BackgroundThe objective of this study was to evaluate the effect of a rehabilitation program in changing the perception of fatigue in patients with multiple sclerosis.Material/MethodsThe study involved 65 respondents/patients with clinically confirmed multiple sclerosis (54 women, 11 men, average age 46.49 years). The evaluation of the effects of fatigue on the physical, psychological, and psychosocial aspects of life was assessed using the Modified Fatigue Impact Scale (MFIS). To test the effectiveness of the neurorehabilitation program, we enrolled 2 groups: the experimental group (EG, n=32, 29 women, 3 men, Expanded Disability Status Scale (EDSS) 4.8 average, SD±1.77, min. 1.5 max 8.0) participated in the intervention and rehabilitation program over a period of 12 weeks and the control group (CG, n=33, 25 women, 8 men. EDSS average 5.12±1.74 SD, min. 2.0 max. 8.0). Each group of patients was divided into 3 sub-groups according to the severity of EDSS: a) 1–3.5, b) 4–6, and c) 6.5–8. For the statistical evaluation of the significance of the observed changes, the MANOVA/ANOVA model was used.ResultsBetween the input and output assessment of the MFIS individual areas questionnaire between the EG and the CG, there existed a statistically significant in the physical area (p<0.000), psychological area (p<0.000), and psychosocial area (p=0.002).ConclusionsOur results support the importance of an active approach in patients with multiple sclerosis using individualized rehabilitation intervention programs.

The aim of the study was to assess the differences in plantar pressure distribution and in posture during slow and very slow walking on the treadmill in flat and high-heeled shoes. Methods: The Pedar-X ® (Novel, Munich, Germany) measuring insoles were used to measure the plantar pressure distribution and to assess temporal parameters during walking on the treadmill with the speed v 1 = 0.97 ms-1 and v 2 = 0.56 ms-1 in flat shoes (FS) and HH. For postural measurement, the SonoSens Monitor Analyzer (Gefremed, Chemnitz, Germany) was used. Thirty healthy females who only occasionally wear HH volunteered to participate in the study (age: 21.8 ± 2.09 years, weight: 55.7 ± 4.05 kg, height: 1.66 ± 0.03 m). For statistical analysis the ANOVA, and paired t-test were used. Results: Significant differences in walking in HH were detected in temporal and plantar pressure variables, compared to FS. The walking speed influenced the temporal variables, but not the measured dynamic parameters, in either shoes. In the sagittal plane, significant differences in all sections of the spine were identified for v 1 and v 2. While walking in HH, lordosis at lumbar spine decreased significantly as well as at cervical spine, and kyphosis increased in the thoracic spine. In HH statistically significant differences between the walking speeds were observed particularly in the thoracic spine. Conclusions: Walking in high heels caused a plantar pressure changes and curvature of the spine, and the slowing of walking speed did not prevent these changes.

The authors present the case of a 16-year-old boy with osteochondroma of the iliac crest which gradually resulted in gluteal muscle atrophy, developing curvature of the spine and compression of the external iliac artery. Osteochondroma excision prevented the development of circulatory disorders in the ipsilateral lower extremity, and effective physical therapy enabled the well cooperating patient to restore fully his gluteal muscle strength and normal gait pattern.

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Aim: The aim of our study was to evaluate the effect of established regime and physiotherapy treatment described by Brems on patients after reverse arthroplasty of shoulder joint, their ability to perform activities of daily living, functional status of the shoulder girdle, and a range of motion. Methods: The research sample consisted of 60 patients, 57±2.9 years, with implanted total reverse endoprosthesis of shoulder joint. To assess the ability of performing the activities of daily living, we used the Simple Shoulder Test. Functional status of shoulder joint was evaluated through a "Constant Score" questionnaire. The range of movement was evaluated through the "Constant Score -Range of Motion" questionnaire. The examined parameters were evaluated before surgery and a month after the surgery. During the one-month post-surgery period, all participants undergone the set of targeted physiotherapy treatment and kept the established regime. After one month of targeted physiotherapeutical treatment and correct regime management we observed significant differences in all examined parameters (p<0.001). Results: After one month of post-surgery physiotherapy, significant differences in the ability to perform certain activities of daily living, functioning of the operated shoulder joint and in the range of movement, have been reported. Conclusion: The results of our study confirmed that if patients follow this specific rehabilitation protocol and cooperate during various stages of recovery, there is a high probability that after one month, they can perform activities of daily living.Sažetak. Cilj: Cilj studije bio je procijeniti učinak uspostavljenog režima i fizioterapeutskog tretmana koji je opisao Brems na pacijentima nakon reverzne artroplastike ramenog zgloba, njihove sposobnosti za obavljanje svakodnevnih aktivnosti, funkcionalno stanje ramena i raspon pokreta. Metode: Uzorak istraživanja sastojao se od 60 pacijenata, 57 ± 2,9 godina, s implantiranom ukupnom reverzibilnom endoprotezom ramenog zgloba. Da bismo procijenili sposobnost pacijenata za obavljanje svakodnevnih aktivnosti koristili smo test Simple shoulder. Funkcionalno stanje ramenog zgloba ocijenjeno je upitnikom "Constant score". Raspon pokreta ocijenjen je upitnikom "Constant score -range of motion". Razmatrani parametri procijenjeni su prije operacije i mjesec dana nakon operacije. Tijekom jednomjesečnog postoperativnog razdoblja svi su sudionici prošli skup ciljanog fizioterapeutskog tretmana i pridržavali se uspostavljenog režima. Nakon mjesec dana ciljanog fizioterapeutskog tretmana i ispravnog Professional article/Stručni članak 275 http://hrcak.srce.hr/medicina J. Čuj et al.: Evaluation of the effectivity of physiotherapy and regime management of patients on functioning of shoulder joint... medicina fluminensis 2019, Vol. 55, No. 3, p. 274-279upravljanja režimom zabilježili smo značajne razlike u svim razmatranim parametrima (p ≤ 0.001). Rezultati: Nakon mjesec dana postoperativne fizioterapije zabilježene su bitne razlike u sposobnosti za obavljan...

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