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Introduction: Work-related musculoskeletal disorders (WRMSDs) are the most common work-related disorders and describe a wide range of degenerative and inflammatory states that affect blood vessels, peripheral nerves, bones, joints, ligaments, tendons, and muscles. Healthcare as a special sector has almost the highest prevalence of WRMSDs in the world, far ahead of construction, mining, and manufacturing. Studies conducted in the EU and the USA indicate that health-care professionals most often have a problem with the lower back between 50% and 57% of cases, resulting in an average loss of more than 7 working days during 1 year. Methods: This study included 177 health professionals of both genders who are actively involved in the provision of health-care services. The study was conducted in the Public Health Center of Sarajevo Canton, which provides primary and specialist consultative healthcare services. The study was designed as a prospective, longitudinal, interventional, and descriptive-analytical that included all respondents who met the inclusion criteria. The instruments used in the study are the standardized Dutch Musculoskeletal Discomfort Questionnaire, modified according to our study, the standardized work ability index, and the ergonomic intervention program (EIP). Results: The highest frequency of work-related MKDs in health-care professionals before and after implementation of the EIP was in the neck area (83.1% before, 64.9% after), in the upper back region (71.8% before, 56.5 % after) and in the lower back region (68.4% before, 55.9% after). The average score of the working ability index before the introduction of the EIP was 35.44 ± 8.59, while after the implementation of the EIP it increased statistically significantly and amounted to 38.40 ± 7.30. Conclusion: The EIP influenced the reduction of the MKDs frequency caused by work, and increased the working capacity of health-care professionals.

Introduction: The complaints that occur in the area of the lumbar spine are summarized under the term lumbar pain syndrome. These include lumbar discopathy, lumbago, lumboischialgia, sciatica, and other complaints associated with the lumbar region of the spine. The purpose of this study is to evaluate sociodemographic characteristics, assess the degree of disability patients experience due to lumbar pain syndrome, evaluate how many patients catastrophize their pain, and assess the effectiveness of the dry needling technique along with other physical therapy modalities in people with lumbar pain syndrome. Methods: The study was designed as a prospective study conducted from March 2022 to June 2022. 35 subjects of both sexes, aged 25-83, agreed to participate in the study. The subjects who enrolled were pre-dominantly suffering from chronic lumbar pain syndrome, and there were also a smaller number of subjects with acute lumbar pain syndrome. Results: The majority of respondents suffer from lumbar pain syndrome, which falls into the chronic category in 29 or 82.9% of cases. The mean score after the application of therapy on the Oswestry Disability Index (ODI) scale was 22.0 ± 16.23% and was statistically significantly lower. The average score after the application of the therapy on the visual analog scale (VAS) was 3.06 ± 2.31 and is statistically significantly lower (p < 0.05) compared to the period before the therapy. Conclusion: Dry needling in combination with standard physical procedures led to statistically significant improvements. The mean score on the pain catastrophe scale, VAS, and ODI was significantly lower than in the pre-therapy period.

Introduction: Musculoskeletal disorders (MSDs) are common in men and women of all ages in all sociodemographic strata of society. Pain and functional limitations caused by MSDs severely limit independence and quality of life and interfere with an individual’s ability to participate in family and social life and work. The aim of this study is to investigate the effects of the Kinesio Tape (KT) technique on pain intensity in patients with MSDs of the upper and/or lower extremities before, during, and after therapeutic treatment. Methods: The study involved 123 patients of both sexes and all ages diagnosed with MSDs of the upper and/or lower extremities. Patients were randomly divided into two groups, a control group and an experimental group. The control group received the standard therapy protocol for MSDs, while the experimental group received the standard therapy protocol for MSDs plus the KT technique on the treated segment. The brief pain inventory was used to assess pain intensity. Both groups of participants were tested with the research instruments at baseline, during and after therapeutic treatment. Results: The ability to walk due to pain was significantly less impaired in the control group than in participants in the experimental group, in whom pain significantly impeded walking (p < 0.001). Normal walking was significantly more impaired in the experimental group than in the control group (p = 0.001). Pain significantly impaired relationships with others in the experimental group compared to the control group (p < 0.001). Conclusion: Subjects in the experimental group showed a significant decrease in pain in all areas after therapeutic treatment with KT compared to subjects in the control group.

Introduction: Knee osteoarthritis (OA) develops gradually and causes pain, a decrease in range of motion, muscle mass, and strength and leads to a decrease in physical activity and a poor quality of life for the patient. The aim of this study was to investigate the effects of different physiotherapy programs on pain intensity, range of motion, and quality of life in people with knee OA. Methods: The study was designed as a prospective, experimental, and randomized trial. Sixty subjects of both sexes and all ages with OA of the knee were enrolled in the study. In the studied Group I (n = 30), in addition to the standard protocol, high induction electromagnetic stimulation was applied using a Salus Talent device with a strength of 3 T and a frequency of up to 50 Hz for 10 min. In the test Group II (n = 30), in addition to the standard protocol, high-intensity laser therapy (HILT) with a power of 5 J was applied with the help of the Ilux Yag 1064 device for 7 min. The therapy protocol for both test groups lasted 8 weeks, with subjects treated once a week. Results: Analysis of the mean scores on the VAS scale shows that in both groups, the lowest mean scores were recorded in the III measurement (4.35) and the highest in the I measurement (7.96). In all three measurements, there was a difference in the extent of mobility of internal rotation in the form of a higher average range of motion in the test group II, in which HILT was applied. Analysis of the mean scores on the knee injury and osteoarthritis outcome score quality of life scale showed that in both groups, the lowest mean scores were recorded at the first measurement (14.84), with the mean score increasing at the second (32.95) and third measurements (41.08). Conclusion: Both methods showed significant results in reducing pain intensity, improving knee mobility, activities of daily living, and quality of life in people with knee OA. The obtained data do not give preference to any method but indicate them as adequate physiotherapy protocols to improve the function and quality of life of people with knee OA.

Introduction: Stress among students is a growing problem. As emotional stress increases, the limbic structures and hypothalamus are stimulated, activating the gamma efferent system, which ultimately leads to an increase in muscle tone or additional muscle activity that can become repetitive behaviors such as bruxism. The aim of the study was to investigate the stress level that students are exposed to, to determine the difference between students in terms of gender, faculty, and year of study, and to evaluate the possible relationship between stress level and self-reported bruxism in college students during the pandemic COVID-19. Methods: In April 2022, a cross-sectional study was conducted on a sample of students from the Faculty of Dentistry and the Faculty of Pharmacy at the University of Sarajevo (BiH). The students answered a questionnaire consisting of two parts: The first part contained questions on basic personal data and data on self-reported bruxism and the second part contained questions on the perceived stress scale (PSS). Results: The study included 756 students from both faculties. Analysis of stress levels among students revealed higher stress levels. Female students were more likely to be under stress than male respondents. Students in the Faculty of Pharmacy were more likely to be stressed than students in the Faculty of Dentistry. At the Faculty of Pharmacy, there was no difference in stress levels between the different years of study, while at the Faculty of Dentistry, the individual score for PSS was highest among 1st-year students. A high prevalence (46.8%) of self-reported bruxism was found among students in both faculties. Conclusion: A slight positive correlation between self-reported bruxism and stress suggests that it is important to implement stress management strategies during academic education and to prevent bruxism and its consequences.

Introduction: Aging is a natural physiological process based on disturbances of homeostatic mechanisms and loss of adaptability that significantly affects life activities over time. The activities of daily living (ADL) in old age represent the relationship between the subjective characteristics of each individual, supplemented by previous life experiences, and objective socioeconomic factors that create a desirable living framework for people in the third age. The objectives of this research are to analyze the sociodemographic characteristics of third-age people, to study the daily activities of third-age people, and to compare the daily life activities of third-age people living in a rural setting with those of third-age people living in an urban setting. Methods: The research was conducted in the area of urban and rural environment of Travnik municipality. One hundred elderly people (50 from urban and 50 from rural areas) were included in the research using the snowball method. The instrument used in our research is a standardized questionnaire on instrumental ADL (IADL) according to Lawton-Brody. The study was conducted during the period from the end of March to the end of May 2022. Results: There is a statistically significant difference in ADL in all eight domains. The mean IADL score in the total sample (n = 100) was 6.36 ± 1.78 and ranged from 1 to 8. The largest number of respondents had the highest IADL score of 8 in 41% of cases, while only one respondent had an IADL score of 1. Conclusion: The obtained results prove that the score of ADL is lower in people of third-age living in rural areas.

Introduction: The use of the Internet is becoming increasingly important in enabling children and adults to fully participate in society, whether it is learning new skills or connecting with friends and family. Consequently, children's opportunities are increasingly dependent on the Internet. The advance of technological innovations has resulted in more and more ICT devices being available to children, contributing to the deterioration of children and adolescents' health. Methods: The study was designed as an epidemiological, cross-sectional, descriptive-analytical, comparative study. The study was conducted from October 18, 2021, to January 16, 2022, using an online questionnaire accessible through the Microsoft Forms platform. Respondents were able to access the questionnaire via a link or QR code located on the child's consent form for participation in the study, which was previously signed by a parent/guardian. Results: The results of the study showed that school-age children were the most frequent users of smartphones and watches TV, with male respondents spending more time using almost all ICT devices, with the exception of tablets, which were used more frequently by female respondents. The analysis of pain intensity in the use of information and communication technologies revealed that respondents most frequently experienced mild pain, especially in the neck/shoulders and lower extremities. The frequency of eye problems after using ICT devices was found to be occasional, with the most pronounced symptoms being fatigue, tearing, and eyestrain, as well as headaches in one in five respondents. Conclusion: Increasing frequency of ICT device use was associated with higher pain intensity in all anatomic regions. A 1-hour increase in weekly ICT device use also increased the likelihood of pain intensity in all anatomic regions, including eye symptoms and headaches. High exposure to ICT is of concern because it leads to adverse health outcomes for children.

Introduction: Lumbar pain syndrome (LPS) is defined as pain or discomfort localized between the edge of the twelfth rib and the lower gluteal region, with or without spread to the lower extremities, and, depending on the etiology and degree of symptomatology, can have negative consequences and be one of the main reasons for work disability and absenteeism worldwide. The aim of this study was to determine the impact of exercise therapy on the activities of daily living of a person with LPS. Methods: This prospective, longitudinal, and randomized controlled trial was conducted from June 2014 to June 2016. It included 200 subjects with symptoms of LPS, both sexes, aged 30 to 50 years, sedentary and standing occupations, randomized and equally divided into two groups: Examined (n = 100) and the control group (n = 100). In this study, the Oswestry Low Back Pain Disability Questionnaire was used after clinical examination. Results: The percentage of disability according to the Oswestry disability index at the first examination was 31.78 ± 14.11% in the participants of the test group and 38.74 ± 17.48% in the participants of the control group (p = 0.002). After the second examination, the percentage of disability was 6.64 ± 3.15% in the test group and 23.92 ± 14.84% in the control group (p = 0.001). At the end of the examination, the percentage of disability was 2.36 ± 0.78% in the subjects of the test group and 13.82 ± 11.25% in the subjects of the control group (p = 0.001). A statistically significant difference was found in all three examinations, and the reduction in the percentage of disability was greater in the study group, p < 0.05. Conclusion: The research conducted showed that motion therapy procedures focused on achieving natural spinal mobility and improving trunk muscle strength are effective in reducing

Introduction: The education system of Federation of Bosnia and Herzegovina includes 60% of people with cerebral palsy (CP), hearing impairment and other associated difficulties, of which 37.50% in regular schools and 22.50% in special schools. From the total number of students, 44.44% attending schools according to the regular curriculum, and 55.56% according to the adjusted curriculum (1). Methods: The study is retrospective and analytical-descriptive. The study was conducted on a sample of 120 respondents from four cantons of the Federation of Bosnia and Herzegovina. Each Canton was used as one subsample of respondents. The data are presented in tabular form using classical descriptive statistics methods. The parametric statistics, analysis of variance (ANOVA) at the level of statistical significance of 0.05 was used to examine the statistical significance of differences between the sub-samples of the respondents. Results: The results of the study showed that persons with cerebral palsy, hearing impairment and other associated difficulties do not have adequate support in educational inclusion. Defectological support at school is provided for 17.50% of persons with cerebral palsy, hearing impairment and other associated difficulties, and only 6.66% of persons have the support of a teaching assistant. Conclusion: Persons with cerebral palsy, hearing impairment and other associated difficulties do not have adequate support in educational inclusion. There is no statistically significant difference between the subsamples of respondents when it comes to special education support and assistant support in the educational inclusion.

Introduction: Neck pain (NP) may have a local mechanical (non-specific) origin caused by dysfunction of the joint, muscle, and ligament structures in the neck or by a discogenic etiology. Most people (50–60%) suffer from NP at some point in their lives. They are more common in highly developed countries and in urban areas. The aim of this study is to determine the prevalence of NP and its impact on daily living activities in the student population. Methods: The study included students of the University of Sarajevo - Faculty of Health Studies in the period from May 2021 to June 2021. The sample of respondents was formed by the method of random selection and included respondents of both sexes, aged 19–28 years. The study was conducted as a transversal cross-sectional study at a specific time point on the frequency of NP and the ability to perform activities of daily living in the student population. Results: Out of the total number of 255 respondents, 77 (30.2%) reported that they have NP while 178 (69.8%) respondents reported that they do not feel NP and it was found that there was no statistically significant difference between the age groups of the subjects with and without NP. The study concluded that a higher percentage of respondents with NP did not engage in leisure activities and that respondents with NP had lower mobility in daily life, sleep disturbance, and poorer ability to perform activities of daily living due to NP. Conclusion: The study conducted revealed that a significant percentage of the student population with NP has a lower ability to perform activities of daily living. Considering the above facts and the current transformation of the educational model, in which static postures dominate, it is necessary to design and implement programs for targeted physical activity and prevention of long-term inactivity that leads to painful musculoskeletal syndromes.

Introduction: People over the age of 50 begin to show manifestations of reduced balance and instability, and as a result, simple activities such as standing or getting up from a chair may become limited or impossible. Therapeutic strengthening exercises can increase muscle strength and improve mobility, as well as the physical functioning of the elderly. The aim of this study was to evaluate therapeutic exercise on balance and gait in elderly. Methods: The prospective study included two groups of 130 respondents over the age of 65 who had come to the “Center for Healthy Aging Novo Sarajevo.” Using the Performance-Oriented Mobility Assessment (POMA) test, we assessed mobility performance. We tested the respondents at the beginning, in the middle and in the end of the research, which lasted 6 months. Results: In the control group, the required time increased by 2.04%. The largest improvement within POMA B was recorded in the examined Group B and it was 12.67 %, while in the examined Group A, the improvement was only 5.07%. Within POMA G, the largest improvement was also recorded in the examined Group B and it was 6.82%, while in the examined Group B, this improvement was 4.14%. Conclusion: Both strengthening and antigravity therapeutic exercises improve the level of physical fitness in older adults, although therapeutic antigravity exercises had a better impact on the level of physical activity.

Introduction: Active aging is a process of optimizing of opportunities for health, participation, and safety to improve the quality of life as people age. Therapeutic exercises to strengthen muscles are especially important for the elderly, and the results of such exercises are positive in people with functional limitations. The aim of the study was to assess functional mobility of people in the 3rd age of life after programmed therapeutic exercises. Methods: The prospective study included two groups of 130 respondents over the age of 65 who came to the “Centre for Healthy Aging” in Novo Sarajevo in the period from September 1, 2014, until March 1, 2015. Using the time up and go test (TUG), the basic functional mobility was assessed and it represents the minimum time the respondent needs to get up from the armchair, walk a distance of three meters, turn around, and sit back in the armchair. We tested the respondents at the beginning, in the middle, and at the end of the study, which lasted for 6 months. Results: Analysis of the gender structure of the control and the test groups, using the Chi-square test, found a statistically significant difference, and in the test group, there were more female subjects than in the control group, χ2 = 50.620; p = 0.001. Analysis of the functional mobility of the respondents of the test groups using the TUG at the end of the study found that the respondents of the test group needed statistically significantly less time to perform the test (8.84 seconds) compared to the control group (9.59 seconds) and test Group B (9.41 seconds), F = 4.711; p = 0.041. Conclusion: Programmed therapeutic exercise leads to a significant improvement in functional mobility of persons in the 3rd age of life.

Introduction: Cervical pain syndrome (CPS), or pain in the neck, is defined as a set of symptoms that limit performing movements in the upper part of the back and last more than 1 day. When the mentioned symptoms last for more than 12 weeks, we talk about chronic CPS. It often represents the condition that results from disability. It is associated with poor posture, work in sitting position, stress, and long-lasting and repetitive movements. The aim of the study was to examine the effect of physical therapy on the degree of disability, pain intensity, and daily life and work activities of persons with chronic CPS. Methods: The research was conducted in the health spa center “Reumal” Fojnica from June 2020 until July 2020. It included 50 subjects of both genders, more than 18 years old, and of all occupations, treated with physiotherapy procedures (transcutaneous electrical nerve stimulation, magnetotherapy, therapeutic ultrasound, and kinesitherapy in the form of McKenzie exercises). In addition, a pre- and post-treatment study analyzed the condition of the respondents at the first examination and the control examination after completion of treatment. Results: By analyzing the results, we established that of the total number of respondents, 74% were female, and the average age was 57.36 years. At the end of the study, the degree of disability caused by neck pain was significantly lower (p < 0.05) than the degree of disability before the therapy. Discomfort caused by symptoms of CPS that occurred and interference with work before the therapy was significantly lower (p < 0.05) after the treatment program. Therapeutic procedures have reduced the pain intensity and improved the activities of everyday life. Conclusion: The treatment with physical therapy procedures effectively reduces the degree of disability and pain intensity and improves people’s daily life and work activities with chronic CPS.

Introduction: The challenges faced by visually impaired people in their efforts to integrate themselves into the labor market and the general position of persons with disabilities, regarding their employment and social security, is extremely difficult. Employment is the best safeguard against social exclusion and one of the main ways to achieve a full involvement in the society of the visually impaired people. Methods: The research was conducted on a sample of 25 visually impaired people employed at “TMP” d.o.o. Sarajevo. The study was used as a cross-sectional survey method wherein data were collected through appropriate survey instruments, using a modified survey questionnaire. Results: Out of the total number of respondents, 48% are male and 52% are female. The majority of respondents use other persons’ assistance when moving (n = 16). The largest number of respondents had 100% visual impairment (n = 17). The majority of subjects have no strenuous physical activity. The largest number of respondents during the previous week walked for at least 10 minutes, in the sequence of all 7 days and was driven in motor vehicles. When doing household chores, 56% of respondents said they had no difficulty. The most common difficulties in recreation, sports and physical activity in leisure time, that were encountered by 32% of respondents, are poor sound signalling and difficulties of visual nature, though 68% of respondents said that they had no difficulty in their recreational activities. Conclusion: The daily activities of employed visually impaired persons have a positive impact on their quality of life. Various are occupations of visually impaired people that improve their quality of life.

In the study, the development of physiotherapy was described through the history and education in Bosnia and Herzegovina (BiH) with a special review on the significance of physiotherapy as a health-care discipline and the display of its development to the academic level of education in BiH.

Introduction: Dietary supplements are an important source of vitamins and minerals that may help prevent several disease-causing biological pathways involved in one-carbon metabolism, including the suppression of cell proliferation, oxidative stress, nitric oxide synthesis, and angiogenesis. The present study aimed to assess the association between the intake of folate, Vitamin B6, Vitamin B12, and minerals and the consumption of alcohol among university students. Methods: This study was participated by students aged 19-22 years from the University of Sarajevo between 2017 and 2018. Using a questionnaire, we interviewed in a week them to collect information regarding age, socio-economic status, alcohol consumption, and dietary supplement intake. Then, we investigated the association between the baseline intake of folate, B vitamins, and minerals and that of alcohol consumption. Results: Most students consumed Vitamin B supplements (32%) and folic acid (10%). Dietary multivitamins and minerals were less prevalent in more than a year, accounting for 186 (23.9%) and 174 (24.3%) students, respectively, than those in less than a year. In a year, 0.05). Conclusion: An extremely low percentage of the participating students in Canton Sarajevo used dietary supplements of Vitamin B, folate, multivitamins, and minerals. Moreover, alcohol consumption and dietary supplement intake were not associated. Further research is needed to establish the best cost-effective public health system to achieve a sufficient intake of dietary supplements.

Introduction: Identification of the risk factors that can be modified is an essential aspect in the development of the effective strategy for therapeutic intervention with the purpose to improve mobility and injury prevention and post-fall consequences. This research aimed to analyze the impact of programmed therapeutic exercises on the fall risk factors in the elderly. Methods: We included 260 patients older than 65 years, and assigned them randomly into three groups. Group A: 65 patients subjected to therapeutic exercises for moderate-intensity muscle strengthening with Theraband stretch straps (corresponding to 11-14 on the Borg rating of perceived exertion scale). Group B: 65 patients subjected to therapeutic anti-gravity exercises. Control group: 130 patients not participating in programmed therapeutic exercises. Presence of fall risk factors was assessed in all three groups with standardized Fast Evaluation of Mobility, Balance, and Fear test (FEMBAF) before the initiation of therapy, after three and after six months of treatment. Results: At the end of the study, the subjects of the group A had significantly fewer limitations in performing basic life activities at home compared to the patients of the control and Group B, p = 0.037. The control group subjects were statistically significantly more likely to complain of vertigo than subjects of the experimental groups, p = 0.021. The subjects of the experimental groups had more than two falls than the control group subjects, p = 0.003 statistically. In the control group, the number of fractures after the fall at the end of the study increased significantly, statistically higher than in the subjects of the experimental groups, P = 0.037. Conclusion: Programmed therapeutic exercise significantly reduces the risk of falling factors, and significant effects have been achieved among subjects who have exercised with elastic strips.

Introduction: Dry needling is a therapeutic procedure using the insertion of thin needles through the skin into myofascial trigger points (MTrPs), muscular or connective tissue with the aim to reduce pain intensity. The objective of this systematic review is to analyze the literature for the efficacy of the dry needle technique in pain reduction in conditions of musculoskeletal pain caused by MTrPs. Reference Sources: Web of Science, Scopus and EBSCOhost database were searched for studies and e-books published from January 2010 to December 2018. Studies Selection: We included randomized controlled studies, prospective and longitudinal studies, and case studies which analyzed the efficacy of dry needling for musculoskeletal pain reduction. Data Extraction Method: The studies, which satisfied criteria for inclusion were further analyzed. The primary instrument of the evaluation was pain intensity analyses. Results: Dry needling treatment is efficient in pain intensity reduction in patients who suffer musculoskeletal pain and is more efficient compared to sham dry needling treatment. In addition, different techniques of dry needling are efficient in the treatment of myofascial pain syndrome. Conclusion: Based on systematic review of the literature, dry needling, independently or as an addition to other intervention, is recommended for treatment of musculoskeletal pain conditions caused by myofascial trigger points. Various techniques of dry needling treatment are almost equally efficient in myofascial pain intensity reduction.

Introduction: Shoulder pain is the most common form of extra-articular rheumatism. We aimed to determine the efficiency of the conventional physical treatment of the shoulder pain compared to the conventional treatment plus the Mulligan's joint mobilization technique and acupuncture. Methods: We included a total of 277 patients with the shoulder pain caused by adhesive capsulitis (frozen shoulder), calcific tendinitis, rotator cuff syndrome, or the tendinitis of the biceps muscle. We used clinical and radiological diagnostic criteria to make the diagnosis. Patients were assigned into group treated with conventional physiotherapy treatment during the ten days (CP)(n=148), and the group treated with conventional physiotherapy treatment plus the Mulligan joint mobilization and acupuncture (CP+MA)(n=128). Treatment efficiency was evaluated by assessing the status of the patients before and after the treatment with the Work Abilities and Activities of Daily Living (WAADL) scale as well as the Treatment Success scale. Results: Mean treatment duration was 13.36±5.83 and 10.86±4.55 days in CP and CP+MA group, respectively (p

Introduction: A number of people with facial injuries after surgical treatment one knee time comes and a violation of the opposite knee. These injuries have a major impact on quality of life if they are not treated properly, but also have consequences and after surgery. The aim of this paper is to analyze the questionnaires used to assess the quality of life after mutual ruptured anterior cruciate ligament, and to make recommendations for optimal use of the same. Our goal is to establish a correlation between the results obtained from questionnaires used descriptive answers to questions descriptive questions about aspects of everyday life, aspects of physical activity as well as aspects of personal perception of the current health and satisfaction with it. Methods: We analyzed questionnaires used to evaluate the quality of life after a bilateral rupture of the anterior cruciate ligament, which are listed in the attached work. In accordance with the subject of research, in this paper were used the following scientific research methods: a method of deduction, analysis, classification, comparison, analysis methods of written documents. Results: By searching the PubMed database for the purpose of this master's thesis under the terms "unilateral rupture ACL" we came across a 2792 articles, while the term "bilateral rupture of the ACL," retrieved only 73 articles, "contralateral ACL rupture" 192 articles, "Quality of life ACL " 41 articles. The most important dates in our study are certainly "Quality of life after bilateral rupture of the anterior cruciate ligament," where we all find only two articles on this topic. Conclusion: The most commonly used questionnaires to be used in assessing the success of treatment and quality of life after a bilateral rupture of the anterior cruciate ligament are: QOL, IKDC, KOOS, HSS, ADL, SF-36, WOMAC. IKDC proved to be most suitable for patients with ACL rupture in this study.

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: Osteoporosis is a skeletal system disease characterized by decline of bone mass and deterioration of bone microarchitecture, which leads to increased bone fragility and, consequently, a greater risk of fractures. Postmenopausal osteoporosis generally occurs between 51 and 75 years of age following ovarian failure. Our aim was to investigate if specific lifestyle habits, i.e., smoking cigarettes and physical activity, as well as the intake of dietary supplements, affect bone mineral density (BMD) in postmenopausal women. Methods: Ultrasound (US) and dual energy X-ray absorptiometry (DEXA) data, obtained between 2008 and 2009 year, were retrospectively reviewed for 150 women in postmenopause, 50-65 years old, who live in Sarajevo Canton. The women were classified into two groups: Group A (75 postmenopausal women who underwent US of the left heel bone); control group B (75 postmenopausal women who underwent US of the left heel bone and had a DEXA scan of the lumbar spine and left hip). Results: The study included 150 women with the average age of 55.39 years. In the total sample, 24.7% of women took calcium and vitamin D supplements, and no statistically significant difference was observed between the groups. In the total sample, the prevalence of osteoporosis was significantly different between smokers and nonsmokers; i.e., osteoporosis was more frequent in women who smoked cigarettes. On average, women in both groups reported low physical activity; the difference was not statistically significant. Conclusions: Menopause is a known risk for osteoporosis. Our results showed that the length of menopause is closely associated with osteoporosis occurrence.

Introduction: Degenerative joint disease, which is standardized in Europe by the name of arthrosis or osteoarthrosis, while in the Anglo-Saxon literature is in use for a long time by the name of osteoarthritis (OA) although this is not a classical inflammation,is the most common joint disease in general and the most common cause of functional damage of the musculoskeletal system. Recently, the term osteoarthritisappears more frequently in domestic literature. Arthroses are degenerative joint diseases with progressive character, also one of the most frequent diseases in orthopedics. The disease fi rst affects the articular cartilage, then the bony edges of the articular surfaces, and then the articular lining.Methods: Retrospective analysis and evaluation of data of treated patients, with the "Praxis" physical treatment during the period of time from 2000 to the end of 2010 on a sample of 79 patients,valorized the efficacy of Praxis treatment. The correlation of these results, with valorisation of the efficacy of standard physical treatment in clinics D.Z. " Novi Grad " on a sample of 81 patients, during the period of time from 2000 to the end of 2010, a statistical analysis was performed for comparing the effi cacy of the two methods.Results: There is a functional difference after therapy of bilateral gonarthrosis in clinics D.Z. "Novi Grad" and "Praxis" with statistical reliability.Conclusion: A combined approach in the treatment of knee arthrosis has a wider range of treatment procedures, comprehensively approaches to the problem and gives better results, so we can say that this method has priority compared to the standard approach to the knee arthrosis treatment.

Introduction: Enthesitis of the trochanter major is characterized by pain and often by limping when walking, then pain, tension, swelling, increased warmth and redness in the area of trochanter, and hip weaknessespecially when performing exercises with resistance. Research goals: Determine the effectiveness of treatment of major trochanter enthesitis, and analyze the representation of it in patients of both gender, different ages and professions.Methods: Retrospective analysis of data from the clinic "Praxis" in the period from 01.01.2001. to 31.12.2011. year because of the major trochanter enthesitis 30 patients were treated. Criteria for inclusion in the study were those people with symptoms and diagnosis of of the trochanter major enthesitis who have accessed treatment, while the criteria for exclusion were inadequate diagnosis, treatment abandonment and lack ofpatient data. The process of therapy included the evaluation of the functional status of patients graded 0-5, then conducted physical therapy that included: bed rest, manual massage and local instillation of depot corticosteroids, and assessment of treatment success ranging from 0 to 5.Research results: The mean score for condition of respondents was 3.27 before therapy, while after treatment it was 4.33. The mean score for status of respondents was 3.13 before treatment, and after therapy itwas 4.33.Conslusion: Based on these data we can conclude that treatment in the clinic "Praxis" leads to the improvement in patients suffering from the enthesitis of trochanter major.

Introduction: Community Based Rehabilitation (CBR) is a strategy within community development for rehabilitation, equalizes opportunities and social integration of incapacitated people. This is a comprehensivestrategy of involving people with disabilities in their communities through the development program. CBR system provides for the people with disabilities equal access to treatment and rehabilitation, education, promotes health and healthy living, and also indicates the existence of other features that make these people become full members of society and the community in which they live and is currently used in over 90 countries around the world.Methods: Research was conducted in two CBRs (CBR-Kumrovec and CBR-Saraj Polje) in the department of physical medicine and rehabilitation in the Sarajevo Canton. The study included and statistically treated 97patients during the period from 01.01.2008 to 31.12.2008 year.Results: In a study from the total number of respondents 65% were women, 35% male respondents, and the most represented were respondents of age group from 71-80 years - 40%. Of all diseases, the most represented were respondents with ICV, 43%.Conclusion: This type of treatment in the home conditions is providing necessary medical rehabilitation services by qualified physical therapists through a sufficiently long period for successful medical rehabilitation inthe natural environment of patients (home conditions), and the presence of family members who we can also educate for the enforcement of basic physical procedures and instruct them on the condition of the patientand his perspective.

Introduction: De Quervain᾽s disease is a stenosing tenosynovitis of common tendon sheath of abducktor policis longus and extensor policis brevis muscles. Due to the superficial positions it can easily lead tomechanical injuries of tendons and their sheaths. The disease more often affects women over 40 years old and people with certain professions who intensively use hand and fingers in their daily work. Pathologicalchanges consist of sheath᾽s fibrous layer thickening. The clinical condition develops gradually with the pain of varying intensity. It is localized above the radial styloid process and radiates from the back side of thethumb. The aim is to determine the efficacy of physical therapy at De Quervain᾽s disease.Methods: The study was conducted on 50 patients with De Quervain's disease who were reported to the CBR "Praxis" Sarajevo. With retrospective analysis the data was processed for the period from 01.01.2001. to 31.12.2011. year. Before the initiation of physical therapy assessment of functional status scored from 0 to 6 was performed. In the chronic phase physical therapy was performed, after which it underwent assessment of therapy success scores of 0-5. Criteria for inclusion in the study were patients with confirmed De Quervain's disease, patients of both sex and of all ages, and criterion for exclusion was non-compliance withtreatment protocols.Results: In the CBR "Praxis" with De Quervain᾽s disease total of 50 patients were treated in that period, of which 34 women and 16 men. 38% of respondents received a score of 4, while 56% of patients at the end oftreatment received a score of 5.Conslusion: Physical therapy and kinesiotherapeutical procedures have greatly contributed to the elimination of symptoms and consequences of De Quervainove disease.

Introduction: Osteoporosis is a progressive metabolic bone disease characterized by reduction of mineral density of bone, which leads to reduction of bone firmness, increased fragility and increased risk of bonefractures. The aims of this study were to determine the age structure and average values of BMI in female patients with a diagnosis of osteoporosis and osteopenia, to determine the value of T-score before and aftertherapy, and to show a correlation of frequency of fractures in relation to already given diagnosed and the presence of menopause.Methods: A retrospective study was conducted on 50 female respondents with diagnosis of osteoporosis and osteopenia. Included female respondents underwent densitometry or ultrasound screening method ofheels in which high degree of osteopenia and osteoporosis is detected.Results: The average age of the female respondents included in this study was 48.06 ± 11.97 years and all the respondents were in the category of women with normal body weight. There is a difference in the values of T-score of respondents with osteoporosis compared to osteopenia. Value of T-score decreases in relation to increase of number of years, so the older female respondents had lower values of T-score.Conclusion: The incidence of osteoporosis and osteopenia was higher among active working female respondents in menopause. Respondents with osteoporosis had lower values of T-score, physical and medicamenttherapy in combination led to improvement of T-score. Female respondents with a low value of T-score, with diagnosis of osteoporosis and in menopause, mostly had bone fractures.

Introduction: Osteoporosis is a silent and invisible disease of bone, great presence and is considered to suffer from osteoporosis at least 200 million women worldwide. The goal of this paper is to show average ageof postmenopausal respondents, values of anthropometric parameters (weight, height, BMI), anamnestic data on clinical symptoms, fractures of women in menopause, analysis of heel ultrasound screening results,analysis of lumbar spine DXA results, analysis of left hip DXA results.Methods: In retrospective study 61 respondents were involved, 33 to 79 years old, treated in u Center for Physical Medicine and Acupuncture “AD” in Sarajevo during the period from 01.01.2008 till 31.12.2009. Alldate are shown numerically and percentage account with calculation of mean value, expressed in the form of tables and charts.Results: Finding of heel ultrosound screening compared to T values of postmenopausal respondents indicates on osteoporosis in case of 17 (27,87%), in case of 44 (72,13%) respondents osteopenia, while normalvalues were not found. T value with lumbar spine DXA method in postmenopausal female respondents correspond to 43 (70,5%) respondents, in 15 respondents (24,6%) finding corresponded to osteopenia, while 3 respondents (4,9%) had physiological finding. Left hip DXA finding shows 36 (59%) respondents corresponded osteoporosis, 19 (31,2%) respondents corresponded osteopenia, while physiological finding was found in 6 respondents (9,8%). T value of lumbar spine DXA finding was - 2,71 ± 1,16; DXA finding of left hip -2,35 ±1,36; heel ultrasound screening -2,19 ± 0,54.Conclusion: Research results indicate that DXA finding in relation to the heel ultrasound screening confirms gold standard in diagnosing osteoporosis.

Introduction: Rheumatic diseases are nonsurgical diseases of the locomotor system and connective tissue. Rheumatoid arthritis (RA) is a systemic inflammatory disease of connective tissue of unknown cause, with progressive chronic or subacute course. The aim of the research is to determine whether stationary spa treatment leads to improvement of the functional status in patients with rheumatoid arthritis. Methods: We included 35 patients with diagnosis of rheumatoid arthritis, referred for treatment at the spa " Ilidža " Gradačac from February to April 2014. Patients not adhering to treatment protocols were excluded. We used Visual analogue pain scale (VAS), HAQ questionnaire and assessment of the clinical condition before and after the treatment based on the scores 1-5. Results: There were 32 female and 3 male patients. The average age was 62.28±8.31 years. Based on the HAQ, 12 patients had no difficulties, 9 of them perform activities with little difficulties, 10 with many difficulties, and 4 patients cannot perform certain activities. Before treatment VAS was 6.63±2.36, and after treatment the 2.51±2.27. Ratings of clinical condition before treatment was 2.38±0.74, and after the treatment 3.64±0.98. The most frequently used therapies were kinesitherapy, magnetotherapy and interferential electricity. Conclusions: Stationary treatment at the spa „Ilidža“ Gradačac leads to an improvement of the functional status in patients with rheumatoid arthritis.

Complex regional pain syndrome (CRPS), once known as reflex sympathetic dystrophy, Sudeck's dystrophy and causalgia, is a pain syndrome with indistinctive pathophysiology and unpredictable clinical course. CRPS can develop after a limb fracture, injury or damage to the peripheral or central nervous system. The diagnosis of CRPS is based on the signs and symptoms obtained from the medical history and physical examination. The disease is often resistant to treatment, and its course is not always favorable. A brief overview of this clinical entity is presented, and most relevant and up-to-date information is discussed.

Introduction: Lumbar pain syndrome is the most common cause of temporary work disability in people under 45 years of age. The aim of this study was to detect the frequency of acute and chronic lumbar pain syndrome in people of both gender, different age structures, different occupations and in active working population, and to determine the efficiency of trunk stabilizing exercises in its treatment. Methods: We analyzed 27 patients with acute and 33 patients with chronic lumbar pain syndrome from 01.01.2010 to 31.12.2012 which undergone trunk stabilizing exercises. We evaluated and scored 0 to 5 the condition of respondents before treatment and after the treatment. Research results: The mean score of condition of respondents with acute lumbar pain syndrome before therapy is 2.96, whereas after treatment is 4.71. The mean score of condition of respondents with chronic lumbar pain syndrome before therapy is 3.76, whereas after treatment is 4.63. Conclusion: Treatment with trunk stabilizing exercises performed in the clinic "Praxis” leads to improved scores of condition of respondents after treatment.

Introduction: Traumatic injuries of the spinal column are among the most devastating injuries in orthopedics. The primary goals of rehabilitation of these injuries are prevention of secondary complications, maximizing physical functioning and reintegration into the community. Rehabilitation after spinal injury reqires multidisciplinary team approach. Team members include, but are not limited to, physical therapists, occupational therapists, nurses, psychologists, health care managers and social workers, with each member having role and responsibility in their area of expertise. This study aimed to determine the difference in the occurrence of spinal injuries according to gender, age, cause of injury, neurological phenomenon in injured patients, the treatment and physical procedures used in the early stages of rehabilitation. Methods: The study was conducted as a retrospective and comparative at the Department of Orthopedics and Traumatology of Clinical Center University of Sarajevo. Medical records of 100 patients, treated at from January 1st 2007 till June 30th 2008, were processed and data about outpatient protocols and surgery protocols analyzed. Results: The results obtained from the data showed greater proportion of women (56%) compared to men (44%). Most patients were in the age group between 41 and 60. Injuries were most often due to falls from height and make 32%, fall from a tree 25%, traffic accidents 12% (²=17.94, p=0.0061). 88% of patients were without neurologic events, while the neurological disturbances occurred 12% (χ²=3.397, p=0.3343). 56% of patients with spinal injuries were treated surgically, while 41% were treated conservatively (χ ²=7.264, p= 0.00153). 73% patient had physical therapy program of early rehabilitation exercises, with at least at least only a massage in 4% of patients X² = 6.573, p = 0.04270). Conclusion: The adoption of national protocols is necessary for future treatment of patients with spinal fractures.