Abstract Objectives Restless legs syndrome (RLS) is a disease from the spectrum of movement disorders, the prevalence of which increases significantly during pregnancy and is associated with poor sleep, a drop in daytime energy, and the development of psychological disorders during pregnancy and the postpartum period. Methods The IRLSS scale was used to determine the presence of RLS symptoms. The total test sample that included the tested and control groups was (n=390) subjects. The examined group consisted of pregnant women (n=260), and the control group consisted of female students (n=130). In total, 260 pregnant women were monitored 6 months after pregnancy. Three measurements were performed, first in the third trimester of pregnancy, second two months after delivery, third 6 months after delivery, while one cross-sectional measurement was performed for the control group. Results The prevalence of RLS in pregnancy is highest in the third trimester and amounts to 26.5 %. In the postpartum period, a significant decrease in the prevalence of RLS was observed, measured two months after delivery (18.1 %). Postpartum, over time, a decrease in the prevalence of RLS was noticed, and six months after delivery it was (7.3 %), when it practically approached the prevalence of the control group (standard population) which was (6.2 %). Conclusions The prevalence of RLS is highest during the third trimester of pregnancy and decreases after delivery so that 6 months after delivery it approaches the prevalence of the standard population.

SUMMARY Inflammation, axonal loss and demyelinating plaques in the brain, which are the background of multiple sclerosis, very often cause changes in speech or dysarthria, in a range from mild to so severe that they impair comprehension of speech by the interlocutor. As a consequence of multiple sclerosis, dysphagia can also occur. The aim of this paper is to present the speech and swallowing difficulties that result from multiple sclerosis, and the importance of assessing the speech and swallowing in people with multiple sclerosis. This article is descriptive and provides a comprehensive overview of the literature dealing with this topic. Speech difficulties impede daily functioning and are often the first sign that other people notice. Swallowing difficulties not only complicate daily life but, if not given sufficient attention, are a possible life-threatening consequence of multiple sclerosis. Assessment of speech and swallowing difficulties should be part of the clinical assessment in each person with multiple sclerosis. As multiple sclerosis progresses, so do speech and swallowing difficulties, and it is of utmost importance to provide appropriate treatment that can alleviate these difficulties. Speech-language pathologists should be part of a team making the diagnosis and providing treatment for a person with multiple sclerosis.

Background: Knee osteoarthritis is the most common rheumatic disease characterized by pain, structural changes and impairment of quality of life. This disease has a multifactorial etiopathogenesis, and the main role is attributed to mechanical factors. There is a primary and secondary form of osteoarthritis. Osteoarthritis diagnosis is carried out on the basis of history, clinical picture and radiological examinations. Osteoarthritis is a major cause of absenteeism for middle-aged people. In the treatment of osteoarthritis, the triad is important: education, rehabilitation and supportive therapy with chondroprotective drugs. As part of the study, 60 patients with clinical and radiographic signs of knee osteoarthritis were given Cartinorm (1500mg glucosamine sulfate, 800mg chondroitin sulfate, 5000mg forti gel, 250mg vitamin C). After 3 months of treatment, there was an improvement in movement, a reduction in pain and an improvement in activities of daily living as measured by the Oswestry score. Objective: The aim of this study was to evaluate the reduction of pain, improvement of the clinical picture and improvement of the quality of life, after three months of supportive therapy with chondroprotective drugs (Cartinorm -1500mg glucosamine sulfate, 800mg chondroitin sulfate, 5000mg forti gel, 250 mg vitamin C). Methods: In a study that is prospective, analytical and descriptive, 60 subjects of both sexes with clinical and radiological signs of knee osteoarthritis were included. The study was conducted in six cities (Sarajevo, Tuzla, Banja Luka, Mostar, Zenica and Bijeljina) and lasted three months. During the study for pain relief, patients could only use Paracetamol and all patients took Cartinorm 1x a day. Pain Scale and Ostwestry index tests were performed for each patient to assess the quality of life at the beginning of the study, at the end of the first, second and third month. Results and Results: Total number of 60 subjects with clinical and radiological signs of knee osteoarthritis were included in the study. The analysis of the gender structure showed the dominance of the female gender (43 respondents), compared to the male population (17 respondents). The largest number of respondents had bilateral knee osteoarthritis. Assessment of pain through the VAS pain scale on the first day and at the end of the 3-month study showed a statistically significant reduction in pain. Analysis of the quality of life at the beginning of the study showed that 22 subjects performed activities with many difficulties, and at the end of the study only 5 subjects performed activities with many difficulties, which shows an improvement in the quality of life after 3 months of taking Cartinorm. Conclusion: Proper education of subjects with knee osteoarthritis and application of chondroprotective drugs (Cartinorm) for a period of 3 months showed an improvement in terms of pain reduction measured through the VAS scale, improvement of knee mobility and improvement of quality of life measured through Oswestry Scor.

<p><strong>Introduction. </strong>The adoption of correct walking patterns is an indicator of the locomotor system readiness to establish optimal interaction between body force and the surface, and the way of creating pressure exerted by the feet during the walking cycle. The aim was to examine how the speed and characteristics of the terrain affect the distribution of force and plantar pressure during the gait of children with different levels of physical activity.</p> <p><strong>Methods.</strong> A prospective comparative study included 150 students aged 11&ndash;12 years and their parents from Banja Luka. According to the protocol, each group of subjects walked at average and maximum speed on flat and 5% inclined terrain. For the purposes of the research, the Physical Activity Questionnaire PAQ-C (The Physical Activity Questionnaire for Older Children), a survey questionnaire for parents, measurement of anthropometric parameters and Zebris strips (Zebris Medical GmbH, Germany) were used for gait analysis.</p> <p><strong>Results.</strong> When walking at maximum speed in inactive subjects, the maximum force on the left (F(148) = 14.878, p &lt; 0.001) and right (F(148) = 8.204, p &lt; 0.001) heel decreased, while in moderately and highly active subjects it grew moderately. In highly active subjects, the highest value of maximum pressure was registered (d = -1.41 for the left leg and d = 1.36 for the right leg). When the slope of the terrain changes in inactive subjects, the maximum force on the front part of both feet decreased (F(148) = 5.043, p = 0.008, d = 0). The influence of terrain characteristics was such that walking on a 5% incline almost as a rule had greater effects on inactive children, while moderately and highly physically active children gave an adequate response when walking on the 5% incline.</p> <p><strong>Conclusion.</strong> Urbanization and new developments in society impose the need to involve children in organized activities so that children acquire the skills and demonstrate the competence they face in their environment.</p>

Background: Corona infection is primarily a respiratory disease, but the SARS-CoV-2 virus also penetrates other organs, causing various symptoms, including olfactory and gustatory dysfunction, which is why we can consider COVID-19 as a multisystem disease. Aim: To present review of some aspects of the olfactory and gustatory dysfunction in SARS-CoV- infection. Methods: The article has an analytical character and review of the literature. Results and Discussion: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a high similarity with SARS-CoV-1 and uses the same receptors to enter the human body (angiotensin-converting enzyme 2/ACE2). COVID-19 is primarily a disease of the respiratory system, but SARS-CoV-2 also penetrates the other organs including central nervous system (CNS). Patients with SARS-CoV-2 infection can experience a range of clinical manifestations, from no symptoms to critical illness. The entry of the virus into the brain can lead to different neurological and psychiatric manifestations, including loss of smell (anosmia) and the loss of taste (ageusia). The frequency of anosmia and ageusia in patients with COVID-19 varies widely, from 10 to 65%, being the primary symptom in about 12% of patients. For now, the etiopathogenesis of anosmia and ageusia in SARS-CoV-2 infection is still unknown. Most of the analyzed subjects reported olfactory recovery. However, anosmia and ageusia can last several months or even longer. While most patients are expected to recover their sense of smell or taste within the first three months, a major subpopulation of patients might develop long lasting dysfunction. Although a substantial proportion of patients with Covid-19 might develop long lasting of diferent level of ansomia and ageusia it is uncertain what proportion of patients develop persistent dysfunction. Anosmia/ageusia can be as an important risk factor for fog, anxiety, and depression that may show a prolonged and/or delayed impact. However, we do not yet know what long-term effects these disorders may have on the central nervous system and mental health in general. Conclusion: The COVID-19 is primarily a disease of the respiratory system, but SARS-CoV-2 also penetrates other organs (multisystem disease), causing various symptoms, including olfactory and gustatory dysfunction. The frequency of anosmia and ageusia in patients with COVID-19 is common but according to different papaers varies widely, from 10 to 65%, being the primary symptom in about 12% of patients. Most of the analyzed subjects reported olfactory recovery. However, anosmia and ageusia can last several months or even longer. We do not yet know what long-term consequences these disorders may have on the central nervous system and mental health in general.

Background: Discus hernia represents an intervertebral disk prolapse. The intervertebral disk provides stability in rest state and distributes the load of the spinal column on the move. Changes that lead to the occurrence of disc prolapse are desiccation, reduction of proteoglycan content, mucoid degeneration, and fibrosing tissue uptake. Predisposing factors of lumbar pain are heavy physical tasks with lifting loads over twenty pounds, especially professional use of heavy tools. Objective: The aims of this article is the review of diagnostics and physical therapy of lumbar disc herniation at levels L4/L5 and L5/S1. Methods: Authors used descriptive method for review lumbar disc herniation including diagnostic procedures and physical therapx based on scientific literature stored in medical databses PubMed, Scopus, Hinari, etc.. Results: The most common area of the spine to experience a herniated disk is the low back, just below the waist level. Herniated disks also commonly occur in the neck.. Conclusion: Rehabilitation is a delicate problem and requires long-term treatment and multidisciplinary cooperation, and is carried out in accordance with the principles of diagnostic and physical therapy of lumbar dics herniation depending of level of demaged and level of causes of lumbar disc herniation. The majority of herniated disks do not require surgery, and respond best to physical therapy. Physical therapists design personalized treatment programs to help people with herniated disks regain normal movement, reduce pain, and get back to their regular activities.

Background: The COVID-19 pandemic has become a major cause of stress and anxiety worldwide. It has generated stress among people from all sections of society, especially to workers who have been assigned to cater to healthcare service or those constrained to secure daily essential items. Yoga practice is actively sought to achieve reduced anxiety and stress so that improved sleep may positively impact immunity. Objective: The aim of this cross-sectional study was to determine whether those who practice Yoga during the COVID-19 pandemic have lower levels of stress, anxiety, and depression than those who do not. Methods: The sample consists of 51 females who have been attending Yoga sessions for many years and who continued this practice during the COVID-19 pandemic twice a week. The control group consisted of 50 non-Yoga respondents. The survey was conducted during April 2021. The Revised Event Impact Scale (IES-R) (4) and the Brief Symptom Inventory (BSI) (Derogatis, 1993) were used to assess stress. Student T-test was used to check the statistical significance of differences. Results: In our research yoga practitioners show a statistically significantly lower average severity of stress symptoms compared to those who do not practice yoga on 5 of the 6 stress indicators shown. The only statistically significant difference was not obtained on the measure of total number of symptoms (PST). Conclusion: The results suggest that yoga practice during COVID-19 pandemic is associated with lower levels of stress, anxiety and depression.

Background: The accessory deep peroneal nerve (ADPN) is as an anomalous nerve derived from the superficial peroneal nerve or its branch and supplies motor innervations for extensor digitorum brevis (EDB) and sensory innervations for the lateral part of the ankle and foot regions. It is the most common anomalous innervation present in the lower limb. Objective: The aim of this study was to determine the prevalence of ADPN electrophysiologically in a sample of Bosnia and Herzegovina subjects who referred to an electromyography lab. Methods: This cross-sectional descriptive study included 316 lower limbs from 171 subjects referred for electrodiagnostic studies to Electromyography Lab, Department of Neurology, University Clinical Center Tuzla (Bosnia and Herzegovina) (102 females/60% and 69/40%) males). Motor nerve conduction studies for the peroneal nerve and ADPN were done. Compound muscle action potential (CMAP) and nerve conduction velocity (NCV) of deep peroneal nerve (DPN) were measured by using EMG machine by stimulating DPN at knee, ankle and lateral malleolus areas accordingly, with recording from extensor digitorum brevis (EDB) muscle. Results: ADPN was found in 46 (14.5%) of 316 legs. ADPN was found in 18 (39.1%) right lower limbs and 28 (60.9%) left lower limbs. Ten subjects (5.8%) had bilateral ADPN. There was no statistically significant difference between the occurrence of ADPN in women versus men (p=0.757), as well as in right versus left legs (p=0.237). Conclusion: This study demonstrated that ADPN prevalence, in a sample of Bosnia and Herzegovina subjects who referred to an electromyography lab is 14.5%. Recognition of ADPN is very important for proper interpretation of lower limbs electrophysiological data.

OBJECTIVE The purpose of this study was to evaluate the efficacy of daily transcutaneous tibial nerve stimulation (TTNS) versus weekly percutaneous tibial nerve stimulation (PTNS) on the quality of life of patients with idiopathic overactive bladder (OAB). PATIENTS AND METHODS The study was designed as a randomized controlled trial. The diagnosis of OAB was made on the basis of clinical symptoms, and urodynamic tests were performed to check whether uncontrolled contractions of the derusor during bladder filling were responsible for the OAB symptoms. The tests used to assess symptoms and quality of life were Overactive Bladder Questionnaires (OAB-q) SF. The patients were divided into 2 groups of 30 patients each. The first group was treated with TTNS every day for 3 months and the second group with PTNS once a week, also for 3 months. RESULTS Stimulation with both TTNS and PTNS led to the reduction of all clinical symptoms of OAB and improved quality of life, with statistical significance (P<0.05) and with no side effects. When comparing these two groups, the improvement was statistically more significant in the group treated with PTNS. When the quality of life scores and symptoms were compared to the type of treatment, it was found that the improved quality of life parameters and the reduced OAB symptoms were more statistically significant in the treatment with PTNS than TTNS therapy (P<0.001). CONCLUSION The results of the study suggest good efficacy of both TTNS and PTNS in the treatment of OAB. Better effects are achieved with weekly PTNS, as it leads to a statistically significant reduction in symptoms as well as an improvement in quality of life, without side effects.

Backgroud: Intervertebral disc herniations are caused by rupture of the fibrous ring and migration of one part of the nucleus pulposus towards the spinal canal. The most commonly affected levels are C5-C6 and C6-C7. Surgical treatment of cervicobrachialgia is indicated in the presence of long-term intense pain syndrome with or without radicular sensory-motor deficit and magnetic resonance (MRI) verified disc herniation with a compressive effect. Objective: The most common surgical treatment is anterior lateral microdiscectomy with or without the use of implants. In addition to this method, dorsolateral microsurgical treatment can be used for foraminal hernias. Methods: This retrospective study included 110 (58 / 52.7% male and 52 / 47.3% female) patients with cervical disc herniations who were surgically treated at the Neurosurgery clinic of Clinical Center of Sarajevo University (CCUS) in a five-year period. Stability, postoperative curvature, arthrodesis, implants, and changes in adjacent segments were radiographically analyzed. In the outcome assessment, functional outcome and patient satisfaction were analyzed using the Pain Self-Evaluation Scale (VAS), Prolo functional and economic score, and White’s classification of treatment outcomes. Results: The dominant prevalence of changes was recorded at the levels of C5-C6 (58%) and C4-C5 (28%) with a ventrolateral approach performed in 90% of patients. The largest representation is hard dorsolateral discs (n = 77). In the group of patients with placed implant, hard discs were present in 96 (90%) cases (p <0.001), while soft discs were dominant in patients without implant placement (p <0.001). In the group of subjects with implant, the most common are hard dorsolateral discs and those of mixed localization in 41 of 55 patients (65.5%; p = 0.001). The most common implant is PEEK cage (74.5%). From complications, we had partial vertebral body fractures in 4.5% of patients. Furtehr, the most common are sensory disturbances in 2.73% of respondents. Reduction of symptoms and improvement of preoperative neurological status were observed in over 95% of patients. Conclusion: Surgical treatment of cervical disc herniation is a safe method with a minimal percentage of complications. Microsurgical discectomy significantly contributes to the improvement of the functional status of patients, the reduction of pain, and the improvement of neurological deficit and overall mobility.

Introduction: Carrying a school bag is a dominant activity that a child performs during daily productive activities. The aim of the research is to examine how carrying a school bag of different weights affects the distribution of force and plantar pressure during normal walking on the flat terrain of children of varying levels of physical activity.Methods: The pilot study included 124 students aged 11-12 from Banja Luka. According to the protocol, each group of respondents was treated with an intervention-customized school bag and a comparator-school bag that the child only opted for. For the research, the Physical Activity Questionnaire for Older Children, measurement of anthropometric parameters, school bag weight, and Zebris tape (Zebris Medical GmbH, Germany) were used for gait analysis.Results: Inactive children achieved the lowest and active children’s highest walking speed during normal walking without a bag, with their customized school bag. When carrying a custom school bag: The highest maximum force is projected on the left heel 330.72 N in inactive children, and the lowest 265.93 N in moderately active children, the highest maximum pressure on the left heel is registered in inactive children, 27.60 N/cm2, and the lowest 21.85 N/cm2 in moderately active children. The maximum force-time of % of standing time on the left foot in the middle part lasted the longest in inactive children, and the shortest active children carried their school bag 40.31% and a custom school bag 39.76%.Conclusion: High physical activity and individual adjustment to distribute the burden well allow the child to adequately respond to the loads carried by the weight of the school bag.

Institute for Physical Medicine and Rehabilitation “Dr Miroslav Zotović”, Banja Luka, the Republic of Srpska, Bosnia and Herzegovina. Faculty of Health Studies, University of Sarajevo, the Federation of Bosnia and Herzegovina, Bosnia and Herzegovina. Department of Physiology, Faculty of Medicine, University of Banja Luka, Banja Luka, the Republic of Srpska, Bosnia and Herzegovina. Medical Faculty of the Military Medical Academy, University of Defence, Belgrade, Serbia.

Infection with the new corona virus (SARS-CoV-2) was first registered in December 2019 in China, and then later spread rapidly to the rest of the world. On December 31, 2019, the World Health Organization (WHO) informed the public for the first time about causes of pneumonnia of unknown origin, in the city of Wuhan (Hubei Province, China), in people who were epidemiologically linked to a seafood and wet animal whole sale local market in Wuhan. Coronavrus disease, called COVID-19 (Corona virus disease 2019), after China quickly spread to most countries in the wold, and the WHO on March 11, 2020 declared a pandmic with this virus. SARS-CoV-2, has a high level of sequential similarities to the SARS-CoV-1 and uses the same receptors when it enters the human body (angiotensin-converting enzyme 2/ACE2). COVID-19 is respiratry infection that is primarily transmitted via respiratry droplets. Typical symptoms of COVID-19 infection can be very moderate (infected can be even asymptomatic) to very severe, with severe respiratory symptoms (bilateral severe pneumonia), septic schock, and fatal outcome. Numeous unknows regarding the biological, epidemilogical adn clinical characteristics of COVID-19, still exist, and make it impossible to predict with certainty the further course of the current pandemic. COVID-19 is primarily a disease of the respiratory system, but SARS-CoV-2, in a number of patients also penetrates the CNS, and apparently could be responsible for fatal outcome in some cases. The entrry of the virus into the brain can lead to neurological and psychiatric manifestationss, which are not uncommon, including headache, paresthesia, myalgia, impaired consciousnessm, confusion or delirum and cerebrovascular diseases. SARS-CoV-2 positive individuals should be evaluated in a timely manner for neurological and psychiatic symptoms because tretament of infection-related neurological and psychiatric complications is an important factor in better prognosis of severe COVID-19 patients.From the current point of view, it seems that in COVID-19 survivors, in the coming years and decades, the inflammatory systemic process and/or the inflammatory process of the brain could trigger long-term mechanisms that generally lead to an increase of neurological and neurodegenerative disorders. Psychosocial consequences as well as consequences for mental health are also significant, both for the general population and especially for health workers of all profiles. COVID-19 pandemia is associtaed with negative psychosocial consequences, including depressive symptoms, anxiety, anger and stress, sleep disorders, simpotms of posttrauamtic stres disorder, social isolation, loneliness and stigmatization.