Background/Objectives: Accurate diagnosis of breast cancer-related lymphedema remains a clinical challenge. This study evaluated the diagnostic utility of ultrasound in detecting early lymphedema compared to conventional criteria, including the International Society of Lymphology staging and limb volume measurements. Methods: In this retrospective cross-sectional study, 68 female participants with unilateral breast cancer, who had completed cancer treatment at least six months before study enrolment, underwent both ultrasonographic assessment and standard limb circumference measurements. Ultrasound was performed bilaterally at five standardized anatomical sites. Sonographic parameters included assessment of cutaneous and subcutaneous thickness and echogenicity. Clinical staging and symptom profiles were assessed using ISL criteria and a structured questionnaire. Volume status was determined by relative volume change (RVC). Results: Among 68 participants, 36 were classified as ISL stage 0 and 32 as ISL stage II, 30 had RVC < 5%, while 38 had RVC ≥ 5%. Advanced stages were associated with older age. Multivariate analysis identified increased skin thickness at the medial upper arm cutis as significantly correlated with RVC ≥ 5% (OR 1.49, 95% CI: 1.01–2.21, p = 0.047). A similar trend was observed at the medial forearm (OR 1.3 (95% CI: (0.99, 1.71))). Conclusions: This study highlights ultrasound’s potential for early breast cancer-related lymphedema detection, especially in patients with minimal volume changes where conventional methods fall short. Increased cutaneous thickness in the medial upper arm emerged as a sensitive marker of early disease, while subcutaneous thickness and echogenicity may reflect in advanced stages. This distinction underscores the clinical value of cutaneous thickness as a potential clinical key marker for early lymphedema detection, emphasizing the need for standardized protocols and defined thresholds to guide timely interventions.

Background/Objectives: Shoulder pain is a common treatment outcome in breast cancer survivors. While various risk factors and mechanisms for shoulder pain have been proposed, evidence is inconsistent. Increased risk of subacromial pain syndrome exists, which can lead to disability and reduced quality of life if untreated. Ultrasound is a valuable tool for detecting rotator cuff changes aiding in timely diagnosis of subacromial pain syndrome. This study aimed to assess the prevalence of rotator cuff changes to better understand chronic shoulder pain in breast cancer survivors. Methods: This cross-sectional study included 74 breast cancer survivors from the University Hospital Split. Data were collected via questionnaires and clinical interviews. Bilateral shoulder ultrasounds were performed by two blinded investigators. Categorical variables were analyzed using Chi-squared tests, and continuous variables were analyzed with T-tests or Mann–Whitney tests. Results: Pathological findings were similarly prevalent on the operated and non-operated sides (p = 0.3 and p = 0.6). Among participants with shoulder pain, ultrasound-detected pathology was present in 91% of right shoulders and 96% of left shoulders (p < 0.005). Non-painful shoulders exhibited pathology in 59% of right and 57% of left shoulders. Ipsilateral pain to the site of breast surgery was reported by 57.7% of participants, with supraspinatus pathology in 56%, acromioclavicular joint pathology in 39%, and subacromial–subdeltoid bursitis in 41%. Conclusions: Similar pathology distribution on operated and non-operated sides and frequent asymptomatic findings highlight unresolved causes of shoulder pain in breast cancer survivors. Ultrasound is valuable but requires integration with clinics for accurate diagnosis of the underlying causes of shoulder pain.

Kontaktni timski sportovi su sportske igre koje po svojoj strukturi naglašavaju ili zahtijevaju fizički kontakt između igrača. Iznimno su popularni kod mladih jer pobuđuju intrinzičnu motiviranost kod sportaša i učenika. Bavljenjem ovakvim vidom tjelesne aktivnosti razvijaju se zdravstveni, motorički, funkcionalni i psihološki potencijali kod sportaša. Osim nabrojanih pozitivnih aspekata, postoje i oni negativni koji su vezani uz ozljede koje mogu biti indicirane kontaktom. Ovo pregledno istraživanje ukazalo je da kod kontaktnih sportova najčešće dolazi do ozljeda kostiju, ligamenata i tetiva. Znanstveno su istraženi najpopularniji sportovi: nogomet, košarka, rukomet, ragbi i vaterpolo. Svaki sport zasebno nosi potencijalne rizike od ozljede te je za svaki posebno objašnjen na osnovi preglednih znanstvenih istraživanja. Osim analize najučestalijih ozljeda kod momčadskih kontaktnih sportova, prezentirane su i modificirane inačice za ragbi, košarku i rukomet, kod kojih nema kontakta, čime je smanjena mogućnost ozljeda kod sportaša. Touch rugby, netball i street handball prezentirani su sa svojim pravilima te se mogu vrlo lako implementirati u rad s mladim sportašima i učenicima na satu TZK-a. Ovakve igre potiču uključivanje velikog broja učenika i sportaša, čime se razvija baza za zdravstveno, tjelesno usmjereno vježbanje gdje je mogućnost ozljede svedena na minimum.

Background: Breast cancer-related lymphedema is a common long-term complication of breast cancer treatment that affects physical functioning, emotional well-being, and quality of life. Although the Lymphedema Quality of Life Questionnaire-Arm (LYMQoL-Arm) is widely used internationally, no Croatian version has been available. The primary objective of this study was to translate and validate the Lymphedema Quality of Life Questionnaire-Upper Limb-Croatian (LYMQoL-UL-CRO) version and evaluate its psychometric properties. A secondary objective was to examine associations between its scores and the relative volume change (RVC) of the affected limb to assess construct validity further. Methods: A retrospective cross-sectional study was conducted in 87 women at least six months post-treatment. The questionnaire was translated using a forward-backward procedure. Participants completed the LYMQoL-UL-CRO, the Short Form-36 Health Survey (SF-36), Pain Intensity Numerical Rating Scale, and underwent clinical examination and limb-volume assessment. Test–retest reliability was assessed in 68 participants after 10 days. Psychometric analyses included internal consistency, intraclass correlation coefficients, measurement error indices, construct and discriminant validity tests, exploratory factor analysis, and evaluation of floor and ceiling effects. Results: LYMQoL-UL-CRO domains demonstrated acceptable to strong internal consistency and moderate test–retest reliability, with low measurement error. Strong negative correlations with the SF-36 Physical Component Summary supported construct validity, and participants with RVC ≥ 5% reported worse scores, supporting discriminant validity. Exploratory factor analysis confirmed the original four-factor structure, and no floor or ceiling effects were observed. Conclusions: The LYMQoL-UL-CRO is a reliable, valid, and culturally appropriate tool for assessing quality of life in Croatian breast cancer survivors with upper-limb lymphedema.

Prikaz slučaja 46 godišnje medicinske sestre koja ima drugi stupanj kasnog primarnog limfedema donjih ekstremiteta koji je dijagnosticiran 30 godina nakon pojave prvih simptoma. Nepostojanje ambulante za limfedem, liječnika specijalista koji se bavi limfedemom, smjernica za zbrinjavanje limfedema niti registra za limfedem glavni su uzroci kašnjenja postavljanja dijagnoze limfedema u Hrvatskoj. Terapija limfedema provedena je kroz sedam tretmana u trajanju od 45 minuta, tri puta tjedno. Korišteni su fizioterapijski postupci: ručna limfna drenaža u kombinaciji s kompresivnom terapijom po dr. Partch i edukacija. Dane su upute o provođenju tjelesne aktivnosti. Postignuto je smanjenje volumena unatoč dugotrajnom trajanju limfedema. Promjene u kvaliteti života i razini tjelesne aktivnosti zabilježili smo uz pomoć upitnika. Po završetku terapije pacijentica je upućena ortotičarki radi uzimanja mjera za ravno tkanu kompresivnu odjeću kompresijske klase III. koja je prikladna za fazu održavanja volumena limfedema. Unatoč činjenici da je primarni limfedem kronično stanje, koje je u slučaju naše pacijentice bilo neliječeno preko trideset godina, uz pomoć timskog rada i sveobuhvatnog terapijskog pristupa zbrinjavanju primarnog limfedema moguće je dobiti zadovoljavajuće rezultate terapije te iste održati, posebno ukoliko imate motiviranog i dobro educiranog pacijenta.

Uvod: Tjelesna aktivnost ima ključnu ulogu u očuvanju zdravlja i prevenciji kroničnihbolesti, no njezina razina nije dovoljno istražena među fizioterapeutima, unatoč njihovojvažnoj ulozi u promicanju zdravih životnih navika. Cilj rada je procijeniti razinu tjelesneaktivnosti među fizioterapeutima na području Hrvatske primjenom Međunarodnogupitnika o tjelesnoj aktivnosti – kratka verzija (IPAQ-SF) te utvrditi postoje li razlike urazini tjelesne aktivnosti s obzirom na spol.Metode: Provedeno je presječno istraživanje među zaposlenim fizioterapeutima u RepubliciHrvatskoj na uzorku od 55 ispitanika putem anonimnog online upitnika. Prikupljenisu demografski i radni podaci te je razina tjelesne aktivnosti procijenjena pomoćuvalidiranog IPAQ-SF upitnika, koji rezultate prikazuje kao kategorije ili u MET-minutamatjedno. Podaci su analizirani metodama deskriptivne i inferencijalne statistike. Ukupnatjelesna aktivnost izračunata je prema IPAQ-SF protokolu i izražena u MET-min/tjedan,a ispitanici su klasificirani prema razini tjelesne aktivnosti. Razlike između spolova analiziranesu Mann–Whitney U testom uz razinu značajnosti p < 0,05.Rezultati: Ispitanici su bili najaktivniji u hodanju, koje je bilo prisutno gotovo svakodnevno,dok je intenzivna tjelesna aktivnost bila rjeđe zastupljena. Medijan ukupnetjelesne aktivnosti iznosio je 5976 MET-min/tjedan. Prema IPAQ klasifikaciji, 78,2% ispitanikaimalo je visoku, 12,7% umjerenu, a 9,1% nisku razinu tjelesne aktivnosti. Prosječnovrijeme provedeno sjedeći iznosilo je 297 minuta dnevno. Nisu utvrđene statistički značajnerazlike u razini tjelesne aktivnosti prema spolu (p = 0,647).Zaključak: Ispitanici su općenito bili tjelesno aktivni, uz istodobnu prisutnost značajnogvremena provedenog sjedeći. Nisu utvrđene statistički značajne razlike u razini tjelesneaktivnosti između muškaraca i žena.