Aim To demonstrate the effects of early diagnosis of overuse syndrome in the wrist on healing, pain intensity and quick recovery to daily work and sport activities. Methods This clinical retrospective study included 60 patients of both sexes aged from 22 to 44 years, with pain in the wrist and clinical signs of creeping tenosynovitis. Patients were divided into two groups: the first group - persons doing sports activity, and the second group - patients who did not deal with sports activities. Results Females in 31 (51.7%) cases compared to males with 29 (48.3%) were slightly more represented in the total sample. Patients with injuries due to sports activities had previously reported to the physician and the diagnosis was set at an average of 3.1±0.9 days after the first symptoms (the range of 2-5 days), compared to the patients of the second group whose diagnosis was set at an average of 4.7±1.1 days after the first symptoms (p<0.05). Conclusion Patients involved in sports activities were more motivated for faster recovery, they had earlier doctor's examination with rapid reduction of subjective symptoms during intensive physical therapy.

Parkinson's disease (PD) is a progressive neurological disease with tremor, bradykinesia, akinesia and rigidity. These symptoms significantly hamper the performance of activities of daily living (ADL), which are necessary for normal functioning of every individual. Exercise therapy is part of physical medicine which is using movements and strength of muscles to aim healing, improvement of health, preventing disabilities and acomplishing higher grade of funcitionality. Often exercise therapy is combined with other therapies of physical medicine. The aim is to examine effects of exercise therapy on ADL in patients with Parkinson's disease. There were 40 examinees who had exercise therapy. In the conducted study there was increased representation of female gender, with no statistically significant difference in representation. Average age of examinees was 73,9±11,6 years and duration of hospitalization in group of examinees was 27,1±12,2 days. Comparation of average values between Barthel index (BI) as patients were admitted and released shows that Barthel index was increased from 10,7±6,3 when patients were admitted to 12,45±6,2 which was statistically significant. Statistical analysis showed that difference between genders is not statistically significant (p>0,05), meaning that influence of gender isn't important when Barthel index was measured. Corelation analysis of age and duration of hospitalization on Barthel index showed that non of monitored parametar has not statistically significant influence on improvement of Barthel index. Exercise therapy shows statistically significant improvement in activities of daily living, measured with Barthel index.

Introduction Disability is one of the factors that can lead to social exclusion and poverty of individuals with hearing and speech impairment. This is due to the fact that individuals with disabilities are often underestimated, in terms of their work and social skills. The employment of people with disabilities represents a powerful mechanism for achieving full participation of the marginalized groups in all spheres of society. Methods The study included a total of 40 people with hearing and speech disabilities, out of which 16 individuals were employed at DES d.o.o. Sarajevo and 24 at SINKRO d.o.o. Sarajevo. A combination of three questionnaires was used for assessing daily activities and their impact on the quality of life (QoL) of the individuals with hearing and speech disabilities. Results In the total sample, there were 35% males and 65% females. Complete deafness was observed in the majority of participants (90%), while the rest had either moderate (7.5%) or mild (2.5%) hearing impairment. A higher number of participants used sign language as the means of communication, compared to manual alphabet. About 17.5% of the participants used a cochlear implant or a hearing aid. Most of the individuals lived with a spouse (70%), 20% lived with their parents, 7.5% lived independently, and 2.5% lived with a guardian. The majority of the participants who were married had a child (57.5%). The average Ferrans and Powers' Quality of Life Index (QLI) was 19.33, and the average value for total daily activities was 11.700 MET. The average value for the level of physical activity in males was M = 13716.5 and in females M = 10613.56 (p > 0.05). Conclusions Overall, we showed that daily activities have a positive effect on the QoL of working individuals with hearing and speech disabilities, i.e., the individuals who had a higher level of physical activity also had a higher QoL.

Introduction: Multiple sclerosis (MS) is a chronic, autoimmune and progressive multifocal demyelinating disease of the central nervous system. The aim of this study was to evaluate rehabilitation of patients with multiple sclerosis using BI (Barthel index) and EDDS (Expanded Disability Status Scale).Methods: A clinical observational study was made at the clinic for physical medicine and rehabilitation in Sarajevo. We analyzed 49 patients with MS in relation of gender, age and level of disability at admission and discharge, patient disability were estimated using EDDS scale. The ability of patients in their activities of daily living were also analyzed according to the BI at admission and discharge.Results: Of the total number of patients (n=49) there were 15 men and 34 women. The average age of female patient was 42.38±13.48 and male patient 46.06±9.56. EDDS values were significantly different at the beginning and at the end of the therapy (p=0.001) as was the value of BI (p=0.001).Conclusion: MS patients, after the rehabilitation in hospital conditions show significant recovery and a reduced level of disability; they show higher independence in activities but rehabilitation demands individual approach and adjustment with what patients are currently capable of achieving.

Introduction: Clostridium difficile is the cause of the post antibiotic colitis. This anaerobe, sporogenous, gram-positive bacteria is most often recognized as the cause of the nosocomial diarrhea. The aim of this work is to show the impact of the infection Clostridium difficile on the result of rehabilitation of the patients that have been treated in the rehabilitation facility.Methods: 448 patients treated at the Clinic for physical medicine and rehabilitation of the Clinical Center University of Sarajevo were included in the study. Gender, age, Barthel index, length of hospitalization, and values of the albumin in the serum were documented. Kolmogorov-Smirnov test, Mann-Whitney U test and One Sample Wilcoxon Signed Rank test were used for data analysis.Results: There were 57% female and 43% of male patients. The average age was 67.5 years for women and 52 years for men. Barthel index at admission was 4.0 and at discharge raised to 8.0 (p=0.047). The length of the hospitalization for patients without infection was shorter (28.8 days) compared to patients with infection (43 days) (p=0.015). Values of the albumin in the blood at patients with confirmed Clostridium difficile infection were significantly lower than referent values (p = 0.016).Conclusion: Patients with Clostridium difficile infection had longer period of the rehabilitation and the results were less favorable.

ABSTRACT Aim: The aim of this study is to evaluate the results of rehabilitation, to determine the prevalence of major risk factors in cerebrovascular accident and their consequences, as well as to propose measures and procedures that will affect the better rehabilitation. Methods: The survey analyzed: age, sex, duration of rehabilitation, activities in daily life through the Barthel index at admission and at discharge, presence of risk factors HTA and DM. The study included a total of 116 patients, the majority of patients are older than 61 years. We had 49% of male patients and 51% of female patients and they spent 31-40 days at the rehabilitation. Results: The most common risk factor is HTA (83%) and diabetes (33%). Most of the patients at admission had a BI from 0 to 4 (32.7%), and at discharge BI in the range 17-20 (36.2%). Statistical analysis shows that there is a statistically significant correlation between the BI at admission, BI at discharge and risk factors of HTA and diabetes mellitus. Conclusions: the rehabilitation results in most patients is good results of rehabilitation. The most important risk factors in patients are HTA, DM and directly affect on results of rehabilitation. For the better results we should have energetic fight against risk factors for HTA and DM through primary and secondary prevention and patient education about early detection and treatment of these risk factors.

AIM To examine the effects of sonotherapy on the activities of daily living or as well as the reduction of pain in gonarthrosis. METHODS A retrospective- prospective clinical study included 63 patients, 47 to 86 years old with a verified diagnosis of gonarthrosis. Subjects were divided into two groups. The first group included 26 patients treated with kinesitherapy in combination with electrotherapy; the second group included 37 patients treated with kinesitherapy combined with sonotherapy. The age, sex, activities of daily living by Barthel Index and the intensity of pain by visual pain scale (VAS) was analyzed at admission and discharge of the patients. RESULTS Both groups were matched for age, sex, and Barthel index values at admission and discharge. There was no statically significant difference between the groups according to demogrfphic characteristics. Visual pain scale at admission was almost identical in both groups; VAS at discharge waa lower in the group treated with kinesiotherapy and sonotherapy. Visual pain scale at discharge was lower in both groups than at admission, but without statisticay difference (p more than 0.05). CONCLUSION Sonotherapy and electrotherapy improved the activities of patien's' lives. Both types of therapy, in combination with kinesitherapy, led to a decrease of pain in patients with gonarthrosis.

Introduction: Cerebrovascular insult (CVI) is acute or sub-acute occurrence of symptoms which signal death of cerebral cells caused by localized disruption of arterial circulation in the brain. The goal of this study is toinvestigate whether ischemic or hemorrhagic CVI can be used as predictor of rehabilitation.Methods: A retrospective study was conducted in the period from January 2009 to the December 2009 and as a source of data we used medical records. The study included 89 patients who had CVI and who werehospitalized at the Clinic for Physical medicine and rehabilitation, Clinical Center University of Sarajevo (CCUS). We analyzed socio-demographic variables such as gender and age and clinical variables: the diagnosis,the length of stay in hospital (LOH), and Barthel index (BI) at admission and discharge from hospital.Results: Out of 89 patients, 78/89 (87.6%) were patients with ischemic CVI (group A), and 11/89 (12.4%) with hemorrhagic CVI (group B). There was not a signifi cant association between the gender and type of CVI[(χ2(1)= .041, P> .05]. There was a statistically signifi cant difference in median of length of hospitalization (LOH) between two groups (U=186.5; z=-3,025; P= .002). There was not a statistically signifi cant differencein median of BI at admission (U=317.0; z=-1,399; P= .162) and  discharge (U=319.0; z=-1.374; P= .169) between two groups.Conclusion: Patients with hemorrhagic CVI have a longer stay in hospital and consequently more expensive cost of treatment.

Cerebrovascular accident is a focal neurological deficiency occurring suddenly and lasting for more than 24 hours. The purpose of our work is to determine the role of the functional electrical simulation (FES) in the rehabilitation of patients with hemiparesis, which occurred as a consequence of a cerebrovascular accident. This study includes the analysis of two groups of 40 patients with hemiparesis (20 patients with deep hemiparesis and 20 patients with light hemiparesis), a control group which was only treated with kinesiotherapy and a tested group which was treated with kinesiotherapy and functional electrical stimulation. Both groups of patients were analyzed in respect to their sex and age. Additional analysis of the walking function was completed in accordance with the BI and RAP index. The analysis of the basic demographical data demonstrated that there is no significant difference between the control and tested group. The patients of both groups are equal in respect of age and sex. After 4 weeks of rehabilitation of patients with deep and light hemiparesis there were no statistically significant differences between the groups after evaluation by the BI index. However, a statistically significant difference was noted between the groups by the RAP index among patients with deep hemiparesis. After 8 weeks of rehabilitation the group of patients who were treated with kinesiotherapy and functional electrical stimulation showed better statistically significant results of rehabilitation in respect to the control group with both the BI index and the RAP index (p<0,001). In conclusion, we can state that the patients in rehabilitation after a cerebrovascular accident require rehabilitation longer than 4 weeks. Walking rehabilitation after stroke is faster and more successful if we used functional electrical stimulation, in combination with kinesiotherapy, in patients with disabled extremities.

Arteriosclerosis is a disease effecting large elastic, elastic muscular and large muscular arteries. The primary pathological changes are found inside the arteries. Salient feature is atherosclerotic plaque. The main purpose of this paper is to determine whether early kinesitherapy with verticalization and mobilization can give better rehabilitation results with patients after lower extremities operation, in comparison to patients which were not mobilized early in this stage. In this paper we have analyzed two groups of 40 patients that were operatively treated for circulation obstruction to lower extremities. The first, tested group was treated with early kinesiotherapy with early verticalization and mobilization. The second, controlled group was treated with kinesitherapy in bed. All the patients were analyzed according to their gender, age, primary diagnosis, postoperative complications, as well as capabilities for everyday activities. For the evaluation of the everyday life activities we used the Barthel index at hospital admission and discharge. Both groups of patients were equable in gender and age. The most common age group within the tested groups was between 61-70 for males and 51-60 for woman.The most common type of obstruction in both groups was occlusion of femoral artery. The complications which occurred among the tested patients were thrombosis, ileus and contracture in 7.5% of cases, while 85% of patients did not have any complications. Within the controlled group, decubitus occurred in 7.5% of cases, as well as gangrene and ileus. Ulcus occurred in 5% of patients, thrombosis in 10%, and contracture in 4% of cases. 40% of patients in this group were without complications. Based on the results stated above we can conclude that early kinesitherapy with verticalization and mobilization of patients in postoperative phase after the treatment of lower extremities obstruction, have shown much better results in comparison to the patients which were only treated with kinesitherapy in bed. This method of treatment should be included as protocol treatment for all patients after surgical treatment of lower extremities obstruction.

The goal of rehabilitation is to reduce consequence of injury or disease and to rise social ability and indenpedence for sick persons. In our work we have shown patients treated on The Clinical for Anesthesia and Intensive care from first January to thirty one June 2006. In the same time patients had hospital treatment and rehabilitation. All the patients were analyzed according to gender, age, the etiology of illness, the duration of rehabilitation and rehabilitation outcome at the time of their admission and at the time of their dismissal assumed by ET test. During six months we treated and rehabilitated 140 patients on The Clinic for Anesthesia and Intesive Care. We had 51% men and 49% women. When we analyzed the age we have seen that until 20 years we had 6.7% patients, 21-30 years 6% patients, 31-40 years 7.5% patients, 41-50 years had 20%, 51-60 years 23.3% patients, 61-70 years 24% patients, 71-80 years 9.2% patients and more than 81 years only 3.3% patients. Most of the examinees had acute cholecystitis 15.8% and ileus 12.5% patients. When we analyzed time for rehabilitation the most examinees 24.5% had only 2 days treatment. More than 15 days treatment had only 12.5% patients. All examinees had kinezitherapy. The rehabilitation outcomes demonstrated by ET- test showed increase from 90-120 at time of admission with 36% patients to the interval 160-200 with 30% at the time of discharge. This results showed excellent results of early rehabilitation after injuries or operative treatments. Therefore we can conclude that rehabilitation has to start as soon as possible after injuries or disease. It is the way how to prevent late complications and make the rehabilitation more successful, complete and shorter.

Cerebrovascular accident (stroke) is focal neurological deficiency occurring suddenly and lasting for more than 24 hours. Among its consequences are hemiplegia, speech impairment, swallowing impairment, changes of the facial nerve, sensibility, sphincter control or physiological changes. The goals of the study are to show the place functional electrical stimulation (FES) in the rehabilitation hemiplegic patients after cerebrovascular accident. In our study we analyzed two comparative groups with 40 hemiplegic patients, the first one, control group treated only with kinezitheraphy, and the second one, tested group treated with kinezitheraphy and functional electrical stimulation. Both groups of patients were analyzed according to gender, the etiology of the cerebrovascular accident and the duration of rehabilitation. We also had special analyzed of walking by BI index. Results has shown that we had two comparative groups according to gender and the etiology of the cerebrovascular accident. The duration of rehabilitation was longer in control group (77.5% for four months, 10% for five months) which is treated with kinezitherapy than in the tested group treated with kinezitheraphy and functional electrical stimulation (80% for three months, 20% for four months). After 4 weeks of rehabilitation of hemiplegic patients there are no significant differences between groups tested by BI index. After 8 and 12 weeks of rehabilitation tested gruop of patients treated with kinezitheraphy and functional electrical stimulation showed statistically significant better results than control group by BI index. In the conclusion we can say that functional electrical stimulation and kinezitherapy is methods which is faster, more successful and with better results in gait training.