Functional assessment in patients with non-specific low back pain

Nespecifična križobolja (NK) predstavlja značajni zdravstveni i socijalno-ekonomski problem zbog svoje velike učestalosti, dugotrajnosti smetnji, rekurentnosti te funkcionalne i radne ograničenosti oboljelih. Čest izostanak određivanja uzroka križobolje i slaba korelacija kliničke slike i dijagnostike pomoću slikovnih prikaza, prvenstveno magnetske rezonancije i rendgena ukazuju na potrebu funkcionalnih mjerenja u pacijenata s NK-om. Funkcionalna mjerenja omogućavaju kvantitativno mjerenje funkcionalnih promjena koje mogu biti uzrokom i posljedicom NK-a te razlogom rekurentnosti i radne ograničenosti. Na temelju podataka funkcionalne procjene mogu se programirati i planirati postupci prevencije NK-a te individualizirati terapijski i rehabilitacijski postupci. Isto tako, funkcionalna mjerenja tijekom liječenja i rehabilitacije omogućavaju praćenje učinkovitosti pojedinih postupaka, a po završetku rehabilitacije i procjenu radne sposobnosti. Premda je značaj funkcionalnih mjerenja za uspješnost rehabilitacije pacijenata s NK-om nedvojben, ne postoji konsenzus o standardizaciji protokola funkcionalnih mjerenja. Definiranje valjanih protokola predstavlja nužnost i važna je pretpostavka uspješnog izlječenja, prevencije rekurentnosti i razvoja kroniciteta nespecifične križobolje.Non-specific low back pain is a serious health and socioeconomic problem because of its frequency, chronicity, recurrence and functional and work restrictions in patients. Frequent absence of cause determination and poor correlation of the symptoms and diagnostics with imaging techniques, primarily magnetic resonance imaging and X-ray, indicate that there is a need for functional assessment in low back pain patients. Functional assessment enables quantitative measurement of functional changes which can be the cause and effect of low back pain and the reason of recurrence and work restrictions. Based on the information gathered by functional evaluation, low back pain prevention procedures can be planned and programmed and therapeutic and rehabilitation procedures can be individualised. Furthermore, functional assessment during the treatment and rehabilitation enable monitoring of the efficacy of different procedures and once the rehabilitation has been completed the evaluation of work ability. Although the significance of functional assessment for successful rehabilitation of patients with low back pain is undeniable, there is no consensus on standardisation of protocol for functional assessment. Defining valid protocols is necessary and an important precondition for a successful treatment and prevention of recurrence and development of chronic non-specific low back pain

KINEMATIC, DYNAMIC AND ELECTROMYOGRAPHIC CHARACTERISTICS OF A SPRINT START

The aim of the study was to establish the major kinematic and dynamic parameters as well as the EMG activation of muscles in a sprint start as the first derivative of sprint velocity. The subject of the analysis was block velocity, the production of force in the front and rear starting blocks, the block acceleration in the first two steps and the EMG activity of the following muscles: the erector spinae, gluteus maximus, rectus femoris, vastus medialis, vastus lateralis, biceps femoris and gastrocnemius–medialis

Utvrđivanje utjecaja bilateralnog deficita na izvedbu skoka s pripremom kod vrhunskih sprintera

The purpose of the present study was to investigate the bilateral deficit (BLD) in elite sprinters and examine the relationship between the BLD and sprint start performance. Twelve male elite sprinters (age: 22.41±3.39 years, 100m personal best: 10.82±.25s) performed sprint starts, two- and one-leg counter- -movement jumps (CMJ). A system of eight CCD cameras with a frequency of 200 Hz was used for the 3D kinematic measurements of CMJ. The ground reaction forces of sprint starts and vertical jumps were measured unilaterally and bilaterally by means of two independent and synchronized force platforms. Significantly lower values of force production of the front leg in the double start compared to the force production in the single start indicated the existence of a phenomenon similar to the bilateral deficit (BLD). The main findings of the present study were that: 1) lower values of BLD in the CMJ are related to higher peak force production of the rear leg in the double start of the sprint start (r=-.630; p=.000), 2) lower BLD in the CMJ is also related to higher total impulse of force on the blocks (r=-.550; p=.000) and 3) BLD values in CMJ are higher in elite sprinters compared to team sport athletes examined in the previous studies. The BLD measured in CMJ is a good indicator of a lower performance in the sprint start. As a consequence, the sprinters with higher BLD produced a lower total impulse of force on the blocks and lower block velocity, which are related to the overall 60m and 100m sprint performance.Cilj ovog istraživanja bio je utvrđivanje bilateralnog deficita (BLD) kod vrhunskih sprintera i istraživanje relacija između BLD i izvedbe niskog starta. Dvanaest vrhunskih muških sprintera (starih: 22.41±3.39 godina, osobni rekord u sprintu na 100 m: 10.82±.25 s) izvodili su niski start, te jednonožne i objenožne skokove s pripremom (CMJ). Sustav od osam CCD kamera frekvencije 220 Hz koristio se za 3D kinematičko mjerenje skokova s pripremom. Sile reakcije podloge sprinterskih startova i vertikalnih skokova mjerene su unilateralno i bilateralno pomoću dvije nezavisne i sinkronizirane tenziometrijske platforme. Statistički značajno slabije vrijednosti manifestiranja sile prednje noge kod objenožnog starta u usporedbi s manifestiranjem sile kod jednonožnog starta uputile su na postojanje fenomena koji je sličan fenomenu bilateralnog deficita. Glavni rezultati ovog istraživanja su: 1) niže vrijednosti bilateralnog deficita kod skoka s pripremom povezane su s očitovanjem veće vršne sile stražnje noge kod objenožnog starta (r=-.630; p=.000); 2) manji BLD kod skoka s pripremom je također povezan s većim ukupnim impulsom sile na startni blok (r=-.550; p=.000) i 3) vrijednosti BLD kod skoka s pripremom su veće kod vrhunskih sprintera u usporedbi sa sportašima iz sportskih igara testiranih u dosadašnjim istraživanjima. Vrijednosti BLD izmjerene pri izvedbi skoka s pripremom su vrlo dobri pokazatelji slabije izvedbe sprinterskog starta. U skladu s navedenim rezultatima provedenog istraživanja sprinteri s većim BLD proizveli su manji ukupan impuls sile na startni blok i nižu brzinu izlaska iz bloka, što je izravno povezano sa slabijim rezultatom sprinta na 60 i 100 metara

Clinical and Medicolegal Characteristics of Neck Injuries

The predominance in performing surgery of major spine injuries by neurosurgeons usually has the consequence of treating all types of spine injuries by neurosurgeons – neurotraumatologists. In the neurosurgical wards of Clinical Hospital Rijeka, we take care of the majority of these patients, following both the major, as well as minor – whiplash injuries of the neck. This article is an overview of the patients admitted in the one year period (October 1st 2009–October 1st 2010) where 1077 cases of neck injuries were analyzed. Vast majority of these injuries were due to traffic accidents (over 94%), and only a small proportion were serious injuries that needed a surgical approach – decompression and stabilization (~1%). We analyzed minor neck injuries thoroughly both because of the increasing number of whiplash neck injuries and because more complicated diagnostic and therapeutic protocols occupy too much time in the ambulatory practice of our neurotraumatologists each year thus representing a growing financial burden to the health organizations and to the society as a whole. Our results proved that the majority of the injured are male (over 60%), young and active (almost two thirds 21–40 years of age), had commonly sustained a Quebec Task Force (QTF) injury of grades 2 and 3 (almost 90%), and, if properly treated, recovered completely after a mean therapy period of ten weeks. Only a minority complained of prolonged residual symptoms, some of them connected with medico-legal issues (less than 20%). The results shown are in contrast with the general opinion that malingerers in search of financial compensation prevail in these cases, and leads to the conclusion that minor neck injuries (including whiplash) as well as Whiplash Associated Disorder (WAD) are real traumatological entities, that have to be seriously dealt with

The Effects of Long-Term Experimental Diabetes Mellitus Type I on Skeletal Muscle Regeneration Capacity

Muscle fibers are dynamic structures capable of altering their phenotype under various pathological conditions. The aim of the present study was to investigate the influence of long-lasting diabetes mellitus on the process of muscle regeneration in the skeletal muscle. Wistar rats were made diabetic by a single intraperitoneal injection of streptozotocin (STZ). The regeneration process in the skeletal muscle was induced in slow (m. soleus, SOL) and fast (m. extensor digitorum longus, EDL) muscles by injection of local anesthetic (bupivacaine). Skeletal muscles were analyzed 10 days, 4 and 8 weeks after bupivacaine treatment. Diabetes mellitus has changed morphological properties of both slow and fast skeletal muscles during the process of regeneration. These changes are evident in redistribution of muscle fibers and significant level of atrophy. All fiber types of diabetic fast muscles showed stronger atrophy than muscle fibers in slow muscles which have more oxidative metabolism. The changes of redistribution of muscle fibers depend on duration of diabetes and affect all types of muscle fibers

Pojednostavljenje određivanja položaja ravnine svjetla za vrijeme skeniranja strukturiranim svjetlom

Structured light illumination is a widely spread approach for 3D shape reconstruction. Scanning the scene of interest with hard edge stripe via video projector is a very common implementation. During the scanning light planes are being projected across the space and their positions in time are needed to triangulate 3D position of some point. Traditionally, light plane equation is readily obtained in case of calibrated video projector. This paper presents a method where light plane positions are determined without explicit projector calibration. The comparison of traditional and proposed method showed no difference in terms of reconstruction accuracy. However, there are two major advantages of proposed method: end user can faster start using the system itself and system implementation is easier primarily in software sense. Also, successful method implementation for computer graphic application is shown.Primjena tzv. strukturiranog svjetla (SL) je vrlo popularna metoda kod 3D rekonstrukcije. Jedna od jednostavnijih implementacija SL-a obuhvaća projiciranje uskog tamnog (svijetlog) vertikalnog »prozora« na svijetloj (tamnoj) pozadini pomoću videoprojektora. Zbog projiciranja tzv. ravnine svjetla udaraju u pojedine točke u prostoru i položaj tih ravnina je preduvjet za 3D triangulaciju dotične točke. Tradicionalni pristup triangulaciji zahtijeva i kalibraciju 3D videoprojektora. Ovaj rad predlaže metodu gdje se do položaja ravnina dolazi bez eksplicitne kalibracije videoprojektora. Usporedba tradicionalnog pristupa i predložene metode pokazala je da nema razlike po pitanju točnosti 3D rekonstrukcije. Međutim, dvije prednosti predložene metode su, kao prvo, da korisnik može jednostavnije i brže prijeći na uporabu sustava za neposrednu 3D rekonstrukciju. I kao drugo, sama implementacija sustava je jednostavnija, posebice u softverskom smislu. Konačno, demonstrirana je uspješna uporaba predloženog sustava (metode) za jednu aplikaciju u računalnoj grafici

Kinematic Measurement of the Lumbar Spine and Pelvis in the Normal Population

Spinal and pelvis motion has been studied by a variety of different methods, the majority of which have a number of limitations. The present study investigated motion characteristics of the lumbar spine and pelvis using a three-dimensional optoelectronic system. The aim of our study was to determine kinematic parameters of spine and pelvis during trunk flexion, extension and lateral bending in normal, healthy subjects. Kinematic motion analysis was performed on 63 asymptomatic volunteers for four different trunk motions. This study has shown that the pelvis range of motion is affected by the gender. Contribution of pelvic movement to trunk flexion was 50%, while pelvic angle was significantly higher in women. During lateral bending female subjects had statistically significant higher values of vertebral arc with respect to male subjects. During extension the contribution of pelvic movement was 45%. There was no significant difference found in total angle, pelvic angle and vertebral arc