There is increasing evidence of neurological involvement in patients with coronavirus disease. Reports of neurological manifestations include altered mental status, Guillain-Barré syndrome (GBS) and its forms, encephalopathy, psychosis, neurocognitive (dementia) syndrome, ischemic strokes, intracerebral hemorrhage, and acute transverse myelitis. We present three patients with rare neurological manifestations of the COVID-19 disease, with a special focus on rehabilitation in a health resort setting. Outcomes were evaluated based on neurological examination and the modified Barthel index. We highlight the importance of an interdisciplinary approach to reduce disability and improve functionality and quality of life.

SUMMARY The aim of the study was to analyze the values of Foot and Ankle Disability Index (FADI) after kinesitherapy in subjects with bimalleolar or trimalleolar fracture of the ankle after surgery treatment and the obtained values of manual muscle test (MMT) and range of motion (ROM) after rehabilitation, compared with the obtained values of FADI index and on that basis evaluate its possibility in assessing the functionality of the respondents after surgery for bimalleolar or trimalleolar fracture of the ankle. The sample included 60 subjects over the age of 18 who underwent surgery for osteosynthesis due to bimalleolar or trimalleolar fracture of the ankle. All subjects were treated with kinesitherapy as part of the postoperative rehabilitation program. The research was conducted from 2013 to 2018 at the Department of Orthopedics of Dr. Safet MujiÊ Cantonal Hospital in Mostar and Mostar University Clinical Hospital. A statistically significant correlation was found between FADI index values per group and average percentage recovery per MMT (p<0.05), as well as a statistically significant correlation between FADI score values per group and mean percentage ROM value (p<0.05). A statistically significant association was found between mean percentage recovery per ROM and MMT (p<0.05). The conducted research confirmed the working hypothesis of the conducted study. The effects of kinesitherapy after ankle surgery can be evaluated using the FADI index, as well as by manual muscle test and ROM measurement.

Introduction: With the advent of the COVID-19 pandemic, people’s dietary habits have changed, so the importance of additional supplementation has become a current topic. The aim of this study is to analyze the attitude of female respondents toward dietary supplementation before and during the COVID-19 pandemic.Methods: The research is a cross-sectional study conducted in two different time periods. The sample consisted of two female subsamples who purchased immunity preparations from Verdant Pharmacy before the pandemic (n = 81) and during the pandemic (n = 120). Female respondents in both subsamples were: Of the same age, in the same health condition, residing in the same area (municipality), users of a local pharmacy located near the health center. The research instrument was a non-standardized questionnaire “Assessment of attitudes towards nutritional supplementation,” which consisted of nine questions.Results: During the pandemic COVID-19, the attitude toward the use of preparations to strengthen immunity differs by 7% compared to the pre-pandemic check. The attitude toward the use of preparations to strengthen immunity throughout the year increased by 32.3% (53.3%) during the pandemic, and the attitude toward the choice of preparations to strengthen immunity changed by 13% during the pandemic COVID-19 based on own experience and by 17% based on the recommendation of the pharmacist.Conclusion: The pandemic COVID-19 has contributed to a change in female respondents’ attitudes toward nutritional supplementation to strengthen the immune system during a pandemic. With the help of the media, public health recommendations, and people’s fear of disease, the COVID-19 pandemic led to a change in respondents’ attitudes compared to the pre-pandemic period.

Introduction: Due to the declaration of a state of emergency in the country due to the pandemic COVID-19, the education system was changed to online teaching. The implementation of distance education has led to an increased sedentary lifestyle, decreased physical activity, and increased use of information technologies. The purpose of this study was to analyze the sedentary habits of female students and their physical health during a period of restricted physical activity with reference to online instruction.Methods: The research was conducted among the first to third grade students of Secondary School Konjic, 45 days after the implementation of online instruction. Students of general secondary school (N = 83), business school (N = 68), and medical school (N = 55) completed the questionnaire after their parents gave their consent.Results: The total number of students surveyed was 206, with students from all three schools studied participating in online classes for up to 4 hours. Medical school students spend more than 3 hours completing schoolwork, while students at the other two schools spend up to 2 hours. Statistically significant differences in non-use of information technology during free time exist among medical students (p = 0.00). Female medical students reported daily symptoms such as headaches, reactions to the visual organ (dry eye, redness, and tearing), and pain in the fist area (twitching, cramps, and tingling). Statistically significant differences in the occurrence of pain in the upper back and chest girdle occurred in students of business school (p = 0.00) and general high school (p = 0.00) compared to medical students.Conclusion: Medical students who use information technology the most reported headaches, pain in the fist area, and frequent reactions to the sense of sight (dry eye, lacrimation, and redness). Assuming inappropriate positions during prolonged use of technology may contribute to poor posture.

Aim To investigate the effect of intermittent traction therapy (ITT) on pain in patients with chronic low back pain (CLBP). Methods A total of 81 patients with CLBP were included: experimental group received ITT (n=40) and control group received conservative physical treatment (n=41) 10 times for two weeks. A visual analogue scale (VAS) was used for measuring low back pain. Results In the experimental group, 26 (out of 40; 65.0%) patients were females, in the control group 20 (out of 41; 48.8%) were females (p=0.141). In a within-group comparison, median of VAS value was significantly decreased in both groups after ITT. A comparison of pre-intervention and post-intervention VAS value showed no statistically significant difference. Females from the experimental group had a significantly greater decrease of VAS compared with females from the control group. Patients in the ITT group with L5/S1 level of hernia had lower estimated marginal mean of VAS scale compared to the control group, as well the patients with left side of leg pain. Conclusion: Intermittent traction therapy is an effective treatment for pain reduction in patients with chronic low back pain.

Poremećaji hoda i poremećaji ravnoteže uobičajeni su klinički problemi za starije osobe. Uzroci poremećaja hoda su individualni, često zbog fiziološkog procesa starenja i somatskih bolesti. Poremećaji hoda dovode do gubitka lične slobode, pada i povreda i rezultiraju značajnim smanjenjem kvaliteta života. Kod starijih osoba, kontrola statičke i dinamičke kontrole položaja i ritma je poremećena, što dovodi do izmijenjenog hoda, smanjuje se korak, povećava se širina hoda kako bi se održala ravnoteža, gornji dio tijela se savija prema naprijed da bi se održala ravnoteža, ruke se ne pomiču dok hodaju, hod je nepravilan, teže je započeti prve korake nakon sjedenja ili stajanja, kao i okretanja. Ako je moguće, najbolje je tretirati etiološki faktor, tj. osnovne bolesti, kao što su parkinsonizam, neki metabolički poremećaji itd. Treba voditi računa o nusefektima nekih lijekova, naročito antiparkinsonika, sedativa, hipnotika i antidepresiva. Također je potrebno uključiti i druge specijaliste, kao što su reumatolozi, fizijatri i fizioterapeuti, kao i internisti, kardiolozi i dijabetolozi. Kognitivne strategije također mogu biti korisne, na primjer usmjeravanje pažnje na svaki pojedinačni korak, a ne čin hodanja kao takav, svjesno pokušavajući napraviti pojedinačne velike korake, ili mentalno brojanje, kao i upotreba pomagala za hodanje.

Aim To investigate the effect of kinesiotherapy on muscle strengthening in patients with Parkinon's disease. Methods This clinical retrospective - prospective study was based on collected data from medical histories and included 40 patients, who, beside medicaments, had undergone kinesiotherapy. This study analysed age, gender, duration of the rehabilitation and estimation of the gross muscle strength at admittance and discharge using Manual Muscle Test (MMT). Results Females was slightly more represented in the total sample without significant statistical difference. After kinesiotherapy significant statistical difference in muscle strength was observed, average MMT of the upper extremities increased from 3.25±0.6 to 3.53±0.8 and on the lower extremities from 2.9±0.8 to 3.3±0.9. The analysis of the gender on the higher score of MMT showed that gender does not affect the score of MMT. Correlational analysis of the age and duration of hospitalization on the score of MMT showed that patients with longer hospitalization had better improvement. Conclusion Results of the study showed that kinesiotherapy has positive effect on muscle strength in patients with Parkinson's disease.

The normal movement of the hip joint allows normal walking. When it is not possible to prevent joint destruction or to eliminate pain, surgery must be considered. Rehabilitation begins before the surgery if it is posibble. The aim of this study is to determine the efficiency of physical therapy in rehabilitation of patients with embedded total hip joint endoprosthesis. The study included 60 patients with hip arthroplasty, who were divided into two groups of 30 patients. Group A – patients who had only early postoperative rehabilitation program at the Department of Orthopedics at RMC, "Dr. Safet Mujić" in Mostar. Group B – patients with hip anthroplasty with early rehabilitation program and fully participated in additional program of 14-day balneotherapy at CMR "Reumal" in Fojnica. The results showed that in Group A cause was fracture in 23,3% and coaxarthrosis in 76,7% examinees, while in Group B cause was in 13,3% and coxarthrosis in 86,7% examinees. Coxarthrosis predominates as a cause of the hip endoprosthesis. Group A did exercises that includes exercise therapy of upper limbs, active exercises with help of lower operated limb, izometric exercise for muscule quadriceps and standing up for 96.7% examinees. Group B had individual therapies: balneotherapy (56,7%), hydrotherapy (100%) and kinesiotherapy (100%), electrotherapy (86,7%). The results obtained show that, within both groups of patients, the largest share of examinees falls within the "rehabilitated" category. Physical therapy has positive effect on results of rehabilitation after implantation of total hip endoprosthesis.

Aim : The aim of this paper is to demonstrate the conservative treatment of knee osteoarthritis by the selected parameters. Methods of the study : The study included 74 patients, both genders, aged between 52-73 years with clinical and radiological signs of osteoarthritis of the knee. Patients were divided in two groups. The first group - patients with osteoarthritis of the knee without comorbidity treated with nonsteroid antireumatics and physical therapy and the other group - patients with osteoarthritis of the knee and cardiovascular comorbidity treated Paracetamol tablets 2xl, lighter opiate in the evening, outpatient physical therapy and individual exercises at home. Results : Findings showed that the total sample was more represented in women than men. Statistically, more frequent (p <0.05) sleeping pain occurred in subjects with comorbidity - 73.7% compared to subjects without comorbidity - 55.6%. The duration of physical therapy was statistically significant (p <0.05) longer in the comorbidity group and was 13.3 ± 1.8 (10-15 days) compared to the noncomorbid group at 11.5 ± 1 , 9 days (range 10-15 days). After 4 months, the VAS score was slightly lower in the noncomorbid group and was 3.9 ± 0.5 (range 7.8-9.4) versus the comorbidity group - 4.3 ± 1.7 (range 3 , 1 to 9.7). Conclusion : Osteoarthritis is a chronically degenerative disease of the elderly population. New findings from the pathophysiology of osteoarthritis, as well as the knowledge about the risks of non-steroidal antireumatics, give priority to physical therapy, analgetics and topical drug administration. Osteoarthritis therapy trend is the maximum self-reliant involvement of patients in a permanent treatment program. Keywords: knee osteoarthritis, conservative treatments

Introduction: An increasing number of people suffer from degenerative diseases of the hip joints. Many studies report the long-term outcomes of invasive therapy in the treatment of coxarthrosis. However, results of prolonged conservative treatment are scarce. The purpose of this study was to evaluate the effects of prolonged conservative physical therapy on functional recovery of degenerative hip changes. Methods: We retrospectively analyzed 47 patients diagnosed with coxarthrosis according to the American College of Rheumatology criteria. Data on sex and age, duration of physical therapy, the type of physical therapy, the values of manual muscle test (MMT) at admission and discharge, were taken from the medical records of the patients. Results: There were 76.6% female and 23.4% male patients. Half of the patients were 70 or more years old. Majority of patients were treated by kinesiotherapy (74.5%) and had significantly different (p < 0.05) values of MMT at admission and discharge. Duration of treatment was 10-20 days for 23.4% of patients, while 29.8% received treatment for 31-40 days. Conclusion: According to our results, MMT significantly improved at the end of the treatment. Thus, physical therapy had a positive effect on the recovery of muscle strength in patients with coxarthrosis.