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Pri fizioterapevtskem ocenjevanju se pogosto uporabljajo provokacijski manualni testi, vendar je uporabnost glede na njihove merske lastnosti vprašljiva. Namen prispevka je bil predstaviti merske lastnosti provokacijskih manualnih testov za določanje utesnitvenega sindroma ramenskega sklepa in z njim povezanih okvar. Metode: Pregledane so bile podatkovne zbirke PubMED, PEDro in The Cochrane Library. Rezultati: Analiziranih je bilo 19 raziskav. Za določanje utesnitvenega sindroma so bile vrednosti testov (Jobov, Hawkins-Kennedyjev, Neerov test) za občutljivost od 58 % do 92 % in za specifičnost od 26 % do 89 %. Pozitivna razmerja verjetnosti so bila od 1,70 do 1,68 in negativna razmerja verjetnosti od 0,37 do 0,68. Testi za določanje nestabilnosti so imeli vrednosti občutljivosti od 61 % do 81 %, specifičnosti od 45,0 % do 95,4 % in najvišje vrednosti pozitivnih razmerij verjetnosti (od 1,15 do 17,21). Za okvaro kite dolge glave mišice biceps brachii (Speedov test, O'Brienov test, test z obremenitvijo II) so vrednosti za občutljivost znašale od 10 % do 98 %, za specifičnost od 37 % do 100 % z najboljšimi razmerji verjetnosti (pozitivno od 0,90 do 30 negativno od 0,10 do 1,19). Zaključki: Na podlagi analiziranih merskih lastnosti testov predlagamo algoritem za klinično uporabo. Provocative manual tests are often used in physiotherapy assessment, but their measurement properties are questionable. The aim of this paper was to present the measurement properties of provocative manual tests for determining shoulder impingement syndrome and associated dysfunction. Methods: PubMED, PEDro, and The Cochrane Library databases were reviewed. Results: Nineteen studies were analysed. The sensitivity and specificity for impingement syndrome (Jobe, Hawkins-Kennedy, Neer test) ranged from 58 % to 92 % and from 26 % to 89 %, respectively. The values of positive likelihood ratios ranged from 1.0 to 1.68 and for negative from 0.37 to 0.68. Instability tests had sensitivity from 61 % to 81 % and specificity from 45.0 % to 95.4 % these tests had the best positive likelihood ratios (from 1.15 to 17.21). For the pathology of the long head tendon of the biceps brachii (Speed test, O'Brien test, biceps load test II) sensitivity ranged from 10 % to 98 % and specificity from 37 % to 100 % positive and negative likelihood ratios were from 0.90 to 30 and from 0.10 to 1.19, respectively. Conclusions: Based on the analysed measurement properties of the tests, we propose an algorithm for clinical use.

Uvod: Nevrodinamični testi so diagnostični postopki, s katerimi ocenjujemo mehaniko oziroma občutljivost živčevja na razteg in drsenje. Če je živec ali živčna korenina okvarjena zaradi kemičnih mediatorjev, poškodbe oziroma utesnitve, lahko normalni funkcijski gibi povzročijo ali izzovejo nevrološke znake in simptome. Najbolj pogosto uporabljena nevrodinamična testa spodnjega uda sta test dvig stegnjenega spodnjega uda in test sesedanja sede. Namen: Namen diplomskega dela je na podlagi pregleda literature predstaviti merske značilnosti nevrodinamičnega testa dviga stegnjenega spodnjega uda in testa sesedanja sede. Metode dela: Raziskovalne članke v angleščini smo iskali v podatkovnih zbirkah CINAHL, PeDRO, PubMed in ScienceDirect. Pri iskanju smo uporabili naslednje ključne besede v angleškem jeziku: neurodynamic test [Title/Abstract] AND lower limb reliability, validity [Title/Abstract] AND straight leg raise test, slump test back pain [Title/Abstract] radiculopathy. Rezultati: Izsledki pregledanih raziskav kažejo na visoko do zelo visoko zanesljivost meritev dviga stegnjenega spodnjega uda pri preiskovancih s simptomi in pri zdravih preiskovancih ter na nizko do srednjo stopnjo zanesljivosti testa sesedanja sede pri preiskovancih s simptomi. Test dviga stegnjenega spodnjega uda je bil zmerno do visoko občutljiv pri preiskovancih s hernio medvretenčne ploščice, predvsem L5/S1, ter zmerno specifičen pri preiskovancih s hujšo obliko hernie medvretenčne ploščice kot test sesedanja sede. Test dviga stegnjenega spodnjega uda je imel visoko stopnjo diagnostične natančnosti pri mlajših preiskovancih (16-25 let) ter je bil uporaben pri potrditvi predhodne diagnoze opravljene z različnimi diagnostičnimi metodami. Test sesedanja sede je imel visoko stopnjo občutljivosti pri preiskovancih z ekstruzijo medvretenčne ploščice ter pri preiskovancih s hernio medvretenčne ploščice, ki je povzročila subartikularno kompresijo živčne korenine. Razprava in zaključek: Test dviga stegnjenega spodnjega uda je pokazal visoko zanesljivost testnih izidov, medtem ko avtorji pri oceni veljavnosti (občutljivost in specifičnost) izidov testa dviga stegnjenega spodnjega uda in testa sesedanja sede niso bili povsem enotni. V raziskavah bi bilo potrebno vključiti bolj natančna merilna orodja za določitev majhnih razlik v gibanju med različnimi položaji skočnega sklepa. Prihodnje raziskave bi lahko vključile večjo število preiskovancev za boljšo natančnost meritev merskih značilnosti nevrodinamičnega testa. Introduction: Neurodynamic tests are diagnostic procedures used to evaluate the mechanics or sensitivity of the nervous system to stretching and sliding. If the nerve or nerve root is damaged due to chemical mediators, injuries or constriction, normal functional movements may cause or induce neurological signs and symptoms. The most commonly used neurodynamic tests are the straight leg raise test and the slump test. Purpose: The purpose of this thesis is to present, based on a literature review, the measurement charactheristics of the straight leg raise test and slump test. Methods: The CINAHL, PeDRO, PubMed and ScienceDirect scientific databases were consulted to find relevant literature for the thesis in Engish using the following keywords in English: neurodynamic test [Title / Abstract] AND lower limb reliability, validity [Title / Abstract] AND straight leg raise test, slump test back pain [Title / Abstract] radiculopathy. Results: Ten research studies were included in the analysis. The results of the reviewed studies reported high to very high reliability levels of straight leg raise test in symptomatic and healthy subjects, and low to medium reliability levels of the slump test in symptomatic subjects. The straight leg raise test was moderately to highly sensitive in subjects with herniated intervertebral discs, especially L5 / S1, and moderately specific in subjects with more severely herniated discs. The straight leg raise test had a high diagnostic accuracy in younger subjects (16-25 age) and was useful in confirming a previous diagnosis performed with different diagnostic methods. The slump test had a high sensitivity level in subjects with intervertebral disc extrusion and in subjects with herniated intervertebral discs that caused subarticular compression of the nerve root. Discussion and conclusion: The straight leg raise test showed high reliability of the measurements, while the authors did not quite agree on the validity (sensitivity and specificity) of the measurements of the straight leg raise test and slump test. Research studies should include more accurate measurement tools to identify small differences in movement between different positions of the ankle. Future research could include a larger number of subjects to more reliably determine the positive outcome of each test.

The evolution of professional ethics in physiotherapy, which is adapting to the changes in the profession and the social environment, is described. Increased clinical autonomy has increased the responsibility of physiotherapists, which entails the obligation to identify and confront ethical dilemmas and questions in physiotherapy practice. Ethical decisions must frequently be made by physiotherapists. The ethical dilemmas and questions that are frequently faced by physiotherapists working in the public health care system, the specifics of the private practise physiotherapy, and research ethics are summarised and described chronologically. The ethical principles of the Word Confederation for Physical Therapy may help to solve some ethical dilemmas. Despite the likely influence of the characteristics of the health care systems in the countries where the ethical dilemmas in physiotherapy have been studied, we believe that the findings from our literature review are at least partially applicable to Slovenia, where this topic has not been researched yet. V prispevku je uvodoma opisan razvoj etike v fizioterapiji, ki se prilagaja spremembam poklica in družbenega okolja. Z večanjem avtonomije fizioterapevtov se povečuje tudi njihova odgovornost, katere del je zaveza za prepoznavo in spoprijemanje z etičnimi dilemami in vprašanji, ki se pojavljajo v fizioterapevtski praksi. Fizioterapevti morajo zato pogosto sprejemati etične odločitve. Kronološko so povzete in opisane etične dileme in vprašanja, s katerimi se pogosto srečujejo fizioterapevti v javnem zdravstvu, in posebnosti zasebne fizioterapevtske dejavnosti ter etika v raziskovanju. Spoprijemanje z nekaterimi etičnimi dilemami olajšajo etična načela Svetovne zveze za fizioterapijo. Kljub verjetnemu vplivu posebnosti zdravstvenih sistemov v posameznih državah na nekatere etične dileme predvidevamo, da ugotovitve iz pregledane literature vsaj delno veljajo tudi za Slovenijo, kjer ta tema še ni bila proučevana.

European core standards of physiotherapy practice were translated into Slovenian language. These standards apply to all physiotherapists in direct or indirect contact with patients. The standards provide clear statements about the expected quality of interaction required to apply the ethical principles. They are considered to be achievable. The core standards are a tool that can be used to evaluate the current physiotherapy service and to plan its improvement by anybody who has an interest in providing or receiving high quality physiotherapy service. In this paper, foundations for the core standards are explained, and the standards are summarized in five sections: patient partnership, assessment and treatment cycle, communication and patient's documentation, promotion of a safe working and treatment environment, and continuing professional development/ lifelong learning. The core standards are in accordance with and are supplementing the Slovenian legislation. Temeljni standardi za fizioterapevtsko prakso Evropske regije Svetovne zveze za fizioterapijo so bili prevedeni v slovenski jezik. Namenjeni so vsem fizioterapevtom, ki so v posrednem ali neposrednem stiku s bolniki. Vključujejo jasna stališča o pričakovani kakovosti medsebojnega delovanja, ki je potrebna za upoštevanje etičnih načel, in so določena kot dosegljivi standardi. So orodje, ki ga za vrednotenje kakovosti obstoječega izvajanja fizioterapevtske dejavnosti in načrtovanje izboljšanja lahko uporabljajo vsi, ki želijo nuditi ali prejemati visokokakovostno fizioterapijo. V prispevku so povzeti temeljni standardi, ki so obsegajo pet sklopov: sodelovanje z bolnikom, cikel ocenjevanja in fizioterapevtske obravnave, sporazumevanje in bolnikova dokumentacija, promocija varnega okolja za delo in fizioterapevtsko obravnavo ter neprekinjen strokovni razvoj oziroma vseživljenjsko učenje. Temeljni standardi se ujemajo in dopolnjujejo s slovensko zakonodajo.

Introduction: A continuing increase in prevalence of non-specific back pain in children and adolescents has been observed. The paper presents the results of a literature review on prevalence of back pain, the factors associated with the occurrence of back pain including gender, age, anthropometric parameters, lifestyle risk factors, school-related risk factors, the role of psychological, social, and behavioural factors and the efficacy of prevention in the treatment of nonspecific back pain in youth with no identified specific structural reason or cause. Methods: The electronic search of the following academic databases was conducted: Medline, PubMed, Google Scholar, PEDro, Springer Link, Elseviewer and The Cochrane Library. Included in the analysis were the cross-sectional, longitudinal, prospective and correlational research studies published between 2001 and 2011 in the English, German and Slovenian languages discussing nonspecific chronic or acute backpain and/or low back pain in children and adolescents. Only 50 out of 97 hits were analysed in the study. Results: Results of the study indicate that the occurrence of back pain has been increasing. According to the results, the observed prevalence increase of non-specific back pain may be related to female gender, age, school furniture, physical inactivity, high intensity training, traumas, previous history of back pain, rapid body growth, mechanical load (principally schoolbag carriage), decreased flexibility of the anterior and posterior thigh muscles, conduct and emotional problems and loneliness. Discussion and conclusion: Numerous etiological studies have identified the factors associated with the occurrence of back pain. The interventional prevention programmes have so far focused mainly on health education of children on proper posture and spine care education, pinpointing the importance of regular daily physical activity or a combination of both. Uvod: Pojav nespecifičnih bolečin v križu pri otrocih in mladostnikih narašča. Namen članka je na podlagi pregleda literature predstaviti rezultate raziskav, katerih namen je bil ugotoviti prevalenco bolečine v križu, dejavnike tveganja v povezavi s spolom, starostjo, antropometričnimi parametri, dejavnike tveganja, povezane z življenjskim slogom, telesne dejavnike tveganja, s šolo povezane dejavnike tveganja, psihosocialne dejavnike tveganja in uspešnost preventive pri obravnavi nespecifične bolečine v križu pri otrocih in mladostnikih. Metode: Za pregled literature so bile uporabljene elektronske baze podatkov: Medline, PubMed, Google Scholar, PEDro, Springer Link, Elseviewer in The Cochrane Library. Za analizo so bile uporabljene presečne, longitudinalne, prospektivne in primerjalne raziskave, objavljene med leti 2001 ter 2011, v angleškem, nemškem in slovenskem jeziku, ki so vključevale otroško in mladostniško populacijo z nespecifično kronično in akutno bolečino v križu in/ali v spodnjem predelu hrbta. Iz iskalnega nabora 97 zadetkov je bilo za analizo uporabljenih 50 raziskav. Rezultati: Prevalenca bolečin v križu se pri otrocih in mladostnikih zvišuje. Največ povezav je bilo z ženskim spolom, starostjo, šolskim pohištvom, telesno neaktivnostjo in športnimi treningi višje intenzitete, poškodbami, bolečinami v križu v preteklosti, hitro rastjo, daljšim časom nošenja šolskega nahrbtnika, zmanjšano raztegljivostjo stegenskih mišic sprednje in zadnje strani, s čustvenimi, vedenjskimi težavami ter osamljenostjo. Diskusija in zaključek: Vpliv dejavnikov tveganja je večdejavniški. Do sedaj izvedeni intervencijski preventivni programi so temeljili na izobraževanju otrok o pravilni skrbi za hrbtenico, vključevanju telesne aktivnosti v njihov vsakdan ali kombinaciji obojega.

Background: Mirror therapy is a recent method that has already been used in patients after stroke. Mirror therapy facilitates the recovery of paretic limb movement by using the nonparetic limb movement to treat the paretic limb. The purpose of our study was to investigate the suitability of mirror therapy for upper extremity in a patient after stroke in the home environment. The effects of mirror therapy on passive range of movement, hand and pinch grip strenght, sensibility, spasticity, dexterity and motor functions of the paretic upper limb were assessed. Methods: A 38-year old man, 11 months after stroke, with right hand dominance was assessed. Mirror therapy continued for four weeks (24 days), six days per week. Goniometry of the wrist joint, dynamometry using pinch Jamar dynamometer, assessment of light touch sensitivity threshold using Semmes Weinstein monofilaments, static and dynamic two point discrimination using Disk-Criminator, assessment of proprioception and kinesthesia, modified Ashworth scale, nine hole peg test and partial modified assessment scale for stroke patients were performed before and after the period of mirror therapy. Results: After mirror therapy, passive range of motion of the wrist joint for the dorsiflexion improved by 10°, grip strength improved by 5.7 kp, and pinch grip improvement (key: by 1.6kp; palmar: by 9.6 kp; tip pinch: by 1.5 kp) was also observed. Performance time of the nine hole peg test decreased by 28 s and the partial motor assessment scale score improved by three grades. Conclusion: Mirror therapy was an appropriate therapeutic method for facilitation of the paretic upper limb movement recovery in the studied case. The use of mirror therapy in the home environment without or with minimum supervision remains an open issue. Izhodišča: Terapija z ogledalom je novejša metoda, ki so jo že uporabljali pri pacientih po možganski kapi. Pri tej terapevtski metodi je za izboljšanje funkcije okvarjenega uda izkoriščeno gibanje uda, ki ni okvarjen. Z analizo predstavljenega primera smo želeli ovrednotiti terapijo z ogledalom za zgornji ud pri pacientu po možganski kapi v domačem okolju ter ugotoviti učinke le-te na izboljšanje pasivne gibljivosti, zmogljivosti prijema roke in pincetnih prijemov, občutenja, mišičnega tonusa, spretnosti in funkcijskih sposobnosti zgornjega uda. Metode: V raziskavo smo vključili 38-letnega pacienta z dominantno desno roko, 11 mesecev po možganski kapi. Terapija z ogledalom je trajala štiri tedne (24 dni), šestkrat na teden. Pred začetkom terapije z ogledalom in po njej smo izvedli goniometrijo, dinamometrijo z dinamometrom Jamar, ocenili občutek za lahen dotik s Semmes- Weinsteinovimi monofilamenti, statično in dinamično razlikovanje dveh točk s pripomočkom Disk-Criminator, ocenili smo tudi: občutek za položaj in gibanje sklepov, z modificirano Ashworthova lestvico povišani mišični tonus flektornih mišic zapestja, spretnost roke pa s testom devetih zatičev ter funkcijske sposobnosti pacientovega zgornjega uda z lestvico za ocenjevanje motoričnih funkcij oseb po možganski kapi (MAS). Rezultati: Po terapiji z ogledalom smo ugotovili, da se je pri pacientu izboljšala pasivna gibljivost zapestnega sklepa v smeri dorzalne fleksije za 10°. Zmogljivost prijema roke se je izboljšala za 5,7 kp, pincetni prijem ključa za 1,6 kp, palmarni uščip za 9,6 kp in uščip z blazinicami palca in kazalca za 1,5 kp. Čas izvedbe testa devetih zatičev se je izboljšal za 28 s, za tri ocene pa so se izboljšale tudi zahtevnejše aktivnosti roke po lestvici MAS. Sklep: Terapija z ogledalom za zgornji ud se je izkazala kot primerna za uporabo pri našem pacientu po možganski kapi v domačem okolju. Uporaba terapije z ogledalom v domačem okolju brez nadzora oz. z manj kot trikrat tedenskim nadzorom terapevta ostaja odprto vprašanje.

Background: The fibromyalgia syndrome is a pathogenetically and ethiologically unexplained chronic pain syndrome. Reliability and validity of self-administered questionnaires are the basic criteria for measuring disability of patients with fibromyalgia for clinical decision making. The aim of this study was to determine validity and reliability of the Slovenian translation of the Fibromyalgia Impact Questionnaire (FIQ). Methods: The questionnaire was translated into Slovenian and sent to 83 persons with fibromyalgia symptoms. The questionnaire was sent twice (with one-month interval) by surface mail. Reliability was examined in terms of internal consistency and stability over time. Predictive and convergent validity were also evaluated. Results: 36 female patients with an average age of 45 years responded. Cronbach Alpha for the translated FIQ was 0.71, which indicates sufficient internal consistency. The average score did not differ significantly between the two time-points (1st completion: M=59.4, SD=11.1; 2nd completion: M=58.3, SD=12.4; p=0.469). Intraclass corellation was 0.69, which indicates sufficient stability over time. Predictive validity was demonstrated by FIQ score being moderately positively corellated with duration of absence from work due to fibromyalgia (r=0.37; p=0.050) and highly positively corellated with self-assessment of symptoms' influence on the ability of performing different tasks (r=0.69; p

Background. One particular criterium for measuring disability of patients withlow back pain (LBP) with self-administered questionnaires for clinical decision making is reliability. Reliable measurement tools are needed for evaluating the effectiveness of physiotherapy treatment. Translating the original version of questionnaires may affect their reliability. The objectiveof this study was to determine the reliability and internal consistency of two low back pain (LBP)-related measurement tools translated into Slovenian lauguage, the Modified Roland-Morris Disability Questionnaire (MRMQ) and the Fear Avoidance Beliefs Questionnaire (FABQ) The later was as recommended by the literature and divided into two parts. The first included statements about how physical activity may affect patient's LBP, and the second included statements how regular work may affect it. Methods. Twenty-eight (16 female, 12 male; age 46.3 7.3 years) subjects with LBP referred to physiotherapy were invited to participate in this study. To assesstest-retest reliahility, the questionuaires were administrated with an interval of 3 to 4 days between test artd retest Results. Test-retest reliability was high artd statistical significant (p < 0.01) for the MRMQ, physical activity and work indices of the FABQ (ICC >= 0.89; r >= 0.90; p >= 0.87). Internal consistency, evaluated by Cronbach's alpha, on test and retestranged from 0.58 to 0.86 and 0.68 to 0.89 respectively. Conclusions. Reliability of Slovenian version of the MRMQ and the FABQ was good and similarto results of previous studies. Both questionnaire may be suitable for use in Slovenia. Izhodišča. Osnovno merilo klinične uporabnosti vprašalnikov pri ocenjevanju nezmožnosti bolnikov z bolečino v križu (BVK) je zanesljivost Ocenjevanje z zanesljivimi merilnimi inštrumenti v fizioterapiji je nujno za ovrednotenje učinkovitosti fizioterapevtskih postopkov. Uporaba tujih vprašalnikov, prevedenih v materni jezik, lahko vpliva na njihovo zanesljivost. Namen raziskave je bil ugotoviti zanesljivosti in notranjo skladnost dveh v slovenski jezik prevedenih vprašalnikov o bolečini v križu: Modificiran Roland-Morrisov vprašalnik (MRMV) in Vprašalnik prepričanja o izogibanju zaradi strahu (VPIS), ki smo ga po priporočilih iz literature razdelili na Vprašalnik o izogibanju zaradi strahu pri telesnih aktivnostih (VPISTA) ter Vprašalnik o izogibanju zaradi strahu pri delu (VPISD). Metode. Testiranje in ponovno testiranje vprašalnikov je potekalo s 3 do 4-dnevnim presledkom. Sodelovalo je 28 bolnikov z BVK (16 žensk in 12 moških), povprečna starost je bila 46,3 7,3 leta, vsi preiskovanci so bili v postopku fizioterapevtske obravnave. Za izračun zanesljivosti pri prvem in ponovnem testiranju so bili uporabljeni ICC, Pearsonov (r) in Spearmanov (p) korelacijski koeficienti, za izračun notranje skladnosti pa koeficient Cronbach alfa. Stopnja statistične značilnosti je bila določena s p = 0,89; r >= 0,90, p >= 0,87) in statistično značilna (p < 0,01). Vrednosti koeficientov alfa za notranjo skladnost so znašale 0,58 do 0,86 pri prvem in 0,68 do 0,89 na ponovnem testiranju. Zaključki. Zanesljivost slovenske različice vprašalnikov MRMV in VPIS je bila dobra in primerljiva z izsledki raziskav v tujini. Oba vprašalnika bi bila primerna za uporabo v slovenskem okolju.

Uvod: Visokošolsko izobraževanje, ki temelji na kompetencah, omogoča študentom usvojitev potrebnih znanj, veščin, vrednot in stališč, ki jih bodo potrebovali v poklicnem in v zasebnem življenju. Pandemija koronavirusne bolezni covid-19 je vplivala na razvoj prilagojenega načina poučevanja, pri katerem je bilo treba študentom zagotoviti enako raven usvojenih kompetenc kot pred izbruhom pandemije. Namen: Namen diplomskega dela je bil ugotoviti, v kolikšni meri so študentje študijskega programa fizioterapije na Zdravstveni fakulteti v Ljubljani usvojili kompetence v času študija v razmerah covida-19. Poleg tega smo želeli ugotoviti, v kolikšni meri so se razlikovale usvojitve kompetenc študentov iz naše raziskave in iz predhodno izvedene raziskave o usvojitvi kompetenc pred pandemijo koronavirusne bolezni covid-19. Metode dela: Za zbiranje podatkov smo uporabili anketni vprašalnik, ki je bil sestavljen iz dveh delov demografskih vprašanj in vprašanj za samooceno kompetenc. Za analizo rezultatov smo uporabili deskriptivne statistične metode, za oceno usvojenih kompetenc smo uporabili 5-stopenjsko Likertovo lestvico, za primerjavo ocene usvojitve kompetenc med anketama smo uporabili t-test za en vzorec. Rezultati: Za analizo smo uporabili odgovore 50 študentov, ki so v celoti izpolnili anketo, 12 moških (24 %) in 38 žensk (76 %). Povprečna starost je bila 23,36 leta (razpon 23–27 let). Povprečna vrednost ocene vseh usvojenih kompetenc je bila 3,45 (±1,08), povprečna vrednost ocene usvojenih kompetenc na fakulteti je bila 3,06 (±1,11), povprečna vrednost ocene usvojenih kompetenc v kliničnem okolju je bila 3,84 (±0,9). Pri primerjavi ocene usvojenih kompetenc na fakulteti in v kliničnem okolju med našo in predhodno raziskavo je do statistično pomembnih razlik prišlo pri večini kompetenc, naši anketiranci so bolje usvojili kompetence v kliničnem okolju s področja fizioterapevtskega ocenjevanja in izvajanja fizioterapevtskega procesa, medtem ko so vse ostale v času pandemije usvojili slabše. Razprava in zaključek: Rezultati naše raziskave so pokazali, da so študenti ocenili, da so v času razmer covida-19 kompetence bolje usvojili v kliničnem okolju kot na fakulteti. Večina usvojenih kompetenc naših študentov je bila ocenjena nižje pri primerjavi z oceno kompetenc študentov v predhodni raziskavi. Introduction: Competency-based higher education enables students to acquire the knowledge, skills, values, and attitudes they need in their professional and personal lives. The pandemic COVID-19 influenced the development of an adapted teaching method in which it was necessary to provide students with the same level of acquired competencies as before the outbreak of the pandemic. Purpose: The purpose of the study was to determine the extent to which students in the physiotherapy program at the Faculty of Health in Ljubljana acquired competencies in the pandemic COVID-19. The study also aimed to compare the students' acquisition of competencies from our study and from a study conducted in 2015 before the pandemic COVID-19. Methods: For data collection, a questionnaire was developed that consisted of two parts: demographics data and self-assessment of competencies. Descriptive statistical methods were used to analyse the results, and a 5-point Likert scale was used to evaluate the acquired competencies. A one-sample t-test was used to compare students’ assessment of acquired competencies between our survey and the 2015 survey. Results: Fifty students participated in the survey, 12 male (24%) and 38 female (76%). The mean age was 23.36 years (range 23 to 27 years). The mean of all self-assessed competence acquisition was 3.45 (±1.08), the mean of assessed competence acquisition at faculty was 3.06 (±1.11), and in the clinical settings 3.84 (±0.9). A comparison of student-assessed competencies acquisition at faculty and in clinical settings between our study and the previous survey revealed statistically significant differences for most competencies, our respondents acquired better competencies in physiotherapy assessment and implementation of the physiotherapy process in the clinical setting, while all others acquired to a lesser extent. Discussion and conclusion: The results of our study showed that the students estimated that during the COVID-19 acquired the competencies better in the clinical settings than at the faculty. Most of the competencies acquired by students in our study were rated lower compared to the students in the previous study.

Uvod: Idiopatska adolescenčna skolioza je najpogostejša oblika tridimenzionalne deformacije hrbtenice, pri kateri je kot po Cobbu, izmerjen v stoječem položaju osebe na rentgenskem posnetku, enak ali večji od 10°. Zdravljenje je lahko konservativno z različnimi vadbenimi programi, operativno ali z uporabo ortoz. Namen: Primerjava učinkov različnih vadbenih programov pri osebah z idiopatsko adolescenčno skoliozo. Metode dela: Uporabljen je bil pregled literature v elektronskih podatkovnih zbirkah PubMed in PEDro. Iskanje je bilo omejeno na angleške članke. Raziskave, uporabljene za analizo, ki niso bile starejše od 10 let, so bile metodološko ovrednotene po lestvici PEDro. Rezultati: Analiziranih je bilo šest raziskav s povprečno metodološko oceno po PEDro lestvici 7,7. V treh raziskavah so proučevali učinkovitost Schroth metode, v eni so jo primerjali s tehnikami proprioceptivne nevromišične facilitacije in v dveh v kombinaciji s standardno fizioterapevtsko obravnavo. V dveh so proučevali učinkovitost izvajanja znanstvenega vadbenega pristopa k skoliozi in ga primerjali z izvajanjem osnovnih vaj ter s skupino, ki ni prejemala nobene terapije. V eni raziskavi so primerjali v dejavnost usmerjeno vadbo s temelji ergonomije, kombinirano z vajami za krepitev hrbtnih mišic, aktivnimi samokorekcijskimi in dihalnimi vajami z vadbenim programom. V vseh raziskavah so ugotovili značilno zmanjšan Cobbov kot in rotacijski kot trupa ter pomembno izboljšanje pljučne funkcije preiskovancev. Zaključek: Učinkovito obliko konservativnega zdravljenja oseb z idiopatsko adolescenčno skoliozo predstavljajo za skoliozo specifične fizioterapevtske vaje. Poleg pravilnega izbora vaj je pomembna doslednost posameznika, da redno samostojno izvaja predpisan vadbeni protokol, saj se s tem hitreje doseže napredek zdravljenja, zaradi katerega se oseba z večjo verjetnostjo izogne zdravljenju z ortozo. V raziskavah je bilo moč zaslediti nekatere načine, kako mladostnika spodbuditi k vadbi: ozaveščanje, spremljanje in motiviranje. Introduction: Adolescent idiopathic scoliosis is the most common form of three-dimensional spinal deformity in which the Cobb angle is equal to or greater than 10⁰, measured on an X-ray in the standing position. Treatment can be conservative with different exercise programs and orthotic treatment or with surgical intervention. Purpose: The goal of the thesis was to compare the effects of different exercise programs on subjects affected by adolescent idiopathic scoliosis. Methodology: The literature review was carried out using bibliographic databases (PubMed and PEDro). The research was confined to articles in English the studies used in the thesis were no more than 10 years old. They were rated using the PEDro scale. Results: Six studies were reviewed and evaluated using the PEDro scale with a mean score of 7.7. Three studies have examined the efficacy of the Schroth method, one has compared it with proprioceptive neuromuscular facilitation techniques and two in combination with a physiotherapeutic standard of care. Two investigated the effectiveness of a scientific exercise approach to scoliosis by comparing it to general exercises and observation. One study compared task-oriented exercises based on ergonomics in combination with spinal strengthening exercises, active self-correction and breathing exercises. In all studies, there was a significant decrease in the Cobb angle, the rotation angle of the trunk, and a significant improvement in the results of the subjects' pulmonary function tests. Conclusion: Physiotherapeutic scoliosis-specific exercises are an effective form of conservative treatment for subjects with adolescent idiopathic scoliosis. In addition to the correct selection of exercises, it is important that the individual is consistent with following prescribed exercise protocol, as this will result in faster treatment progress, making it more likely that the person will avoid orthotic treatment. Research has identified a number of ways to encourage adolescents to exercise: education, monitoring and motivation.

Uvod: Nespecifična bolečina v zgornjem delu hrbta je lahko posledica mehanskih motenj, okvar v predelu zgornjega dela hrbta, vratu in/ali miofascialnih motenj. Kronično bolečino definiramo kot vztrajno nelagodje v zgornjem delu hrbta, ki traja več kot dvanajst tednov, nespecifično pa kot bolečino brez znakov ali simptomov večje strukturne patologije. Zdravimo jo lahko konzervativno z edukacijo, s protibolečinsko terapijo, z manualno terapijo in manualno terapijo v kombinaciji z drugimi postopki, kot je terapevtska vadba. Namen: Namen je na podlagi pregleda literature pri pacientih s kronično nespecifično bolečino v zgornjem delu hrbta predstaviti in analizirati učinke manualne terapije na celostno zdravstveno stanje, zmanjšanje bolečine, dinamično ravnotežje, obseg gibljivosti in mišično zmogljivost. Metode dela: Literatura, ki je bila objavljena po letu 2010, je bila iskana v spletnih podatkovnih zbirkah PubMed, Cochrane Library, PEDro ter z iskanjem v referencah objavljenih pregledov literature. Rezultati: V analizo smo vključili enajst raziskav, ki so bile dostopne v celotnem besedilu. Rezultati so pokazali, da manualna terapija vpliva na zmanjšanje bolečine in povečan obseg gibljivosti. Dokazi o učinkovitosti manualne terapije pri izboljšanju splošnega zdravstvenega stanja in dinamičnega ravnotežja so nejasni. Manualna terapija ni bila učinkovita pri izboljšanju mišične zmogljivosti. Razprava in zaključek: V večini analiziranih raziskavah ni bilo jasnega dokaza o učinkovitosti manualne terapije, saj so njen učinek večkrat preučevali v kombinaciji z drugimi postopki zdravljenja. Potrebne so nadaljnje raziskave, ki bi natančneje opredelile tako samostojni učinek manualne terapije kot tudi njen dolgoročni učinek. Introduction: Nonspecific upper back pain may be caused by mechanical disorders, neck deformities, and/or myofascial disorders. Chronic pain is defined as persistent upper back discomfort lasting longer than twelve weeks. Non-specific pain is defined as pain without signs or symptoms of major structural pathology. It can be treated conservatively with education, pain-relieving therapy with manual therapy, and manual therapy in combination with other treatments such as exercise. Purpose: Based on a literature review, the effects of manual therapy on general health status, pain, range of motion, functional capacity, dynamic balance, and muscle strength in patients with chronic nonspecific neck pain are presented and analysed. Methods: Literature published after 2010 was searched in PubMed, Cochrane Library, and PEDro databases and by searching the references of published literature reviews. Results: Eleven studies that were available in full text were included in the analysis. The results provide evidence for the effects of manual therapy on pain reduction and increase in range of motion. Evidence for the effectiveness of manual therapy in improving general health and dynamic balance is unclear. Manual therapy was not effective in improving muscle performance. Discussion and Conclusion: Most of the studies reviewed examined manual therapy in combination with other treatments. Further studies are needed to determine the individual effectiveness of manual therapy and its long-term effects.

Uvod: Propriocepcija je temeljni del somatosenzoričnega sistema in je pomembna pri ugotavljanju proprioceptivnih primanjkljajev. Test občutka za položaj sklepa ostaja najbolj razširjen način merjenja propriocepcije. Za izvedbo meritev uporabljamo različne pripomočke kot so digitalni in izokinetični goniometer, elektrogoniometer, dinanometer, inklinometer in 3D sistemi. Najpogosteje se občutek za položaj kolenskega sklepa ocenjuje v položaju odprte kinetične verige, priporoča pa se tudi ocena v položaju zaprte kinetične verige, saj je le-ta bolj funkcijska. Namen: Namen diplomskega dela je na podlagi pregleda literature predstaviti zanesljivost merjenja občutka za položaj kolenskega sklepa v zaprti in odprti kinetični verigi. Metode dela: Iskanje literature je potekalo preko spletnega vira v podatkovni zbirki PubMed z različnimi kombinacijami ključnih besed v angleškem jeziku ter s posamičnim iskanjem v referencah objavljenih virov. Rezultati: V pregled literature je bilo vključenih osem raziskav, v katerih so avtorji proučevali zanesljivost merjenja občutka za položaj kolenskega sklepa v zaprti in/ali odprti kinetični verigi. V raziskavah so sodelovali zdravi posamezniki, stari med 18 in 60 let. V raziskavah so preverjali zanesljivost posameznega preiskovalca, zanesljivost med preiskovalci, ter zanesljivost med ocenjevanji. Zanesljivost v odprti kot tudi v zaprti kinetični verigi se je izkazala za dobro. Razprava in zaključek: Pri meritvah občutka za položaj kolenskega sklepa se je kot najbolj zanesljiv, cenovno dostopen in praktičen dokazal inklinometer v primerjavi z dinamometrom. Izvedba meritev tako v zaprti kot v odprti kinetični verigi je zanesljiva. V zaprti kinetični verigi pride do večje aktivacije mehanoreceptorjev, medtem ko odprta kinetična veriga predstavlja izoliran občutek za položaj kolenskega sklepa Introduction: Proprioception is a fundamental part of the somatosensory system and is important in identifying proprioceptive deficits. The test for joint position remains the most widespread method of measuring proprioception, using various devices such as digital and isokinetic goniometer, electro goniometer, dynamometer, inclinometer and 3D systems to perform measurements. Most often, the joint position sense of the knee joint is assessed in the position of the open kinetic chain, but the assessment in the position of the closed kinetic chain is also recommended, as it is more functional. Purpose: The purpose of this thesis is to present the reliability of knee joint position sense measuring in a closed and open kinetic chain, based on a review of the literature. Methods: The literature was found in the PubMed database using various combinations of keywords in English and by individual search in the references of published sources. Results: Eight studies were included in the literature review in which authors examined the reliability of knee joint position sense measuring in a closed and/or open kinetic chain. Healthy individuals between the ages of 18 and 60 participated in the research. The research examined intra-examiner, inter-examiner and test-retest reliability. Measurements in the open as well as in the closed kinetic chain showed high reliability scores. Discussion and conclusion: In knee joint position sense measuring, the inclinometer proved to be the most reliable, affordable and practical compared to the dynamometer. Performing measurements in both closed and open kinetic chains showed reliability. In the closed kinetic chain, there is a greater activation of mechanoreceptors, while the open kinetic chain represents an isolated sense of the position of the knee joint.

Uvod: Zapoznela mišična bolečina je pogost pojav. Gre za posledice mikro mišičnih poškodb, ki nastanejo zaradi telesne dejavnosti, izrazitejša pa je pri ekscentričnem mišičnem delu. Simptomi zapoznele mišične bolečine se pojavijo od 12 do 24 ur po telesni dejavnosti, vrh pa dosežejo znotraj 72 ur. Ena izmed intervencij, ki se uporabljajo za lajšanje simptomov zapoznele mišične bolečine, je miofascialno sproščanje s penastim valjem. Gre za postopek samomasaže, pri kateri posamezniki za pritisk na mehkotkivne strukture uporabijo težo telesa. Obstajajo dokazi, da miofascialno sproščanje s penastim valjem izboljša obseg sklepne gibljivosti, zmanjša akutno mišično okorelost in občutenje zapoznele mišične bolečine. Namen: Namen diplomskega dela je na podlagi pregleda literature predstaviti učinkovitost miofascialnega sproščanja s pomočjo penastega valja na zmanjšanje zapoznele mišične bolečine. Metode dela: Iskanje literature je potekalo v podatkovni bazi PubMed z različnimi kombinacijami ključnih besed v angleščini: »delayed onset muscle soreness«, »foam rolling«, »myofascial release«, »exercise induced muscle damage« in »muscle recovery«. Iskanje literature je bilo omejeno na obdobje od leta 2011 do 2021. Vključene so bile kontrolirane randomizirane raziskave in raziskave, kjer so bili preiskovanci deljeni na kontrolno in intervencijsko skupino. V vključenih raziskavah so sodelovali samo zdravi preiskovanci. Rezultati: V pregled literature je bilo vključenih sedem raziskav, v katerih so avtorji želeli ugotoviti učinkovitost miofascialnega sproščanja s penastim valjem na zmanjšanje zapoznele mišične bolečine. V vseh raziskavah so izvedli protokole, s katerimi so povzročili z vadbo povzročene mišične poškodbe in izzvali zapoznelo mišično bolečino. V šestih raziskavah so primerjali rezultate med kontrolno skupino, ki ni bila deležna nobene terapije, in intervencijsko skupino, v kateri so preiskovanci izvajali miofascialno sproščanje s penastim valjem. V eni raziskavi pa so primerjali učinkovitost terapije z običajnim in vibracijskim penastim valjem. V šestih od sedmih vključenih raziskav so rezultati meritev nakazali, da se je občutenje bolečine pri preiskovancih, ki so bili deležni intervencije s penastim valjem, občutno zmanjšalo v primerjavi s preiskovanci iz kontrolne skupine. Razprava in zaključek: Iz pregledanih raziskav lahko sklepamo, da je miofascialno sproščanje s penastim valjem učinkovita tehnika pri zmanjševanju občutenja zapoznele mišične bolečine. Rezultati so sicer omejeni samo na zdrave mlade preiskovance, zato se jih ne da posplošiti na širšo populacijo. Potrebne so še dodatne raziskave z jasnejšimi določili terapevtskih parametrov. Introduction: Delayed onset muscle soreness is a common occurrence, it is a consequence of micro muscle damage which arise after physical activity, especially after eccentric muscle work. The symptoms of delayed onset muscle soreness appear 12 – 24 hours after physical activity and usually peak within the first 72 hours. One of the interventions, that is supposed to be effective in minimizing symptoms of delayed onset muscle soreness is myofascial release with foam rollers. It is a technique of self-massage, where individuals use their body mass to apply pressure on soft tissue structures. There is evidence, that besides lowering the perception of delayed onset muscle soreness, myofascial release is also effective in increasing range of motion and lowering acute muscle stiffness. Purpose: The purpose of this diploma work is to review the efficiency of myofascial release with foam rolling on reducing delayed onset muscle soreness. Methods: The literature search was proceeded through the PubMed article browser with the different combinations of keywords: »delayed onset muscle soreness«, »foam rolling«, »myofascial release«, »exercise induced muscle damage« in »muscle recovery«. We have searched for the articles published between years 2011 and 2021. Research that was included were randomized controlled trials and the ones where subjects under investigation were divided into control and foam rolling group. All the people included in analysed articles were healthy young adults without any injuries. Results: Seven articles were included in this literature review. In every analysed article exercised induced muscle damage protocols were performed to achieve delayed onset muscle soreness. In six articles comparisons were made between control group and intervention group, in which foam rolling protocols were performed. In one research they also compared effects of normal and vibration foam roller. In six out of seven research results have shown that people in intervention groups had reported greater decrease in perception of muscle pain compared to people in control group. Discussion and conclusion: From the current available results regarding efficiency of foam rolling on decreasing delayed onset muscle soreness we can conclude that it could be efficient. Although the results are limited only on healthy young adults. Regardless, some additional research are needed for clearer guided lines regarding therapeutic parameters.

Uvod: Osteoartroza je pogosta degenerativna okvara sklepnega hrustanca, povezana s hipertrofičnimi spremembami na kosteh. Klinično se osteoartroza kolka kaže z bolečino, splošno zmanjšano gibljivostjo, spremenjeno hojo, zmanjšano propriocepcijo spodnjih udov ter slabšim ravnotežjem in šibkostjo okoliških mišic. Za terapijo se priporoča telesna vadba in izguba telesne mase, medtem ko se samo nadzorovani terapevtski programi in uporaba manualne terapije v kombinaciji s telesno vadbo pogojno priporoča. Namen: Na podlagi pregleda literature predstaviti učinke manualne terapije na splošno zdravstveno stanje, bolečino, obseg gibljivosti, funkcijsko zmogljivost, dinamično ravnotežje in mišično zmogljivost pri pacientih z osteoartrozo kolka. Metode dela: Literaturo objavljeno po letu 2010 smo iskali v podatkovnih zbirkah PubMed, Cochrane Library, PEDro ter z iskanjem v referencah objavljenih pregledov literature. Rezultati: V analizo smo vključili devet člankov, ki so bili dostopni v polnem besedilu. Rezultati o učinkih manualne terapije na obseg gibljivosti in zmanjšanje bolečine so v večini raziskav dokazali učinkovitost. Manualna terapija ni bila učinkovita pri izboljšanju funkcijske zmogljivosti in splošnega zdravstvenega stanja, vendar so rezultati nejasni. Manualna terapija ni bila učinkovita pri izboljšanju dinamičnega ravnotežja in mišične zmogljivosti. Razprava in zaključek: V nekaterih analiziranih raziskavah je bil učinek manualne terapije nejasen, ker so njen učinek preučevali v kombinaciji z drugimi terapevtskimi postopki. Potrebne so nadaljnje raziskave, v katerih bi učinke manualne terapije preučevali samostojno in daljše časovno obdobje. Introduction: Osteoarthritis is a common degenerative disorder of articular cartilage associated with hypertrophic changes in bone. Clinically, osteoarthritis of the hip manifested by pain, globally reduced range of motion, altered gait, decreased proprioception of the lower extremities and poorer balance and weakness of the surrounding muscles. Physical exercises and weight loss are highly recommended, while participation in self-controlled programs and the use of manual therapy in combination with physical exercises were conditionally recommended. Purpose: Based on a literature review, the effects of manual therapy on general health, pain, range of motion, functional performance, dynamic balance and muscle strenght in patient with hip osteoarthritis are presented. Methods: Literature published after 2010 was searched in the databases PubMed, Cochrane Library, PEDro and by searching the references of published literature reviews. Results: Nine articles, available in full text were included in the analysis. Results on the effects of manual therapy on range of motion have been shown to be effective in most studies. Manual therapy has not been effective in improving functional performance and general health, but the results are unclear. Manual therapy has not been effective in improving dynamic balance and muscle performance. Discussion and conclusion: In some analysed studies, the effect of manual therapy is unclear because manual therapy has been studied in combination with other therapies. Further research is needed to study manual therapy individually and over longer period.