Self-Evaluation of Health Status and some Aspects of Quality of Life of Older People with Knee Osteoarthritis

Osteoartritis koljena predstavlja važan čimbenik u nastanku tjelesnog oštećenja kod starijih osoba i utječe na funkcionalne sposobnosti osobe, a time i na kvalitetu života. Cilj ovog istraživanja bio je utvrditi postoje li statistički značajne razlike u samoprocjeni zdravlja i nekim aspektima kvalitete života starijih osoba s OA-om koljena. Istraživanje je provedeno na uzorku od 74 ispitanika starijih od 65 godina. U analizi su primijenjeni validirani instrumenti: upitnik WOMAC i upitnik SF-36. Rezultati istraživanja ukazuju kako je najviša povezanost između ukupnog intenziteta pojavnosti simptoma OA-a s tjelesnim bolovima i ograničenjima u ostvarenju životnih uloga zbog tjelesnog zdravlja. Također, utvrđeno je da se ispitanici statistički značajno razlikuju u procjenama jedino prema dobi i trajanju boli, dok nisu utvrđene statistički značajne razlike prema spolu i bračnom statusu. Stoga se može zaključiti kako OA koljena utječe na samoprocjenu zdravstvenog statusa osobe i na kvalitetu života pojedinca.Knee osteoarthritis can results in physical disability, especially when the person is older. It affects the person´s functional abilities and quality of life. The aim of this paper is to determine if there are statistically significant differences in the self- assessment of health and some aspects of quality of life of older persons with knee OA. The sample included 74 participants aged 65 years and older. WOMAC Questionnaire and SF-36 questionnaire were used for data analysis. The findings show that the highest correlation is between the overall intensity of OA symptoms with pain and inability to achieve a certain life role because of physical pain. The results show that there are statistically significant differences between age and duration of pain, while there is no statistically significant differences between gender and marital status. Knee OA has a great impact on self-evaluation of health status and some aspects of quality of life of older people

Application of a radiofrequency resonance in treatment of painful shoulder syndrome

Bolno rame jedan je od najčešćih bolnih sindroma u fizijatrijsko-reumatološkoj ambulanti. Fizikalna terapija je metoda izbora u konzervativnom liječenju bolnog ramena. Rani početak liječenja i mogućnost izbora neke od terapijskih procedura fizikalne terapije otvaraju mogućnost dobrog rezultata liječenja. Cilj ovoga rada je prikazati rezultate učinka radiofrekventne rezonance (RFR) na smanjenje boli i poboljšanje funkcionalnog statusa u liječenju pacijenata sa sindromom bolnog ramena. Ispitanici i metode: u ispitivanje je bilo uključeno 37 bolesnika sa sindromom bolnog ramena, koji su unatoč primijenjenoj medikamentoznoj terapiji i ranije primjenjivanih uobičajenih modaliteta fizikalne terapije, imali trajne bolove u ramenom zglobu, prosječno 3,5 mjeseca. Metode rada orijentirane na analizu bolnosti i funkcionalni status, uključivale su primjenu vizualne analogne skale (VAS) za ocjenu bolnosti, te primjenu Roles-Maudsley specifičnog upitnika za ocjenu funkcionalnog statusa. Za primjenu radiofrekeventne terapije korišten je uređaj Physio Wave Prestige. Modalitet fizikalne terapije apliciran je tijekom dva tjedna svaki drugi dan u trajanju od 40 minuta. Analize su izvršene prije tretmana RFR, te nakon prvog i drugog tjedna od primjene iste. Rezultati: nakon primjenjene RFR postigli smo značajnu redukciju bolnosti u svih ispitanika, te poboljšanje funkcionalnog statusa. Prosječna bolnost prije tretmana RFR iznosila je 67 mm (u rasponu od 50 do 85 mm), nakon tretmana bila je značajno manja (p < 0,01) i iznosila je 25,5 mm (u rasponu od 0 do 50 mm). Prije tretmana prosječna vrijednost funkcionalnog statusa iznosila je 3,1 (slab), a nakon tretmana 2,3 (vrlo dobar: p < 0,05). U 16 % ispitanika postigli smo potpunu odsutnost bolova i potpuni opseg pokreta, ocjena funkcionalnog statusa 1 (odličan). Zaključak: radiofrekventna rezonanca je učinkovita, sigurna, neinvazivna fizikalno- terapijska procedura koja u bolesnika sa sindromom bolnog ramena može smanjiti bolove i poboljšati funkcionalni status.Painful shoulder is one of the most common pain syndromes in physiatrist and rheumatological practice. Physical therapy is the method of choice in the conservative treatment of painful shoulder. Early initiation of treatment and choice of some of the treatment procedures of physical therapy opens the possibility of good treatment outcomes. The aim of this paper is to present the results of the effect of radio-frequency resonance (RFR) to reduce pain and improve functional status in the treatment of patients with the syndrome of painful shoulder. Patients and methods: the study included 37 patients with the syndrome of painful shoulder, who in spite of the applied medical therapy and applied before the usual modalities of physical therapy, had persistent pain in the shoulder joint for an average of 3.5 months. Methods of work-oriented analysis of pain and functional status included the implementation of a visual analogue scale (VAS) for pain assessment and application of Roles-Maudsley specific questionnaire for the assessment of functional status. The device that is used to apply radiofrequent therapy was the Physio Wave Prestige. The modality of physical therapy was administered for two weeks, every second day for 40 minutes. Analyses were performed before treatment and RFR after the first and second weeks of the their application Results: after applied RFR, we achieved a significant reduction in pain and improvement in the functional status of all patients. The average pain before AFA treatment was 67 mm (in the range of 50 to 85 mm), after treatment it was significantly lower (p < 0.01) and amounted to 25.5 mm (in the range 0 to 50 mm). Before treatment the average value of the functional status was 3.1 (weak), after treatment it was 2.3 (very good: p <0.05). 16% of subjects achieved the complete absence of pain and full range of motion, assessment of functional status of 1 (excellent). Conclusion: radiofrequency resonance is an effective, safe, non-invasive physical-therapeutic procedure in patients with the syndrome of painful shoulder which can reduce pain and improve functional status

Isokinetics – quick and effective rehabilitation Use of isokinetic device in rehabilitation of patients with neurological deficit

Cilj: Medicinska gimnastika ili kineziterapija ima posebnu važnost u prevenciji, liječenju i rehabilitaciji bolesti sustava za kretanje. Danas se ističe potreba za što bržim izlječenjem i vraćanjem pune funkcije zahvaćenog zgloba, ekstremiteta ili organizma u cjelini. Cilj ovog rada je prikaz primjene izokinetičkog sustava u rehabilitaciji bolesnika s neurološkom slabošću razvijenom uslijed cerebrovaskularne bolesti. Prikaz slučaja: Izokinetičke vježbe, kao dio kineziterapije, pripadaju skupini vježbi snaženja mišića kod kojih se odabire/propisuje brzina pokreta, dok istovremeno posebno programirani uređaj automatski prilagođuje otpor pokretu. Osnova izokinetičkog vježbanja jest promjenjiv otpor kod vježbanja pri određenoj brzini, čime se postižu optimalni rezultati u povećanju snage i izdržljivosti mišića. Rasprava: Navedeno načelo vježbanja otvara šire terapijske mogućnosti medicinske rehabilitacije bolesnika sa zadobivenim ozljedama i kroničnim stanjima zglobova i mišića, a posebnu vrijednost pruža u liječenju medicinski zahtjevnijih skupina bolesnika, uključujući one u razdoblju rane postoperacijske rehabilitacije, neurološke bolesnike, kao i u rehabilitaciji sportaša. Zaključak: Uvažavajući poznate kontraindikacije za primjenu izokinetičkih uređaja, može se kod pažljivo odabranih bolesnika postići značajan napredak u funkcionalnom oporavku.Aim: Medical exercises or kinesiotherapy has a special importance in the prevention, treatment and rehabilitation of diseases of the locomotor system. Today emphasizes the need for faster healing and restoring full function of the affected joint, limb or entire organisms. The aim of this article is to demonstrate the application of isokinetic system in the rehabilitation of patients with neurological weakness developed due to cerebrovascular disease. Case report: Isokinetic exercises as part kinesiotherapy-group exercises strengthen the muscles in which the selection / provides movement speed, while specially programmed device automatically adjusts the resistance movement. Basis isokinetic exercise is variable resistance with exercise at some speeds to deliver optimal results in increasing muscle strength and endurance. Discussion: The above principle exercise opens wider therapeutic possibilities of medical rehabilitation of patients with his injuries and chronic joint and muscle conditions, and provides a special value in the treatment of medically demanding patient groups, including those in the period of early postoperative rehabilitation, neurological patients, as well as rehabilitating athletes. Conclusion: Acknowledging known contraindications for for the application of isokinetic devices can be used with carefully selected patients to achieve significant progress in functional recovery

SHOULDER ROTATOR STRENGTH RATIO IN PROFESSIONAL SWIMMERS

CILJ Cilj ovog istraživanja je uz pomoć rezultata izokinetičkog testiranja usporediti snagu unutarnjih i vanjskih rotatora ramena kod plivača Hrvatske seniorske reprezentacije te procijeniti je li omjer snage istih u okvirima konvencionalnog omjera snage

SHOULDER ROTATOR STRENGTH RATIO IN PROFESSIONAL SWIMMERS

CILJ Cilj ovog istraživanja je uz pomoć rezultata izokinetičkog testiranja usporediti snagu unutarnjih i vanjskih rotatora ramena kod plivača Hrvatske seniorske reprezentacije te procijeniti je li omjer snage istih u okvirima konvencionalnog omjera snage

Can pain intensity in osteoarthritis joint be indicator of the impairment of endothelial function?

We propose that pathological remodeling in joint tissues of osteoarthritis (OA) patients persistently stimulates local secretion of pro-inflammatory mediators, which overflow into the blood, activating leukocytes that impair endothelial function and accelerate the atherosclerotic process. During periods of pain, endothelial dysfunction progresses more aggressively due to elevated secretion of these pro-inflammatory mediators, which are involved in both atherosclerosis and the sensation of pain. Concentrations of pro-inflammatory cytokines and their antagonists, activating and decoy receptors of the broad interleukin (IL)-1 and IL-17 families, IL-15, and monocyte chemotactic protein-1 should be measured in peripheral blood samples of OA patients and compared with (I) OA clinical severity ; (II) subclinical parameters of atherosclerosis ; (III) ischemic heart disease risk factors ; (IV) soluble factors indicating endothelial dysfunction ; (V) degree of bone destruction ; and (VI) results of a six-minute walk test. Arthroscopy and joint replacement surgery provide an opportunity to estimate mRNA and protein expression of inflammatory mediators in specimens of synovial fluid, synovial membrane, cartilage, and/or subarticular bone. A range of methods, including questionnaires, X-ray, computed tomography, ultrasound, enzyme-linked immunosorbent assay, immunohistology, immunofluorescence, and reverse transcription and in situ polymerase chain reaction are available. Understanding the inflammatory and immune mechanisms underlying OA may allow the early identification of patients at high risk of cardiovascular disease, independently of classical coronary risk factors. Pain may constitute an extrinsic indicator of currently worsening endothelial functio