of both knees and hips for both groups. For the statistical analysis we used pointbiserialcorrelation coefficient.Results: Based on clinical examination, Osgood–Schlatter disease was diagnosed in 51 examinees (42.5%). In “athletic group” Osgood–Schlatter disease had 31 boys or 52%, comparing with “non-athletic group” wherewe found 20 adolescents with disease (33%). Number of boys with Osgood–Schlatter disease was higher for 19% in “athletic group” comparing with “non-athletic group”. Comparing incidence rate for boys in both groups with diagnosed II and III level of Osgood–Schlatter disease we found that rate is higher in “athletic group” 2.25 times comparing with “non-athletic group”.Conclusions: Clinical examination is critical method in the process of diagnosing Osgood–Schlatter disease especially for identifying II and III level of this disease

Assessment of functional mobility of persons in the 3rd age of life after programmed therapeutic exercises

Introduction: Active aging is a process of optimizing of opportunities for health, participation, and safety to improve the quality of life as people age. Therapeutic exercises to strengthen muscles are especially important for the elderly, and the results of such exercises are positive in people with functional limitations. The aim of the study was to assess functional mobility of people in the 3rd age of life after programmed therapeutic exercises.Methods: The prospective study included two groups of 130 respondents over the age of 65 who came to the “Centre for Healthy Aging” in Novo Sarajevo in the period from September 1, 2014, until March 1, 2015. Using the time up and go test (TUG), the basic functional mobility was assessed and it represents the minimum time the respondent needs to get up from the armchair, walk a distance of three meters, turn around, and sit back in the armchair. We tested the respondents at the beginning, in the middle, and at the end of the study, which lasted for 6 months.Results: Analysis of the gender structure of the control and the test groups, using the Chi-square test, found a statistically significant difference, and in the test group, there were more female subjects than in the control group, χ2 = 50.620; p = 0.001. Analysis of the functional mobility of the respondents of the test groups using the TUG at the end of the study found that the respondents of the test group needed statistically significantly less time to perform the test (8.84 seconds) compared to the control group (9.59 seconds) and test Group B (9.41 seconds), F = 4.711; p = 0.041.Conclusion: Programmed therapeutic exercise leads to a significant improvement in functional mobility of persons in the 3rd age of life

Effectiveness of physical treatment at De Quervain᾽s disease

<strong>Introduction:</strong> De Quervain᾽s disease is a stenosing tenosynovitis of common tendon sheath of abducktor policis longus and extensor policis brevis muscles. Due to the superficial positions it can easily lead to<br />mechanical injuries of tendons and their sheaths. The disease more often affects women over 40 years old and people with certain professions who intensively use hand and fingers in their daily work. Pathological<br />changes consist of sheath᾽s fibrous layer thickening. The clinical condition develops gradually with the pain of varying intensity. It is localized above the radial styloid process and radiates from the back side of the<br />thumb. The aim is to determine the efficacy of physical therapy at De Quervain᾽s disease.<br /><strong>Methods: T</strong>he study was conducted on 50 patients with De Quervain's disease who were reported to the CBR "Praxis" Sarajevo. With retrospective analysis the data was processed for the period from 01.01.2001. to 31.12.2011. year. Before the initiation of physical therapy assessment of functional status scored from 0 to 6 was performed. In the chronic phase physical therapy was performed, after which it underwent assessment of therapy success scores of 0-5. Criteria for inclusion in the study were patients with confirmed De Quervain's disease, patients of both sex and of all ages, and criterion for exclusion was non-compliance with<br />treatment protocols.<br /><strong>Results: </strong>In the CBR "Praxis" with De Quervain᾽s disease total of 50 patients were treated in that period, of which 34 women and 16 men. 38% of respondents received a score of 4, while 56% of patients at the end of<br />treatment received a score of 5.<br /><strong>Conslusion:</strong> Physical therapy and kinesiotherapeutical procedures have greatly contributed to the elimination of symptoms and consequences of De Quervainove disease

Daily activities of employed persons with visual impairment

Introduction: The challenges faced by visually impaired people in their efforts to integrate themselves into the labor market and the general position of persons with disabilities, regarding their employment and social security, is extremely difficult. Employment is the best safeguard against social exclusion and one of the main ways to achieve a full involvement in the society of the visually impaired people.Methods: The research was conducted on a sample of 25 visually impaired people employed at “TMP” d.o.o. Sarajevo. The study was used as a cross-sectional survey method wherein data were collected through appropriate survey instruments, using a modified survey questionnaire.Results: Out of the total number of respondents, 48% are male and 52% are female. The majority of respondents use other persons’ assistance when moving (n = 16). The largest number of respondents had 100% visual impairment (n = 17). The majority of subjects have no strenuous physical activity. The largest number of respondents during the previous week walked for at least 10 minutes, in the sequence of all 7 days and was driven in motor vehicles. When doing household chores, 56% of respondents said they had no difficulty. The most common difficulties in recreation, sports and physical activity in leisure time, that were encountered by 32% of respondents, are poor sound signalling and difficulties of visual nature, though 68% of respondents said that they had no difficulty in their recreational activities.Conclusion: The daily activities of employed visually impaired persons have a positive impact on their quality of life. Various are occupations of visually impaired people that improve their quality of life