Introduction:Pedobarography as a new diagnostic tool enables measuring the pressure between the foot and the floor during dynamic loading. Dynamic analysis of the foot shows advantage over static analysis due to its capabilities for detecting high load points in certain diseases and in certain phases of walking. Pedobarography as a new method in the context of rehabilitation include wide range of clinical entities.Goal:To show the advantages of pedobarography as new diagnostic and rehabilitation method in prevention programs.Material and methods:A prospective study included 100 patients with diabetes mellitus type 2. Research was conducted in the Primary Health Care Center of the Sarajevo Canton and the Center for Physical Medicine and Rehabilitation. The test parameters were: Test of balance–symmetric load for the test, the number of comorbidity, clinical examination of foot deformity, test with 10 g monofilament, HbA1c. From the total sample 45 patients (Group I) were selected, aged 50-65 years, which underwent pedobarography (on the appliance Novel Inc., Munich with EMED™ platform) and robotic fabrication of individual orthopedic insoles, followed by control pedobarography. Plantar pressure was determined using standard pedobarography, computer recorded parameters: peak pressure (kPa), force (Ns), area (cm).Results:The average age of the respondents was 59.4±11.38 years; altered results on the balance test were present in 34% of patients; 61% of respondents have ≤2 comorbidity. In the total sample, the average number of foot deformity was 2.84. Flat feet have 66% of respondents, and valgus position 57%. The average HbA1c values were 7.783±1.58% (min.5–max.15.0). All subjects (45) after the first, and after the second measurement of peak pressure, have values above 200 kPa, or are in the designated zone of peak pressure that needs to be corrected. In a study was determined the correlation between the number of deformities and peak pressure, the number of deformities and the area upon which plantar pressure act, test with 10g monofilament and peak pressure.Conclusion:Within the framework of prevention programs early diagnosis, detection of sensitivity disorders, adequate treatment and taking load from the feet with the help of pedobarography, are of great importance for the patient suffering from diabetes
Introduction:Therapeutic ultrasound is a physical modality which is constantly expanding range of indications. Analgesic effect of ultrasound is still under discussion. Regardless the extensive application of pulsed ultrasound of low intensity, continuous ultrasound has a better analgesis effect, which is explained by its mechanism of action.Aims:The main research objective of this study was to determine the effect of continuous ultrasound to pain caused by degenerative diseases of the musculoskeletal system in the intensity and duration of ultrasound treatment. Other objectives are entailed determining the correlation between the degree of pain reduction with: location of pain, age, gender and body mass index (BMI).Material and methods:The study included 68 patients with chronic pain localized in the region of the spine or major joints of the extremities, depending on the localization of the degenerative changes. Patients are divided into two groups. The first group was treated with 10 applications of continuous ultrasound with frequency of 1 MHz, intensity 0.4 W/cm2 for 8 minutes, and the other group with 10 applications of ultrasound with frequency of 1 MHz, intensity 0.8 W/cm 2 for 4 minutes.Results and Discussion:Pain intensity was assessed before and after ultrasound therapy performed by subjective visual analogue scale (VAS) for pain, numbered from 0-10, where 0 is the rating for the state of no pain, and 10 grades for severe pain. The average VAS improvement in the first group was 3.97, and 4.74 in second one. The results of F (1.66) = 2.93, p = 0.09 analysis of variance showed no significance difference between the average improvement of two groups. Correlation between the degree of pain reduction showed significance only with BMI, or that higher BMI is associated with a lower degree of pain reduction. The results of this study showed that application of continuous ultrasound in patients with chronic pain, caused by degenerative changes in the musculoskeletal system, led to a significant reduction in pain. Different intensity and duration of ultrasound application showed no significant effect on the degree of pain reduction. Body mass index showed significant negative correlation with the degree of pain reduction, but age, gender and location of pain did not show significant correlation.
Introduction:Risk assessment for development foot ulcer in diabetics is a key aspect in any plan and program for prevention of non-traumatic amputation of lower extremities.Material and methods:In the prospective research to assessed diabetic neuropathy in diabetic patients, to determined the dynamic function of the foot (plantar pressure), by using pedobarography (Group I), and after the use of orthopedic insoles with help of pedobarography, to determined the connection between the risk factors: deformity of the foot, limited joint movements, diabetic polyneuropathy, plantar pressure in effort preventing changes in the diabetic foot.Results:Out of 1806 patients, who are registered in one Team of family medicine examined 100 patients with diabetes mellitus Type 2. The average age of subjects was 59.4, SD11.38. The average HbA1c was 7.78% SD1.58. Combining monofilament and tuning fork tests, the diagnosis of polyneuropathy have 65% of patients. Comparing Test Symptom Score individual parameters between the first and second measurement, using pedobarography, in Group I, statistically significant difference was found for all of the assessed parameters: pain, burning sensation, paresthesia and insensitivity (p<0,05). The measurements of peak pressure, both first and the second measurement, for all of the subjects in Group I(45) show values above 200kPa. That’s a level of pressure that needs to be corrected. The study finds correlation between the foot deformation, diabetic polyneuropathy and plantar pressure (p>0,05).Conclusion:A detail clinical exam of diabetic food in a family doctor office equipped with pedobarography (plantar pressure measurements), use of orthopedic insoles, significantly reduces clinical symptoms of diabetic polyneuropathy in patients with diabetes.
T score (UZ) and maximum T score (DXA) (lumbal spine and hip) has statisticly similar value with potential possibility to predict osteoporosis fractures.
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