101 research outputs found
Ozljede lokomotornog sustava u trkaÄa poÄetnika: incidencija, vrste ozljeda, vremenski obrasci, sociodemografski i motivacijski Äimbenici rizika ā prospektivna kohortna studija
The aim was to determine types and incidence of running-related lower extremity injuries and identify sociodemographic and motivational risk factors in novice runners attending an eight-month running school. Between January 2011 and October 2014, 349 novice runners were included. Sociodemographic, anthropometric, and data on running motivation and self-perceived health and fitness were collected. Subjects were screened for lower extremity injuries at regular three-month intervals. The cohort mean age was 35.46Ā±7.31 years, and 271 (79.5%) were female. There were 173 (49.9%) injuries recorded, less frequently among women (42.9% vs. 62.7%, p=0.016; OR 0.878, 95% CI 0.788-0.977). The mean body mass index was 23.89Ā±3.88 kg/m2 at baseline and 22.99Ā±3.35 kg/m2 post-school (p<0.001). Median self-perceived fitness level on a ten-point visual analog scale was 4 (interquartile range (IQR) 3-5) at baseline and 8 (IQR 7-8) post-school (p<0.001). Median self-perceived overall health was 6 (IQR 5-8) at baseline and 8 (IQR 7-9) post-school (p<0.001). The knee had a significantly higher rate of injuries compared to other anatomic regions (p<0.001). Subjects listed improvement of fitness as the most common motivation for entering the school (n=159; 45.7%). In conclusion, novice runners should include strengthening exercises for knee injury prevention into their training routine.Cilj je bio istražiti incidenciju ozljeda lokomotornog sustava donjih ekstremiteta vezanih uz trÄanje i utvrditi sociodemografske i motivacijske Äimbenike rizika u trkaÄa poÄetnika tijekom osmomjeseÄnog programa Å”kole trÄanja. U istraživanje je bilo ukljuÄeno 349 trkaÄica i trkaÄa koji su pohaÄali Å”kolu trÄanja izmeÄu sijeÄnja 2011. i listopada 2014. Prikupljani su Āpodaci o sociodemografskim, antropometrijskim znaÄajkama ispitanika, kao i oni o percipiranju vlastitog zdravlja, kondicije i motivacije za trÄanje. Srednja vrijednost dobi kohorte je bila 35,46Ā±7,31 godina, a 271 (79,5%) su bile žene. Ukupno su zabilježene 173 (49,9%) ozljede, s manjom uÄestalosti meÄu ženama (42,9% prema 62,7%, p=0,016; OR 0,878, 95% CI 0,788-0,977). Srednja vrijednost indeksa tjelesne mase je bila 23,89Ā±3,88 kg/m2 na poÄetku i 22,99Ā±3,35 kg/m2 na kraju Å”kole (p<0,001). Medijan razine percepcije vlastite tjelesne kondicije je bio na vizualno numeriÄkoj ljestvici (1-10) 4 (interkvartilni raspon (IQR) 3-5) na poÄetku i 8 (IQR 7-8) na kraju Å”kole (p<0,001). Medijan razine percepcije vlastitog zdravlja je bio 6 (IQR5-8) na poÄetku i 8 (IQR 7-9) na kraju Å”kole (p<0,001). Koljeno je bilo ozlijeÄeno znaÄajnije ÄeÅ”Äe nego ostale anatomske regije (p<0,001). Ispitanici su naveli želju za poboljÅ”anje tjelesne kondicije kao najÄeÅ”Äi razlog ukljuÄivanja u Å”kolu trÄanja (n=159; 45,7%). ZakljuÄno, trkaÄima poÄetnicima bi trebalo prije i tijekom trkaÄkog treninga uvesti vježbe za prevenciju ozljeda koljena
Torticollis
Tortikolis je nagnut položaj glave i ograniÄena pokretljivost vratne kralježnice uz hipertonus miÅ”iÄa sternokleidomasteidousa. Nakon iÅ”ÄaÅ”enja kuka i deformacija stopala, jedan je od tri najÄeÅ”Äa deformiteta s kojim se raÄaju djeca.
U radu se prikazuje moguÄnost rane dijagnoze i terapije tortikolisa, s naglaskom na važnost terapije aktivnim pokretom, kao srediÅ”nje metode u lijeÄenju, koju provodi fizioterapeut ili roditelj.Torticolis is the condition that causes the neck to involuntarily twist to one side secondary to contraction of the neck muscles combined with limited range of movement and sternocleidomastoideus muscle hypertonus. This presents one of three most common deformities along with hip dislocation, and feet deformities. In this paper are presented possibilities of early diagnosis and therapy, emphasizing the importance of active range of movement as a central method of treatment, performed by therapist or by a parent
NeuroriziÄno dijete
NeuroriziÄno dijete je ono dijete koje je bilo izloženo prenatalnim, perinatalnim ili postnatalnim Äimbenicima rizika. Mjesto i nastanak oÅ”teÄenja mozga ovisi o gestacijskoj zrelosti novoroÄenÄeta, a objaÅ”njava se postojanjem prijelaznih oblika neuroanatomske organizacije i promjenama prokrvljenosti centralnog živÄanog sustava tijekom sazrijevanja. Neurorazvojni ishod djeteta nakon oÅ”teÄenja ovisi o interakciji: djeteta i okoline, postojeÄeg oÅ”teÄenja mozga (tip, opseg i lokalizacija) te kompenzacijskih procesa maturacije i plastiÄnosti mozga. KliniÄki ishod može iÄi u dva smjera: potpuni oporavak ili neurorazvojno odstupanje. Neurorazvojno odstupanje može biti niskoneuroriziÄno ili visokoneuroriziÄno. U ovom radu prikazano je dijete P. L. koje je bilo izloženo prenatalnim, perinatalnim i postnatalnim Äimbenicima rizika. Zbog poznatih Äimbenika rizika i evidentnog odstupanja tijekom prvog pregleda djeÄjeg fizijatra odmah je planirana intenzivna stimulacija neuromotoriÄkog razvoja. UkljuÄen je interdisciplinarni tim struÄnjaka kako bi prevenirali stvaranje patoloÅ”kih obrazaca pokreta i ponaÅ”anja.Child at neurorisk is the child who has been exposed to prenatal, perinatal or postnatal risk factors. Place and damage to the brain depends on the gestational age of the newborn, and explains the existence of transitional forms neuroanatomical organization and blood flow changes of the central nervous system during maturation. Child at neurorisk after the damage depends on the interaction: both the child and the environment, the existing brain damage (type, extent and localization) and compensation process of maturation and brain plasticity. Clinical outcome can go in two directions: a full recovery or neurodevelopmental disorders. Neurodevelopmental disorders can be either at low risk or at high risk. In this paper, the child P. L., the subject of interest, has been exposed to prenatal, perinatal and postnatal risk factors. Because of the known risk factors and the evident discrepancies during the first examination of child physiatrist we immediately started planned intensive stimulation of neuromotor development. An interdisciplinary team of experts was involved to help preventing the formation of pathological movement patterns and behavior
Usporedba probirnog testa razvoj psihomotorike i kliniÄke procjene psihomotornog razvoja
Numerous adverse factors are acting in the prenatal, perinatal and postnatal period of life and may be the cause of later mild or severe deviations from normal psychomotor development. Therefore, it is crucial to identify infants with neurological risk factors and infants that already have a delay from orderly development, in order to immediately initiate the rehabilitation process. The aim of this study was to determine whether there is difference in the assessment of psychomotor development in neurological risk children based on the psychomotor development test (Croatian, Razvoj psihomotorike, RPM test) and clinical evaluation of neuromotor development. RPM test is designed for rough estimate of psychomotor development in children in the first two years of life. The study included 15 full term children (8 male and 7 female) with clinical diagnosis of mild paraparesis and mild deviation from normal psychological and social development, and 15 full term children (8 male and 7 female) without neurological risk factors and deviations from normal psychomotor development, all at the age of 12-24 months. Of the 15 children diagnosed with mild paraparesis, none had delayed psychomotor development, 6.7% had suspect development and 93.3% had normal development on RPM test. All children in the control group had normal development on RPM test. According to the results, the RPM test is not sensitive enough to detect mild neurodevelopmental disorders.MnoÅ”tvo je nepovoljnih Äimbenika koji djeluju u prenatalnom, perinatalnom i postnatalnom razdoblju života, a mogu biti uzrokom kasnijih blažih ili težih odstupanja od normalnog psihomotornog razvoja. Stoga je od presudne važnosti identificirati dojenÄad s neuroriziÄnim Äimbenicima i dojenÄad u koje veÄ postoji odstupanje od urednog neuromotornog razvoja kako bi ih se odmah ukljuÄilo u rehabilitacijski proces. Cilj ove studije bio je utvrditi postoji li razlika u procjeni psihomotornog razvoja neuroriziÄne djece na temelju testa Razvoj psihomotorike (test RPM) i kliniÄke procjene neuromotornog razvoja. Test RPM je namijenjen za grubu procjenu psihomotornog razvoja doneÅ”ene djece u prve dvije godine života. U studiju je bilo ukljuÄeno 15 doneÅ”ene djece (8 muÅ”kih, 7 ženskih) s kliniÄkom dijagnozom diskretne parapareze te blagim odstupanjem od normalnog psiholoÅ”kog ili socijalnog razvoja i 15 doneÅ”ene djece (8 muÅ”kih, 7 ženskih) bez neuroriziÄnih Äimbenika i odstupanja od normalnog psihomotornog razvoja, a svi u dobi od 12-24 mjeseca. Od 15 djece s dijagnozom diskretne parapareze niti jedno dijete prema testu RPM nije imalo usporen razvoj, 6,7% je imalo sumnjiv razvoj, dok je u 93,3% razvoj bio uredan. Sva djeca u kontrolnoj skupini su prema testu RPM imala uredan razvoj. Prema dobivenim rezultatima test RPM nije dovoljno osjetljiv da bi otkrio blage neurorazvojne poremeÄaje
Utjecaj motoriÄke ograniÄenosti na izražavanje agresivnosti u adolescenata
This study examined how motor limitations in terms of reduced possibilities to move influence aggression, starting from the fact that motor skills and movement have an important place in the expression of aggression, as well as the tendency of adolescents to ābody languageā. Adolescent with motor deficit is hindered in gaining experience of oneās own body, which is reflected in the formation of complete experience of himself, or constitution of the self. In many of the functions of motor skills and movement aggression has a significant place that we wanted to determine without deeper analysis of whether the origin of aggression is instinctive or it is always just the result of frustration. The sample on which testing was performed consisted of 100 randomly selected subjects of both genders aged 16-18 years. Fifty subjects had motor limitations due to illness or injury, and another fifty subjects had intact motor functions. The study used three instruments: 1) A-87 questionnaire for aggressiveness examination; 2) structured interview; and 3) protocol for observation under natural conditions. Results of the analysis of data obtained in total score, as well as in all five subscales of the A-87 questionnaire for aggressiveness examination showed that the two groups were not significantly different. The results obtained by structured interview showed the adolescents with motor limitations to demonstrate greater verbal aggressiveness, then latent physical aggressiveness. A statistically significant between-group difference was obtained on the factor of self-destructiveness, which implies that adolescents with motor limitations are somewhat more self-destructive compared to those in control group. From the results obtained by the protocol for systematic observation in natural conditions, it was evident that there were significant differences on most of perceptual conducts between control and experimental group, whereby adolescents with motor limitations were more aggressive than control group subjects, especially in behaviors that apply to all forms of verbal aggressiveness. All examined adolescents in which some apparent forms of aggressive behavior were noticed in the observation protocol showed comparable expression of aggressiveness according to the results obtained on the subscales of the A-87 aggressiveness questionnaire, which connects these two measuring instruments and justifies their use in the study of aggressiveness regardless of the understanding of the origin of aggression.Ovim istraživanjem pokuÅ”alo se utvrditi koliko motoriÄka ograniÄenost u smislu umanjene moguÄnosti kretanja utjeÄe na agresivnost, polazeÄi od Äinjenice da motorika i kretanje u izražavanju agresivnosti imaju znaÄajno mjesto, kao i tendencija adolescenata prema āgovoru tijelaā. Adolescent s motoriÄkim deficitom ometen je u stjecanju iskustva o vlastitom tijelu, Å”to se odražava i na formiranje cjelovitog doživljaja sebe, odnosno na konstituciju sebstva (selfa). MeÄu mnogim funkcijama koje kretanje i motorika posjeduju agresija ima znaÄajno mjesto koje smo ovim istraživanjem željeli utvrditi, pri Äemu nismo ulazili dublje u analizu je li podrijetlo agresivnosti nagonsko ili je ona uvijek rezultat samo frustracije. Uzorak na kojem se provodilo ispitivanje sastojao se od ukupno sto sluÄajno odabranih ispitanika oba spola u dobi od 16 do 18 godina. Pedesetero ispitanika imalo je motoriÄku ograniÄenost zbog bolesti ili povreda, a pedesetero ispitanika bilo je intaktnih motoriÄkih funkcija. U istraživanju su se koristila tri instrumenta: 1. upitnik za ispitivanje agresivnosti A-87; 2. strukturirani intervju; i 3. protokol opažanja u prirodnim uvjetima. Rezultati analize podataka dobivenih na ukupnom rezultatu kao i na svih pet podljestvica upitnika za mjerenje agresivnosti A-87 pokazuju da se ispitivane skupine statistiÄki znaÄajno ne razlikuju. U rezultatima dobivenim strukturiranim intervjuom vidi se da adolescenti s motoriÄkom ograniÄenoÅ”Äu iskazuju veÄu verbalnu latentnu, a zatim i latentnu fiziÄku agresivnost. StatistiÄki je znaÄajna razlika izmeÄu ispitivanih skupina dobivena i na Äimbeniku autodestruktivnosti, Å”to govori da su adolescenti s motoriÄkom ograniÄenoÅ”Äu neÅ”to viÅ”e autodestruktivni u odnosu na one iz kontrolne skupine. Iz rezultata dobivenih protokolom za sustavno opažanje u prirodnim uvjetima vidljivo je da postoje izražene razlike na veÄini opažajnih ponaÅ”anja izmeÄu kontrolne i eksperimentalne skupine, priÄem su adolescenti s motoriÄkom ograniÄenoÅ”Äu agresivniji od ispitanika kontrolne skupine i to naroÄito u ponaÅ”anjima koja se odnose na sve oblike verbalne agresivnosti. Svi ukupno ispitivani adolescenti kod kojih su zapaženi pojedini oblici manifestnog agresivnog ponaÅ”anja na protokolu opažanja nadopunjuju se rezultatima agresivnosti dobivenim na podljestvicama agresivnosti upitnika A-87, Å”to povezuje ova dva mjerna instrumenta i opravdava njihovu upotrebu u istraživanju agresivnosti bez obzira na shvaÄanje samog podrijetla agresije
Tireoidna disfunkcija u trudnoÄi: usporedba ishoda u novoroÄenÄadi
The aim of this study was to compare the incidence of mild psychomotor delay in
infants whose mothers were treated for thyroid dysfunction regardless of the cause during first trimester
of pregnancy with those whose mothers did not use medications prenatally. The sample included
200 infants up to 4 months of age. Half of the infants were examined by a pediatric physiatrist, while
the other half were chosen randomly from the primary pediatric clinic. Binary logistic regression was
performed to assess the impact of factors on psychomotor delay. The model contained seven independent
variables derived from bivariate analyses and clinical relevance. Results showed that the infantās
chance of having psychomotor delay was 5.53 times higher if the mother had drug-compensated
thyroid dysfunction. Younger gestational age increased the likelihood of delay 2.12 times per each gestational
week. The likelihood of psychomotor delay also rose by 1% per 1 g of birth weight reduction.
We found strong positive linear correlation between maternal drug-compensated thyroid dysfunction
during pregnancy and psychomotor delay in infants, which has not been reported elsewhere. This differentiates
an important and common prenatal risk factor and lays the foundation for faster initiation
of habilitation of infants at risk. These insights provide a basis for planning the National Screening
Program for Neurorisk Infants.Cilj istraživanja bio je usporediti uÄestalost blagog psihomotornog odstupanja dojenÄadi Äije su majke tijekom trudnoÄe
uzimale lijek za disfunkciju Å”titne žijezde neovisno o uzroku s onima Äije majke nisu rabile lijekove prije poroÄaja. Istraživanjem
je obuhvaÄeno 200 dojenÄadi u dobi do 4 mjeseca. Polovinu ih je pregledao djeÄji fizijatar. Preostalih 100 ispitanika
prikupljeno je nasumce iz ambulante primarne pedijatrijske skrbi. Metodom binarne logistiÄke regresije procijenjen je utjecaj
niza Äimbenika na vjerojatnost nastanka psihomotornog odstupanja. Model je sadržavao sedam neovisnih varijabla kliniÄke
važnosti dobivenih temeljem prethodno napravljenih bivarijatnih analiza. Provedenim je istraživanjem dokazana 5,53 puta
veÄa vjerojatnost nastanka blagog psihomotornog odstupanja dojenÄeta ako je majka imala lijekom kompenziranu disfunkciju
Å”titnjaÄe tijekom trudnoÄe. Niža gestacijska dob poveÄava vjerojatnost nastanka odstupanja 2,12 puta za svaki gestacijski
tjedan. Takodjer, za 1 g smanjene poroÄajne težine vjerojatnost psihomotornog odstupanja raste za 1%. Ovom je studijom
potvrÄena snažna pozitivna linearna korelacija izmeÄu lijekovima kompenziranog poremeÄaja rada Å”titnjaÄe majke tijekom
trudnoÄe i blagog psihomotornog odstupanja dojenÄadi, Å”to dosad nije drugdje zabilježeno. Diferencira se važan i Äest prenatalni
riziÄni Äimbenik, Å”to Äini temelj za brži poÄetak habilitacije riziÄne dojenÄadi radi sprjeÄavanja brojnih kognitivnih
i motoriÄkih smetnja. Saznanja dobivena ovim istraživanjem mogu poslužiti kao osnova razvoja Nacionalnog programa
probira neuroriziÄne dojenÄadi
- ā¦