Dijana Avdić

Physical and Exercise Therapy for Treatment of the Rheumatoid Hand

OBJECTIVE To study the short-term effects of physical therapy (ice massage or wax packs, thermal baths, and faradic hand baths) and exercise therapy on the rheumatoid hand. METHODS The effect of individual physical therapy and exercise therapy programs was evaluated in 50 randomly selected rheumatoid arthritis inpatients (38 women and 12 men). Mean patient age (+/- SD) was 47.94 +/- 11.22 years, and mean disease duration was 5.04 +/- 4.80 years. The control group consisted of 50 randomly selected rheumatoid arthritis outpatients (37 women and 13 men; mean age 48.46 +/- 10.65 years, mean duration of disease 5.23 +/- 4.89 years) who at the time of the investigation were not receiving any physical or exercise therapy. The clinical indices used for evaluation of inflammation included erythrocyte sedimentation rate (ESR), pain intensity, proximal interphalangeal (PIP) joint size, and Ritchie articular index. Hand grip strength, palmar tip-to-tip and key pinch finger strength, finger range of motion, and activities of daily living (ADL) were the parameters used to assess the functional hand status. The study was single-blinded and of 3 weeks duration. RESULTS In the physical therapy treated group, there was an improvement for most of the observed indices from baseline parameters that achieved statistical significance (P < 0.01 and P < 0.005) after the 3-week study period. ESR and PIP joint size improved clinically but failed to reach statistical significance. Patients had a more significant improvement in hand pain, joint tenderness, and ADL score (P < 0.005) than in range of motion (P < 0.01). All parameters in the control group slightly deteriorated over the study period. CONCLUSION At least in the short term, physical and, particularly, exercise therapy produce a favorable improvement in the functional status of the rheumatoid hand.

Influence of Motion Therapy in the Prevention of Lumbar Pain Syndrome Relapse

Introduction: Lumbar pain syndrome is one of the most common conditions in clinical practice, more common than 290 other pathological conditions, which affect up to 84% of adults in a certain period of their life. The origin of the lower back pain can be classified as mechanical, neuropathic and secondary due to another illness. Patient education and information, muscle strengthening exercises, maintenance of routine daily physical activity and pain therapy are the basis of acute non-specific pain syndrome therapy. Aim: To determine the success of the motion therapy procedure in the prevention of lumbar pain syndrome relapse. Material and methods: The research is prospective, longitudinal, manipulative and controllable. It was conducted in the private practice “Praxis - dr. Pecar” in the period from June 20, 2014 to June 1, 2016, and included 200 respondents with symptoms of lumbar pain syndromes divided into the experimental (n=100) and control (n=100) groups. The presence of lumbar pain syndrome relapse in respondents experimental and control group was recorded in the second and third clinical examination. Results: In the second examination, 4 (4%) of the respondents from experimental group and 37 (37%) of the control group responded had LBS relapse. In the third examination, the number of respondents with recurrent LBS in the experimental group was 4 (4%), while in the control group was 17 (17%). After the study, no statistically significant difference was observed in the mean age of respondents who had LBS relapse compared to respondents without LBS relapse, as well as significant influence of sex structure on relapse in the experimental and control group during the second and third examination. Conclusion: After the second examination, the relapse rate in the experimental group was statistically significantly higher in the respondents withstanding jobs, while there was no statistically significant difference in the control group and both groups after the third examination.

Thermoregulatory Responses During Submaximal Exercise in Young Labile Hypertensives

Introduction: The aim of this study was to assess core stabilization exercise effects in reducing functional disability in patients with chronic low back pain (CLBP). Methods: This study included total of 90 patients aged 40 to 60 years. After a ten-day rehabilitation program the patients from an examination group (n = 30) performed home exercise program five times a week, patients from a first control group (n = 30) three times a week, while patients from a second control group (n = 30) did not perform the exercises at all. The patients performed core stabilization exercises of moderate intensity once a day in 30 minutes sessions. The patient’s functional disability was estimated using the Oswestry Disability Index (ODI). Results: After two months of rehabilitation there was a statistically significant increase in functional ability in patients who performed the core stabilization exercises five times a week (p = 0.0001) and in patients who performed the core stabilization exercises three times per week (p = 0.0001). A statistically significant difference in functional ability was not recorded in patients who did not perform the exercises. The analysis of the average values of the ODI differences at the beginning and after two months of rehabilitation showed a statistically significant difference between the group who did not perform the exercises and the group who performed the core stabilization exercises three times a week (p = 0.0001), and between the group who did not perform the exercises and the group who performed the core stabilization exercises five times a week (p = 0.0001). Conclusions: The implementation of the core stabilization exercises leads to a reduction of functional disability in patients with CLBP.

A retrospective study of surgical treatment of spinal injuries with rehabilitation program

Introduction: Traumatic injuries of the spinal column are among the most devastating injuries in orthopedics. The primary goals of rehabilitation of these injuries are prevention of secondary complications, maximizing physical functioning and reintegration into the community. Rehabilitation after spinal injury reqires multidisciplinary team approach. Team members include, but are not limited to, physical therapists, occupational therapists, nurses, psychologists, health care managers and social workers, with each member having role and responsibility in their area of expertise. This study aimed to determine the difference in the occurrence of spinal injuries according to gender, age, cause of injury, neurological phenomenon in injured patients, the treatment and physical procedures used in the early stages of rehabilitation. Methods: The study was conducted as a retrospective and comparative at the Department of Orthopedics and Traumatology of Clinical Center University of Sarajevo. Medical records of 100 patients, treated at from January 1 st 2007 till June 30 th 2008, were processed and data about outpatient protocols and surgery protocols analyzed. Results: The results obtained from the data showed greater proportion of women (56%) compared to men (44%). Most patients were in the age group between 41 and 60. Injuries were most often due to falls from height