Introduction/Objective. Neurological impairment and immobility in stroke patients can lead to numerous complications. This study aimed to evaluate the effect of cycling exercises with visual feedback combined with conventional rehabilitation on neurological and motor recovery, balance, walking speed and endurance, and activities of daily living (ADL) in patients after acute and subacute stroke. Methods. A randomized prospective controlled trial was applied to this research. One hundred and twenty-seven hemiplegic stroke patients who received in-hospital rehabilitation were randomly assigned into two groups. Both groups received conventional rehabilitation treatment. The experimental group had an extra 30 minutes of cycling exercises for the upper and lower extremities on a stationary ergocycle MOTOmed muvi. Both groups? neurological status, upper and lower limb function, independence in ADL, balance, walking speed, and endurance were observed before and after the rehabilitation treatment. Outcome measures used were the National Institute of Health Stroke Scale (NIHSS), the modified Ashworth scale (MAS), the Brunnstrom Motor Evaluation Scale (BMES), upper and lower Fugl-Meyer assessment (FMA), the Barthel index (BI), the Berg Balance Scale (BBS), the six-minute walk test (6MWT) and the Timed Up and Go test (TUG). Results. The neurological recovery on the NIHSS scale, spasticity of the knee extensor measured by the MAS, the BMES and FMA-LE subscale for the affected leg, and the 6MWT presented more significant improvement in the experimental group than in the control group after the treatment (p < 0.05 for all three analyses). Conclusion. Cycling exercises with visual feedback combined with conventional rehabilitation could promote neurological recovery and improve the motor function of the affected leg and walking speed in patients recuperating after acute and subacute stroke.

Microdiscectomy is one of the surgical methods for the treatment of herniated intervertebral disc in patients with low back pain. The aim of the research was to evaluate the presence of psychological and cognitive-behavioral factors, including anxi...

Introduction. Although transcutaneous electrical nerve stimulation and diadynamic currents are widely used in the treatment of painful conditions, their effectiveness in acute low back pain is still controversial. The aim of this study was to evaluate the therapeutic effects of transcutaneous electrical nerve stimulation and diadynamic current therapy in patients with acute low back pain. The study was designed as a single-blind randomized controlled trial. Material and Methods. A total of 60 patients with acute low back pain, recruited from physiotherapy referrals, were included in the study. Thirty consecutive patients randomized to receive transcutaneous electrical nerve stimulation were in the experimental group, and 30 patients treated with diadynamic current were included in the control group. The primary outcome variable, measured at days 1 and 10 was pain intensity, measured using a visual analogue scale. Secondary outcome measures were lumbosacral spine flexibility (measured by Schober test), lumbar paraspinal muscle tone evaluated by palpation of the affected paraspinal muscles, and hip range of motion during the straight leg raise test in the supine position. Results. All the parameters in each group showed significant improvements after 10 days of physical therapy (p < 0.01). Statistical analysis showed that there were significant differences between the groups in pain relief and sensitivity of paraspinal muscles after the treatment, mostly due to the experimental group (p < 0.01). Conclusion. In conclusion, transcutaneous electrical nerve stimulation and diadynamic current therapy can be used in rehabilitation of patients with acute low back pain, but transcutaneous electrical nerve stimulation seems to have better pain modulation effect than diadynamic current therapy.

Introduction. A multidisciplinary and therapeutic approach is used for patients with osteoporotic bone fractures. Falls, leading to injuries, including bone fractures, are a common occurrence in the elderly suffering from osteoporosis. Multifactorial risk assessment is of great importance in identifying risk factors for the occurrence of falls, their removal and implementing preventive measures. The issue of risk assessment is very current and treated by related professional recommendations and national and international guidelines. The latter point out the following fall risks: previous falls, use of psychotropic substances, vision impairment, mobility, gait, muscle strength and balance and impairment of cognitive functions. Fear of falling, psychological passivity, urinary incontinence, inadequate footwear and certain neurologic and cardiovascular conditions are also considered additional risks. Fall risks may also be environmental (within the dwelling and outside), such as low lighting, inadequate furniture and its disposition, difficulty in accessing the bed, chair, toilet, bathroom, stairs and other. For a realistic fall risk estimate, besides using adequate questionnaires, several static and dynamic tests may be used to assess balance and mobility. Depending on the type of risk factors present, actions for their removal through information, education and participation of the elderly in preventive measures are also recommended. Conclusion. Multifactorial risk assessment of fall occurrence and bone fracture, as of recovery, are of great importance within certain population groups, especially the elderly.

Background/Aim. A very limited amount of data regarding the rehabilitation outcome of surgical patients with COVID-19 is available in the current literature. The aim of this study was to point out the characteristics of early rehabilitation of these patients and determine the predictors of rehabilitation outcomes. Methods. The study was designed as a prospective clinical trial. It included patients who had surgical treatment from April 1, 2022, to March 31, 2023, at the University Clinical Center of Vojvodina, Serbia and either had positive results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) preoperatively or developed coronavirus disease 2019 (COVID-19) within 72 hrs after surgery. The rehabilitation program was planned for each patient according to the type of surgical treatment, age, clinical presentation and severity of the COVID-19, length of immobilization, and comorbidities. Rehabilitation treatment (RT) started with a minimum of one 30-minute daily session, up to three 30-minute sessions daily. Patients were assessed at the beginning of RT and discharge. Outcomes were assessed with the Modified Borg Scale (MBS) for dyspnoea, Barthel index (BI) for activities of daily living, Six-Minute Walk Test (6MWT) for exercise tolerance, and Timed up and Go (TUG) test for balance and lower limb mobility. Results. A total of 81 patients were included in the study. RT was successful for 42 patients (24 female and 18 male) with an average age of 62.10 ? 20.07 years. These patients exhibited significant functional improvement, which was measured by all tests that assessed rehabilitation outcome at discharge: BI (p < 0.001), MBS (p < 0.001), 6MWT (p < 0.001), and TUG test (p < 0.001). The remaining 31 patients had unsuccessful RT. The binary logistic regression analysis has shown that age (p = 0.009), cardiovascular disease (p = 0.017), and malignancy (p = 0.022) were significant predictors of rehabilitation outcome. Conclusion. Results of the present study implicate that individually tailored RT during the acute phase of COVID-19 in surgical patients is very challenging. Advanced age, cardiovascular disease, and malignancy are predictors of unfavorable outcomes, and careful consideration is needed when planning the treatment for these patients.