SUMMARY – Comorbidity decreases survival but it still remains unknown to what extent functional recovery after ischemic stroke is affected. The aim of this research was to determine the prevalence of the most common comorbidities in patients with ischemic stroke and to examine their predictive value on the functional status and recovery. In order to obtain relevant information for this research, we conducted a prospective study over a two-year period. It included patients with acute/subacute ischemic stroke who had inhospital rehabilitation treatment in our institution. Functional status of the patients was evaluated by the following three aspects at the beginning and at the end of rehabilitation treatment: Rivermead Mobility Index was used for mobility, Barthel Index for independence in activities of daily living, and modified Rankin Scale for total disability. Modified Charlston Comorbidity Index was used to assess comorbidity. Multivariate analysis was applied to evaluate the impact of recorded comorbidities on the patient functional outcome. Independent predictors of rehabilitation success in our study were the value of modified Charlston Comorbidity Index, atrial fibrillation and myocardial infarction. Our study demonstrated that patients with more comorbidities had worse functional outcome after stroke, so it is important to consider the comorbidity status when planning the rehabilitation treatment.
Background:Sarcopenia is a loss of skeletal muscle mass, muscle strength, and function, with an impact on the quality of life, increased risk of bone loss and fracture, which is associated with normal aging.Objectives:To determine the effect of sarcopenia on the recovery of patients after hip fracture, their fitness, functionality, and quality of lifeMethods:A prospective study had 60 patients with hip fractures of both sexes,> 65 years of age (70.8), in the experimental group of patients with sarcopenia and the control group without sarcopenia. All anthropometric measurements were performed: BMI (kg / m2), waist circumference, the volume of the upper arm and lower leg muscle mass, handgrip force (kg) - dynamometry. The following questionnaires were used to assess functionality, mobility, and quality of life: Health assessment questionnaire (HAQ), Harrison hip score (HHS), Sarcopenia and Quality of life (SarQol)Results:Muscle mass (BMI) was significantly lower in the experimental group patients (p <0.005) compared to the control group. The clamp strength measured by the dynamometer was significantly lower in patients with hip fractures (p <0.005) compared to the control group. About 2/3 of the subjects with sarcopenia and hip fracture have a severe and complete physical disability. There was a significant difference in all domains of quality of life between subjects with hip fractures and the control group due to the presence of sarcopenia (p <0.005).Conclusion:The presence of sarcopenia indicates consequently reduced functionality and a degree of disability in patients with hip fractures, slows recovery and increases the need for mobility aids, thus extending hospital stay and patient recovery.References:[1]He H, Liu Y, Tian Q, Papasian CJ, Hu T, Deng HW. Relationship of sarcopenia and body composition with osteoporosis. Osteoporos Int. 2016 Feb; 27(2):473–82.https://doi.org/10.1007/s00198-015-3241-8PMID: 26243357[2]Oliveira A, Vaz C. The role of sarcopenia in the risk of osteoporotic hip fracture. Clin Rheumatol. 2015 Oct; 34(10):1673–80.https://doi.org/10.1007/s10067-015-2943-9PMID: 25912213[3]Tarantino U, Piccirilli E, Fantini M, Baldi J, Gasbarra E, Bei R. Sarcopenia and fragility fractures: molecular and clinical evidence of the bone-muscle interaction. J Bone Joint Surg Am. 2015 Mar 4; 97(5):429–37.https://doi.org/10.2106/JBJS.N.00648PMID: 25740034 Benichou O, Lord SR. Rationale for Strengthening Muscle to Prevent Falls and Fractures: A Review of the Evidence. Calcif Tissue Int. 2016 Jun; 98(6):531–45.https://doi.org/10.1007/s00223-016-0107-9PMID: 26847435[4]Hirschfeld HP, Kinsella R, Duque G. Osteosarcopenia: where bone, muscle, and fat collide. Osteoporos Int. 2017 Oct; 28(10):2781–2790.https://doi.org/10.1007/s00198-017-4151-8PMID: 28733716[5]Rantanen T, Volpato S, Ferrucci L, Heikkinen E, Fried LP, Guralnik JM. Handgrip strength and causespecific and total mortality in older disabled women: exploring the mechanism. J Am Geriatr Soc. 2003 May; 51(5):636–41.https://doi.org/10.1034/j.1600-0579.2003.00207.xPMID: 12752838[6]Syddall H, Cooper C, Martin F, Briggs R, Aihie Sayer A. Is grip strength a useful single marker of frailty? Age Ageing. 2003 Nov; 32(6):650–6.https://doi.org/10.1093/ageing/afg111PMID: 14600007[7]Chen LK, Liu LK, Woo J, Assantachai P, Auyeung TW, Bahyah KS, et al. Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. J Am Med Dir Assoc. 2014 Feb; 15(2):95–101.https://doi.org/10.1016/j.jamda.2013.11.025PMID: 24461239[8]Wehren LE, Hawkes WG, Hebel JR, Orwig DL, Magaziner J. Bone mineral density, soft tissue body composition, strength, and functioning after hip fracture. J Gerontol A Biol Sci Med Sci. 2005 Jan; 60 (1):80–4.https://doi.org/10.1093/gerona/60.1.80PMID: 15741287Disclosure of Interests:None declared
Introduction. The aim of this paper was to determine the attitudes of physical education teachers and primary school teachers towards inclusive physical education in Serbia. Material and Methods. The research included 132 examinees of both genders: 59.09% females and 40.91% males. Data were collected using an anonymous questionnaire with a 4-point Likert scale. The questionnaire dealt with teachers' previous experience, their qualifications for implementation of inclusive physical education, support and additional training for realization of inclusive physical education. Data were processed using Statistical Package for the Social Sciences 20. Normality distribution was tested by Kolmogorov-Smirnov and Shapiro-Wilk test, whilst the differences between groups (sexual dimorphism, environment, professional orientation) were examined using Mann-Whitney and Kruskal-Wallis tests at the significance level of p ≤ 0.05. Results. The findings showed that the average scores were inclined towards positive attitudes to inclusive physical education. The findings also showed that there was no statistically significant gender-related difference of attitudes between physical education teachers and primary school teachers. However, there was a statistically significant difference related to geographical background in terms of qualification levels (p = 0.02) for work with children with disorders and disabilities, as well in terms of additional training (p = 0.02) and professional orientation, since physical education teachers have less experience working with students with developmental disorders. Conclusion. Both physical education teachers and primary school teachers have positive attitudes towards inclusion. Physical education teachers have less experience working with challenged students than primary school teachers, therefore additional training programs may be required.
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