Association Between Risk Factors and Prevalence of Musculoskeletal Disorders Among Laboratory Professionals-an European Perspective.

Background: Musculoskeletal disorders (MSDs) are a large group of diseases that severely affect work productivity and quality of life. Objective: To examine the differences in the prevalence of MSDs among laboratory professionals (LP) and to assess their association with individual, psychosocial, and occupational risk factors. Methods: In a multicenter, cross-sectional study, a questionnaire was distributed online through professional association networks. Participants were divided into two groups based on their territorial affiliation-European Union (EU) and non-EU member states. Descriptive and inferential statistics were included in the analysis, and statistical significance was set at ≤0.05. Results: A total of 640 LPs from 20 European countries participated in the study, predominantly females (78.4%) with university degree (59.4%) and mean age of 41.2 ± 10.1 years. Statistically significant differences between groups were confirmed for several variables studied: neck flexion > 15o (p = 0.008), hands at chest level (p = 0.000), longer screen time, and sitting (p = 0.000). One-third of participants reported wrist (35.6%), shoulder (32.7%), and elbow (31.6%) pain, while low back pain was more common (48.9%). A statistically significant association was confirmed between the incidence of MSDs and stress at work, repetitive movements, and prolonged standing (p = 0.000). Several variables showed significant correlations with MSDs in different body parts (p <0.05). Conclusion: Our results show a higher prevalence of MSDs in LPs and recommend the development of targeted prevention programs and additional measures to modify the work environment and organizational activities.

FADI EVALUATION OF THE EFFECTS OF KINESITHERAPY AFTER ANKLE FRACTURE.

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.

The Vitamine Source, Usual Food Intake at Students.

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.

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.

Physical Therapy in Elderly Suffering from Degenerative Diseases.

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.

Modified Algorithm for the Risk of Coronary Heart Disease Estimation.

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.

Sore shoulder in physical practice.

Sore shoulder or shoulder region is frequently encountered in general population. According to reference data prevalence ranges between 15 and 20% in 40-45 age group. A weak bone support enables extensive excursions of this joint and simultaneously reduces its stability. We analyzed successfulness of sore shoulder treatment in a sample of 1115 patients treated in the Center for physical medicine and rehabilitation between 1996 and 2004. All the patients reported to the Center either in acute phase or in the phase of chronic state exacerbation, with limited function that was graded on the scale 0 to 5. Type and kind of sore shoulder cause was determined by clinical examination and, where needed, by X-ray. Of the total number of cases, 33 patients did not report for follow up examination, 166 patients were forwarded to other physical therapy centers for treatment so the final analysis included 916 patients (82%) whose treatment success was evaluated on the scale 0 to 5. In 659 (58%) patients the inflammation of musculus biceps long tendon was identified as a cause of sore shoulder. The least frequent cause was the blow syndrome (impingement)--20 (2%). In 666 patients (73%) the problem was resolved by local instillation of depo corticosteroids (Betamethason 7 mg) so the physical treatment was not required.

[Rehabilitation of war injuries of the upper extremities with peripheral nerve lesions at the and Praxis Clinic for physical medicine and rehabilitation in Sarajevo]. / Rehabilitacija ratnih povreda gornjih ekstremiteta sa lezijama perifernih nerava u Ambulanti za fizikalnu medicinu i rehabilitaciju "PRAXIS" u Sarajevu.

The war injuries are the most frequent multiple, with the difficult distructions of the tissue and the lesions of the peripheral nerves. By the injuries, the lesions of the nerv system represent the delicate problem for the physical medicine and the rehabilitation during the siege of Sarajevo (1992-1995), in the injuries with the lesions of the peripheral nerves, if they are not treated in the frame of the multiple las urgent, they are postponed the operative treatments longer than three months. This is from the aspect of the successfullness, prognostically and therapeutically, the limiting moment. The successfullness of the operative treatment of the lesions of the peripheral nerves significantly depends on that whether the operation was performed incide tree months. The more difficult consequences in these injuries can appear if simultaneously with the taking care of war injuries does not perform adequately surgical treatment adn the in time physical therapy trough the sufficient long time period. On the four year sample was analyzed the success fullness of the rehabilitation of the injuries of the upper extremities with the lesions of the peripheral nerves. Clinically, uniform, we valorized the success fullness of the treatment of all the patients by the marks from 0.5. In the complete sample the excellent success of the rehabilitation we confirmed in more than a half of patients. The better results show the group of the operated patients, in which is performed neuropathia or neurolisis. The capability of the regeneration of the injured peripheral nerves offers the real possibility for extraordinary recovery also in the most difficult injuries, then the preventions of the significant number of the consequences.

[Treatment of lumbar pain syndrome of disk etiology at the Physical Medicine and Rehabilitation Clinic (Praxis) 1996-2000]. / Tretman lumbalnog bolnog sindroma diskogene etiologije u ambulanti za fizikalnu medicinu i rehabilitaciju ("Praxis") u periodu 1996. do 2000. godine.

In this paper is valoriziaed the successfulness of the treatment of 1,431 patients with the verification disc hernia (CT, MRI) in the surgery for the physical medicine and the rehabilitation in the period from 1966 till 2000 year, by "Praxis method". It is established that in the structure of the treated patients by the structure of the treated patients by the application of this method the best results were achieved by disc hernia in the level L4-L5 without the motor deficiency (567 patients), with the average treatment length 24.38 days and the average estimation of the results 4.06 and then in patients with the disc hernia L5-S1. In disc hernia without diagnostic verified disorder of the motorics, the result of the physical therapy and the rehabilitation was better. This can be observed from the treatment successfulness estimation and the treatment length and number of days of the treatment. The longest treatment was by hernia L5-S1 with the motor disorderly (43.10 days), and the shortest in the disc lesion at the level L4-L5 (24.38 days). Among the patients with disc hernia which in this period were treated was operated only 58 or 4.05%. The age structure of the treated patients with disc hernia amounted averagelly 49.95 years, and the greatest number of the treated belonged to the age group 35 to 44 years.

Effects of the treatment of acute lumbar painful syndrome (ALPS) by "PRAXIS METHOD" during the period from 1996 to 2000.

Acute lumbar syndrome occurs suddenly and is accompanied with strong pain in the lower part of the back. The most frequent APLS causes are vertebral (herniation of intervertebral disc, subluxation of intervertebral disc, subluxation of intervertebral joint, fracture of vertebra--traumatic or pathological), or extravertebral (subluxation of sacroiliac joint, acute bursitis of iliolumbar segment, muscle injuries or injuries of tendo-ligamentous apparatus of lumbosacral region). The treatment of acute lumbar painful syndrome is classified as medical, alternatively medical, surgical and combined. On the basis of durable experience, "Praxis method" as a treatment of lumbar pain (general and acute) is being applied in the Centre for Physical Medicine and Rehabilitation "Praxis" in Sarajevo. During the period from 1996 to 2000, the total number of 5.663 patients were examined in the centre "Praxis". Out of that number, 17.7% (1.003) of patients had acute lumbar painful syndrome (ALPS). Immediately after the therapeutic manipulation, which included "Praxis method, 31.5% (317) patients experienced the cessation of pains followed by ending of the treatment. The length of treatment for the rest of patients lasted: 1-7 days in 412 or 41.07 % of patients, 8-21 days in 195 or 19.48% of patients, and more than 21 days in 79 or 7.88% of patients. For all patients (1.003) the average treatment duration was 6.6 days. The recidivation occurred in 127 patients (12.66%). Throughout the treatment successfulness estimation according to clinical results scaled from 0 to 5, it was confirmed that out of the total number of 831 patients (82.85%) results were excellent in 459 patients (45.76%) or very good in 372 patients (35.09%). The average age of patients was ranging between 35 and 45 years (621 patients or 61.9%). The male/female distribution was 2:1.