The aim of the study was testing the hypothesis that body height has a moderating effect on the association of weight and chronic low back pain (LBP) induced disability, and that this moderating ...effect is different in women and men. We performed a nested cross-sectional analysis using data collected at baseline in a prospective cohort study conducted in 2008-2009 at a special hospital for medical rehabilitation in Croatia. The outcome was the Roland-Morris Disability Questionnaire (RMDQ) score. The independent variable was body weight. The focal moderators were body height and sex. The moderation analysis was adjusted for seven sociodemographic and clinical covariates. We analyzed data on 72 patients with a median (interquartile range) age of 50 (43-55) years, 36 (50%) of whom were women, treated for nonspecific, chronic LBP. The interaction of sex, body weight and height was a significant predictor of the RMDQ score after adjustments for all covariates (increase of R2=0.13; p=0.001; false discovery rate <5%). In both sexes, the correlation between body weight and the RMDQ score was significantly moderated by body height but in opposite ways. In conclusion, the effects of body weight on physical disability are moderated by body height, but this moderation effect differs between women and men.
The aim of the study was to compare the effect ofwater-based exercise in thermal mineral water versus land-based exercise therapy on the lumbar spine range of motion and physical disability in adult ...patients with chronic low back pain. Out of 72 patients hospitalized for inpatient treatment in a special rehabilitation hospital, 36 patients performed a 3-week standardized program of group water-based exercises and the other 36 performed a program of group land-based exercises. All patients were also treated with electro analgesic therapy and underwater massage. The patients were assessed for lumbar spine motion using standardized measures with flexible tape, while physical disability was measured by the Physical Disability Index. Evaluations were performed at the beginning and at the end of treatment. Compared with baseline, a statistically significant improvement was detected in both groups regarding both primary outcome measures. At the end of treatment, there was no statistically significant difference between the two exercise treatments in any parameter of interest (p < 0.01). In conclusion, in our sample of patients with chronic low back pain, exercise treatment improved lumbar motion and decreased the level of physical disability. However, comparison of land-based exercises and water-based exercises in thermal mineral water did not demonstrate any significantly different result.
Cervical spondylotic myelopathy is a disease of high variability and its progressive form leads to severe disability. This paper reports on a case of a 31-year-old woman with whiplash neck injury ...sustained at the age of 11, and subsequent neck pain and numbness of arms. Slow progression of symptoms led to tetraparesis, and C3C4 disc herniation along with cervical myelopathy were revealed at the age of 26. Previously, she started a treatment for hypothyroidism. She underwent anterior cervical discectomy and fusion. Two additional operative treatments were done during the next two years due to lack of clinical improvement. Because of chronic pain the number of medications and the number of symptoms have gradually increased. We emphasize the problem of long-term treatment for chronic non-malignant pain and therapeutic dilemma in situations of inadequate analgesia.
Bol u stopalu čest je simptom koji se susreće u ambulantnom radu. Kompresivna neuropatija nervusa tibialisa u tarzalnom kanalu, kao uzrok boli u stopalu, rijetko se dijagnosticira.Ubraja se među ...rijetke kompresivne mononeuropatije i „entrapment“ sindrome.Cilj istraživanja bio je utvrditi učestalost i osobine kompresivne neuropatije nervusa tibialisa u bolesnika s bolnim stopalom. Istraživanje je provedeno u dvije specijalističke fizijatrijsko-reumatološke ambulante, na uzorku od 10 000 bolesnika u razdoblju od 12 mjeseci. Sumnja na sindrom tarzalnog kanala postojala je kod 43 bolesnika. Neuropatija nervusa tibialisa utvrđena je u 48,8% ispitanika, dok su ostali bolesnici imali
znakove radikularne lezije, polineuropatije ili uredan nalaz. Kao mogući uzroci kompresivne neuropatije izdvojeni su upalna reumatska bolest, trauma stopala i nožnog zgloba te degenerativne promjene svoda stopala i nožnog zgloba. Incidencija od 0,0021% u sveukupnom uzorku naših bolesnika pokazuje da, iako je u našoj praksi sindrom tarzalnog kanala rijedak, neophodno ga je razmotriti u diferencijalnoj dijagnozi bolnog stopala
The paper presents a 33 - year - old patient who has been suffering from ankylosing spondylitis
since the age of 28. Pain in his right shoulder and weakness in his right arm developed after
more ...hours of walking with a backpack. The performed procedure diagnosed a lesion of the
long thoracic nerve without of sensory damage. Peripheral nerve injuries long thoracic nerve
lead to weakness of the muscles -serratus anterior muscle and result in a protrusion of the medial
side of the scapula (scapula alata). It is difficult to raise the arm in the shoulder joint above the
horizontal line, that is to raise the shoulder from the chest when the arm is extended and pressed
against a fixed object in front of the patient. Due to its long, relatively superficial course, long
thoracic nerve is susceptible to injury, either through direct trauma or stretching. The long
thoracic nerve, also called Charles Bell’s external respiratory nerve, is a rare isolated nerve
damage. The nerve is often injured from carrying a load on his shoulder, with supraclavicular
and axillary injuries, blows in the neck area. Injury has been reported in almost all sports,
usually occurring from a blow to the ribs with an outstretched arm. Long thoracic nerve can be
damaged during breast cancer surgery, especially radical mastectomy that involve the removal
of axillary lymph nodes. It is a common lesion in spinal surgeries.
Key words: Lesion, long thoracic nerve, ankylosing spondylitis
The aim of the study was testing the hypothesis that body height has a moderating effect on the association of weight and chronic low back pain (LBP) induced disability, and that this moderating ...effect is different in women and men. We performed a nested cross-sectional analysis using data collected at baseline in a prospective cohort study conducted in 2008-2009 at a special hospital for medical rehabilitation in Croatia. The outcome was the Roland-Morris Disability Questionnaire (RMDQ) score. The independent variable was body weight. The focal moderators were body height and sex. The moderation analysis was adjusted for seven sociodemographic and clinical covariates. We analyzed data on 72 patients with a median (interquartile range) age of 50 (43-55) years, 36 (50%) of whom were women, treated for nonspecific, chronic LBP. The interaction of sex, body weight and height was a significant predictor of the RMDQ score after adjustments for all covariates (increase of R2=0.13; p=0.001; false discovery rate <5%). In both sexes, the correlation between body weight and the RMDQ score was significantly moderated by body height but in opposite ways. In conclusion, the effects of body weight on physical disability are moderated by body height, but this moderation effect differs between women and men. Key words: Low back pain; Body weight; Body height; Physical disability; Sex Cilj je bio testirati hipotezu da tjelesna visina ima moderatorski ucinak na povezanost te?ine i onesposobljenosti uzrokovane kronicnim bolovima u kri?ima (KBK) te da se taj moderatorski ucinak razlikuje kod ?ena i mu?karaca. Proveli smo ugnije?denu presjecnu analizu koristeci podatke prikupljene na pocetku prospektivne kohortne studije provedene 2008.-2009. godine u specijalnoj bolnici za medicinsku rehabilitaciju u Hrvatskoj. Ishod je bio rezultat Roland-Morrisova upitnika onesposobljenosti (RMDQ). Neovisna varijabla bila je tjelesna masa. Ciljani moderatori bili su tjelesna visina i spol. Analiza moderacije prilagodena je za sedam sociodemografskih i klinickih kovarijata. Analizirali smo podatke za 72 bolesnika s medijanom (IQR) dobi 50 (43-55) godina, od kojih su 36 (50%) bile ?ene, lijecenih zbog nespecificne KBK. Interakcija spola, tjelesne mase i visine bila je znacajan prediktor rezultata RMDQ nakon prilagodbi za sve kovarijate (porast R.sup.2=0,13; p=0,001; stopa la?nih otkrica <5%). U oba spola je korelacija izmedu tjelesne mase i rezultata RMDQ znacajno moderirana tjelesnom visinom, ali u suprotnim smjerovima. U zakljucku, ucinci tjelesne mase na tjelesnu onesposobljenost moderirani su tjelesnom visinom, ali taj se moderatorski ucinak razlikuje kod ?ena i mu?karaca. Kljucne rijeci: Bolovi u kri?ima; Tjelesna te?ina; Tjelesna visina; Tjelesna onesposobljenost; Spol
Balneoklimatologija je medicinska disciplina koja se počela razvijati sredinom druge polovice 19. stoljeća u Hrvatskoj. Razvoj balneoklimatologije na hrvatskoj obali počinje 1875. godine na preporuku ...bečkih liječnika (Julius Glax, Theodora Billroth,
Max Oertel). Veliki uspjeh za razvoj balneoklimatologije bio je IV. kongres 1904. godine austrijskih balneologa pod vodstvom prof. dr. Juliusa Glaxa kao i IV. međunarodni kongres talasoterapije 1908. godine u Opatiji. Na Medicinskom fakultetu u Zagrebu 1937. godine počela su prva predavanja iz balneoklimatologije i fizikalne terapije u okviru Neurološkopsihijatrijske klinike zahvaljujući predstojniku klinike prof. dr. Radoslavu Lopašiću. U kabinetu prof. dr. Lopašića polagali su se i prvi specijalistički ispiti iz balneoklimatologije i fizikalne terapije 1939. godine. Balneološko-klimatološki institut „Dr. Vladimir Franković“ osnovan je 28. kolovoza 1949. godine pri Ministarstvu narodnog zdravlja. Najuspješniji i najplodniji period za balneoklimatologiju bio je od 1949. do 1999.godine. Tada je Balneološko klimatološki institut djelovao pri Zavodu za fizikalnu medicinu i rehabilitaciju, u okviru Medicinskog fakulteta.
