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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.

Introduction: The challenges faced by visually impaired people in their efforts to integrate themselves into the labor market and the general position of persons with disabilities, regarding their employment and social security, is extremely difficult. Employment is the best safeguard against social exclusion and one of the main ways to achieve a full involvement in the society of the visually impaired people.Methods: The research was conducted on a sample of 25 visually impaired people employed at “TMP” d.o.o. Sarajevo. The study was used as a cross-sectional survey method wherein data were collected through appropriate survey instruments, using a modified survey questionnaire.Results: Out of the total number of respondents, 48% are male and 52% are female. The majority of respondents use other persons’ assistance when moving (n = 16). The largest number of respondents had 100% visual impairment (n = 17). The majority of subjects have no strenuous physical activity. The largest number of respondents during the previous week walked for at least 10 minutes, in the sequence of all 7 days and was driven in motor vehicles. When doing household chores, 56% of respondents said they had no difficulty. The most common difficulties in recreation, sports and physical activity in leisure time, that were encountered by 32% of respondents, are poor sound signalling and difficulties of visual nature, though 68% of respondents said that they had no difficulty in their recreational activities.Conclusion: The daily activities of employed visually impaired persons have a positive impact on their quality of life. Various are occupations of visually impaired people that improve their quality of life.

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.

Amela Halilbasic, A. Kreso, Muhamed Klepic, Amila Jaganjac, D. Avdić

Introduction: Osgood-Schlatter’s syndrome (Osgood-Schlatter disease [OSD]) is caused by an accumulation of repeated microtraumas and is classified as a type of chronic injury called “overload syndrome“. It is considered that the root causes of OSD are accelerated growth as well as excessive sports and recreational activity. Currently, more than 50% of children of school age are involved in sports activities. In this study, 40 external risk factors were analyzed. Considering that frequent medical examinations, expensive rehabilitation, time-consuming sports activities, and school obligations result in major socio-economic and financial consequences, a need to work on a preventive program was recognized. The aim of this study was to determine external risk factors and to develop an algorithm for the prevention of injuries caused by overload syndrome through a detailed analysis of Osgood-Schlatter’s syndrome concerning aerobic and anaerobic sports (football, basketball, karate, and taekwondo). Methods: The research has been conducted on 200 patients who were previously diagnosed with Osgood-Schlatter’s syndrome. The participants were divided into two groups, each containing 100 patients, first group – aerobic sports (football and basketball) and the second group – anaerobic sports (karate and taekwondo). Personal information, anthropometric measurements, complete medical, and sports history were taken from the patients. A clinical examination was conducted by the researcher himself. This clinical study was prospective, comparative, analytical, and descriptive. The research was conducted in the Public Center for Sports Medicine of Canton Sarajevo. Software used for statistical data analysis was SPSS for Windows (version 20.0, SPSS Inc., Chicago, Illinois, USA) and Microsoft Excel (version 13 of Microsoft Corporation, Redmond, WA, USA). Results: Patients experienced the first symptoms of OSD at 4 years (football) and 6 years (taekwondo). About 60% of patients who trained in anaerobic sports and 38% of patients who trained in aerobic sports trained other sports more often as well. The research showed that a higher percentage of patients who trained anaerobic sports trained multiple sports at the same time (karate 88%, and taekwondo 82%) compared to patients who trained aerobic sports (football 68%, and basketball 76%). Patients who trained in anaerobic sports were also more likely to engage in recreational activities (58.3%) compared to patients who trained in aerobic sports (41.7%). On average, the number of hours per week which patients spent actively training (primary sport, additional sports activity, and recreational sport) was 17.2 h for basketball players, 16.8 h for taekwondo trainees, 16.7 h for caratists, and 15.7 h in case of football players. About 32% of football players, 24% of basketball players, 12% of karate trainees, and 18% of taekwondo trainees did not engage in additional sports or recreational activities. Only 36% of patients who trained in aerobic sports and 37% of patients who trained anaerobic sports respected the planned rest days, and in both groups, some subjects trained for 12 months. Conclusion: The research showed that patients who trained in anaerobic sports more frequently trained more than one sport at the same time and spent more hours doing recreational activities compared to patients who trained in aerobic sports. By analyzing weekly physical activity, it was concluded that the rest is limited. Future research aims to identify risk factors so that children, parents, and trainers can be educated to work on prevention through teamwork.

Amela Halilbasic, A. Kreso, Muhamed Klepic, Amila Jaganjac, D. Avdić

Introduction: Two findings can be highlighted from recent medical research, first children of a young age are involved in organized sports activities more frequently than ever and second the first symptoms of Osgood-Schlatter disease (OSD) have been reported in children at the age of 5.5 years. The latest research has shown that children from ages 10 to 12 years have already been actively involved in sports activities for 5–7 years. In recent years, the practice of young children training to master sports has become a trend. Said exposes young children who are training intensively to various external risk factors such as social isolation, addiction, frequent injuries, and syndrome of overload. Enablers of this behavior are commonly parents and coaches who notice the child’s abilities stand out from those of other children in the group and find that such talent requires intensive sport-specific training. The purpose of this study was to determine the average age of the patients and the average age when the first symptoms of the disease appeared as well as to provide an analysis of the average duration of children being actively involved in sports activities before the first symptoms of OSD appeared. Methods: The research has been conducted on 200 patients who were previously diagnosed with Osgood-Schlatter’s syndrome. The participants were divided into two groups each containing 100 patients, first group –aerobic sports (football and basketball) and the second group –anaerobic sports (karate and taekwondo). Personal information, anthropometric measurements, complete medical, and sports history were taken from the patients. A clinical examination was conducted by the researcher himself. The study was prospective, clinical, comparative, analytical, and descriptive. The research was conducted in Public Center for Sports Medicine of Canton Sarajevo. Software used for statistical data analysis was SPSS for Windows (version 20.0, SPSS Inc., Chicago, Illinois, USA) and Microsoft Excel (version 13 of Microsoft Corporation, Redmond, WA, USA). Results: The average age when the patients started with intensive training was highest with basketball players (7.8 years) following with karate trainees (6.8 years). Basketball players had statistically the lowest duration of being actively involved in sports activities before the first symptoms of OSD appeared (5.4 years). No statistically significant difference in the average duration of training was discovered between the test groups. The average age when knee pain or swelling under the knee first appeared was at the age of 11.4 years with players of aerobic sports and 11.8 years with players of anaerobic sports. Furthermore, no statistically significant difference was found between test groups and subgroups. Before the first appearance of knee pain, the taekwondo patients had been in training the longest (4.7 years) and basketball players the least amount of time (3.4 years). Conclusion: By conducting retrospective analysis, it has been concluded that children had started training at the age of 3 or 4 years and had encountered the first symptoms of OSD at the ages of 4 years (football) and 6 years (taekwondo). Research showed that the early involvement of children in sports and their early specialization in sports are both external risk factors that have a dominant influence on OSD development.

Introduction: The dietary supplements are defined as vitamins and minerals or herbal products and are typically given in the form of a capsule or tablet. The nonsmokers are more attempted to use dietary supplements than individuals who smoke. Aim: In our investigation, we examined associations between vitamin B, folic acid, multivitamin or mineral intake among the student population and their correlation with smoking prevalence and drinking coffee. Materials and methods: We used a questionnaire to examine the general characteristics of the subjects, age, sex, their lifestyle, cigarette smoking, coffee intake and their use of dietary supplements. Data were collected from participants of the University of Sarajevo and a longitudinal study of 960 men and women aged 18-24 years from 2017 to 2018 was conducted. Results: The results showed that 32% of students took vitamin B supplements and 10% folic acid. In opposite, more than half of students took multivitamins (59.5%) and minerals (60.4%) less than one year. About a quarter or less took multivitamins (23.9%) and minerals (24.3%) for years. Less than 20% of students took multivitamins and minerals within a period of one year. In student population smoking prevalence was estimated at 21.2% and coffee intake in 71.2%. The smoking and use of vitamin B supplements were independent of each other, p = 0.201. The use of folic acid did not depend on smoking p = 0.501. There were no observed correlations between multivitamin and mineral supplement consumption compared to smoking status or drinking coffee. Conclusion: Deficient dietary intake of folic acid and B vitamins from food and supplemental sources appear to be one of the atherosclerosis incidences. Further studies should examine associations between dietary supplements intake and lifestyle of students, as well as smoking status and coffee intake.

N. Serdarević, Arzija Pašalić, Eldina Smječanin, Vedran Đido, R. Gojak, Muris Pecar, Fatima Jusupović, D. Avdić et al.

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.

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.

Materials and research methods: The study is retrospective-prospective and controlled. For the purpose of this research, a measuring instrument used was a survey "Assessment of Preschool Teachers Preparedness in Inclusive Practice", an expanded Belan T. The final sample covered 62 participants; 37 (60%) preschool teachers were in the test group and 25 (40%) school teachers were in the control group. Average age of respondents was 38,5 years, where the youngest was 26 years old, and the oldest 59. Results: With regard to preparedness and work organization with a child with developmental disabilities, school teachers had a higher degree of preparedness, while preschool teachers were less prepared. There is a statistically significant difference in terms of preparedness and organization of work with a child with developmental disorders between these groups. To a greater extent, school teachers consider that they possess necessary knowledge, and to a lesser extent preschool teacher consider that they possess the necessary knowledge.

Introduction: Shoulder pain is the most common form of extra-articular rheumatism. We aimed to determine the efficiency of the conventional physical treatment of the shoulder pain compared to the conventional treatment plus the Mulligan's joint mobilization technique and acupuncture. Methods: We included a total of 277 patients with the shoulder pain caused by adhesive capsulitis (frozen shoulder), calcific tendinitis, rotator cuff syndrome, or the tendinitis of the biceps muscle. We used clinical and radiological diagnostic criteria to make the diagnosis. Patients were assigned into group treated with conventional physiotherapy treatment during the ten days (CP)(n=148), and the group treated with conventional physiotherapy treatment plus the Mulligan joint mobilization and acupuncture (CP+MA)(n=128). Treatment efficiency was evaluated by assessing the status of the patients before and after the treatment with the Work Abilities and Activities of Daily Living (WAADL) scale as well as the Treatment Success scale. Results: Mean treatment duration was 13.36±5.83 and 10.86±4.55 days in CP and CP+MA group, respectively (p<0.05). Mean WAADL scores after the treatment were 3.98±1.04 and 4.61±1.10 in CP and CP+MA group, respectively (p<0.05). Mean Treatment success score was 3.16±0.74 and 4.35±0.78 in CP and CP+MA group, respectively (p< 0.05). Conclusions: Conventional physical therapy plus the Mulligan's joint mobilization technique and acupuncture resulted in shorter treatment duration and higher WAADL and Treatment success scores in patients with shoulder pain.

Amila Kapetanović, Adila Horić, D. Avdić, Amila Jaganjac, E. Softić

Introduction: The aim of this study was to assess effects of strength, stretching and balance home exercise program (moderate intensity, performed once a day, five times a week) on quality of life of people with knee osteoarthritis. Methods: Participants with knee osteoarthritis performed physical therapy for a period of two weeks at the Department for Physical Medicine and Rehabilitation. The study group (n=30) continued to perform exercise program at home while the control group (n=30) did not continue the exercise program. The participants in the study group performed strength, stretching and balance exercises of moderate intensity, once a day, five times a week, for a total of eight weeks. The Short Form-36 Health Questionnaire (SF-36) was used to examine the effects of exercise program. Results: There was no the difference between the average value of quality of life in all examined areas (physical functioning, role limitations due to physical problems, role limitations due to emotional problems, vitality/energy, mental health, social functioning, physical pain, perception of general health) at the beginning of the study between the study group and control group (p>0.05 in all eight areas). The difference between the average value of quality of life at the beginning and end of the study was statistically significantly higher in the study group compared to the control group (physical functioning p=0.0001; role limitations due to physical problems p=0.0001; role limitations due to emotional problems p=0.0001; vitality/energy p=0.0001; mental health p=0.0001; social functioning p=0.0001; bodily pain p=0.0001; perception of general health p=0.0001). Conclusion: Home exercise program consisting of strength, stretching and balance exercises, of moderate intensity, performed once a day, five times a week is effective in improving quality of life of people with knee osteoarthritis.

A. Hadžiomerović, Amila Jaganjac, D. Avdić, Emira Švraka, Arzija Pašalić, Eldad Kaljić, D. Domljan, Edita Omerović

Introduction: The most common health problem associated with the negative effect of heavy school bags is back pain, and non-specific back pain is frequently observed in childhood. The prevalence of back pain in schoolchildren varies from 12% to 92%, depending on the age and affected region of the back. To prevent the occurrence of back pain in schoolchildren, the weight of school bag should not exceed 10% of the child’s body mass.Methods: This was a descriptive, cross-sectional study conducted in April 2017. We included 79 students of the fifth and sixth grade from the elementary school in Sarajevo. Information on the weight and type of school bag, method of carrying a school bag, and feelings of pain and tiredness due to school bag were obtained by questionnaire.Results: In the total sample, the majority of the students (64.6%) reported occasional back pain while carrying the bag, 20.3% of students reported no back pain, and 11.4% of students experienced frequent back pain. The mean school bag weight in the fifth grade was 4.01 ± 0.57 kg, and it was significantly higher (4.61 ± 0.86 kg) in the sixth grade. About 48.5% of the students in the fifth and 50% in the sixth grade carried school bags weighing more than 10% of the body mass. A higher mean weight of school bag was significantly more frequent in students who reported always feeling tired (11.03 ± 2.74%) compared to those who did not feel tired while carrying the school bag (8.41 ± 2%).Conclusions: Overall, more frequent occurrence of back pain and tiredness in schoolchildren was associated with heavier school bags (>10% of the body mass), and the occurrence of back pain due to school bag was related to gender (i.e., back pain was more common in girls compared to boys).

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