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Fizioterapija kreće 27 godine pr.Kr. začetkom Rimskog carstva. U Hrvatskoj početkom 20 stoljeća. Fizioterapija započinje u Rimskim termama. Kroz godine na nju se nadograđuju razne tehnike koje pomažu ljudima, te tako i Hrvatska prihvaća fizioterapiju kao zanimanje koje pomaže ljudskom tijelu i pospješuje zdravlje čovjeka. Naime daljinsko jahanje u Hrvatskoj zastupljeno je tek 17 godina. Daljinsko jahanje sklop je terenskog jahanja i utrkivanja s konjima pod kontroliranim i humanim uvjetima za konja. Za dobar uspjeh u daljinskom jahanju potrebna je dobra fizička spremnost konja i jahača. Ovim završnim radom cilj je upoznati jahače endurance jahanja s fizioterapijskom strukom, te im ukazati na dobrobiti koje bi ona donijela primjenom u ovoj sportskoj disciplini. Provedeno je anketno istraživanje u kojem se pokazalo da endurance jahači imaju opće znanje o fizioterapijskoj struci. Voljeli bi imati fizioterapeuta kao člana logističkog tima i vjeruju da bi im to donijelo bolje uspjehe na natjecanjima. Prevencijom ozljeda te posebno usmjerenim treningom jahača poboljšao bi se sam način jahanja i interakcije između konja i jahača. Pozornost bi se obratila i na emocionalno stanje jahača. Endurance jahači slažu da zbog pritiska i adrenalina koji proživljavaju na utrkama iziskuju potrebu za psihološkom pomoći jednako kao i za onom fizičkom koju bi odradio fizioterapeut. Sve većom popularizacijom ove sportske discipline povećava se i njezina profitabilnost što će omogućiti napredak ovog sporta. Popularizacija raste iz godine u godinu, a tako i nada za logističarskim timom enduranca jahača koji će možda jednog dana sadržavati fizioterapeuta kao člana. Physiotherapy begins 27 years before Christ, the beginning of the Roman Empire. In Croatia at the beginning of the 20th century. Physiotherapy begins in Roman baths. Over the years, various techniques that help people have been upgraded to it, and so Croatia accepts physiotherapy as an occupation that helps the human body and improves human health. Remote riding in Croatia has only been represented for 17 years. Distance riding is a combination of off-road riding and horse racing under controlled and humane conditions for the horse. Good physical fitness of horse and rider is required for good success in distance riding. The goal of this final paper is to introduce endurance riding riders to the physiotherapy profession, and to point out the benefits it would bring to this sport discipline. A survey was conducted in which it was shown that endurance riders have general knowledge about the physiotherapy profession. They would like to have a physiotherapist as a member of the logistics team and believe that it would bring them better success in competitions. Prevention of injuries and specially targeted training of riders would improve the way of riding and the interaction between horse and rider. Attention was also paid on the emotional state of the riders, where endurance riders agree that due to the pressure and adrenaline they experience at the races, they require the need for psychological help just as much as for the physical one that would be done by a physiotherapist. The increasing popularization of this sports discipline will lead to greater financial resources that will enable progress. Its popularity grows year by year, and so does the hope for a logistical team of endurance riders that may one day include a physiotherapist as a member.

Ozljeda prednjih križnih ligamenata vrlo je česta danas. Cilj završnog rada je prikazati nastanak i rehabilitaciju u ranoj fazi ozljede. Koljeno je vrlo složen zglob pa je oporavak dugotrajan i mukotrpan. Kod potpune rupture ligamenta izvodi se operativni zahvat nakon kojeg bolesnik boravi na odjelu ortopedije i traumatologije. Slabo je pokretan pa se izvode vježbe cirkulacije i disanja kako bi se spriječile posljedice i oštećenja kardiovaskularnog sustava. U početnoj fazi je vrlo važno ukloniti bol i edem koji predstavljaju najveći problem kako za rehabilitaciju tako i za psihološko stanje pacijenta. Kako bi se smanjila upala, odnosno edem koristi se krioterapija. Važno je postići punu ekstenziju u zglobu u prvoj fazi pa se koristi kinetek za pasivno razgibavanje i aktivno potpomognute vježbe. Zbog imobilizacije snaga mišića natkoljenice je vrlo oslabljena pa elektrostimulacijom dobivamo poticaj mišića na pokret, a statičkim vježbama jačamo oslabljene mišiće, posebice m. quadriceps jer on izvodi ekstenziju, a u toj ranoj fazi baziramo se na tom pokretu. Bolesnika je bitno educirati o izvođenju svakodnevnih aktivnosti, naravno i hodanja sa štakama. Na početku bolesnik nikako ne smije punom težinom opteretiti nogu jer zglob nakon operacije nije stabilan i može se dogoditi ponovno oštećenje unutar zgloba. Smije opteretiti nogu minimalno tek toliko da dobije osjećaj položaja zgloba. To je ujedno i prvobitni cilj rehabilitacije, samostalno kretanje kao i obavljanje aktivnosti svakodnevnog života. U kasnijoj fazi, kad bolesnik savlada prvobitne ciljeve, uvode se aktivne vježbe kojima se poboljšavaju motoričke funkcije kao što su snaga, propriocepcija i ravnoteža. Također bolesnika se priprema na profesionalne aktivnosti, te ako je osoba sportaš na aktivnosti u sportu. Anterior cruciate ligament injury is very common today. The goal of the final paper is to show the occurence of injury and rehabilitation in the early stages of that injury. The knee is a very complex joint, so the recovery is long and arduous. In the case of a complete rupture of the ligament, surgery is performed after which the patient stays in the traumatology department.The patient is poorly mobile, so circulation and breathing exercises are performed to prevent the consequences of other systems of the human body. In the initial phase, it is very important to remove pain and edema, which represent the biggest problem in rehabilitation as well as for the patient's psychological condition. In order to reduce inflammation or edema, cryotherapy is used. It is important to achieve full extension in the joint in the first phase so kinetek is used for passive stretching and actively supported exercises. Because of immobilization, the strength of the muscles of the upper leg is greatly weakened, so by electrostimulation we gain the stimulation of muscles to move, and with static exercises we strengthen weakened muscles, especially m quadriceps because it performs the extension, and in that early phase we base on that movement. It is important to educate the patient about the performance of daily activities, and also of course how to walk with crutches. At the beginning, the patient must never put full weight on the leg because the joint is not stable after surgery and re-damage can occur within the joint. The patient may load the leg minimally, just enough to get a sense of the position of the joint. It is at the same time the original goal of rehabilitation, independent movement as well as the performance of daily life activities. In the later phase, when the patient overcomes the original goals, active exercises are introduced with which motor functions such as strength, proprioception and balance are improved. Also the patient is being prepared for professional activities and, if the person is an athlete, for activities in sports.

Trkačka potkoljenica naziv je za mnogobrojna stanja ili ozljede koje nastaju na području ispod koljena te zahvaćaju dijelove potkoljenice uslijed aktivnosti koje uključuju trčanje ili skakanje. Sindromi trkačke potkoljenice svrstavaju se u sindrome prenaprezanja jer se tegobe javljaju kroz duži vremenski period, zbog opetovanog ponavljanja određenih pokreta. Stanja koja su opisana u ovome radu su: stres frakture tibie i fibule, kompartment sindrom prednjeg odjeljka potkoljenice, sindrom musculus tibialis posteriora i medijalni tibijalni stres sindrom (periostitis potkoljenice). Svaki od ovih stanja ima slične ili iste simptome te se na sličnim lokacijama javlja bol. Pri tome, stres frakture označavaju mikrotraume na kostima, kompartment sindrom se odnosi na previsoki intersticijski tlak unutar odjeljka, periostitis potkoljenice označava bolnost pokosnice goljenične kosti, a sindrom m. tibialis posteriora je oštećenje tibijalne tetive. Osim etiologije nastanka, postoje i čimbenici rizika koji mogu doprinijeti nastajanju nekog od stanja. Čimbenike rizika dijelimo na one unutarnje (spol, anatomska odstupanja) i vanjske (neadekvatna podloga ili obuća, pogreške u treningu). Bitno je razmatrati čimbenike rizika prilikom određivanja dijagnoze te je cilj odstraniti ih kako bi se minimalizirala mogućnost recidiva simptoma. Dijagnosticiranje se provodi prikupljanjem objektivne i subjektivne anamneze, provođenjem testova i mjerenja. U ovome slučaju je veoma bitna diferencijalna dijagnoza zbog sličnih kliničkih slika, koje su zapravo različita odvojena stanja. Od dodatnih dijagnostičkih postupaka, najjčešće se koriste rendgensko snimanje, scintigrafija kostiju i magnetska rezonanca. Rehabilitacija je kod većine spomenutih stanja konzervativna i univerzalna, osim kod liječenja kompartment sindroma prednjeg odjeljka potkoljenice. Glavni aspekti liječenja su odmor, smanjenje boli i prilagodba aktivnosti. U početnoj fazi, nakon prestanka aktivnosti, uz pomoću krioterapije i nesteroidnih protuuplanih lijekova, smanjuje se upala i bolnost. U sljedećoj fazi cilj je omogućiti osnovu za povratak prijašnjim aktivnostima, a to se provodi postepenim uvođenjem i doziranjem vježbi snage, vježbi istezanja i propriocepcije. Osim svega spomenutog mogu se primjenjivati i fizioterapijski modaliteti poput ultrazvuka, električne stimulacije ili masaže. Uloga fizioterapeuta, osim u točnom i pravodobnom određivanju dijagnoze i izrade individualnog plana rehabilitacije te vođenje kroz isti, leži i u edukaciji pacijenta te u pružanju podrške svojim pacijentima. „Shin splints“ is a term encompassing various conditions or injuries that occur below the knee and affect the lower leg due to activities involving running or jumping. These conditions are classified as overuse syndromes because the symptoms develop over a longer period of of time due to repetitive motions. The conditions discussed in this paper include tibia and fibula stress fractures, anterior compartment syndrome of the lower leg, posterior tibial muscle syndrome, and medial tibial stress syndrome. Each of these conditions presents similar or identical symptoms, with pain occurring in similar locations. Stress fractures involve microtrauma to the bones, compartment syndrome refers to elevated interstitial pressure within the compartment, shin medial tibial stress syndrome denote tenderness along the shinbone's periosteum, and posterior tibial muscle syndrome involves damage to to the tibial tendon. In addition to the etiology of these conditions, there are risk factors that can contribute to their development. Risk factors can be categorized as internal (gender, anatomical deviations) and external (inadequate surface or footwear, training errors). Considering these risk factors is crucial in determining a diagnosis, with the goal of eliminating them to minimize the possibility of symptom recurrence. Diagnosis is established through the collection of objective and subjective medical histories, conducting tests, and measurements. In this case, differential diagnosis is crucial due to similar clinical presentations, which are actually distinct conditions. Additional diagnostic procedures commonly used include X-rays, bone scintigraphy, and magnetic resonance imaging. Rehabilitation is generally conservative and uniform for most of the mentioned conditions, except for the treatment of anterior compartment syndrome of the lower leg. Key aspects of treatment include rest, pain reduction, and activity modification. In the initial phase, after ceasing activity, inflammation and pain are reduced through cryotherapy and nonsteroidal anti-inflammatory drugs. The subsequent phase aims to establish a foundation for returning to previous activities, achieved through gradual introduction and dosage of strength exercises, stretching, and proprioception exercises. Additionally, physiotherapy modalities such as ultrasound, electrical stimulation, or massage may be applied alongside the aforementioned measures. The role of a physiotherapist, in addition to accurately and timely determining the diagnosis and creating an individualized rehabilitation plan, includes educating the patient and providing support throughout the process.

Reumatoidni artritis (RA) predstavlja kroničnu upalnu, progresivnu i autoimunu bolest koja se bazira na zahvaćanje lokomotornog sustava i koja je popraćena sa fazama remisije i egzacerbacije. Valja naglasiti kako su na prvom mjestu zahvaćeni zglobovi, a s protekom vremena, vidljiva su i veća oštećenja i unutar i izvan zglobova što u konačnici rezultira sa invaliditetom te izuzetno niskom kvalitetnom života za oboljelog kao i niskom stopom njegove samostalne funkcionalnosti. Uspostava rane dijagnoze može znatno utjecati na progresiju bolesti u pozitivnom smislu za pacijenta. Postoji veliki spektar različitih metoda liječenja ove specifične bolesti, ali ovisi o stupnju oboljenja. S obzirom na to postoje dva principa liječenja od onih jednostavnijih, konzervativnih do, u težim slučajevima, kirurških metoda liječenja. Rad fizioterapeuta kod reumatoloških bolesnika sve je samo ne zanemariv. Postoje manualne tehnike, razgibavanja, razne vježbe, manipulacije tkiva, elektroterapija itd. te sve te metode itekako pomažu u suzbijanju i progresiji ove bolesti. Rheumatoid arthritis (RA) is a chronic inflammatory, progressive and autoimmune disease based on involvement of the locomotor system and accompanied by phases of remission and exacerbation. It should be emphasized that the joints are affected first, and with the passage of time, greater damage is visible both inside and outside the joints, which ultimately results in disability and an extremely low quality of life for the patient, as well as a low rate of independent functionality. Establishing an early diagnosis can significantly affect the progression of the disease in a positive sense for the patient. There is a wide range of different methods of treatment for this specific disease, but it depends on the degree of the disease. With this in mind, there are two principles of treatment, from simpler, conservative ones to, in more severe cases, surgical treatment methods. The work of physiotherapists with rheumatological patients is anything but negligible. There are manual techniques, stretches, various exercises, tissue manipulation, electrotherapy, etc., and all these methods really help in the suppression and progression of this disease.

Moždani udar je jedan od vodećih zdrastvenih problema i drugi uzrok smrti u svijetu, a prvi uzrok invalidnosti u Republici Hrvatskoj. Procjenjuje se da u svijetu na godinu od moždanog udara nastrada oko 4 milijuna ljudi. Učestalost moždanog udara bilježi se u mnogim Europskim zemljama pa se u bližoj budućnosti predviđa puno stradavanja od moždanog udara. Muškarci su skloniji nastanku moždanog udara u generativnoj životnoj dobi. Međutim, nakon menopauze rizik od nastanka moždanog udara raste u ženskoj populaciji. Ta činjenica i podatak da je prosječni životni vijek u žena duži dovodi do pojave da u apsolutnom broju ima više žena s moždanim udarom. Zbog navedenih razloga potrebno je bolje razumijeti i spriječiti faktore rizika za njegov nastanak. Potrebno je ljudima približiti primarnu i sekundarnu prevenciju i objasniti kako takvom prevencijom mogu spriječiti nastanak cerebrovaskularnog inzulta. CVI dolazi naglo i neočekivano, a nastaje zbog poremećaja cirkulacije u mozgu. Kod osoba, moždani udar ostavlja teške fizičke i psihičke posljedice. Sukladno tome rehabilitaciju treba započeti kod akutnog liječenja u specijaliziranim jedinicama za liječenje moždanog udara kroz multidisciplinarni pristup i adekvatnu procjenu i samu intervenciju od strane fizioterapeuta. Stoga je potrebno omogućiti fizioterapeutima lakši pristup edukaciji i poticati multidisciplinarni pristup rješavanju posljedica moždanog udara jer će tako i sam oporavak biti brži. Cilj rehabilitacije je poboljšati funkcionalnost kako bi oboljela osoba mogla biti uključena u obitelja, radnu okolinu i zajednicu. Stoga je u rehabilitaciji edukacija obitelji i pacijenta izuzetno bitna. Potrebno je napomenuti kako moždani udar ostavlja psihičke probleme koji predstavljaju veliki prepreku za brži oporavak. Fizioterapija u današnje vrijeme trebala bi biti lakše dostupnija i suradnja između liječnika i fizioterapeuta bi trebala biti bolja. Svaka stručna osoba trebala bi razumijeti pacijenta i daljnje liječenje trebalo bi se dogovarati sa pacijentom i njegovim željama. Stroke is one of the leading health problems worldwide, as well as the second most-common cause of death around the globe and the first on the list in the Republic of Croatia. It has been estimated that around 4 million people die annually from stroke. There has been an upward trend in stroke related deaths in the EU, thus we are to expect even more deaths caused by it in the future. The occurrence of strokes is more frequent in men than women. Due to the aforementioned causes of stroke it is necessary to better understand and minimize the factors of risk that lead to occurrence of a stroke. Patients must be provided with primary and secondary intervention and educated about the benefits of such intervention in preventing cerebrovascular accidents. CVA occurs due to a disorder caused in blood circulation; it comes fast and cannot be predicted. People who suffer from them can develop serious physical and mental side-effects as a consequence. Therefore, rehabilitation should be commenced during the acute phase of the patient treatment in specialized units that are used for a multidisciplinary approach. It should also be based on an adequate evaluation and intervention from the physiotherapist's side. Thus, it is of the paramount importance to provide physiotherapists with an access to necessary education, as well as to promote a multidisciplinary approach to solving the consequences of a stroke in order to achieve the recovery as fast as possible. The goal of rehabilitation is to improve the functionality so that the patient could be back to his everyday life; family, working environment and the community. Therefore, educating the patient’s family plays an important role in his/her rehabilitation. It is important to note that a stroke may result in mental deficiencies that could hinder a fast recovery. Physiotherapy today should be more accessible, while the cooperation between doctors and physiotherapists is a field that needs improvements. Every medical expert should understand a patient's needs and wishes in order to adjust the recovery process accordingly.

Bimaleolarna fraktura gležnja je ozljeda kod koje dolazi do prijeloma u lateranom i medijalnom maleolu, odnosno na distalnim dijelovima tibije i fibule. Ove dvije kosti zajedno sa talusom čine gornji gležanjski zglob. Jedan od najčešćih mehanizma ozljede je pad (u jednoj od studija 66%). Faktori koji utječu na ovu vrstu ozjede su dob, spol, dijabetes, reumatizam i alkoholizam. Može se liječiti na operativni i neoperativni način. U radu je opisan fizioterapijski postupak koji je fizioteraput dužan napraviti. Rehabilitacijski proces počinje od same fizioterapijske procjene koja se sastoji od subjektivnog i objektivnog dijela. Fizioterapeut će uzimati anamnezu te će raditi testove i mjerenja da dobije uvid u stupanj oštećenja bimaleolarnog prijeloma. Goniometrijom će se mjeriti opseg pokreta, manualnim mišićnim testom utvrditi snaga mišića. Značajni su nam ti podatci jer će ekstremitet biti imobiliziran i važna je informacija u kakvom je stanju gležanj nakon same imobilizacije. Nakon procjene, fizioteraput kreće u planiranje rehabilitacije i planiranje ciljeva. Neki od ciljeva će biti povećanje snage, pokretljivosti i vraćanje potpune funkcije zgloba. U proces rehabilitacije spadaju manualne tehnike kao što je ručna limfna trenaža, zatim TENS, krioterapija, ultrazvučna terapija, Mulligan koncept, EasyFlossing, kinesio taping, terapijsko vježbanje (statičko, dinamičko, pasivno), poprioceptivne vježbe, mobilizacija mekih tkiva, vježbe istezanja i naravno edukacija pacijenta o ozljedi i rehabilitaciji. A bimalleolar ankle fracture is an injury in which a fracture occurs in the lateral and medial malleolus, that is, in the distal parts of the tibia and fibula. These two bones together with the talus form the upper ankle joint. One of the most common mechanisms of injury is a fall (66% in one study). Factors influencing this type of injury are age, sex, diabetes, rheumatism and alcoholism. It can be treated operatively and non-operatively. The paper describes the physiotherapy procedure that the physiotherapist is obliged to perform. The rehabilitation process begins with the physical assessment itself, which consists of a subjective and an objective part. The physiotherapist will take a medical history and perform tests and measurements to gain insight into the degree of damage to the bimalleolar fracture. Goniometry will measure range of motion, manual muscle test will determine muscle strength. These data are important to us because the extremity will be immobilized and it is important to know the condition of the ankle after the immobilization itself. After the assessment, the physiotherapist begins planning rehabilitation and planning goals. Some of the goals will be to increase strength, mobility and restore full joint function. The rehabilitation process includes manual techniques such as manual lymphatic training, then TENS, cryotherapy, ultrasound therapy, the Mulligan concept, EasyFlossing, kinesio taping, therapeutic exercise (static, dynamic, passive), proprioceptive exercises, soft tissue mobilization, stretching exercises and of course patient education about injury and rehabilitation.

Down sindrom je genetski poremećaj koji nastaje prilikom nepravilnog prijenosa kromosoma. Tri su tipa Down sindroma: klasični tip, mozaički tip i translokacijski tip. Starija životna dob majke predstavlja jedan od najčešćih rizika za razvijanje ploda s Downovim sindromom. Karakteristike navedena sindroma su individualne te se uglavnom radi o malim ušima, širokim šakama i koso položenim očima. Uz to, nerijetko je prisutna i slabovidnost, nagluhost, mišićna slabost i sl. Kako bi se na vrijeme počelo s rehabilitacijom, važno je prvo postaviti ispravnu dijagnozu koja u ovom slučaju može uključivati procese kao što su: amniocenteza, ultrazvučna dijagnostika i fish metoda. S obzirom na kombinacije mogućih stanja u vidu srčanih, endokrinoloških, probavnih, lokomotornih, osjetilih i psiholoških teškoća određuje se funkcionalni status. Liječenje uključuje timski rad koji čine fizioterapeut, kardiolog, endokrinolog, logoped, ortoped, oftamolog, psiholog i svi ostali potrebni zdravstveni stručnjaci ovisno o zdravstvenom stanju pacijenta. U liječenju Downova sindroma fizioterapija uz ostale medicinske intervencije zauzima važnu ulogu. Fizioterapija kod ovog oboljenja može uključivati postupke kao što su: senzorna integracija, neurorazvojna tehnika, terapija pokretom, hipoterapija, halliwick terapija, vojta terapija i sl. Fizioterapijskim procesima se nastoji optimizirati motoričke vještine i minimizirati razvoj neprirodnih kompenzacijskih pokreta. Važno je pristupiti svakom djetetu individualno s obzirom na različitosti poteškoća koje se mogu javiti uz navedenu dijagnozu. Glavni cilj liječenja djece s Downovim sindromom je olakšavanje njihovog odrastanja i da im se omogući ostvarivanje potencijala u potpunosti. Za kvalitetne rezultate liječenja potrebna je i angažiranost roditelja i što bolja motivaciju djeteta. Down syndrome is a genetic disorder that occurs when chromosomes are transferred incorrectly. There are three types of Down syndrome: classical type, mosaic type and translocation type. Older age of the mother represents one of the most common risks for the development of a fetus with Down syndrome. The characteristics of the mentioned syndrome are individual and are mostly small ears, wide hands and specifically set eyes. In addition, it is not uncommon to have low vision, hearing loss, muscle weakness, etc. In order to start rehabilitation on time, it is important to first make a correct diagnosis, which in this case may include processes such as: amniocentesis, ultrasound diagnostics and the fish method. Considering the combinations of possible conditions in the form of cardiac, endocrinological, digestive, locomotor, sensory and psychological difficulties, the functional status is determined. Treatment includes teamwork consisting of a physiotherapist, cardiologist, endocrinologist, speech therapist, orthopedist, ophthalmologist, psychologist and all other necessary health professionals depending on the patient's health condition. Physiotherapy, along with other medical interventions, plays an important role in the treatment of Down's syndrome. Physiotherapy for this disease can include procedures such as: sensory integration, neurodevelopmental technique, movement therapy, hippotherapy, Halliwick therapy, Vojta therapy, etc. Physiotherapy processes aim to optimize motor skills and minimize the development of unnatural compensatory movements. It is important to approach each child individually, considering the variety of difficulties that can occur with the above diagnosis. The main goal of treating children with Down syndrome is to facilitate their growth and to enable them to fully realize their potential. Quality treatment results require the involvement of the parents, as well as the best possible motivation of the child.

Palijativna medicina je nova grana medicine koja se temelji na proučavanju i liječenju pacijenta s aktivnom, progresivnom, uznapredovalom bolešću, ograničene prognoze. Starenjem stanovništva i porastom broja osoba oboljelih od kroničnih bolesti i karcinoma povećala se potreba za palijativnom skrbi. Palijativna skrb je medicinska skrb kojom se pacijentima suočenima sa smrtonosnom bolesti i njihovim obiteljima nastoji poboljšati kvaliteta života. Cilj ovog istraživačkog rada je usporediti stavove i mišljenje studenata prve, druge i treće godine preddiplomskog stručnog studija Fizioterapije, Sveučilišta Sjever o važnosti fizioterapeuta u multidisciplinarnom palijativnom timu. U provedenom istraživanju sudjelovalo je ukupno 158 anketiranih sudionika. Istraživanje je provedeno među studentima prve, druge i treće godine preddiplomskog stručnog studija Fizioterapije, Sveučilišta Sjever u razdoblju od 02. kolovoza do 20. kolovoza 2021. godine pomoću Google form obrasca. Anketa je bila anonimna, dobrovoljna, sadržavala je 15 pitanja sociodemografskog tipa, pitanja koja ispituju mišljenje o palijativnoj skrbi i palijativnim pacijentima te pitanja koja ispituju stavove studenata o ulozi fizioterapeuta u palijativnoj skrbi. U radu su korištene deskriptivne i inferencijalne statističke metode. Rezultati ankete potvrđuju da je većina studenata upoznata sa važnosti fizioterapeuta u multidiciplinarnom palijativnom timu. Unatoč tome samo 41,1% studenata vidi sebe kao fizioterapeuta na odjelu za palijativnu skrb. Najveći broj sudionika smatra da nema dovoljno znanja i vještina za rad na palijativnom odjelu što ukazuje na potrebu za većim brojem edukacija. Palijativna skrb zahtjeva organizirani multidisciplinarni palijativni tim. Unutar tima važnu ulogu imaju fizioterapeuti sa adekvatnim stručnim kompetencijama. Svakodnevna edukacija fizioterapeuta o radu s palijativnim pacijentom razvija i poboljšava vještine u praksi i omogućava razvoj kritičkog razmišljanja. Dobro educiran fizioterapeut od iznimne je važnosti u palijativnoj skrbi. Potrebno je poticati zdravstvene radnike i uključiti volontere u izobrazbu te na taj način poboljšati medicinsku skrb i timski rad u palijativnoj medicini. Palliative medicine is a new branch of medicine based on studying and treating patients with an active, progressive, advanced illness with a limited prognosis. As a result of ageing population and the increase of people diagnosed with chronical illnesses and cancers the need for palliative case has also risen. Palliative care is a medical care intended for patients facing terminal diagnosis and their family members with of view to improving life quality. The goal of this paper is to compare the attitudes and opinions of first, second and third-year students of undergraduate professional study of physiotherapy, University North about the importance of a physiotherapist in a multidisciplinary palliative care team. A total of 158 participants have been surveyed in this research from 2nd to 20th August 2021 using a Google form. The survey was anonymous, voluntary and consisted of 15 questions of sociodemographic type examining their opinion on palliative care and palliative patients as well as the opinions on the role of a physiotherapist in palliative care. The findings of the survey confirm that the majority of students are familiar with the importance of a physiotherapist in a multidisciplinary palliative team. However, only 14.1% of students imagine themselves working at a palliative ward, which confirms the need to increase the number of educative seminars. Palliative care demands an organised multidisciplinary palliative care team. Physiotherapist with adequate professional competences have a key role in this team. Everyday education of a physiotherapist about the care of a palliative care patient develops and improves practical skills and enables critical thinking. A well-educated physiotherapist is extremely important for palliative care. Both health care practitioners as well as volunteers should be encouraged to take part in educative seminars, which will contribute, to the improvement of medical care and teamwork in palliative care medicine.

Ljudske ruke su čudesno složeni senzorički i motorički organi sposobni za interakciju s okolinom. Fine manipulativne vještine i kompleksni uzorci hvatanja ruke teško se mogu duplicirati. Zbog amputacije podlaktice, sposobnost obavljanja normalnih svakodnevnih zadataka se uvelike mijenja. U ovom završnom radu govorit ćemo o procesu fizioterapijske rehabilitacije osoba s amputacijom podlaktice i o transradijalnoj amputaciji koja je najčešći primjer amputacije podlaktice. Postoje razne patologije koje dovode do amputacije podlaktice, a najveći uzrok su slučajne traume i bolesti koje prekidaju dotok krvi u dio tijela. Oko 54% svih kirurških amputacija rezultat je komplikacija vaskularnih bolesti i drugih stanja koja utječu na protok krvi, kao što su dijabetes, bolesti perifernih arterija i ateroskleroza. Takvi kronični vaskularni problemi mogu dovesti do gangrene, što je vrsta smrti tkiva uzrokovana nedostatkom opskrbe krvlju, a koja posljedično uzrokuje odumiranja tkiva prstiju, šake ili stopala koja ako se navedeno ne liječi na vrijeme, može doći do širenja na ostatak ruke ili noge, što dovodi do amputacije. Proces amputacije zahtjeva vješto rukovanje i stabilizaciju svih različitih tkiva i dijelova tijela uključujući kožu, krvne žile, mišiće, živce, tetive i kosti. Iako proteza ne može zamijeniti funkciju ruke, može pomoći u osiguravanju osnovnog hvatanja i obavljanju normalnih svakodnevnih aktivnosti. Ako će se kasnije pacijent odlučiti za stavljanje proteze, krajnji ud treba biti dovoljno podstavljen pacijentovim mekim tkivom, kako bi proteza bila udobna i mogla podnijeti težinu bez izazivanja boli, infekcija, i oštećenja tkiva. Pacijent ima mogućnost odabira izmeĎu funkcionalne i kozmetičke proteze ovisno prema pacijentovim potrebama i svakodnevnim aktivnostima, a prilikom izbora proteze najčešće se odlučuje za proteze na tjelesni pogon i mioelektrične proteze. Ovaj završni rad ima za cilj osvrnuti se na predoperacijsku, postoperacijsku, predprotetičku i protetičku fazu rehabilitacije. Rehabilitacija osoba s amputacijom podlaktice zahtijeva timski pristup u kojem sudjeluje liječnik, fizioterapeut, protetičar i sam pacijent. Pacijenta se potiče da ima aktivnu ulogu u vlastitoj rehabilitaciji. Uloga fizioterapeuta u rehabilitaciji osoba s amputacijom podlaktice jest ublažavanje boli i kontrola edema bataljka, sprječavanje nastanka kontraktura u zglobovima, povećanje snage mišića i opsega pokreta te olakšavanje pojedincu povratak svakodnevnom životu te poduka kako koristiti i maksimalno iskoristiti protezu. Human hands are miraculously complex sensory and motor organs capable of interacting with the environment. Fine manipulative skills and complex hand-grabbing patterns are hard to duplicate. Due to forearm amputation, the ability to perform normal daily tasks changes immensely. In this thesis, the process of physiotherapeutic rehabilitation of people with forearm amputation and transradial amputation will be discussed, highlighting the most common example of forearm amputation. There are various pathologies that can lead to the amputation of the forearm, while the biggest causes are accidental trauma and diseases that interrupt the blood flow to a part of the body. Approximately 54% of all surgical amputations stem from complications of vascular disease and other conditions that affect blood flow, such as diabetes, peripheral artery disease, and atherosclerosis. Such chronic vascular problems can lead to gangrene. Gangrene is a type of tissue death caused by a lack of blood supply, which causes the death of the tissues from fingers, hands or feet that, if not treated in a timely fashion, can spread to the rest of the arm or leg, leading to amputation. The amputation process requires skillful handling and stabilization of all different tissues and parts of the body including skin, blood vessels, muscles, nerves, tendons and bones. Although a prosthesis cannot replace the function of the arm, it can help ensure basic grip and perform normal daily activities. If the patient later decides to wear a prosthesis, the end of the limb should be sufficiently lined with the patient’s soft tissue, so that the prosthesis is comfortable and can withstand weight without causing pain, infection, and tissue damage. The patient has the option to choose between functional and cosmetic prostheses depending on the patient’s needs and daily activities, and when choosing a prosthesis, most often opt for body-powered prostheses and myoelectric prostheses. This thesis aims to describe the preoperative, postoperative, preprosthetic and prosthetic phase of rehabilitation. Rehabilitation of people with forearm amputation requires a team approach involving a physician, physiotherapist, prosthetist, and the patient himself. The patient is encouraged to play an active role in their own rehabilitation. The role of physiotherapists in the rehabilitation of people with forearm amputation is to alleviate pain and control edema, prevent joint contractures, increase muscle strength and range of motion and make it easier for individuals to return to daily life and teach them how to use and maximize prosthesis.

Prijelom femura vodeći je uzrok morbiditeta u osoba starije životne dobi od 65 i više godina, svrstavajući se u prvih 10 uzroka gubitka životnih godina prilagođenih invalidnosti starijih odraslih osoba. U svijetu se očekuje da će broj ljudi s prijelomom femura značajno porasti zbog starenje stanovništva i drugih rizičnih čimbenika. Ljudi koji se oporavljaju od prijeloma femura izloženi su visokom riziku od slabosti mišića, strahu od pada i ograničenju u pokretljivosti, samopomoći i sudjelovanjima koja traju mjesecima nakon operacije. Prijelom femura najčešća je ozljeda koja zahtijeva hospitalizaciju kod starijih osoba, a očekuje se da će se stope incidencije eksponencijalno povećati do 6,3 milijuna u 2050. godini. U zdravstvenoj skrbi osoba s frakturom femura, temelj rehabilitacijskog pristupa uključuje tim različitih disciplina (fizioterapija, radna terapija, prehrana, socijalni rad, psihologija, medicina) koji se redovito sastaju, postavljaju ciljeve i evaluiraju napredak prema tim ciljevima s pacijentom, te naposljetku procjenjuju ishode. Šansa za oporavak maksimalna je ako su navedeni elementi uključeni u zdravstvenu skrb. Fizioterapijska uloga je procijeniti ozbiljnost i karakteristike zdravstvenih problema pacijenta. Polazna točka evaluacije je utvrđivanje potreba i ciljeva pacijenta. Pacijent sam preuzima inicijativu ili ga liječnik upućuje fizioterapeutu. Poželjna je dobra suradnja obiteljskih liječnika, specijalista i fizioterapeuta kako bi se postiglo recipročno upućivanje pacijenata. Da bi ciljevi bili postignuti, postupci fizioterapije počinju odmah nakon akutnog zbrinjavanja. Uključuju edukaciju bolesnika, pozicioniranje, vježbe, korištenje pomagala, proceduru fizikalne terapije, lijekove, prilagodbu okoline i drugo. Važan je kontinuitet kroz čitavo razdoblje rehabilitacije, bez obzira na to gdje se postupci odvijaju, u akutnoj bolnici, općem ili specijaliziranom rehabilitacijskom centru, stacionarno, dnevnoj bolnici, ambulantno, u bolesnikovu domu ili instituciji u koju je smješten. Postupci su u početku individualni, ali mogu biti provođeni i u grupi, što ima pozitivne učinke kao što su motiviranje bolesnika, izmjena iskustava i informacija iz prve ruke te povezivanje s fizioterapeutom. Osnovni postupci koji se koriste su: fizioterapijska vježba i drugi modaliteti fizikalne terapije. Femoral water fracture is the cause of deep morbidity in a person aged 65 and over, ranking among the top 10 causes of loss of life-adjusted disability of older adults. Worldwide, the number of people with femoral fractures is expected to increase significantly due to population aging and other risk factors. People recovering from a femur fracture are at high risk for muscle weakness, fear of falls, and limitations in mobility, self-help, and participation that last for months after surgery. Femoral fractures are the most common injury requiring hospitalization in the elderly, and an exponential increase to 6.3 million in 2050 is expected to stop. In clinical practice, the cornerstone of the rehabilitation approach to femoral fractures is a team of different disciplines (physiotherapy, occupational therapy, nutrition, social work, psychology, medicine) that meet regularly, set goals and assess progress toward those goals with the patient, and ultimately assess outcomes. The chance of recovery is maximal if the listed elements are included in the clinical approach. The physiotherapeutic role is to assess the severity and characteristics of patients' health problems. The starting point of the evaluation determines the need and goals of the patient. The patient takes the initiative himself or is referred by a doctor to a physiotherapist. Good collaboration between family physicians, specialists, and physiotherapists is desirable to achieve reciprocal referral of patients. In order to achieve the goals, physiotherapy procedures begin immediately after acute care. They include patient education, positioning, exercises, use of aids, physical medicine procedures, medications, environmental adaptation, and more. Continuity throughout the rehabilitation period is important, regardless of where the procedures take place, in an acute hospital, general or specialized rehabilitation center, inpatient, day hospital, outpatient, in a nursing home or institution where it is located. Procedures are initially individual, but can also be performed in a group, which has positive effects such as motivating patients, exchanging experiences and first-hand information, and connecting with a physiotherapist. The basic procedures used are: physiotherapy exercise and other modalities of physical therapy.

Zdravstveni sektor i svaki pojedinac se trenutno suočavaju s novonastalom situacijom radi bolesti koja se zove COVID-19. Potonje je predstavlja bolest koju uzrokuje virus pod nazivom SARS-CoV-2 radi kojeg se nalazimo u izvanrednim svakodnevnim situacijama koje se oslovljavaju kao “novo normalno”. Pod novo normalno podrazumjeva se socijalna distanca, preporuka boravka kod kuće, nošenje zaštitnih maski, povećana dezinfekcija i higijena na razini koju prije koju godinu nismo mogli ni zamisliti. Prijenos virusa od osobe do osbe odvija se putem respiratornih sekreta poput kapljica koje nastaju te putuju iz organizma pri kihanju, kašljanju ili curenju nosa, a s obzirom na lakoću prijenosa naglašava se opasnost prenošenja. Kao svaki medicinski radnik, tako i svaki fizioterapeut mora prilagoditi svoje vještine i unaprijediti svoje znanje radi što veće sposobnosti kod rada sa pacijentom, a kao pomoć pri tome izdane su preporuke za što sigurnije obavljanje posla. Također, preporuke su izdate u svrhu liječenja hospitaliziranih bolesnika kojima je potvrđena bolest COVID-19 ili pak postoji sumnja na pojavu iste. Radi se o bolesti koja zahvaća respiratorni sustav tako da je intervencija fizioterapeuta u liječenju bitna radi funkcionalnog oporavka i rehabilitacije svakog pojedinca te iz tog razloga svaki terpeut mora shvatiti važnost pridržavanja datih smjernica. The healthcare sector as a whole, but also individuals are currently facing an emerging situation due to a coronavirus disease 2019 (COVID-19). The latter is a condition caused by the virus known as SARS-CoV-2 that changed our life in a way that we refer to as the "new normal". Such ‘normality’ includes social distancing, recommendations of staying at home, wearing protective masks, as well as increased disinfection and hygiene at a level we could not have imagined a few years ago. Transmission of the virus from person to person occurs through respiratory secretions such as the droplets that form and travel from the human body when sneezing, coughing or having a runny nose; given the ease of transmission, the danger of infection has to be emphasized. Like any medical professional, every physiotherapist must adjust their skills and improve their knowledge as much as possible when working with the potentially infected patient, while recommendations have been issued to help them do the job as safely as possible. Also recommendations are issued for the purpose of treating hospitalized patients in which COVID-19 has been confirmed, or there is a suspicion the infection might be under way. In short, this is a disease that affects the respiratory system so that the intervention of physiotherapists in treatment is pivotal for the functional recovery and rehabilitation of each individual. For this reason, physical therapy professionals must understand the importance of adherence to the given guidelines.

Amnezija, gubitak pamćenja. Nemogućnost prisjećanja nečega u bliskoj ili davnoj prošlosti. Najčešće povezan pojam s neurološkom problematikom, kao što je gubitak pamćenja nakon traumatskih ozljeda mozga. U ovom smislu kojega ja želim opisati, odnosi se na mišćne strukture koje kada se ne upotrebljavaju, „zaboravljaju“ svoju funkciju i tako dolazi do posljedica koje vežu probleme na drugim segmentima. Gluteusi, spadaju u skupinu stražnjih mišića zdjelice. Čine ga tri mišića, m. gluteus maximus kao najveći, m. gluteus medius koji je od iznimne važnosti za održavanje uspravnog tijela tokom hoda i m. gluteus minimus zaslužan za abdukciju natkoljenice. Tada kada dođe do inhibicije, kočenja u prijenosu živčanih impulsa ili nedostatnog aktiviranja mišićne skupine ili nepravilnog izvođenja pokreta, dolazi i do posljedica. U 21. stoljeću, modernizacijom načina života i napretkom tehnologije od koje imamo velike koristi kao čovječanstvo, povuklo je sa sobom i neke nepoželjne efekte. Sjedilačkim načinom života, ugrozili smo funkciju naših gluteusa i to je rezultiralo sa problematikom u bolnim leđima, anteriornom tiltu zdjelice i mnogo drugih kompenzatornih mehanizma. No, povezanost boli u donjem dijelu leđa i sjedilačkim životom nije jedina paralela. S druge strane nailazimo na isti problem i kod profesionalnih sportaša kao što su atletičari, posebno maratonci. Zbog biomehanike pokreta kojeg izvode, skraćeni su im fleksori kuka (m. psoas major, m. iliacus, m. rectus femoris, m. pectineus i m. sartorius) i dolazi do amnezije u regiji gluteusa. Svrha fizioterapeuta je promovirati zdravi način života i ulaganjem u proučavanje i davanje važnosti situacijama koje se daju prevenirati i upješno rehabilitirati, problem glutelane amnezije je riješiv. Zato je vrlo važno educirati fizioterapeute da procjenjuju pacijenta holistički, jer tako i 'sitnica' poput sindroma mrtve stražnjice koja za sobom vuče posljedice koje itekako mogu biti ozbiljne za nesmetano provođenje svakodnevne aktivnosti života može biti pravovremeno uklonjena. Amnesia, memory loss. Inability to remember something in the recent or distant past. The term most commonly associated with neurological issues, such as memory loss after traumatic brain injury. In this sense, which I want to describe, it refers to muscle structures that are not used, they „forget“ their function and thus come to the consequences that bind problems in other segments. Gluteus, belong to the group of posterior pelvic muscles. It consists of three muscles, m. gluteus maximus as the largest, m. gluteus medius, which is extremely important for maintaining an upright body during walking, and m. gluteus minimus, which is responsible for the abduction of the thigh. When inhibitions, inhibitions in the transmission of nerve impulses or insufficient activation of muscle groups or improper performance of movements occur, consequences also occur. In the 21st century, with the modernization of lifestyles and advances in technology from which we benefit greatly as humanity, some undesirable effects have receded. With a sedentary lifestyle, we have compromised the function of our glutes and this has resulted in problems in the painful back, the anterior tilt of the pelvis, and many other compensatory mechanisms. But the connection between lower back pain and sedentary life is not the only parallel. On the other hand, we encounter the same problem with professional athletes such as athletes, especially marathoners. Due to the biomechanics of the movement they perform, their hip flexors (m. psoas major, m. iliacus, m. rectus femoris, m. pectineus and m. sartorius) are shortened and amnesia occurs in the gluteus region. The purpose of a physiotherapist is to promote a healthy lifestyle and by investing in studying and giving importance to situations that can be prevented and successfully rehabilitated, the problem of gluteal amnesia is solvable. That is why it is very important to educate a physiotherapist to evaluate the patient holistically, because even 'little things' like dead butt syndrome that have consequences that can be very serious for the smooth conduct of daily activities of life can be removed in a timely manner.

Ozljede brachialnog plexusa najčešće su ozljede perifernih živaca koje dovode do ozbiljnih društvenih i financijskih teškoća, a uvelike utječu na kvalitetu života. Brachialni plexus složena je mreža živaca koja putuje od vrata, ispod ključne kosti i u ruku. Plexus brachialis čine korijenovi C5 - Th1, a odgovorni su za kožnu i mišićnu inervaciju cijelog gornjeg uda. Iako uzroci mogu biti prenatalni, perinatalni i postnatalni, većina ozljeda brachialnog plexusa događa se tijekom teškog poroda. Ozljede su različite težine i uzroka, a posljedice mogu biti blage ili teške. Ozbiljnost ozljede ovisi o broju zahvaćenih živaca i količini oštećenja svakog živca. Porođajna ozljeda plexusa brachialisa može se klasificirati u četiri kategorije, ovisno o zahvaćenim živcima. Ako su oštećeni gornji korijenovi (C5 i C6), dolazi do gornje brachialne paralize, tzv. Erb - Duchenneova kljenut ujedno i najčešći oblik. Kod srednjeg, tzv. proširenog tipa oštećen je korijen C7. Znatno rjeđa ozljeda donjih korijenova C8 i Th1 naziva se Klumpkeova kljenut te kompletna ozljeda koja nastaje oštećenjem korijenova C5, C6, C7, C8 i Th1. Kao posljedica oštećenja ovih korijenova pogođena ruka novorođenčeta visi mlohavo uz tijelo, ekstendirana je u laktu, šaka je okrenuta unutra, a pokreti prstiju su mogući. Abdukcija i vanjska rotacija ramena nije moguća pa oštećena ruka ne sudjeluje u refleksu po Morou. Većina djece oporavi se kroz fizioterapijsku intervenciju. Fizioterapeut izrađuje individualni plan i program terapije uz sve članove tima. Fizioterapiju treba započeti rano kako bi se spriječile brojne komplikacije poput kontraktura i deformacija u zglobovima te razvoj nepravilnih obrazaca pokreta. Fizioterapijska intervencija u početnoj fazi uključuje edukaciju roditelja o pozicioniranju djeteta i baby handlingu kako bi zahvaćeni ekstremitet bio zaštićen od daljnjih mogućih ozljeda. Daljnja rehabilitacija bazira se na različitim terapijskim vježbama koje imaju za cilj očuvanje i povećanje opsega pokreta, snaženje muskulature i facilitacija normalnog pokreta. Primjenjuju se pasivne i aktivne metode vježbi te razni koncepti kao što su Vojta i Bobath koncept. U okviru fizikalne terapije primjenjuju se i drugi postupci terapije, a to su: elektroterapija, hidroterapija, termoterapija, senzorna i motorna integracija te radna terapija. Uz ove postupke bitna je i edukacija roditelja kako bi nastavili kontinuirano raditi sa djetetom. Brachial plexus injuries are the most common injuries of peripheral nerves that lead to serious social and financial difficulties and greatly affects the quality of life. The brachial plexus is a complex chain of nerves that travels from the neck, bellow the collarbone and into the arm. The plexus brachialis consists of the roots C5 - Th1 and they are responsible for the skin and muscle innervation of the entire upper limb. Although the causes can be prenatal, perinatal and postnatal, most of the brachial plexus injuries occur during difficult birth. Injuries are of different severity and causes, and the consequences can be mild or severe. The severity of the injury depends on the number of nerves affected and the amount of damage to each of the nerve. Childbirth injury of the brachial plexus can be classified into four categories, depending on the nerves that are affected. If the upper roots (C5 and C6) are damaged, upper brachial paralysis occurs, so-called Erb – Duchenne palsy is also the most common form. At the middle, the so-called extended type, the C7 root is damaged. Significantly rarer injury of the lower roots C8 and Th1 is called the Klumpke palsy and a complete injury that occurs with damage to the roots of C5, C6, C7, C8 and Th1. As a result of damage to these roots the affected hand of the newborn hangs limply along the body, is extended at the elbow, the hand is turned inward, and finger movements are possible. Abduction and external rotation of the shoulder is not possible so the are does not participate in the Morrow reflex. Most children recover through physiotherapy intervention. The physiotherapist creates an individual therapy plan and program with all team members. Physiotherapy should be started early to prevent several complications such as contractures and deformities in the joints and the development of irregular movement patterns. Physiotherapy intervention in the initial phase includes educating parents about child positioning and baby handling so that the affected limb is protected from further possible injuries. Further rehabilitation is based on various therapeutic exercises aimed at preserving and increasing the range of motion, strengthening the musculature and facilitating normal movement. Passive and active exercise methods and various concepts such as Vojta and Bobath concept are applied. Within physical therapy, other therapy procedures are applied, such as: electrotherapy, hydrotherapy, thermotherapy, sensory and motor integration, and occupational therapy. In addition to these procedures, the education of parents is important in order to continue working with the child.

Trudnoća je fiziološko stanje žene koje traje od 37. do 42. tjedna i podijeljeno je na tri tromjesečja. Naziva se i „drugo stanje“ u kojemu su odvijaju brojne psihološke, fiziološke i anatomske promjene. Fiziološke promjene događaju se kod respiratornog sustava, kardiovaskularnog sustava te metaboličkih i termoregulacijskih sustava u tijelu trudnice. Radi povećanja težine i rasta ploda dolazi i do promjena u posturi koje su uvjetovane mišićno-koštanim promjenama, pa samim time moguće su razne disfunkcije toga sustava. Vrlo bitnu ulogu u trudnoći ima fizioterapeut koji svojom stručnošću provodi vježbe za dobrobit trudnice i ploda, fizioterapijskom procjenom i planom povoljno utječe na otklanjanje smanjenje simptoma uzrokovanih nekim patološkim promjenama u trudnoći. Edukacijom trudnica olakšava se provođenje aktivnosti svakodnevnog života. Vježbanje u trudnoći ima povoljan utjecaj kako na trudnicu tako i na sam fetus. Trudnoća i vježbanje zahtijevaju brojne promjene i prilagodbe tjelesnih funkcija poput cirkulacije, disanja, rada srca i korištenje energije. Fizioterapeut, svojim znanjem o promjenama tjelesnih funkcija, prilagođava program vježbanja koji je najpovoljniji individualno za svaku trudnicu. Najčešći problemi u mišićno-koštanom sustavu u trudnoći nalaze se u sakroilijakalnim zglobovima, gdje zbog rasta uterusa i posturalnih promjena pojavljuje se sakroilijakalna disfunkcija koja je često praćena dijastazom simfize. Raznim testovima i stručnim znanjem fizioterapeuta, može se odrediti kvalitetna fizioterapijska intervencija usmjerena individualno svakoj trudnici. Pregnancy is a physiological condition of a woman that lasts from 37 to 42 weeks and is divided into three trimesters. It is also called the "second state" in which numerous psychological, physiological and anatomical changes take place. Physiological changes occur in the respiratory system, cardiovascular system and metabolic and thermoregulatory systems in the pregnant woman's body. In order to increase the weight and growth of the fetus, there are changes in posture that are caused by musculoskeletal changes, and thus various dysfunctions of this system are possible. A very important role in pregnancy is played by a physiotherapist who, with his expertise, performs exercises for the well-being of the pregnant woman and the fetus, with a physiotherapeutic assessment and plan has a favorable effect on eliminating the reduction of symptoms caused by some pathological changes in pregnancy. Education of pregnant women facilitates the implementation of activities of everyday life. Exercise in pregnancy has a beneficial effect on both the pregnant woman and the fetus itself. Pregnancy and exercise require a number of changes and adjustments to body functions such as circulation, respiration, heart rate and energy use. The physiotherapist, with his knowledge of changes in body functions, adjusts the exercise program that is most favorable individually for each pregnant woman. The most common problems in the musculoskeletal system in pregnancy are found in the sacroiliac joints, where due to uterine growth and postural changes, sacroiliac dysfunction occurs, which is often accompanied by symphysis diastase. Through various tests and the expert knowledge of a physiotherapist, a quality physiotherapy intervention can be determined, directed individually to each pregnant woman.

Ozljede prednjega križnoga ligamenta vrlo su česte, što se posebno odnosi na sportaše. Unatoč velikom znanju o prevenciji i liječenju LCA, ova je ozljeda još uvijek teška i iznimno izazovna za ortopeda. Koljenski je zglob najveći zglob u ljudskom tijelu. Mehanika je toga zgloba vrlo složena, a sam se zglob sastoji od triju kostiju. Važnu ulogu u stabilnosti i funkciji koljena imaju ligamenti i menisci. Velik broj mišića prolazi kroz koljeno te je njihova funkcija, između ostalog, pokretanje i stabilizacija zgloba. Razlikujemo primarne i sekundarne stabilizatore u koljenu. LCA je ključna struktura u koljenskome zglobu te je primarno stabilizator anteriornog pomaka tibije u odnosu na femur. Dijagnostičke metode koje se primjenjuju kod sumnje na ozljedu prednjega križnoga ligamenta uključuju specijalne testove i radiološke pretrage. U operativnom liječenju najčešće se koristi graft iz patelarnog ligamenta ili tetive hamstringsa. Posao se fizioterapeuta sastoji od fizioterapijske procjene; plana tretmana; intervencije i edukacije pacijenta. Razlikujemo rehabilitacijski protokol kod konzervativnoga pristupa liječenju u odnosu na operacijski pristup liječenju ozljede. Koriste se razne vrste kineziterapije, fizikalne terapije i specijalne tehnike. Injuries of the LCA are very common, specifically in sport. Despite great knowledge of prevention and treatment of the LCA, this injury is still heavy and extremely challenging for an orthopedist. The knee joint is the biggest joint in human body. The mehanics of that joint is very complex, and the joint itself consist of 3 bones. The ligaments and meniscus play an important role in the stability and function of the knee. A large number of muscles pass through the knee and their function is, among other things, to move and stabilize the joint. We distinguish between primary and secondary stabilizers in the knee. The LCA is a key structure in the knee joint and is primarily a stabilizer of the anterior displacement of the tibia relative to the femur. Diagnostic methods used in suspected anterior cruciate ligament injury include special tests and radiological examinations. A graft from the patellar ligament or hamstring tendon is most commonly used in surgical treatment. The job of a physiotherapist consists of physiotherapy assessment; treatment plan; patient interventions and education of the patient. We distinguish a rehabilitation protocol in a conservative approach to treatment from an operative approach to the injurie. Various types of kinesitherapy, physical therapy and special tehniques are used.

Ortopedija je grana medicine koja se bavi liječenjem bolesti i ozljeda koštano – mišićnog sustava. Unutarzglobni prijelomi su prijelomi kod kojih prijelomna pukotina komunicira sa zglobom. Mjesta gdje se unutarzglobni prijelomi najčešće događaju su područja oko ručnog zgloba, lakta i koljena, no to ne isključuje mogućnost pojave ovakvih prijeloma da područjima drugih zglobova u tijelu. Izgled unutarzglobnih prijeloma nema određenu specifičnost po kojoj bi se na prvi pogled moglo reći da se radi o takvoj vrsti ozljede. Unutarzglobne prijelome prate bol, edem, hematom i ograničeno izvođenje pokreta u zglobu kojeg je prijelom zahvatio. Kako bi se sa sigurnošću utvrdilo o kakvom se prijelomu radi potrebno je provesti dodatne dijagnostičke metode. Provodi se rendgensko snimanje, magnetska rezonanca te kompjuterska (računalna) tomografija. Liječenje prijeloma se provodi operativno ili konzervativno. Konzervativno liječenje provodi se repozicijom i imobilizacijom, fizikalnom terapijom ili neoperativnim funkcijskim liječenjem prema Sarmientu. Kod operacijskog liječenja ortopedskih stanja liječnik odabire tehniku i metodu liječenja koja je najprimjerenija ozljedi tog pacijenta. Konkretni slučaj prijeloma lateralnog maleola fibule daje nam uvid u način liječenja te tijek rehabilitacije. Poslijeoperacijska rehabilitacija prijeloma lateralnog maleola fibule trajala je punih sedam tjedana. Rehabilitacija nakon operacijsko liječenja je od esencijalne važnosti. Prije rehabilitacije fizioterapeut prema uputama liječnika zajedno s pacijentom radi plan i program rehabilitacije. Postavljaju se kratkoročni i dugoročni ciljevi. Orthopedics is a branch of medicine that deals with the treatment of diseases and injuries of the musculoskeletal system. Intra-articular fractures are fractures in which the fracture crack communicates with the joint. The places where intra-articular fractures most often occur are the areas around the wrist, elbow and knee, but this does not exclude the possibility of such fractures in areas of other joints in the body. The appearance of intra-articular fractures does not have a certain specificity according to which it could be said that you are dealing with this type of injury. Intra-articular fractures are accompanied by pain, edema, hematoma, and limited movement in the joint affected by the fracture. In order to determine with certainty what kind of fracture it is, it is necessary to perform additional diagnostic methods. X-rays, magnetic resonance imaging and computed tomography are performed. Fracture treatment is performed surgically or conservatively. Conservative treatment is performed by repositioning and immobilization, physical therapy or non-operative functional treatment according to Sarmiento. In the surgical treatment of orthopedic conditions, the physician selects the technique and method of treatment that is the most appropriate for the injury of that patient. The specific case of a fracture of the lateral maleola of the fibula gives us an insight into the method of treatment and the course of rehabilitation. Postoperative rehabilitation of the lateral maleola fibula fracture lasted a full seven weeks. Rehabilitation after surgical treatment is essential. Prior to rehabilitation, the physiotherapist works with the patient on a rehabilitation plan according to the doctors instructions. Short-term and long-term goals are then set.

Normalan motorički razvoj se može objasniti kao proces stjecanja vještina u kojima dijete koristi vlastito tijelo kako bi savladalo prostor i rukovalo s predmetima u svrhu postizanja određenog cilja. Razvoj motorike je usko povezan sa emocionalnim, socijalnim, tjelesnim i psihičkim razvojem djeteta pa neki istraživači psihički razvoj djeteta u vrlo ranoj dobi interpretiraju prema osnovi razvoja i napredovanja pokreta. Čitav razvoj motorike se može podijeliti u četiri razvojna područja, a to su: kontrola glave, pokreti trupa, pokreti ruku i pokreti nogu. Vrlo važni događaji u djetetovu motoričkom razvoju se nazivaju miljokazi, no oni su različiti za svako dijete. Svako se dijete rađa s određenim mogućnostima i sposobnostima koje kroz mjesece i godine unaprjeđuje te je brzina kojom dijete napreduje individualna i tipična samo za njega, isto kao i lakoća izvođenja vještina. Kako bi se otkrila i uvidjela eventualna odstupanja djeteta od normalnog motoričkog razvoja, postoji podjela motoričkog razvoja na razvojne faze te svaka od njih obuhvaća tri mjeseca djetetova života. Prema razvojnim fazama se može uočiti koje bi dijete motoričke vještine trebalo izvoditi u određenom periodu. Ako dijete kasni u svojem razvoju 3 ili više mjeseca, roditelji bi trebali obratiti pažnju na simptome rizika za razvoj motorike, koji se isto tako promatraju po mjesecima. Važno je i da roditelji dobiju smjernice o tome što točno trebaju promatrati kako bi se ustanovila odstupanja. Jedan od poremećaja koji se mogu javiti kod djece koja odstupaju od pravilnog motoričkog razvoja su poremećaji mišićnog tonusa te on može biti povećan pa se radi o hipertonusu ili smanjen pa se govori o hipotonusu. Kombinacija hipotonusa i hipertonusa se naziva distoni sindrom te se isto tako svrstava u odstupanje od pravilnog motoričkog razvoja. Neizostavan član multidisciplinarnog tima, koji liječi djecu koja odstupaju od normalnog motoričkog razvoja, je fizioterapeut, čija je uloga procjena djeteta te planiranje rehabilitacije za samo dijete. Veoma važnu ulogu u tretmanu djeteta ima roditelj koji mora biti educiran o pravilnoj njezi djeteta od strane fizioterapeuta. Osim toga, fizioterapeut educira roditelje o baby handlingu i vježbama za razvoj motorike. Normal motor development can be explained as the process of acquiring skills in which a child uses his own body to master space and handle objects in order to achieve certain goals. The development of motor skills is closely related to the emotional, social, physical and mental development of the child, so some researchers, of the mental development of the child at a very early age, interpret it according to the basis of development and progress of movement. The whole development of motor skills can be divided into four developmental areas: head control, torso movements, arm movements and leg movements. Very important events in a child's motor development are called milestones, but they are different for each child. Every child is born with certain abilities that he improves over the months and years, and the speed with which the child progresses is individual and typical only for him, as well as the ease of performing the skill. In order to detect and increase possible deviations of the child from normal motor development, there is a division of motor development into developmental stages, each of which covers three months of the child's life. According to the developmental stages, it can be noticed which motor skills a child should report in a certain period. If children are 3 or more months late in their development, parents should pay attention to the symptoms of motor development risk, which are also observed by months. It is also important that parents are given guidance on what exactly they should observe in order to establish deviations. One of the disorders that can occur in children who deviate from proper motor development are disorders of muscle tone. Muscle tone can be increased, so it is called hypertonia or reduced and then it is called hypotonia. The combination of hypotonia and hypertonia is called dystonic syndrome and is also classified as a deviation from proper motor development. An indispensable member of the multidisciplinary team, which treats children who deviate from normal motor development, is a physiotherapist, whose role is to assess the child by planning rehabilitation for the child himself. A very important role in the treatment of a child is played by the parent who must be educated about the proper care of the child by a physiotherapist. In addition, the physiotherapist educates parents about baby handling and motor development exercises.

Trčanje je jedno od najčešćih aktivnosti te uz hodanje predstavlja osnovni oblik kretanja i izvrstan način za zadovoljavanje osnovne biološke potrebe čovjeka. Dostupno je cijeloj populaciji, a predstavlja jednu od najučinkovitijih, najekonomičnijih i najjednostavnijih tjelesnih aktivnosti. Spoznajom „zdravog života“ trčanje dobiva sve veću popularnost i postaje apsolutni hit današnjice. Naime, ono prevenira debljinu, bolesti srca, visoki krvni tlak i dijabetes tipa 2, smanjuje rizik od srčanog udara, povećava kardiorespiratorni kapacitet, poboljšava cirkulaciju i funkciju cijelog organizma, a uz to, promiče zdrave stilove života. No, jedan od najčešćih razloga za opuštanje u takvu tjelesnu aktivnost jest postizanje zadovoljavajućeg izgleda. Trčanje kao i ostali sport ima dvije strane medalje, odnosno pozitivnu i negativnu, a to su ozljede. Ozljede mogu nastati različitim načinima te različitim uzrocima. Najčešći razlog je neadekvatno zagrijavanje, nepravilna tehnika trčanja te neadekvatna oprema. Uganuće gležnja, plantarni fascitis, sindrom Ahilove tetive, trkačka potkoljenica, trkačko koljeno i sindrom prenaprezanja najčešće su ozljede u trkača. Prevencija je jedna od najvažnijih metoda u procesu sprječavanja ozljeda. Fizioterapeut predstavlja bitnu kariku u timu sportaša. Naime, edukacija trkača o pravilnoj tehnici i načinu trčanja te upoznavanje s mogućim rizicima koji pridonose ozljeđivanju, prvi je korak u prevenciji ozljeda trkača. Zadaća fizioterapeuta je osvještavanje trkača o važnosti zagrijavanja i istezanja, korištenju adekvatne opreme, postavljanju realnih i dostižnih ciljeva, ne zanemarivanju energetske potrebe organizma, prepoznavanju rizičnih čimbenika te adekvatnim reagiranjem na bol. Osim toga, važnost fizioterapeuta je u holističkom pristupu trkaču, stoga plan treninga mora sadržavati vježbe jakosti i snage, mišićne izdržljivosti, vježbe fleksibilnosti, propriocepcije i balansa, vježbe pravilnog hoda te vježbe za poboljšanje držanja tijela, a sve to u cilju prevencije ozljeda i što uspješnijeg trčanja. U radu je provedeno anketno istraživanje o specifičnosti trkača kojim se dobio uvid u najčešće ozljede trkača, duljini sputavanja ozljede u nastavku trčanja, karakteru trkača i njihovim stavovima prema zagrijavanju, istezanju, dodatnim aktivnostima, ali i energetskom unosu ispitanika i djelovanju trčanja na njihovu psihu. Running is one of the most frequent activities, and alongside walking it represents the basic form of movement and an excellent way to meet the basic biological needs of a person. It is accessible to the entire population and represents one of the most efficient, economical, and simplest physical activities. With the knowledge of “healthy life”, running gets more and more popularity and nowadays it is becoming an absolute hit. It prevents thickness, heart diseases, high blood pressure, type 2 diabetes, reduces the risk of heart attack, increases cardiorespiratory capacity, improves circulation and function of the entire body, and also promotes a healthy lifestyle. However, one of the most common reasons to take up such physical activity is to achieve a satisfactory appearance. Running, as well as other sports, has two sides of the medal, that is, positive and negative, and these are injuries. Injuries can occur in different ways and with different causes. The most common reason is an inadequate warm-up, improper running technique, and inadequate equipment. Ankle sprain, plantar fasciitis, Achilles tendon syndrome, running shin, racing knee, and overstressing syndrome are the most common injuries among runners. Prevention is one of the most important methods in the process of preventing injuries. The physiotherapist represents an important part of the athletes' team. Namely, the first step in preventing runner injuries is educating the runners about the proper technique and manner of running and getting acquainted with the possible risks that contribute to injuries. The task of the physiotherapist is to educate the runners about the importance of warming up and stretching, the use of adequate equipment, setting realistic and attainable goals, not neglecting the energy needs of the body, recognizing risk factors, and adequately responding to pain. In addition, the importance of the physiotherapist is in the holistic approach to the runner, so the training plan must contain exercises of strength, muscle endurance, exercises of flexibility, proprioception and balance, exercises of correct walking and exercises for improvement of body posture, all to prevent injuries and contribute to more successful running. A survey on the specificity of runners was conducted in the paper, providing an insight into the most frequent injuries of runners, the length of restraining injuries in the continuation of runs, the character of runners and their attitudes towards warming, stretching, and additional activities, but also the energy input of examinees and the effect of running on their psyche.

Background Electronic health record can facilitate everyday clinical practice of physiotherapists. The aim of this study is to determine attitude of physiotherapists towards implementation of information technology in their work and the differences in attitude in relation to gender, age, level of education and type of health institutions. Methods This study is a cross-sectional survey of Croatian physiotherapists. The questionnaire ″Attitude of physiotherapists towards implementation of electronic health record included 12 items scored on a Likert-type scale from 1 to 5 and presented the award values as “Disagree”, “Neither agree nor disagree” and “Agree”. Croatian physiotherapists were (n = 267) recruited from 13 health care institutions. For analysis chi square test, t-test, one-way analysis of variance and as a post-hoc Tukey test were used. Results Explanatory factorial analysis confirmed two factors: Satisfaction in the work of physiotherapists using computers (SAT) and Necessity of computers in the work of physiotherapists (NEC). Most physiotherapists agree on (SAT) (47.9%) and on (NEC) (51.3%). Male physiotherapists were significantly more likely to disagree with statements related to SAT (p p = 0.035) than female physiotherapists. Physiotherapists aged between 46 and 55 years were significantly more like to disagree on NEC in comparison to all the other groups of participants (p p = 0.009), as well as in comparison with physiotherapists with a university degree (p = 0.002). Most of the physiotherapists who are employed in Clinical hospitals and in the Speciality hospital agree with that statement (all p > 0.05). Conclusion The attitude of Croatian physiotherapists towards electronic health record differs according to the age, gender, level of education and type of health care institutions. This finding can facilitate implementation of electronic health record in physiotherapy. Trial registration Not applicable.

Ortoze su medicinsko-mehanička pomagala koja uz pomoć vanjskih sila, popravljaju, poboljšavaju ili čuvaju određenu funkciju pokreta. Većinom ih imenujemo prema dijelu tijela koji obuhvaćaju uz eventualnu naznaku funkcije. Upotrebljavaju se kod oštećenja tjelesnih funkcija (nestabilnost zglobova, bol, smanjena mišićna snaga ili gibljivost zglobova) i pri oštećenjima tjelesne građe (prijelomi, djelomičan ili potpun prikid tetiva, živaca ligamenata, kože) koji mogu imati različiti uzrok (traume – kostiju, zglobova, mišića; oštećenja središnjeg i perifernog živčanog sustava, kongenitalne anomalije, bolesti - npr. reumatoidni artritis). Ortoze imaju širok spektar primjene i danas su one toliko kvalitetne da mogu aktivno unaprijediti liječenje i netočno je mišljenje da se upotrebljavaju samo u tijeku rahabilitacije. U rehabilitaciji ortoze koristimo za poboljšanje funkcije. Kod njihove izrade treba dobro poznavati anatomiju, funkciju i bimehaniku pokreta određenog dijela tijela. Suvremene metode mjerenja uz kvalitetne materijale i alate za izradu mogu cijeli proces opskrbe ortozom ubrzati i olakšati. Poboljšavajući funkciju jednog dijela treba uvijek paziti kako će se to odraziti na druge dijelove tijela jer su svi u međusobnoj korelaciji. Prije propisivanja ortoze uvijek je potreban pregled liječnika specijaliste koji će, skupa s drugim članovima multidisciplinarnog tima, odrediti ciljeve rehabilitacije. Posebno za izradu korektivnih ortoza za kralježnicu potrebna je kontinuirana suradnja liječnika, inžinjera protetike i ortotike i fizioterapeuta. Pošto je ortotika usko povezana uz napredak tehnike treba uvijek pratiti što se u svijetu dešava na ovom području kako bi se pacijentu mogla pripisati najbolja moguća ortoza . Orthoses are medical - mechanical devices which with the help of external forces, repair, improve or preserve the particular function of motion. Most of them are called by the part of the body that they include with a possible indication of function. They are used on damages of body functions (joint instability, pain, reduced muscle strength or flexibility of the joints) and in the damages of body structure (fractures, partial or complete cessation of tendons, ligaments nervs, skin) that can have different causes (traumas - of bones, joints, muscles; damage of the central or peripheral nervous system, congenital abnormalities, disease - for example rheumatoid arthritis). Orthoses have a wide range of use and today they are so high-quality that can actively improve treatment and it is incorrect opinion it is used only in the course of rehabilitation. In rehabilitation orthoses is used to improve function. In their preparation is necessary good knowledge of anatomy, function and biomehanic movement of a certain part of the body. Modern methods of measurement with high-quality materials and creating tools, can accelerate the whole process of supply with orthoses and make it easier. By improving the function of one part, we must always be careful of how it will affect on other parts of the body, because they are all correlated with each other. Before prescribing orthos we always need to have it inspected by a specialist who will, together with other members of multidisciplinary team, set the goals of rehabilitation. Especially for the preparation of corrective orthoses for the spine, it requires sustained cooperation of doctors, engineers of prosthetics and physiotherapist. As the orthotics is closely associated with the progress of technology, we should always keep track of what is happening in the world in this area to be able to prescribe to the patient the best possible orthosis.