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Cilj rada je ustvrditi na koje načine bolest utječe na pojedinca, njegove vrijednosti, djelovanja te značenja pripisivana tijelu, a zatim i ima li potencijal promjene društvenih. Pritom se na bolest gleda kao na utjelovljeno iskustvo, a na tijelo kao na mjesto društvene koreografije. Ovaj pristup u fokus stavlja prostor intersubjektivnosti, odnosno propituje tenziju između individualnog subjekta i društveno konstruiranog objekta. Pritom u prvi plan dolaze pojmovi poput srama, epistemičke nepravde, aspektnog zatočeništva, ali i društveno-povijesni procesi koji utječu na poimanje i doživljavanje bolesti, poput kršćanstva, kartezijanskog naslijeđa te biomedicinskog diskursa. Metodologija kojom se koristim je etnografska, a obuhvaća kvalitativne intervjue, analizu autobiografskog narativa te stručne literature iz područja fenomenologije bolesti, medicinske antropologije i antropologije tijela. The purpose of this thesis is to determine the ways in which illness affects the individual, his values, actions and meanings attributed to the body, and subsequently whether it has the potential for social change. In doing so, illness is seen as an embodied experience, while the body is perceived as a place of social choreography. This approach focuses on the space of intersubjectivity, that is, questions the tension between the individual subject and the socially constructed object. Concepts such as shame, epistemic injustice, aspectival captivity come to the fore, but also socio-historical processes that influence our understanding and experiencing of illness, such as Christianity, the Cartesian legacy and the biomedical discourse. The methodology I use is ethnographic. It includes qualitative interviews, analysis of autobiographical narrative and of scientific literature from the fields of illness phenomenology, medical anthropology and anthropology of the body.

Uvod: Najpogostejša strukturna deformacija hrbtenice je skolioza. Pri nekaterih pacientih je mogoče določiti osnovni vzrok skolioze, vendar pa vzrok pri večini skolioz ni znan. Izraz idiopatska skolioza se nanaša na paciente, pri katerih ne najdemo jasnega vzroka bolezni. Adolescentna idiopatska skolioza je najpogostejša idiopatska skolioza, ki jo diagnosticiramo kadar je Cobbov kot na rentgenskem posnetku večji od 10°. Dejavniki ki napovedujejo povečanje patološke krivine hrbtenice so: zrelost (kronološka starost, menarha, skeletna zrelost, Risserjev znak), velikost, tip in lokacija krivine. Cilj konservativnega kot tudi operativnega zdravljenja skolioze je preprečiti napredovanje ukrivljenosti hrbtenice. Kot pomemben del konservativnega zdravljenja so se izkazale tudi stabilizacijske vaje, ki se pogosto uporabljajo pri zdravljenju adolescentne idiopatske skolioze. Namen: Namen diplomskega dela je, na podlagi pregleda strokovne in znanstvene literature, ugotoviti učinkovitost stabilizacijskih vaj pri pacientih z adolescentno idiopatsko skoliozo. Metode dela: Raziskave so bile izbrane v elektronski podatkovni zbirki PubMed s ključnimi besedami »adolescent scoliosis AND stabilization exercise«. Izbrane so bile raziskave, ki so ustrezale sledečim vključitvenim merilom: članki s prosto dostopnim celotnim besedilom, raziskave, ki so bile objavljene po letu 2012, randomizirane kontrolirane raziskave, raziskave, v katerih so ocenjevali učinkovitost stabilizacijskih vaj pri pacientih z adolescentno idiopatsko skoliozo. Rezultati: V pregled literature je bilo vključenih pet raziskav. V štirih raziskavah je bila učinkovitost stabilizacijske vadbe primerjana z drugo obliko vadbe (za skoliozo specifične fizioterapevtske vaje, vaje za osnovno zavedanje telesa, Schroth pristop), v eni raziskavi pa sta bili primerjani nadzorovana, vodena stabilizacijska vadba s strani strokovnjaka in nenadzorovana stabilizacijska vadba, izvajana samostojno v domačem okolju. V večini izbranih raziskav so ugotovili statistično značilno izboljšanje rezultatov meritev rotacije trupa s skolimetrom, Cobbovega kota, intenzitete bolečine, kakovosti življenja, vizualnega in haptičnega zaznavanja, zaznavanja položaja telesa, subjektivne zaznave deformacije trupa in izboljšanje periferne mišične moči. Večinoma so bile v teh raziskavah ugotovljene statistično značilne izboljšave znotraj posameznih intervencijskih skupin. Vse raziskave pa niso pokazale statistično značilnih razlik med različnimi vadbenimi pristopi, zato je potrebno nadaljnje raziskovanje. Razprava in zaključek: Rezultati pregledanih raziskav kažejo, da ima stabilizacijska vadba pozitivne učinke pri zmanjševanju intenzitete bolečine, povezane s skoliozo, preprečuje napredovanja skolioze, zmanjša asimetrijo in deformacijo hrbtenice ter vpliva na kakovost življenja posameznika s skoliozo. V prihodnjih raziskavah bi bilo potrebno upoštevati naslednja priporočila: vključiti večje število preiskovancev, daljše vadbene programe, uporabiti enotna merilna orodja za vrednotenje rezultatov in spremljati dolgoročne vplive vadbe. Introduction: Scoliosis is the most common structural deformity of the spine. In some patients, the underlying cause of scoliosis can be determined, but the cause of most scoliosis is unknown. Idiopathic scoliosis refers to patients in whom no clear cause of the disease is found. Adolescent idiopathic scoliosis is the most common idiopathic scoliosis and is diagnosed when the Cobb angle on the radiograph is greater than 10⁰. Factors predictive of increase in the pathological curvature of the spine are: maturity (chronological age, menarche, skeletal maturity, Risser sign), size, type and location of curvature. The aim of conservative as well as operative treatment of scoliosis is to prevent the progression of spinal curvature. Stabilisation exercises, which are commonly used in the treatment of adolescent idiopathic scoliosis, have proven to be an important part of conservative treatment. Purpose: The aim of this diploma work is to determine the effectiveness of stabilisation exercises in patients with adolescent idiopathic scoliosis based on a review of the literature. Methods: Studies were selected if they met the following inclusion criteria: articles with freely available full text, studies published after 2012, randomised controlled trials, studies evaluating the effectiveness of stabilisation exercises in patients with adolescent idiopathic scoliosis. Results: Five studies were included in the literature review. Four studies compared the effectiveness of stabilisation exercise with another form of exercise (Scientific Exercises Approach to Scoliosis, basic body awareness therapy, Schroth exercises) and one study compared supervised, guided stabilisation exercise with unsupervised stabilisation exercise performed independently in the home environment. Most studies found statistically significant results within-group differences for measures of trunk rotation with a scoliometer, Cobb angle, pain intensity, quality of life, visual and haptic perception, body position perception, subjective perception of trunk deformity, peripheral muscle strength. However, not all studies showed the same statistically significant differences between the different exercise approaches, so further investigation is needed. Discussion and conclusion: The results of reviewed research suggest that stabilisation exercise has positive effects in reducing the intensity of pain associated with scoliosis, preventing scoliosis progression, reducing asymmetry and spinal deformity, and affects on the quality of life of individuals with scoliosis. Future research should consider the following recommendations: include a larger number of subjects, longer exercise programmes, use uniform measurement tools to evaluate the results and monitor the long-term effects of exercise.

Skolioza je medicinsko stanje koje je, u širem smislu, opisano kao lateralna zakrivljenost kralježnice, odnosno zakrivljenost u frontalnoj ravnini. Međutim, skolioza nije iskrivljenje kralježnice samo u jednoj (frontalnoj) ravnini nego u sve tri ravnine (i sagitalnoj i horizontalnoj). Dakle, radi se o trodimenzionalnoj deformaciji kralježnice. Kralježnica je u frontalnoj ravnini savijena prema lateralno (postranično), u sagitalnoj je ravnini smanjena fiziološka torakalna kifoza (ili fiziološka lumbalna lordoza), a u horizontalnoj ravnini nastaje torzija kralježaka (zavrtanje jednog dijela trupa prema drugom dijelu trupa) uz rotaciju cijele kralježnice (oko uzdužne osovine), zajedno s rebrima. Tako nastaje deformitet prsnog koša sa stražnjom rebrenom grbom na strani konveksiteta zakrivljenosti te prednjom rebrenom grbom na strani konkaviteta zakrivljenosti. U lumbalnom dijelu gdje nema rebara, izbočenje (grba) je znatno manje,a izbočenje se odnosi na vrh zdjelice i na meka tkiva. Kroz povijest su se prije svega koristile konzervativne metode,tj. ne operacijske kojima se pokušala zaustaviti progresija ili pak potpuno izlječenje osobe sa skoliozom. Danas su glavne metode konzervativnog liječenja fizikalna terapija i terapija ortozama. Razlikujemo više oblika i metoda tjelovježbe od kojih su se neke formirale od početka 20.stoljeća. Danas ih prilagođavamo potrebama svakog pacijenta, također razlikujemo brojne oblike ortoza u liječenju skolioza s naglaskom od koliko dijelova su rađene, od kakvog su materijala, na koji segment kralježnice djeluju itd. Scoliosis is a medical condition that, in a broader sense is described as a lateral curvature of the spine, ie a curvature in the frontal plane. However, scoliosis is not a curvature of the spine in only one (frontal) plain but in all three plaines (sagittal and horizontal). Thus, it is a three-dimensional deformity of spine. The spine is bent laterally in the frontal plain, physiological thoracic kyphosis (or physiological lumbar lordosis) is reduced in the sagittal plain, and torsion of the spine occurs in the horizontal plain (rotation of one part of the torso towards the other part of the torso) with rotation of the whole spine (around the longitudinal axis), together with the ribs. This creates a deformity of the chest with the posterior rib crest on the side od the convexity of curvature and the front rib crest on the side of the concavity of curvature. In the lumbar region where there are no ribs, the protrusion (hump) is much smaller, and the protrusion refers to the top of the pelvis and to the soft tissues. Throughout history, conservative methods have been used, ie non – surgical methods that tried to stop the progression or complete cure of each patient, we also distinguish many forms of orthosis in treatment of scoliosis with emphasis on how many parts they are made of, what material they are, what segment of the spine they act on,etc.

Patients with severe adolescent idiopathic scoliosis (AIS) require instrumented spinal fusion surgery. The range of instrumented vertebra is still questioned, especially the selection of the lowest instrumented vertebra (LIV). This single institution retrospective consecutive study is to provide real-world data on outcomes. The study aims to assess whether bending films can determine the LIV. The method of determination of the lower tilted vertebra (LTV) is presented. The selection of the LTV was identified on standing PA (LTVs) and on bending X-rays (LTVb). Group A is a reference group, with less flexible curves. Groups B and C contained patients with more flexible curves. Group B covered patients with instrumentation ending at the LTVs and group C with shorter instrumentation ending at LTVb. The disc angle below the LIV was monitored for postoperative decompensation. Sixty-eight subjects with AIS Lenke 1A and 1B types underwent selective fusion. The decompensation criteria of the unfused disc below the fusion were determined as a wedging disk of >5 degrees of the Cobb angle. The patients were monitored during the postoperative period with 5.8 years average followup (minimum of 2 years). The rate of decompensation was comparable in groups A and B (31% and 33%, respectively). In contrast, the rate of decompensation was doubled in group C (60%). Caudal fusion shortening in more flexible curves according to bending films is associated with the first free disc asymmetry, which leads to decompensation below the fusion. This method should be considered in addition to other LIV selection criteria. Pacienti s těžkou adolescentní idiopatickou skoliózou (AIS) vyžadují operační léčbu instrumentovanou spinální fúzí. Rozsah instrumentované fúze je stále zpochybňován, zejména výběr nejnižšího instrumentovaného obratle (LIV). Tato retrospektivní konsekutivní studie poskytuje real-world data evidence. Cílem studie je posoudit, zda úklonové snímky páteře mohou ovlivnit selekci LIV. Je uvedena metoda stanovení dolního tiltovaného obratle (LTV). Výběr LTV byl identifikován na stojících PA (LTV) a na úklonových rentgenových snímcích (LTVb). Skupina A je referenční skupina s méně flexibilními křivkami. Skupiny B a C obashují pacienty s flexibilnějšími křivkami. Skupina B zahrnuje pacienty s instrumentací končící na LTV a skupina C s kratší instrumentací končící na LTVb. Úhel disku pod LIV byl sledován pro pooperační dekompenzaci. Šedesát osm subjektů s typy AIS Lenke 1A a 1B podstoupilo selektivní fúzi. Kritéria dekompenzace prvního volného disku pod fúzí byla stanovena jako úhel disku s >5° Cobbova úhlu. Pacienti byli sledováni v pooperačním období s průměrnou dobou sledování 5,8 roku (minimálně 2 roky). Míra dekompenzace byla srovnatelná ve skupinách A a B (31 %, resp. 33 %). Naopak míra dekompenzace byla ve skupině C dvojnásobná (60 %). Zkracování kaudální fúze v pružnějších křivkách podle úklonových snímků je spojeno s asymetrickým rozevřením disku, které vede k dekompenzaci pod fúzí. Tato metoda by měla být brána v potaz jako doplněk k dalším kritériím výběru LIV.

Sažetak: Glavni cilj ovog istraživanja bio je na osnovu pregleda najnovijih smjernica za skoliozu sistematizirati te prikazati najnovije smjernice za fizioterapijsku procjenu kod pojedinih tipova skolioze. Pri tomu je naglasak bio na standardnoj fizioterapijskoj procjeni. Za prikupljanje podataka korištene su sljedeće baze podataka: PubMed, Pedro i Google Scholar, zaključno sa 12. veljače 2022. godine. Radovi su navedeni prema referencama, a uključivali su one koji su imali za cilj prikazati pristup u liječenju raznih tipova skolioze te smjernice za terapiju istih. Nakon sustavnog pregleda literature, odnosno metoda pristupa tretiranju skolioze, može se reći da je kod navedenih smjernica za provođenje fizioterapijske procjene utvrđena klinička vjerodostojnost. Obzirom na multifaktorsku etiologiju skolioze, pristup fizioterapijskoj procjeni također treba sagledati u tom kontekstu. Stoga je jedan od glavnih ciljeva međunarodnog Znanstvenog društva za ortopedsko i rehabilitacijsko (konzervativno) liječenje skolioze uskladiti glavne smjernice za standardnu procjenu skolioze. Upravo su fizioterapeuti važna karika za uspješno djelovanje u prevenciji daljnjeg razvoja i terapiji skolioze. Summary: The main objective of this review was to systematize and present the latest guidelines for physiotherapy assessment in certain types of scoliosis based on a review of the latest guidelines for scoliosis. The emphasis was on standard physiotherapy assessment. For data collection, PubMed, Pedro and Google Scholar were used, as of February 12, 2022. The papers were listed according to the references. They included those that aimed to present an approach in the treatment of various types of scoliosis and guidelines for their treatment. After a systematic review of the literature, ie the method of approach to the treatment of scoliosis, it can be said that the clinical guidelines have been established in the above guidelines for conducting physiotherapy assessment. Given the multifactorial etiology of scoliosis, the approach to physiotherapy assessment should also be considered in this context. Therefore, one of the main goals of the International Scientific Society for Orthopedic and Rehabilitation (Conservative) Treatment of Scoliosis is to harmonize the main guidelines for standard assessment of scoliosis. Physiotherapists are an important link for successful action in the prevention of further development and treatment of scoliosis.

The bachelor thesis is divided into two parts, namely the theoretical and practical parts. The theoretical part of the bachelor thesis deals with a description of the kinesiology of the spine, defining the term scoliosis and classification of scoliosis, focuses on respiratory function, deep stabilization system, and its connection with respiratory and postural functions. At the end of the theoretical part, respiratory physiotherapy and its individual methods are described, which are widely used in patients with scoliosis. The aim of the bachelor thesis is to describe the treatment options for patients with scoliosis, which was fulfilled in the theoretical part of the bachelor thesis, and in the form of case studies to describe therapeutic procedures affecting postural and respiratory functions in specific patients. The practical part of the bachelor´s thesis is conducted in the form of qualitative research, because the research sample consists of three adult patients who were diagnosed with the scoliosis. The sub-targets are verified through individual therapies lasting between two and three months, during which postural and respiratory functions in specific patients are monitored. The results of the survey are recorded in a brief evaluation of the effectiveness of the therapy. The bachelor thesis can be used by physiotherapists as an inspiration for therapeutic procedures in individual patients, or it can serve as educational material for the general public, who would like to learn more about the topic of scoliosis or methods used in the treatment of scoliosis.

Bakalářská práce Terapie neuromuskulárních skolióz 1 Abstract The aim of this thesis is to present the methods of therapy of neuromuscular scoliosis in the Czech Republic and in the world and to compare their effects on the basis of published research. The theoretical part describes the basic anatomy of the spine, biomechanical view of the spine and its pathology. Subsequently, the concept of scoliosis is characterized, the classification of scoliosis according to different criteria and idiopathic scoliosis is briefly described. Neuromuscular scoliosis, its definition, classification and the most common disease in pediatric patients, where secondary scoliosis develops and is an integral part of the clinical picture of the underlying disease, are described in detail. The basic examination of idiopathic scoliosis and specifics for the examination of neuromuscular scoliosis are then described. Last but not least, the therapy in the Czech Republic and subsequently abroad is reviewed. The practical part of the thesis is based on a case report of a patient with primary disease spinal muscular atrophy type I who developed neuromuscular scoliosis. Based on the initial kinesiological analysis, an appropriate therapy will be selected. The Cobb angle will be monitored as an objective parameter.

Uvod: Hrbtenica omogoča telesu gibljivost trupa in glave, prav tako pa mu daje oporo, ravnotežje in pokončno držo. Pri človeku ima v sagitalni ravnini obliko črke S, v frontalni ravnini pri vzravnanem telesu pa je ravna. V prsnem in križničnem delu je izbočena nazaj, v ledvenem in vratnem delu pa naprej. Raznovrstne deformacije in bolezenski procesi pa lahko privedejo do stranske ukrivljenosti hrbtenice ali skolioze. Danes jo opredeljujemo kot tridimenzionalno torzijsko deformacijo hrbtenice in trupa, ki povzroči lateralni odklon v frontalni ravnini, aksialno rotacijo v horizontalni ravnini in spremembo sagitalnega profila. Idiopatskih skolioz je 80 %, ostalih 20 % pa sekundarnih. Zdravljenje skolioze lahko poteka operativno oziroma konzervativno. Namen: Namen diplomskega dela je raziskati vplive konzervativnega in operativnega zdravljenja za paciente v odrasli dobi. Metode dela: V diplomskem delu je bila uporabljena deskriptivna metoda s pregledom domače in tuje literature pri primerjavi med ortotičnim in operativnim zdravljenjem pri pacientih z AIS. Analizirali smo tri vprašalnike ter na podlagi pregledanega sestavili anketo, s katero smo anonimno anketirali odrasle paciente z adolescentno idiopatsko skoliozo. Rezultati: Anketni vprašalnik je sestavljen iz osnovnih podatkov, ki zajemajo starost in spol preiskovancev ter šestnajst vprašanj o velikosti krivine hrbtenice pred in po zdravljenju AIS, bolečini, težavah z dihanjem ter vrstah zdravljenja. V raziskavi je sodelovalo 71 oseb, od tega je bilo 63 žensk in 8 moških. Povprečna starost preiskovancev je bila 39,1 let. Razprava in sklep: Med pregledom rezultatov ankete smo ugotovili, da je bila večina preiskovancev zdravljenih konzervativno, nekaj pa tudi operativno. Preiskovanci so navajali močne bolečine in težave z dihanjem predvsem ob večjem fizičnem naporu. Prišli smo do spoznanja, da se zdravstveno stanje pacientov s starostjo slabša, prav tako pa smo opazili, da delež pacientov z AIS ne pozna velikosti ukrivljenosti svoje hrbtenice. Introduction: The spine enables the movement of the torso and head, as well providing it with support, balance and an upright posture. The sagittal plane of the human spine is the shape of an 'S', whereas the frontal plane of an upright corpus is straight. It is extruded backwards at the height of the chest and sacrum, intruded at the kidneys and neck. Various deformations and illnesses can also lead to a lateral deformation of the spine or scoliosis. Today this condition is classified as a three-dimensional torsional deformation of the spine, caused by a lateral deviation of the frontal plane, axial rotation of the horizontal plane, implicitly, the change of the sagittal profile. The total of 80 % of all cases are recognized as idiopathic scoliosis, with the other 20 % being secondary. Treatment of this condition can be surgical or conservative. Purpose: The intent of the diploma thesis is to research the impacts of both conservative and surgical treatment methods on adult patients. Methods: The literature review of domestic and foreign literature was conducted. Comparisons of orthotic and operative treatments on patients with AIS were of primary focus in the source material. We analyzed three questionnaires and based on the review we compiled a survey with which we will anonymously survey adult patients with adolescent idiopathic scoliosis. Results: The survey questionnaire consists of basic data, which are gender and age and sixteen questions, which were all related to the curvature of spine before and after treatment of AIS, pain, breathing problems and form of treatment. In total, 71 people participated in the survey, 63 of which were women and 8 participants were men. The average age of participants was 39.1 years. Discussion and conclusion: Upon analysis it was determined that most subjects were treated conservatively, only a few were treated operatively. Subjects reported of severe pain and difficult breathing, especially with increased physical exertion. It can be observed that the health status of patients deteriorates with age. The data also show that a number of patients with AIS are not aware of the extent of their spinal curvature.

Koncept kvalitete života se često koristi u medicini kao ishodišna mjera određenog liječenja ili rehabilitacije. Zbog toga danas postoje brojni upitnici kojima se mjeri kvaliteta života kod raznih patoloških stanja te mjerni instrumenti za procjenu kvalitete života kod osoba s deformacijama kraljeţnice. S obzirom na to da je idiopatska skolioza na prvom mjestu deformiteta po prevalenciji i po kompleksnosti, uzorak u istraživanju čine adolescenti s dijagnozom idiopatske skolioze tretirani specijaliziranim vježbama po Schroth metodi. SRS-22r upitnik, koji se koristi kod procjene kvalitete života osoba sa skoliozom neovisno o načinu liječenja, do sada nije bio validiran u Republici Hrvatskoj. Osnovni cilj ovog rada je stoga validacija i multikulturalna adaptacija spomenutog mjernog instrumenta. Prvi korak istraživanja bio je proces prijevoda upitnika u duhu hrvatskog jezika. Nakon toga uslijedio je proces validacije. Upitnik sadrži 22 čestice odnosno 22 pitanja koja čine pojedine subskale unutar samog upitnika. Statističkim rječnikom rečeno učinjena je faktorska analiza čestica u upitniku te je mjerena unutarnja konzistencija tih čestica u hrvatskoj verziji prijevoda. Na taj način su dobivene sljedeće subskale: mentalno zdravlje, bol, slika o sebi, funkcionalnost, aktivnost i (ne)zadovoljstvo terapijom. Iako testiranje ne daje identičnu strukturu izvorne verzije upitnika, njime je potvrđeno da je upitnik primjenjiv u zadanom uzorku istraživanja na hrvatskom jeziku. Na osnovu demografskih čimbenika iz upitnika o osobnim podatcima, kao sporedna stvar istraživanja bilo je ispitivanje sporednih hipoteza od kojih su dvije pokazale statistički značajnu razliku. Ispitanici koji nisu imali indikaciju za nošenje ortoze imali su značajno viši rezultat na subskali slika o sebi. To nam govori kako osobe koje ne nose ortozu sebe vide bolje. Ispitanici muškog roda imaju značajno viši rezultat na subskali mentalno zdravlje što govori kako dječaci sa skoliozom imaju manje emocionalnih problema u usporedbi s djevojčicama. Klinički značaj istraživanja leži u tome da je upitnik primjenjiv u budućnosti kao dio slžţbene medicinske dokumentacije u procjeni stanja kod deformacija kralježnice. The concept of quality of life is often used in medicine as a finishing point for a particular treatment or rehabilitation. For this reason, today we have a number of questionnaires that measure the QoL in various pathological conditions. There are also measuring instruments for assessing the quality of life in people with spinal deformities. Since idiopathic scoliosis is the number one deformity in terms of prevalence and also in terms of complexity, the sample in the study consisted of adolescents diagnosed with idiopathic scoliosis treated with specialized exercises according to the Schroth method. The SRS-22r questionnaire used to assess the QoL of people with scoliosis, regardless of the method of treatment, has not yet been validated in Croatia. Therefore, the main goal of this study was the validation and multicultural adaptation of the mentioned measuring instrument. The first step was to translate the questionnaire authentically in the spirit of the Croatian language. After that the validation process could begin. Factor analysis of individual particles in the questionnaire was performed and the internal consistency of the Croatian version was measured. Testing did not give an identical version of the original, but confirmed that the questionnaire was applicable in a selected sample. A side issue of the research was to examine secondary hypotheses compiled within individual subscales of the questionnaire based on demographic factors from the personal data questionnaire. Two statistically significant differences were found; subject who have no indication for wearing an orthosis have a significantly higher score on the self-image subscale which tells us how people who do not wear orthoses see themselves better. Male respondents have had a significantly higher score on the mental health subscale suggesting that boys with scoliosis have fewer emotional problems compared to girls. The clinical significance of the research lies in the fact that the questionnaire is applicable in the future as part of the official medical documentation in the assessment of the condition of spinal deformities.

Zbog današnjeg sjedilačkog načina života, procjena posture postaje sve bitnija. Jedna od komponenti sustava za procjenu posture jest korisničko sučelje. Cilj ovog rada jest razviti korisničko sučelje za postojeći program za 3D skeniranje. Postojeći program koristi sučelje komandne linije, što nije intuitivno niti je pristupačno za korisnike. Dizajnirano je korisničko sučelje za tri glavna zadatka: postavljanje sustava, snimanje pacijenata i analizu rezultata. Korisničko sučelje ujedno ima dodatne mogućnosti, poput podrške za više jezika, što pridodaje boljem i pristupačnijem korisničkom iskustvu. Izvedeno korisničko sučelje odgovara postavljenim ciljevima koji su bili učiniti sučelje intuitivnijim i jednostavnijim za korištenje. Due to today's modern sedentary lifestyle, posture assessment is becoming a necessity. One component of a posture assessment system is the user interface. The goal of this thesis was to design and develop a graphical user interface for an existing 3D scanning software. The existing software uses a command line interface which is neither intuitive nor user friendly. The UI was designed for three key tasks: system preparation, patient scanning, and results analysis. The UI also has additional features such as multi-language support, which adds up to a better and a more accessible user experience. The designed and implemented user interface corresponds with the goal that has been set, which was to make the interface more intuitive and easier to use.

Skolioza je trodimenzionalna deformacija kralježnice u sve tri ravnine, a danas se javlja sve češće zbog sjedilačkog načina života. Osoba koja ima skoliozu najčešće svoje držanje i posturu drži u pasivnom obliku zbog hipotonije ili hipertonije muskulature. Prema etiologiji dijele se na dvije velike skupine: funkcionalne i strukturalne. Funkcionalne se dijele na posturalne i kompenzatorne, dok se strukturalne dijele na kongenitalne i stečene (idiopatske) skolioze. Čimbenici koji utječu na pojavu skolioza najčešće su nagli rast u pubertetu, genetske predispozicije, neurološki deficiti, promjene u mišićnim i vezivnim strukturama, no najčešće je problem u načinu života, odnosno premalo tjelesne aktivnosti. Češće su u djevojčica, nego u dječaka te stvaraju velike zdravstvene, ali i estetske probleme. Dijagnostičke metode uz pomoć kojih se ustanovljuje skolioza ili skoliotično držanje su klinički pregled koji obuhvaća specifične testove, mogućnost rendgenskih snimaka, CT, magnetska rezonanca. Skolioze se liječe konzervativno uz pomoć tjelesne aktivnosti, korektivne gimnastike i primjenom ortoza. Visoku učinkovitost u korekciji skolioza pokazuju primjena kinesio tape-a, plivanje i hipoterapija. Skoliozu je potrebno otkriti što ranije i započeti liječenje na vrijeme kako bi se spriječile moguće komplikacije. Prije operativnog liječenja, ukoliko je neophodno, važno je provesti sve konzervativne metode liječenja kojih je danas sve više. U rehabilitaciji skolioza neophodna je suradnja svih članova tima, uključujući pacijenta i njegovu obitelj. Nastanak skolioze i skoliotičnog držanja mogu se spriječiti edukacijom populacije o korisnosti kretanja i tjelesne aktivnosti te pravilnih navika sjedenja, stajanja, hodanja i nošenja tereta. Scoliosis is a three-dimensional deformity of the spine in all three planes, and today it occurs more and more often due to a sedentary lifestyle. A person who has scoliosis usually keeps his posture in a passive form due to hypotonia or hypertension of the musculature. According to the etiology, we can divide them into two large groups: functional and structural. Functional are divided into postural and compensatory, and structural into congenital and acquired (idiopathic) scoliosis. Factors influencing the occurrence of scoliosis are most often sudden growth at puberty, genetic predispositions, neurological deficits, changes in muscles and connective structures, but most often the problem is lifestyle, or too little physical activity. They are more common in girls than in boys and create major health and aesthetic problems. Diagnostic methods used to establish scoliosis or scoliotic posture are a clinical examination that includes specific tests, the possibility of X-rays, CT, magnetic resonance imaging. Scoliosis is treated conservatively with the help of physical activity, corrective gymnastics and the use of orthoses. The use of kinesio tape, swimming and hippotherapy show high efficiency in the correction of scoliosis. Scoliosis needs to be detected as early as possible and treatment started on time to prevent possible complications. Before surgical treatment, if necessary, it is important to implement all conservative methods of treatment, which are more and more common today. In the rehabilitation of scoliosis, the cooperation of all team members is necessary, including the patient and his family. The development of scoliosis and scoliotic posture can be prevented by educating the population about the usefulness of movement and physical activity and proper habits of sitting, standing, walking and carrying loads.

Cilj ovog istraživanja je ispitati kvalitetu života povezanu sa zdravljem [KŽPZ] u odraslih osoba s adolescentnom idiopatskom skoliozom [AIS]. Cilj istraživanja operacionaliziran je kroz dva istraživačka problema: ispitati razinu kvalitete života povezane sa zdravljem odraslih osoba s adolescentnom idiopatskom skoliozom te ispitati doprinos percepcije bolesti, socijalne podrške, prihvaćanja bolesti i trenutne psihološke uznemirenosti u objašnjenju kvalitete života povezane sa zdravljem. Istraživanje je provedeno putem online upitnika na ukupno 127 sudionika u dobi od 17-50 godina (M=25.9, SD=6.58). U istraživanju je sudjelovalo 112 žena i 15 muškaraca. Sudionici su pružili sociodemografske i zdravstvene informacije te ispunili sljedeće upitnike: skraćena verzija Upitnika o percepciji bolesti, SRS-22r upitnik o kvaliteti života povezanoj sa zdravljem za osobe sa skoliozom, Upitnik prihvaćanja bolesti, Višedimenzionalna ljestvica percipirane socijalne podrške te Upitnik za ispitivanje općih psihopatoloških teškoća CORE-OM. Rezultati pokazuju kako većina sudionika doživljava barem blagu bol radi kralježnice, a slika o sebi prosječno je blago narušena, kao i njihovo psihičko zdravlje. Najveće prosječno nezadovoljstvo sudionika tiče se njihovog tretmana, pri čemu većina sudionika ne iskazuje zadovoljstvo tretmanom leđa te nije sigurna da bi ili sigurno ne bi ponovno izabrala isti tretman. Ukupan rezultat ukazuje na prosječno blago sniženu KŽPZ sudionika. Značajnim prediktorima KŽPZ pokazali su se: prihvaćanje bolesti, percepcija bolesti i psihološka uznemirenost. Dobiveni rezultati ukazuju na potrebu holističkog pristupa pacijentima s AIS te eventualnu dobrobit psihoedukacije ili slične psihološke intervencije. The aim of the study was to investigate health-related quality of life [HRQL] in adults with adolescent idiopathic scoliosis [AIS]. Two research problems included examining the level of health-related quality of life in adults with adolescent idiopathic scoliosis and examining the contribution of perception of illness, social support, illness acceptance and current psychological distress in explaining health-related quality of life. The research was conducted through an online questionnaire on 127 participants aged between 17-50 years old (M=25.9, SD=6.58). There were 112 women and 15 men. Participants provided sociodemographic and health data and completed the following questionnaires: Brief Illness Perception Questionnaire, SRS-22r HRQL Questionnaire, Acceptance of Illness Scale, Multidimensional Scale of Perceived Social Support, and The Young Person's Clinical Outcomes in Routine Evaluation. Results show that most participants experience at least minor pain due to their spine issues, and their self-image, as well as mental health, is mildly impaired. Participants are most unhappy with their treatment, where most participants don’t state they are satisfied with their back treatment and aren’t sure if they would, or they certainly wouldn’t pick the same treatment again. The total score shows a mildly disturbed HRQL. Illness acceptance, illness perception and current psychological distress are significant predictors of HRQL. These results indicate the need for holistic approach in treating AIS patients and potential benefits of psychoeducational or a similar type of intervention for these patients.

Idiopatska skolioza je razvojni poremećaj kralježnice s postraničnom krivinom u frontalnoj ravnini uz kut prema Cobbu veći od 10 st. Izražena u manjem stupnju je estetski poremećaj, ali kod većeg može doći do oštećenja funkcije srca i pluća. Zbog nepoznavanja etio- logije liječenje je simptomsko, usmjereno na ranije prepoznavanje i pravodobno liječenje radi sprječavanja progresije. Cilj istraživanja je identificiranje prediktora za razvoj idiopatske skolioze analizom perinatalnih čimbenika, ranog razvoja i prirođenih malformacija sustava za kretanje, kako bi se anamnezom i kliničkim pregledom prepoznala rizična djeca. Analizirali smo 100 ispitanika s idiopat- skom skoliozom (79 djevojčica i 21 dječak) u dobi od 6-18 godina s kutom prema Cobbu od 15 i više stupnjeva, te kontrolnu skupinu od 100 ispitanika bez idiopatske skolioze. Podatci su unešeni u upitnik, a statistička analiza rađena je Mann-Whitneyjevim, Leveneo- vim testom, hi-kvadrat, Fisherovim egzaktnim i t-testom. U ispitivanim skupinama našli smo značajnu razliku u parametrima: miro- vanje majki u trudnoći, faza puzanja, menarhe i mutacija glasa, pojavnost ravnih stopala, dorzalgija, skraćenje noge i deformacija koštano-zglobnog sustava. Kod devetero djece kasno je dijagnosticirana skolioza u dobi od 15-18 godina, a prema tipu skolioze bilo je: 4C 55, 3C 20, E 18 i n3n4 7 ispitanika. Postoji značajna razlika u skupini djece s idiopatskom skoliozom i bez nje u razvoju, simptomi- ma i deformacijama koštanog sustava koje se identificiraju anamnezom i pregledom prije kliničkih znakova, a upućuju na povećani rizik razvoja u kasnijoj životnoj dobi. Sastavili smo upitnik ispunjavanjem kojeg kod mlađe klinički neupadne djece identificiramo onu s povećanim rizikom, te ih možemo češće kontrolirati, ranije dijagnosticirati idiopatsku skoliozu i započeti optimalno liječenje., Idiopathic scoliosis is a developmental disorder of the spine with lateral curvature in the frontal plane and Cobb angle of more than 10 degrees. Idiopathic scoliosis with minor Cobb angle is an aesthetic disorder, but a significant Cobb angle can cause damage to the heart and lung function. Because its aetiology is unknown, treatment is symptomatic, focused on early recognition and timely treatment to prevent progression. The objective of the study was to identify predictors for the development of idiopathic scoliosis by analysis of perinatal factors, early development and congenital malformations of the locomotor system in order to identify children at risk by history and clinical examination. We analysed 100 subjects with idiopathic scoliosis, 79 girls and 21 boys aged 6-18 years with a Cobb angle of 15 degrees or more, and a control group of 100 subjects without idiopathic scoliosis. Data were entered into the questionnaire, and statistical analysis was done by Mann-Whitney test, Levene test, χ2-test, Fisher exact test and t-test. In the idio- pathic scoliosis group, significant differences were recorded in the following parameters: complications/rest during pregnancy, crawling stage, menarche, and mutation/voice change in boys, expression of flat feet, dorsalgia, leg shortening and deformities of the musculoskeletal system. Idiopathic scoliosis was diagnosed late in nine children aged 15-18 years; according to the type of sco- liosis, 4C type was recorded in 55, 3C in 20, E in 18 and n3n4 in seven subjects. In conclusion, there was a significant between-group difference in development, symptoms and deformities of the skeletal system, identified by history and examination before the onset of clinical signs of idiopathic scoliosis, indicating an increased risk of scoliosis development later in life. We have designed a question- naire to be filled out for younger clinically inconspicuous children in order to identify those at an increased risk, so we can follow-up them more often, diagnose idiopathic scoliosis earlier and start optimal treatment on time.

Skolioza predstavlja učestalu deformaciju kralješnice koju karakterizira patološka lateralna zakrivljenost kralješnice povezana s različitim stupnjem hiperlordoze i poremećajem rotacije s Cobb-ovim kutom zakrivljenosti većim od 10 stupnjeva. Patogeneza i etiologija skolioze je multifaktorijalna te uključuje brojne dokazane okolišne (konzumiranje alkohola, nedostatak vitamina kod KS) i genetske (jednonukleotidni polimorfizam) faktore, no unatoč tome točni molekularni i stanični mehanizmi razvoja bolesti i dalje su nepoznati.