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.

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.

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.