The quality of life of lumbar radiculopathy patients under conservative treatment

Background/Aim. The quality of life of lumbar radiculopathy patients conditioned by their health status is a result of both their subjective perception of the disease and their objective health status. The aim of this study was to evaluate the quality of life of lumbar radiculopathy patients under conservative treatment by means of generic and another lumbar syndrome specific questionnaires. Methods. A total of 50 patients (33 males, 17 females average age 46.1 years,) under conservative treatment in a hospital over four weeks were included in the study. They were interviewed using two questionnaires: the SF36 (Short form (36) Health Survey) generic questionnaire measuring eight domains of their quality of life summarized into two main ones (i.e. overall physical and overall mental health), and the lumbar syndrome specific North American Spine Society - Low Back Pain Outcome Instrument (NASS LBP), a questionnaire measuring four domains (functional limitations, motor and sensitive neurological symptoms, expectations from the treatment and satisfaction with it). Results. The values of physical health domain was low as 31.1 at the beginning of the treatment, were rising over the following six months and dropped insignificantly after four years (42.1/48.7 /47.0) The mental health values (47.2) did not alter as compared to that of the general population. A values of the quality of life stabilized within six months. The neurological symptoms domain did not correlate with other value scales and domains. Conclusion. The quality of life of lumbar radiculopathy patients was impaired only from its physical aspect, but after conservative treatment it improved over the following six months. After four years there is an insignificant drop of all quality of life values, indicating a need for a longer term monitoring of there patients

KVALITETA ŽIVOTA PACIJENTICA S OSTEOPOROTIČNIM VERTEBRALNIM PRIJELOMIMA

The aim of this study was to estimate the quality of life in females with primary osteoporosis and vertebral fractures as a consequence of the disease, and to compare it to people without vertebral fractures. Subjects and Methods: Our crosssectional study included 200 female patients with primary osteoporosis (100 with vertebral fractures and 100 without fractures), mean age 63.85±8.52 years, who received treatment at the Clinic for Medical Rehabilitation, Clinical Center of Vojvodina in Novi Sad. Data were based on history, questionnaire, and measurements of bone mineral density by DXA method using the Lunar Prodigy Primo device. Quality of life assessment was done by use of the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO-41). Vertebral deformities were established by lateral radiography of the cervical, thoracic and lumbar regions by an experienced radiologist. Statistically signifi cant differences were established between the two groups, in particular for pain (t=-2.72, p=0.01), daily activities (t=-3.67, p=0.01), performing housework (t=- 4.84, p=0.01), mobility (t=-3.40, p=0.01), leisure activities (t=-2.66, p=0.01) and perception of health status (t=2.48, p=0.05). Results: The results indicated that the quality of life in patients with vertebral fractures did not differ according to the level of fracture compared to the control group. Patients with vertebral fractures had a number of limitations due to pain and poorer physical functioning compared to those without fractures, while the quality of life dependence on the level of fracture was not recorded.Cilj istraživanja bio je procijeniti kvalitetu života žena s primarnom osteoporozom i prisutnim vertebralnim prijelomima kao posljedicom bolesti u odnosu na osobe bez vertebralnih prijeloma. U ispitivanju je sudjelovalo 200 bolesnica s primarnom osteoporozom (100 s vertebralnim prijelomima, 100 bez vertebralnih prijeloma) srednje dobi 63,85±8,52 godina, koje su provele terapiju u Klinici za medicinsku rehabilitaciju Kliničkog centra Vojvodine u Novom Sadu. Podatci su zasnovani na anamnezi, upitnicima, kao i mjerenjima mineralne koštane gustoće metodom DXA pomoću uređaja Lunar Prodigy Primo. Vertebralne frakture su potvrđene rendgenskim slikama cervikalne, torakalne i lumbalne kralježnice očitanim od iskusnog radiologa. Kvaliteta života procijenjena je primjenom upitnika QUALEFFO-41. Dobiveni rezultati ukazali su na statistički značajne razlike između ispitivanih skupina u intenzitetu boli (t=-2,72; p=0,01), svakodnevnim aktivnostima (t=-3,67; p=0,01), obavljanju kućanskih poslova (t=-4,84; p=0,01), pokretljivosti (t=-3,40; p=0,01), društvenim aktivnostima (t=-2,66; p=0,01), percepciji zdravstvenog stanja (t=2,48; p=0,05). Rezultati ukazuju na to da se kvaliteta života u bolesnica s vertebralnim prijelomima ne razlikuje prema razini prijeloma u odnosu na kontrolnu skupinu. Bolesnici s vertebralnim prijelomima imaju brojna ograničenja zbog boli i lošijeg fi zičkog funkcioniranja u odnosu na osobe bez osteoporotičnih prijeloma, dok zavisnost kvalitete života o razini prijeloma nije utvrđena

KVALITETA ŽIVOTA PACIJENTICA S OSTEOPOROTIČNIM VERTEBRALNIM PRIJELOMIMA

The aim of this study was to estimate the quality of life in females with primary osteoporosis and vertebral fractures as a consequence of the disease, and to compare it to people without vertebral fractures. Subjects and Methods: Our crosssectional study included 200 female patients with primary osteoporosis (100 with vertebral fractures and 100 without fractures), mean age 63.85±8.52 years, who received treatment at the Clinic for Medical Rehabilitation, Clinical Center of Vojvodina in Novi Sad. Data were based on history, questionnaire, and measurements of bone mineral density by DXA method using the Lunar Prodigy Primo device. Quality of life assessment was done by use of the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO-41). Vertebral deformities were established by lateral radiography of the cervical, thoracic and lumbar regions by an experienced radiologist. Statistically signifi cant differences were established between the two groups, in particular for pain (t=-2.72, p=0.01), daily activities (t=-3.67, p=0.01), performing housework (t=- 4.84, p=0.01), mobility (t=-3.40, p=0.01), leisure activities (t=-2.66, p=0.01) and perception of health status (t=2.48, p=0.05). Results: The results indicated that the quality of life in patients with vertebral fractures did not differ according to the level of fracture compared to the control group. Patients with vertebral fractures had a number of limitations due to pain and poorer physical functioning compared to those without fractures, while the quality of life dependence on the level of fracture was not recorded.Cilj istraživanja bio je procijeniti kvalitetu života žena s primarnom osteoporozom i prisutnim vertebralnim prijelomima kao posljedicom bolesti u odnosu na osobe bez vertebralnih prijeloma. U ispitivanju je sudjelovalo 200 bolesnica s primarnom osteoporozom (100 s vertebralnim prijelomima, 100 bez vertebralnih prijeloma) srednje dobi 63,85±8,52 godina, koje su provele terapiju u Klinici za medicinsku rehabilitaciju Kliničkog centra Vojvodine u Novom Sadu. Podatci su zasnovani na anamnezi, upitnicima, kao i mjerenjima mineralne koštane gustoće metodom DXA pomoću uređaja Lunar Prodigy Primo. Vertebralne frakture su potvrđene rendgenskim slikama cervikalne, torakalne i lumbalne kralježnice očitanim od iskusnog radiologa. Kvaliteta života procijenjena je primjenom upitnika QUALEFFO-41. Dobiveni rezultati ukazali su na statistički značajne razlike između ispitivanih skupina u intenzitetu boli (t=-2,72; p=0,01), svakodnevnim aktivnostima (t=-3,67; p=0,01), obavljanju kućanskih poslova (t=-4,84; p=0,01), pokretljivosti (t=-3,40; p=0,01), društvenim aktivnostima (t=-2,66; p=0,01), percepciji zdravstvenog stanja (t=2,48; p=0,05). Rezultati ukazuju na to da se kvaliteta života u bolesnica s vertebralnim prijelomima ne razlikuje prema razini prijeloma u odnosu na kontrolnu skupinu. Bolesnici s vertebralnim prijelomima imaju brojna ograničenja zbog boli i lošijeg fi zičkog funkcioniranja u odnosu na osobe bez osteoporotičnih prijeloma, dok zavisnost kvalitete života o razini prijeloma nije utvrđena

Utjecaj komorbiditeta na ishod rehabilitacije nakon ishemijskog moždanog udara

Comorbidity decreases survival but it still remains unknown to what extent functional recovery after ischemic stroke is affected. The aim of this research was to determine the prevalence of the most common comorbidities in patients with ischemic stroke and to examine their predictive value on the functional status and recovery. In order to obtain relevant information for this research, we conducted a prospective study over a two-year period. It included patients with acute/subacute ischemic stroke who had inhospital rehabilitation treatment in our institution. Functional status of the patients was evaluated by the following three aspects at the beginning and at the end of rehabilitation treatment: Rivermead Mobility Index was used for mobility, Barthel Index for independence in activities of daily living, and modified Rankin Scale for total disability. Modified Charlston Comorbidity Index was used to assess comorbidity. Multivariate analysis was applied to evaluate the impact of recorded comorbidities on the patient functional outcome. Independent predictors of rehabilitation success in our study were the value of modified Charlston Comorbidity Index, atrial fibrillation and myocardial infarction. Our study demonstrated that patients with more comorbidities had worse functional outcome after stroke, so it is important to consider the comorbidity status when planning the rehabilitation treatment.Komorbiditeti smanjuju preživljavanje nakon ishemijskog moždanog udara, ali još uvijek ostaje nepoznato koliki je njihov utjecaj na funkcijski oporavak. Cilj ovoga istraživanja bio je utvrditi učestalost najčešćih komorbiditeta u bolesnika s ishemijskim moždanim udarom i ispitati njihovu prediktivnu vrijednost na funkcijski status i oporavak. U cilju dobivanja relevantnih podataka za ovu studiju proveli smo prospektivno istraživanje u razdoblju od dvije godine. Studija je uključila bolesnike s akutnim/subakutnim ishemijskim moždanim udarom koji su imali bolnički rehabilitacijski tretman u našoj ustanovi. Funkcijsko stanje bolesnika je ocijenjeno s tri aspekta na početku i na kraju rehabilitacijskog tretmana: Indeks mobilnosti Rivermead je primijenjen za mobilnost, Barthelov indeks za neovisnost u aktivnostima svakodnevnog života, a modificirana Rankinova ljestvica za ukupnu onesposobljenost. Charlstonov indeks komorbiditeta modificiran za moždani udar je primijenjen za procjenu komorbiditeta u bolesnika. Multivarijatna analiza primijenjena je za procjenu utjecaja ispitivanih komorbiditeta na funkcionalni ishod bolesnika. Nezavisni prediktori uspjeha rehabilitacije u našem istraživanju bili su vrijednost Charlstonova indeksa komorbiditeta modificiranog za moždani udar, atrijska fibrilacija i infarkt miokarda. S obzirom na to da je naše istraživanje pokazalo kako bolesnici s većim brojem komorbiditeta postižu lošiji funkcijski ishod nakon ishemijskog moždanog udara, bitno je razmotriti komorbiditetni status pri planiranju rehabilitacijskog tretmana

Risk factors for osteoarthritis of the hip

INTRODUCTION: Osteoarthritis of the hip is a degenerative disease of hip unknown origin, with pain, stiffness and diminished joint function. AIM: determine the influence of the load of the hip joint during professional activity and BMI as risk factors for the hip osteoarthritis. MATERIAL AND METHOD: We analysed 148 patients. Patients were divided into two groups ( I group with osteoarthritis of the hip, II group without osteoarthritis of the hip). In all, performed diagnostic procedure: anamnesis, physical examination (estimate of walking and hip joint movement), laboratory blood test and urine test radiological examination and taking data on the height and weight to calculated BMI. We assessed the data that is related to the load of the hip joint during professional activities (mostly sitting work and mostly standing job with carrying load). Statistical analysis was done using the software package SPSS 14.0, Microsoft Office Word 2003. RESULTS: In the first group, average age was 67.76 years, with females prevailing (67.6%). In this group the larger body mass was noted (81.82 ± 12.18), with statistically significant difference (T-test 2.923, p<0.01); the average BMI was higher the average BMI was higher (30.18 ± 4.6), with statistically significant difference (T-test 3.832, p<0.01). This group had more overweight patients (87.7%),with statistically significant difference (Fisher test, p<0.01). In I group 62,2% of patients were doing hard physical work (standing job with repeated carrying load) and we found statistically significant difference between groups (Fisher test p<0,01). CONCLUSION: Patients with osteoarthritis of the hip had a higher body weight, higher BMI. Also we found the influence of hard physical labor at work, and they were performed mostly standing job with carrying load

COMPARISON BETWEEN ULTRASONOGRAPHY RESULTS AND RESULTS OF MAGNETIC RESONANCE IN SHOULDER PATHOLOGY – CASE REPORT

The common pathological condition of the shoulder joint is rotator cuff diseases. Patient, 68 years, had pain in the shoulder with limited joint mobility. After clinical examination, blood tests (SE >100 nmol/L, CSF normal, hypergamma- globulinemia) and radiographic examination (bone dilution with deformities of the humeral head), a solitary plasmocytoma was suspected. This diagnosis was excluded after biopsy. Patient was referred to the magnetic resonance imaging (MRI) of the shoulder, so ultrasonographic (US) examination was performed. Our case study points to comparability between US and MRI results regarding tendinitis of muscles in the rotator cuff. By applying both diagnostic methods, calcifications within muscle tendons were evident. Sonography is faster, cheaper, more accessible and readily available method that certainly is a valuable tool for clinicians when it comes to rotator cuff lesions

Identifying elderly persons who are at risk of falling and fall risk factors in the general population

Introduction/Objective. The aim of this study was to identify the elderly who are at increased risk of falling, as well as the risk factors for falls in the general population. Methods. This cross sectional study included a random sample of 400 people (164 men and 236 women) with the average age of 75.04 (65–94) years selected from the Register of the Primary Health Center in Niš, Serbia. Socio-demographic questionnaire, the Elderly Fall Screening Test, and the Multi-factor Falls Questionnaire were used. Odds ratio (OR) was evaluated and adjusted for gender, age, marital status, education level, and self-assessment of the health state. Results. The risk of falling and risk factors for falls were as follows: age [odds ratio (OR) = 1.129, confidence interval (CI) = 1.067–1.196], health self-assessed as good (OR = 0.365; CI = 0.142–0.938), limitation of activities (OR = 7.189; CI = 3.559–14.522), walking problems (OR = 2.153; CI = 1.046–4.428), osteoporosis (OR = 4.611; CI = 1.231–17.265), female gender (OR = 3.770, CI = 1.648–8.624), vision problems (OR = 2.719; CI = 1.588–108.581), cognitive problems (OR = 4.485; CI = 17.721), arthritis (OR = 6.524; CI = 2.077–20.496), and urination problems (OR = 2.511; CI = 1.083–5.820). Conclusion. Risk factors for falls were the following: age, self-assessment of health state, walking problems, osteoporosis, female gender, vision problems, arthritis, and urination problems

Factors that predict walking ability with a prosthesis in lower limb amputees

Introduction. Identification of predictive factors for walking ability with a prosthesis, after lower limb amputation, is very important in order to define patient’s potentials and realistic rehabilitation goals, however challenging they are. Objective. The objective of this study was to investigate whether variables determined at the beginning of rehabilitation process are able to predict walking ability at the end of the treatment using support vector machines (SVMs). Methods. This research was designed as a retrospective clinical case series. The outcome was defined as three-leveled ambulation ability. SVMs were used for predicting model forming. Results. The study included 263 patients, average age 60.82 Ѓ} 9.27 years. In creating SVM models, eleven variables were included: age, gender, cause of amputation, amputation level, period from amputation to prosthetic rehabilitation, Functional Comorbidity Index (FCI), presence of diabetes, presence of a partner, restriction concerning hip or knee extension, residual limb hip extensor strength, and mobility at admission. Six SVM models were created with four, five, six, eight, 10, and 11 variables, respectively. Genetic algorithm was used as an optimization procedure in order to select the best variables for predicting the level of walking ability. The accuracy of these models ranged from 72.5% to 82.5%. Conclusion. By using SVM model with four variables (age, FCI, level of amputation, and mobility at admission) we are able to predict the level of ambulation with a prosthesis in lower limb amputees with high accuracy