Abstract-In spite of the extensive clinical work reported in the area of electrical wound healing, electrical stimulation to augment chronic wound repair is still far from being widely accepted in clinical practice. Problems in designing clinical studies (size of the sample observed, control group, ethics of the procedure), evaluating treatment efficacy, rationales for use of the treatment, and unknown underlying mechanisms contribute to the aforementioned fact. In the present study, we evaluated low frequency electrical current for its beneficial effects in pressure ulcer management. Seventy-three spinal cord injured patients with 109 pressure ulcers participated in the study. Patients were randomly assigned to a control group receiving conventional treatment of their ulcers, or to a stimulation group, in which the ulcers were additionally treated with low frequency pulsed current. A comparison of the two groups showed significantly higher average healing rate for the stimulated group. Patients from the control group had the opportunity of crossing over to the stimulation group after the required control period of four weeks. This group (the crossover group) was analyzed separately. In all but one ulcer out of 20, an improvement in the healing process was observed after electrical stimulation was initiated.
No difference in cystometric capacity and intravesical leak point pressure at terminal detrusor overactivity was shown between complete and incomplete spinal cord injury patients in our survey, that is, represented findings are equally unfavorable for both groups. Incomplete SCI patients with NDO should be tested with cystometry and observed with same caution as we proceed in complete SCI patients.
Sources of rehabilitation medicine, the need for rehabilitation and its practice in Croatia were studied, based on available data. The study revealed that current practice has advanced since the country's independence, but that there are many shortcomings; adequate care is not provided to all who could benefit from it, and there is wastage of resources.
The increased number of young people with spinal cord injuries in Croatia led us to study their functional abilities after completing medical rehabilitation and extended hospitalisation, as due to destroyed homes, they had no place to return to. They were all wounded during war in Croatia (1990Croatia ( ± 1992 and their average age was 27 years. Our tetraplegic patients achieved a mean Modi®ed Barthel Index (MBI) of 57.3 after completing medical rehabilitation and 61.3, 3 years later, which is a signi®cantly higher rate than is given in Yarkony's study (30.3 ± 37.8) where American civilian patients were monitored.1 Patients with paraplegia showed similar results (74.5 ± 76.8) relating to those published by Yarkony (72.0 ± 75.6).
Medical rehabilitation in Croatia needs a national strategic plan for a three-level system that incorporates inpatient, outpatient and community-based rehabilitation.
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