Comparison of efficacy of biofeedback, electrical stimulation and therapeutic exercise in patients with knee osteoarthritis

Cilj ovog istraživanja bio je usporediti učinkovitost pojedinih fizikalnih postupaka u liječenju početnog OA koljena. Uspoređivali smo EMG BFB terapiju, ES terapiju i terapijsko vježbanje s pretpostavkom da će najbolji učinak imati EMG BFB terapija. Ispitivali smo bol, funkciju koljena, snagu mišića, m. vastus medialis obliquus. Pomoću upitnika SF 36 i kratkog sržnog seta MKF klasifikacije, ispitivali smo utjecaj liječenja na kvalitetu života i na biopsihosocijalno funkcioniranje ispitanika. U istraživanje smo uključili 94 ispitanika koji su proveli tri tjedna na fizikalnoj terapiji te smo ih pratili tijekom 6 mjeseci. Rezultati su pokazali dobar učinak fizikalne terapije na ispitivane parametre bez statistički značajne razlike između skupina. Ovo istraživanje pokazalo je da 6 mjeseci nakon fizikalne terapije dolazi do blagog pada snage mišića, ali bez pogoršanja u osjećaju boli i funkciji koljena. S obzirom na to da nije pronađena razlika između navedenih fizikalnih procedura, zaključili smo da je terapijsko vježbanje učinkovito u liječenju OA koljena i da nije potrebno uključivati EMG BFB terapiju, ni ES terapiju u rehabilitacijske protokole.The aim of this research was to compare the effectiveness of specific physical procedures in treating initial knee osteoarthritis (OA). We compared EMG BFB therapy, ES therapy and therapeutic exercise with the assumption that EMG BFB therapy would have the best effect. We examined pain, knee function, and the strength of the vastus medialis obliquus muscle. The SF 36 questionnaire and the brief ICF core set for osteoarthritis were used to assess the impact of treatment on the subjects' quality of life and biopsychosocial functioning. This research included 94 subjects who underwent three weeks of physical therapy and they were followed up for 6 months. The results showed a positive effect of physical therapy on the examined parameters with no statistically significant difference between the groups. The study revealed that 6 months after physical therapy there was a slight decrease in muscle strength, but no deterioration in pain sensation and knee function. Given these findings, no significant differences were observed between the mentioned physical procedures. In conclusion, we found that therapeutic exercise is effective in treating knee OA and there is no necessity to include EMG BFB therapy or ES therapy in rehabilitation protocols

A Comprehensive Approach to the Osteoporosis Patient / What is the Perspective of Cooperation in the Prevention, Recognition and Treatment of Osteoporotic Fractures?

Osteoporoza je bolest čije komplikacije značajno utječu na kvalitetu života bolesnika. Najznačajnija komplikacija je osteoporotski prijelom, osobito kralježnice i femura. Osteoporotski prijelomi povećavaju morbiditet i mortalitet bolesnika, što predstavlja veliko opterećenje za pojedinca, ali i društvo u cijelosti. Stoga se naglasak u liječenju stavlja na prevenciju osteoporotskih prijeloma. Važno je rano prepoznavanje čimbenika rizika, korekcija istih i pravodobno liječenje. Prevencija i liječenje provode se na svim razinama zdravstvene zaštite od obiteljskog liječnika do specijalista u ustanovama tercijarne razine. Uključeni su i ostali stručnjaci poput nutricionista i fizioterapeuta. Nezanemariva je i uloga bolesnika i zajednice u prepoznavanju čimbenika rizika, edukacija bolesnika o tome kada trebaju potražiti pomoć te u pridržavanju propisanog liječenja. Kako bi se postigli optimalni rezultati, liječenje je interdisciplinarno i teži se da bude prilagođeno pojedincu.Osteoporosis is a disease whose complications can significantly alter a patient\u27s quality of life. The most common complications are osteoporotic fractures of the spine and femur. Such fractures increase the morbidity and mortality of patients, which may become a great burden for the individual and society as a whole. Emphasis in treatment is thus placed on prevention of osteoporotic fractures. Risk factors should be identified as early as possible, then continue with correction and timely treatment. Prevention and treatment are interdisciplinary, from family physicians to specialists in tertiary level healthcare institutions. Other experts such as nutritionists and physiotherapists are also involved. The role of the patient and the community in risk factor recognition, patient education on when help and assistance should be sought, and adherence to prescribed treatment is not to be neglected. In order to achieve optimal results, treatment should be interdisciplinary and individualized

Current practice variations in the management of anterior cruciate ligament injuries in Croatia

AIM: To investigate current preferences and opinions on the diagnosis, treatment and rehabilitation of patients with anterior cruciate ligament (ACL) injury in Croatia. ----- METHODS: The survey was conducted using a questionnaire which was sent by e-mail to all 189 members of the Croatian Orthopaedic and Traumatology Association. Only respondents who had performed at least one ACL reconstruction during 2011 were asked to fill out the questionnaire. ----- RESULTS: Thirty nine surgeons responded to the survey. Nearly all participants (95%) used semitendinosus/gracilis tendon autograft for reconstruction and only 5% used bone-patellar tendon-bone autograft. No other graft type had been used. The accessory anteromedial portal was preferred over the transtibial approach (67% vs 33%). Suspensory fixation was the most common graft fixation method (62%) for the femoral side, followed by the cross-pin (33%) and bioabsorbable interference screw (5%). Almost all respondents (97%) used a bioabsorbable interference screw for tibial side graft fixation. ----- CONCLUSION: The results show that ACL reconstruction surgery in Croatia is in step with the recommendations from latest world literature