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.

Background: Correct measuring of blood and urine creatinine level is necessary for identification and tracking of chronic kidney disease (CKD). Objective: The aim of this study is a comparison of Jaffe and enzymatic methods for measuring creatinine in serum and in urine, in order to determine whether there are any statistical significant differences between them, and whether they are reflected on creatinine clearance calculation and estimated glomerular filtration rate (eGFR). Methods: Creatinine in serum and urine was measured for the group of patients (N=60; female=34, male=26) from 24 to 69 years of age by using Jaffe’s method on Dimension RxL biochemical analyzer, and enzymatic method on integrated biochemical and immunochemical analyzer Architect ci8200, and obtained levels are used for creatinine clearance calculation and eGFR. Results: The methods correlate well, both in measuring serum creatinine (r 1 = 0.990) and in measuring urine creatinine (r 2 =0.974). There are no statistically significant differences between them (p=0.57). Measuring creatinine using different methods showed no statistically significant differences in the calculated clearances (p=0.93), they significantly correlate (r=0.9722). eGFR, using the MDRD and CKD-EPI formulas, were not statistically significantly different, regardless of the used method. Conclusion: Apart from significant correlations between the used methods, the results of using the Jaffe and enzymatic methods showed no significant differences at measuring serum creatinine level, or creatinine clearance and glomerular filtration rate.

Introduction: Cervical pain syndrome (CPS), or pain in the neck, is defined as a set of symptoms that limit performing movements in the upper part of the back and last more than 1 day. When the mentioned symptoms last for more than 12 weeks, we talk about chronic CPS. It often represents the condition that results from disability. It is associated with poor posture, work in sitting position, stress, and long-lasting and repetitive movements. The aim of the study was to examine the effect of physical therapy on the degree of disability, pain intensity, and daily life and work activities of persons with chronic CPS.Methods: The research was conducted in the health spa center “Reumal” Fojnica from June 2020 until July 2020. It included 50 subjects of both genders, more than 18 years old, and of all occupations, treated with physiotherapy procedures (transcutaneous electrical nerve stimulation, magnetotherapy, therapeutic ultrasound, and kinesitherapy in the form of McKenzie exercises). In addition, a pre- and post-treatment study analyzed the condition of the respondents at the first examination and the control examination after completion of treatment.Results: By analyzing the results, we established that of the total number of respondents, 74% were female, and the average age was 57.36 years. At the end of the study, the degree of disability caused by neck pain was significantly lower (p < 0.05) than the degree of disability before the therapy. Discomfort caused by symptoms of CPS that occurred and interference with work before the therapy was significantly lower (p < 0.05) after the treatment program. Therapeutic procedures have reduced the pain intensity and improved the activities of everyday life.Conclusion: The treatment with physical therapy procedures effectively reduces the degree of disability and pain intensity and improves people’s daily life and work activities with chronic CPS.

In the study, the development of physiotherapy was described through the history and education in Bosnia and Herzegovina (BiH) with a special review on the significance of physiotherapy as a health-care discipline and the display of its development to the academic level of education in BiH.

Introduction: Inadequate vitamin B 12, folate status and B6 are associated with an increased risk for chronic diseases that may have a negative impact on the health. Aim: The aim of our study was to investigate dietary intake of vitamin B12, B6 and folates from various foods among the university students. Methods: Dietary intake of foods having vitamins B12, B6 and folate was assessed among the students of University of Sarajevo, 19-22 years old, from 2017 to 2018. The participants were interviewed to collect information regarding age, socioeconomic status, B12, folate, B6 vitamin, and usual food intake during one week. Results: The main sources of vitamin B12 and B6 in the students’ diet were chicken white meat (51.8-53.7 %), beef (45-63 %), cream (62.2 -72.1 %), sardines in oil (47.9-52.2 %), tuna (55.2 -60.4 %), cheese edamer (80.1%) and cheese feta (67.4%-73%). The foods with a high source of vitamin B12 and B6 but rarely consumed were fish, shellfish, salmon, roasted trout and mackerel. Sufficient folate intake was mainly achieved through dietary intake of beans (48.5-57.2%) and oatmeal (46.3-48.2%), while folate-insufficient diet resulted from intake of spinach (30.9-35 %), turkey (26.2-33.4 %), lentils (16.9-19.7 %) and soy (9.4-15.5%). Conclusion: Our results show that there is an important percentage of the students in Canton Sarajevo that do not meet the recommended intakes for vitamin B12 and B6 and folate. Additional research is needed to establish the best cost-effective public health approach to achieve sufficient intake of these vitamins.

Introduction: Dietary supplements are an important source of vitamins and minerals that may help prevent several disease-causing biological pathways involved in one-carbon metabolism, including the suppression of cell proliferation, oxidative stress, nitric oxide synthesis, and angiogenesis. The present study aimed to assess the association between the intake of folate, Vitamin B6, Vitamin B12, and minerals and the consumption of alcohol among university students. Methods: This study was participated by students aged 19-22 years from the University of Sarajevo between 2017 and 2018. Using a questionnaire, we interviewed in a week them to collect information regarding age, socio-economic status, alcohol consumption, and dietary supplement intake. Then, we investigated the association between the baseline intake of folate, B vitamins, and minerals and that of alcohol consumption. Results: Most students consumed Vitamin B supplements (32%) and folic acid (10%). Dietary multivitamins and minerals were less prevalent in more than a year, accounting for 186 (23.9%) and 174 (24.3%) students, respectively, than those in less than a year. In a year, <20% of students consumed multivitamins 129 (16.6%) and minerals 116 (15.3%). Meanwhile, 256 (27.1%) students consumed alcohol. The Chi-square test of independence showed that drinking habits and the intake of such dietary supplements had no association (p > 0.05). Conclusion: An extremely low percentage of the participating students in Canton Sarajevo used dietary supplements of Vitamin B, folate, multivitamins, and minerals. Moreover, alcohol consumption and dietary supplement intake were not associated. Further research is needed to establish the best cost-effective public health system to achieve a sufficient intake of dietary supplements.

Introduction:  Identification of the risk factors that can be modified is an essential aspect in the development of the effective strategy for therapeutic intervention with the purpose to improve mobility and injury prevention and post-fall consequences. This research aimed to analyze the impact of programmed therapeutic exercises on the fall risk factors in the elderly. Methods: We included 260 patients older than 65 years, and assigned them randomly into three groups. Group A: 65 patients subjected to therapeutic exercises for moderate-intensity muscle strengthening with Theraband stretch straps (corresponding to 11-14 on the Borg rating of perceived exertion scale). Group B: 65 patients subjected to therapeutic anti-gravity exercises. Control group: 130 patients not participating in programmed therapeutic exercises. Presence of fall risk factors was assessed in all three groups with standardized Fast Evaluation of Mobility, Balance, and Fear test (FEMBAF) before the initiation of therapy, after three and after six months of treatment. Results: At the end of the study, the subjects of the group A had significantly fewer limitations in performing basic life activities at home compared to the patients of the control and Group B, p = 0.037. The control group subjects were statistically significantly more likely to complain of vertigo than subjects of the experimental groups, p = 0.021. The subjects of the experimental groups had more than two falls than the control group subjects, p = 0.003 statistically. In the control group, the number of fractures after the fall at the end of the study increased significantly, statistically higher than in the subjects of the experimental groups, P = 0.037. Conclusion: Programmed therapeutic exercise significantly reduces the risk of falling factors, and significant effects have been achieved among subjects who have exercised with elastic strips.

Introduction: Dry needling is a therapeutic procedure using the insertion of thin needles through the skin into myofascial trigger points (MTrPs), muscular or connective tissue with the aim to reduce pain intensity. The objective of this systematic review is to analyze the literature for the efficacy of the dry needle technique in pain reduction in conditions of musculoskeletal pain caused by MTrPs. Reference Sources: Web of Science, Scopus and EBSCOhost database were searched for studies and e-books published from January 2010 to December 2018. Studies Selection: We included randomized controlled studies, prospective and longitudinal studies, and case studies which analyzed the efficacy of dry needling for musculoskeletal pain reduction. Data Extraction Method: The studies, which satisfied criteria for inclusion were further analyzed. The primary instrument of the evaluation was pain intensity analyses. Results: Dry needling treatment is efficient in pain intensity reduction in patients who suffer musculoskeletal pain and is more efficient compared to sham dry needling treatment. In addition, different techniques of dry needling are efficient in the treatment of myofascial pain syndrome. Conclusion: Based on systematic review of the literature, dry needling, independently or as an addition to other intervention, is recommended for treatment of musculoskeletal pain conditions caused by myofascial trigger points. Various techniques of dry needling treatment are almost equally efficient in myofascial pain intensity reduction.

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.

Introduction: Osteoarthritis of the joints (osteoarthritis or arthritis) represents the largest group of rheumatic diseases. Within rheumatic diseases 50% are degenerative rheumatic diseases, 10% inflammatory and 40% extra-articular. Goal: To determine the modalities of physical therapy for elderly with degenerative diseases. Material and methods: The study is retrospective-prospective and descriptive. The survey conducted included 25 patients with degenerative diseases of the musculoskeletal and nervous systems in Gerontology Center in Sarajevo, from May 1, 2014- April 30, 2015. As research instruments were used: Questionnaire for users of physical therapy in Gerontology Center in Sarajevo, self-developed, visual-analog scale to assess pain and patient records. Results: Of the total number of patients with degenerative diseases (25), 10 (40%) were male and 15 (60%) were female. The most common degenerative disease is knee osteoarthritis which had 11 patients (29%), 3 males and 8 females. From physical therapy modalities in the treatment of degenerative diseases at the Gerontology Center in Sarajevo, kinetic therapy was administered to all patients, followed by manual massage and TENS in 15 cases (60%). From twenty-two patients, who completed a questionnaire, 11 (50%, 2 male and 9 female) rated their health as poor. Seven patients (32%, 3 male and 4 female) assessed their health as good. Three patients (14%, 2 male and 1 female) rated their health as very poor, and one patient (4%, 1 male) rated its health as very good. Conclusion: The Research Physical therapy in elderly with degenerative diseases is a pilot project, which highlights the need for: Conducting research for a longer time period, with a larger sample; Quality of keeping health records; Implementation of a continuous evaluation of functional status and; Stricter control for optimal effectiveness of physical therapy in order to improve the quality of life of elderly patients.

Introduction: Determination of the overall risk of coronary disease, enables the health professionals for planning the intensity of preventive action. Aim: The aim of this study is that by the results obtained using a modified algorithm with tables adopted by the European Society of Cardiology demonstrate the possibilities for assessment of the risk of coronary heart disease degree, for application to the targeted individual or risk factors groups. Material and methods: The study was conducted as a retrospective, prospective and controlled (included two groups of 200 respondents). Results: By comparing the presence of risk factors according to the representation of groups of diseases, or myocardial infarction, results showed that the European and SCORE table have significantly lower levels of risk factors, or those with sustained myocardial infarction are ranked in groups of low and present risk in relation to our algorithm which patients with myocardial infarction ranked as high and pronounced degree of risk. Results showed that the European and SCORE table significantly reduce the levels of risk or the persons with heart failure have been ranked in the group of low and present risks in relation to our algorithm which patients with coronary insufficiency ranked as pronounced degree of risk. Conclusion: Determination of the overall risk of coronary disease, enables the health professionals for planning the intensity of preventive action. The activities of primary prevention of risk factors, or already resulting disease, may be helpful in assessing the reduction in economic costs in healthcare, both due to lower morbidity, and reducing the total cost of treatment of patients with coronary disease.

Introduction: Lumbar pain syndrome is the most common cause of temporary work disability in people under 45 years of age. The aim of this study was to detect the frequency of acute and chronic lumbar painsyndrome in people of both gender, different age structures, different occupations and in active working population, and to determine the efficiency of trunk stabilizing exercises in its treatment.Methods: We analyzed 27 patients with acute and 33 patients with chronic lumbar pain syndrome from 01.01.2010 to 31.12.2012 which undergone trunk stabilizing exercises. We evaluated and scored 0 to 5the condition of respondents before treatment and after the treatment.Research results: The mean score of condition of respondents with acute lumbar pain syndrome before therapy is 2.96, whereas after treatment is 4.71. The mean score of condition of respondents with chroniclumbar pain syndrome before therapy is 3.76, whereas after treatment is 4.63.Conclusion: Treatment with trunk stabilizing exercises performed in the clinic "Praxis” leads to improved scores of condition of respondents after treatment.

Introduction: De Quervain᾽s disease is a stenosing tenosynovitis of common tendon sheath of abducktor policis longus and extensor policis brevis muscles. Due to the superficial positions it can easily lead tomechanical injuries of tendons and their sheaths. The disease more often affects women over 40 years old and people with certain professions who intensively use hand and fingers in their daily work. Pathologicalchanges consist of sheath᾽s fibrous layer thickening. The clinical condition develops gradually with the pain of varying intensity. It is localized above the radial styloid process and radiates from the back side of thethumb. The aim is to determine the efficacy of physical therapy at De Quervain᾽s disease.Methods: The study was conducted on 50 patients with De Quervain's disease who were reported to the CBR "Praxis" Sarajevo. With retrospective analysis the data was processed for the period from 01.01.2001. to 31.12.2011. year. Before the initiation of physical therapy assessment of functional status scored from 0 to 6 was performed. In the chronic phase physical therapy was performed, after which it underwent assessment of therapy success scores of 0-5. Criteria for inclusion in the study were patients with confirmed De Quervain's disease, patients of both sex and of all ages, and criterion for exclusion was non-compliance withtreatment protocols.Results: In the CBR "Praxis" with De Quervain᾽s disease total of 50 patients were treated in that period, of which 34 women and 16 men. 38% of respondents received a score of 4, while 56% of patients at the end oftreatment received a score of 5.Conslusion: Physical therapy and kinesiotherapeutical procedures have greatly contributed to the elimination of symptoms and consequences of De Quervainove disease.

Introduction: Enthesitis of the trochanter major is characterized by pain and often by limping when walking, then pain, tension, swelling, increased warmth and redness in the area of trochanter, and hip weaknessespecially when performing exercises with resistance. Research goals: Determine the effectiveness of treatment of major trochanter enthesitis, and analyze the representation of it in patients of both gender, different ages and professions.Methods: Retrospective analysis of data from the clinic "Praxis" in the period from 01.01.2001. to 31.12.2011. year because of the major trochanter enthesitis 30 patients were treated. Criteria for inclusion in the study were those people with symptoms and diagnosis of of the trochanter major enthesitis who have accessed treatment, while the criteria for exclusion were inadequate diagnosis, treatment abandonment and lack ofpatient data. The process of therapy included the evaluation of the functional status of patients graded 0-5, then conducted physical therapy that included: bed rest, manual massage and local instillation of depot corticosteroids, and assessment of treatment success ranging from 0 to 5.Research results: The mean score for condition of respondents was 3.27 before therapy, while after treatment it was 4.33. The mean score for status of respondents was 3.13 before treatment, and after therapy itwas 4.33.Conslusion: Based on these data we can conclude that treatment in the clinic "Praxis" leads to the improvement in patients suffering from the enthesitis of trochanter major.