Balneo and PRM Research Journal

680 Evaluating Hepatic Toxicity of Chitosan and Chitosan- Functionalized Iron Oxide Nanoparticles in a Rat Model of Peripheral Nerve Injury — Relevance for Rehabilitation Medicine

2024-08-22T10:37:08+03:00

Background: Peripheral nerve injuries (PNI) can generate important medium- and long-term disability, as patients mostly complain about associated pain, sensibility and, or motor deficit, and even psychological manifestations. Chitosan and different nanoparticles types were previously used in several studies as treatment of peripheral nerve injuries. The present study aimed to assess the hepatic responses at oral administration of simple chitosan solution and of magnetic iron oxide nanoparticles functionalized with chitosan (CMNPs) solution in an experimentally induced peripheral nerve injury. (2) Methods: Chitosan or CMNPs were oral administrated, for 21 days, to animals with peripheral nerve injury. The treated groups were compared with a control group (peripheric nerve injury without any treatment). The hepatic toxicity of administered solutions was analyzed histologically, through transmission electron microscopy (TEM) and through the oxidative stress parameters, in comparison with the control group. (3) Results: Liver tissue histological evaluation showed non-significant degeneration of hepatocytes in Chitosan group and, in CMNPs group, slight periportal inflammation. TEM investigation revealed nuclear and mitochondrial polymorphism and lipid accumulation in hepatocytes in Chitosan group, and in CMNPs group, irregular nucleus profiles and increased glycogen storage in cytosol. Oxidative stress analysis showed antioxidant hepatic effect of both treatments. (4) Conclusions: Compared to control group, both treatments produced significant increases of hepatic antioxidant protection, probably induced by chitosan properties. Histological modifications of the liver were minimal for both treatment groups. TEM investigation showed unspecific alterations of the hepatocytes structure.

681 Impact of Nusinersen on Neurofilament, Creatinine Levels, and Motor Function in Pediatric Spinal Muscular Atrophy Rehabilitation: A Biomarker Analysis

2024-08-22T10:53:18+03:00

Background: Spinal amyotrophy is a rare, neurodegenerative disease, with progressive evolution, disabling until death in severe forms, but for which 3 disease-modifying drugs have recently been approved (in the last 8 years). In this context, it became necessary to find predictive factors for the evolution of patients and for the effectiveness of the treatment applied to personalize the therapy to obtain the best results according to the particularities of each patient. Objective: The objective of this retrospective study is to analyze the evolution of different clinical (motor functional scales) and paraclinical biomarkers (level of pNF-H neurofilaments in serum and cerebrospinal fluid and of serum creatinine) under treatment with nusinersen in various types of spinal muscular atrophy (SMA). Methods: We analyzed the biomarkers values for a group of 69 pediatric patients diagnosed with SMA in different stages of treatment over three years, depending on the type of SMA, the number of copies of the SMN2 gene, and the age at initiation of therapy. Results: We observed significant increases in the levels of pNF-H neurofilaments in both cerebrospinal fluid (CSF) and serum, with correlations to the age of symptom onset in patients and an inverse relationship to the number of copies of the SMN2 gene. These levels decreased during treatment with nusinersen, coinciding with increased serum creatinine values and improved motor functional assessment scores. The most pronounced effects were noted in patients with severe forms of the disease, such as SMA type 1, mainly when treatment was initiated at a younger age. Conclusion: The evolution of patients under disease-modifying treatments should be analyzed both for the evolution on specific motor functional scales, as well as against the biomarkers of neuronal degradation: pNF-H, present in CSF and serum, and serum creatinine, a marker of muscle activity. Administering the disease-modifying treatment promptly after diagnostic confirmation halts neural degradation and enhances the patient's motor function.

682 Efficacy and Safety of Balneotherapy using Diverse Natural Resources in Lithuania: A Multicenter Study

2024-08-22T10:56:17+03:00

Background: Balneotherapy or spa therapy, with its multimodal effects, has shown clinical efficacy in treating various pathological conditions. However, further studies are needed to assess its impact on mental health and to evaluate treatment safety. This study aimed to evaluate the effectiveness of different natural resources of the Lithuanian medical spa for stress-related disorders and skin health and to disclose the safety profile of using natural resources. Methodology. We performed a multicenter randomized controlled single-blinded study in 6 Lithuanian medical spas. The 1- 2-week treatment combining mineral water, therapeutic mud, and salt procedures was provided for the 364 participants with moderate stress levels and the effect was evaluated using surveys, instrumental, and laboratory measures. Results. The findings highlighted that the effects of BT using different natural resources significantly improve mental and skin health, as well as contribute to overall health status for up to 6 months. A significant reduction of anxiety, depression, and fatigue as well as improvement in sleep, skin moisture, subjective skin state, and integrative outcomes was achieved in all centers after treatment, while stress and saliva cortisol, working speed, skin oiliness, and elasticity improved in a few centers. A positive result was related to the duration of the treatment, and possibly- to the features of natural resources. Mineral water most commonly caused side effects; it varied among centers, however, they were predominantly local, mild, and transient. Conclusions. Balneotherapy using natural resources is effective for the enhancement of mental and skin health. Further research is necessary for a better understanding of the role of different natural resources on health status and safety profile.

683 Benefits of sacubitril/valsartan administration and physical training in cardiac rehabilitation: current trends and bibliometric analysis of the years 2015-2024

2024-08-22T11:01:18+03:00

Introduction. Heart failure, with its economic and social burden and increasing incidence in the general population, is a global problem. Since 2015, a new class of drugs with angiotensin and neprilysin re-ceptor inhibitory action, namely the combination of sacubitril and valsartan (S/V), has been introduced in the treatment of HF. The study aimed to perform a bibliometric analysis of the available knowledge and assess research trends through quantitative analysis of the literature related to the use of S/V and physical training in HF. Methods. In the study, we used the Web of Science database, period 2015-January 2024. The data obtained was processed with Vos viewer and Microsoft Excel. The results obtained and their interpretation provided an overview of the most relevant and prolific journals, countries, authors, and organizations. Conclusion. After marketing approval, the publication trend was upward until 2023, when the number of publica-tions decreased significantly. Our study shows that although the number of publications de-creased, updates of treatment guidelines were published, and a significant number of articles supporting the benefits of S/V treatment in chronic HF (with reduced or preserved ejection frac-tion) but also in acute forms were published. Although the number of articles on cardiac rehabilitation is low, this is highlighted in treatment guidelines and studies have emerged assessing the reasons why patients do not follow a cardiac rehabilitation programme. Cardiac rehabilitation is important for its physiological benefits: improving VO2max, myocardial blood flow and endothelial function. Health policies should be put in place to raise awareness of the importance of cardiac rehabilitation, including distances to a rehabilitation centre.

684 Current evidence of extracorporeal shock wave therapy (ESWT) in chronic musculoskeletal conditions

2024-03-12T21:54:00+02:00

Abstract: Objective. To assess the current evidence of extracorporeal shockwave therapy (ESWT) for patients with musculoskeletal conditions. This form of treatment involves ballistic shock waves, generated by a piezoelectric, electromagnetic or electrohydraulic source. Methods. This was a systematic review designed in accordance with the Preferred Reporting Items for Systematic Reviews. We identified relevant studies by searching multiple electronic databases, relevant publications in English from 2010 to 2022. Two levels of screening were applied. During the first screening, titles and abstracts were reviewed and irrelevant studies were excluded. For the second screening, full-text articles were reviewed using predetermined inclusion and exclusion criteria. Results: The search of electronic databases resulted in 384 articles. After having removed the duplicates, the full texts and abstracts were assessed for eligibility criteria, and a total of 21 studies were included in this review. The results showed that ESWT has a beneficial effect in musculoskeletal conditions by reducing pain, and it is recommended when other non-surgical therapies have. Conclusion: ESWT can play an important role in the treatment of musculoskeletal disorders, if there are appropriate indications, unitary treatment protocols that are correctly applied and reproducible.

685 Does the Impact Force Depend on Arm Position and Run-up Speed during Forward Handspring on the Vault in Elite Gym-nasts? A Pilot Study

2024-03-19T12:54:02+02:00

(1) Background: This pilot study's aim was to examine the relationship between impact force, arm position and run-up speed, as well as to test new methods of measuring direct impact force on the vault while performing a forward handspring. (2) Methods: Data were collected from three elite, male artistic gymnasts (age 28.7±3.6 years, body weight 66.7±4.4kg; body height 169.7±3.2cm; experience 22±5.1 years), who performed two trials of the forward handspring. A high-speed camera, photocells and force plate were used to obtain and analyze the mechanical characteristics of the vault. Impact force (N), arm angle (degrees) and run-up speed (m/s) parameters underwent normality testing via the Shapiro-Wilks test, and bivariate correlations were used to explore relationships between them (p<0.05). (3) Results: Determined correlations between impact force and arm angle (r=0.02; p=0.97) and between arm angle and run-up speed (r=-0.45; p=0.37) have revealed non-significant relationship. Likewise, similar result was observed between impact force and run-up speed (r=0.44; p=0.38). (4) Conclusion: Non-significant correlations were observed, and new set-up (force plate-vault) for measuring maximal vertical impact force encountered in gymnastics vaulting showed consistent values with each vault performance, enabling researchers to measure the precise load magnitude.

686 A Physical Fitness Perspective on Physical Education Lesson with Rampage Method Application

2024-03-28T12:50:38+02:00

The purpose of this study is to investigate the effect of a program prepared in accordance with the Rampage method in physical education classes on the development of health-related physical fitness in children aged 9-12 (3rd-6th grade). Randomly selected control (n:30) and performance (n:34) groups were administered initial and final tests. SPSS 25.0 was used for statistical analysis. CG showed SLJ pre-test and post-test values of 106.33 ± 20.604 and 107.07 ± 18.94, respectively, while PG exhibited pre-test and post-test values of 116.03 ± 19.983 and 123.71 ± 20.09 for SLJ. For the 20Meter running test, CG had pre-test and post-test values of 15.23 ± 8.95 and 20.60 ± 9.06, whereas PG showed pre-test and post-test values of 18.59 ± 10.49 and 21.21 ± 10.10. Results of statistical analysis; A variable was found in the standing long jump measurements between the performance group(PG) and the control group(CG) (p<0.05). No significant difference was detected in the pre-test and post-test data for the other measured parameters. Based on these results, it is recommended to conduct comprehensive studies examining the effects of physical education classes prepared with the RAMPAGE method on children's physical fitness using different age groups or different physical fitness tests.

687 Exploring the Impact of Physical Inactivity on Digital Gaming Attitudes and Addiction among Secondary School Students

2024-04-07T02:06:58+03:00

The escalating concern regarding internet and digital game addiction among pre-adolescent children and its potential link to psychological issues prompted this study, aimed at evaluating digital game addiction levels and attitudes towards gaming in secondary school students. Conducted with a sample of 897 students from Ankara, Türkiye, the study employed a survey method, utilizing the "Attitude Scale towards Digital Game Addiction and Digital Games". Results indicated significant gender differences in addiction levels and attitudes, with boys showing higher scores. Age also played a role, with seventh graders exhibiting the lowest and eighth graders the highest addiction behaviors. Notably, those engaged in martial arts games and using consoles for gaming reported the highest addiction and positive attitude scores. The study underscores the prevalent issue of digital game addiction among youths, suggesting a strong correlation with physical inactivity. It concludes that promoting physical activity is essential not only for physical health but also as a preventative measure against the development of psychological issues stemming from digital game addiction.

688 How much do disuse syndrome patients improve with convalescent rehabilitation? Assessment of improvement

2024-04-12T16:55:19+03:00

The purpose of this study is to analyse the therapeutic effects of patients with disuse syndrome who underwent rehabilitation. The subjects were 168 patients (87 male and 81 female). We investigated the relationship between the degree of FIM gain and etiology, age, gender, history of cerebrovascular disease, dementia, body weight, body mass index(BMI), hemoglobin, protein, albumin, prognostic nutritional index, malnutrition and dysphagia. The main etiologies that resulted in disuse syndrome were COVID-19, respiratory disease, gastrointestinal disease, urinary disease, cardio-vascular disease1, and others . The average FIM-total gain by age decreased as age increased. FIM-total gain was 8.0 for the patients in their 90s. FIM-total gain was 13.8 for those with no past incident of cerebrovascular diseases, 7.6 for one past incident, and 4.0 for two or more past incidents. FIM-total gain of the patients of severe dysphagia was significantly lower than that of the patients of normophagia / mild or moderate dysphagia. There was mild correlation between FIM-total gain and gain of body weight (r=0.21) and between FIM-total gain and gain of BMI (r=0.21). Patients with disuse syndrome over 90s or with two or more incidents of cerebrovascular diseases should be treated, not in rehabilitation but in nursing care.

689 Overweight and Obesity in High School Students of 15-18 ages. A Cross-Sectional Study

2024-04-14T10:46:41+03:00

The aim of study was to to determine the characteristics of the age groups of adolescents in terms of the relationship between body mass and height, especially the relative number of overweight and obese. A cross-sectional study of the health status (overweight and obesity) of students was conducted on a sample of 400 subjects, (186 boys and 214 girls, aged 15 to 18. Anthropometric data including body height (BH), body weight (TM), age and Body Mass Index (BMI). Participants' BMI was estimated using the Percentile BMI calculator for children and teenagers aged 2 to 19 years. Study adolescents were defined as underweight, normal (healthy) weight, overweight, and obese according to the CDC child growth characteristics for age, sex, and BMI. 26 respondent (6.5%) were overweight, while 17 (4.25%) were obese, which is a total of 10.75% of students. The analysis of the individual results of male and female subjects points to increased values of the body mass of males (18.81%), compared to female pupils (3%). Out of a total of 186 male students, 10.75% were in the overweight category, and 8.06% were categorized as obese, while 2.80% of the girls were overweight and (1%<) in the obese category, which is an extremely good result, where obesity practically does not exist. Even 87.5% students are in the healthy weight category 149 male (80.10%) and 201 female (93.92%) respondents. Only 7 or (2%<) students were categorized as malnourished, while in relation to gender, there were more malnourished girls (2.33%) compared to boys (1%<). Among high school students in Bosnia and Herzegovina, the number of children with overweight and obesity is relatively low compared to data from other countriesș it requires the development of evidence-based recommendations for physical activity and dietary habits that are most appropriate for both this country and other countries.

690 Validation of the mathematical model of upper body biomechanics using neural networks

2024-04-17T20:46:20+03:00

The paper presents artificial neural networks (ANNs) as a tool for validating the mathematical model. The neural network architecture must learn the relationship between the inputs (which are the parameters of the biomechanical mathematical model, such as height and body mass) and the desired outputs (i.e. the perturbing forces of the biomechanical model elements. We used part of the perturbing force values of the muscle groups responsible for the movement of the spine, neck, and head, which were determined using the mathematical model and the C++ application, to train the neural network, while the remaining data were used to validate the neural network. The neural network architecture was created using the Easy NN application. After training the network, we concluded that the subject's height has the greatest impact on generating muscle force, and it is also the most sensitive parameter. The muscle force values of the data used for validation are almost equal to the values determined using the mathematical model. Therefore, we can conclude that the mathematical model is correct, and the neural network can make predictions for various subject dimensions, even if their values are not within the range of values for which we trained the network.

691 „Digital therapeutics” in musculoskeletal pain management: a narrative review of Gamification, Virtual Reality and Augmented Reality approaches

2024-08-23T07:36:01+03:00

This review aims at highlighting the potential of the „digital therapeutics” as adjuncts to traditional physical medicine and rehabilitation methods, to explore the clinical effects and relevance of using them in the rehabilitation of patients experiencing musculoskeletal pain, acute or chronic, and to provide a comprehensive understanding of how these technologies can improve pain management, enhance rehabilitation outcomes, and contribute to the overall well-being of patients. A comprehensive analysis of existing literature, clinical trials, and observational studies was conducted to assess the benefits and outcomes associated with rehabilitation interventions in this specific patient population. Multiple studies have suggested that „digital therapeutics” in musculoskeletal pain management have the potential to complement traditional interventions, improve treatment outcomes, and enhance patient engagement. Gamification, virtual reality and augmented reality are promising tools for managing musculoskeletal pain, offering innovative approaches to pain relief, rehabilitation, assessment, education, and remote care delivery.

692 Mineral metabolism assays and osteoporotic fracture risk evaluation in menopausal population diagnosed with adrenal incidentalomas: a sub-analysis of PRECES study

2024-08-23T07:40:41+03:00

Adrenal incidentalomas (AIs) are clinically silent adrenal masses that are unintentionally found during various abdominal imaging procedures. Our objective was to evaluate the bone profile in menopausal females diagnosed with AI versus a non-AI control group. This was an observational, retrospective, multi-centric, case-control study, a sub-analysis of PRECES study (“Parameters of Romanian Patients with Endocrine Conditions with or without Endocrine Surgery: real-world-evidence and retrospective study”), a multi-centric, Romanian collaborative in the field of endocrinology and connected specialities (real-world community setting). Inclusion criteria: women in menopause between 40 and 85 years. Ex-clusion criteria: active endocrine tumours or cancers, prior or current medication against osteoporosis. Assessments included bone turnover markers, central DXA, FRAX-based os-teoporotic fracture risk evaluation. AIs were defined as having a value of second day plas-ma morning cortisol after 1-mg dexamethasone suppression test of < 1.8 µg/dL [without mild autonomous cortisol secretion (MACS free), as seen in control group that did not dis-play the imaging evidence of an adrenal tumour] or between 1.8 and 5 µg/dL (MACS sub-group). Results: Demographic features of both groups (N=39 versus 95 patients) were simi-lar in terms of age (60.95±10.46 versus 61.55±7.2 years), years since menopause (14.92±10.32 versus 14.52±8.85 years), body mass index (28.03 versus 27 kg/sqcm); (p>0.1 for each). Osteopenia was the most prevalent DXA category in each group (43.6% versus 53.7%), followed by osteoporosis (20.5% versus 22.1%), while lumbar, total hip, femoral neck BMD were similar between AIs and controls. A statistically significant lower osteocal-cin in subjects with AIs, with a median (Q1, Q3) of 16.5 (11.96-20.09) ng/mL compared with the value in control groups of 23.17 (15.9-31.46) ng/mL (p=0.003) was found. In AIs group, serum baseline morning cortisol positively correlated with lumbar Z-score, and correlation coefficient reached a statistical significance (p = 0.035). Of note, a tendency for correlation with total hip BMD was found, too. To conclude, decreased osteocalcin might be the signa-ture of mild cortisol anomalies in AIs, but DXA-BMD and FRAX algorithm revealed similar parameters in AI group versus controls, as found between MACS and MACS free sub-groups.

693 Physical exercise as part of the rehabilitation in primary osteoporosis: insights into the signal transduction bone formation pathways

2024-08-23T07:46:53+03:00

Primary osteoporosis, a geriatric bone metabolic condition affecting both the mineral density and the microarchitecture, comes with a complex burden. Bone turnover markers tidily reflect the changes of skeleton status that are part of the physiological process or theyhighlight the abnormal status including in osteoporosis in addition to other biomolecules evaluation such as hormones, inflammatory markers, myokines and adipokines. In this narrative review, we aimed to highlight several aspects regarding osteoporosis-related rehabilitation amid mitigating the role of physical exercise as bone formation booster. Bone turnover markers assays, by capturing the essence of the bone remodelling, registered a great progress during latest years, thus show-ing an enhanced index of applicability in daily practice (despite being known and studied for more than three decades). Irisin, a novel player in the muscle-bone-metabolism cross-talk, represents a muscle-derivate hormone that is expected to highlight the interplay between physical exercise and bone formation. Other concurrent signal transduction pathways include recently described biomarkers such as preptin or the spectrum associated with serotonin-LRP5-Wnt/beta catenin canonical and non-canonical loops. Current pitfalls of the topic include the personalized recommendation of physical activity due to severe co-morbidities, the lack of homogenous studies to measure the intervention and the consecutive bone health and great variations of using the bone turnover markers amid daily pracPrimary osteoporosis, a geriatric bone metabolic condition affecting both the mineral density and the microarchitecture, comes with a complex burden. Bone turnover markers tidily reflect the changes of skeleton status that are part of the physiological process or theyhighlight the abnormal status including in osteoporosis in addition to other biomolecules evaluation such as hormones, inflammatory markers, myokines and adipokines. In this narrative review, we aimed to highlight several aspects regarding osteoporosis-related rehabilitation amid mitigating the role of physical exercise as bone formation booster. Bone turnover markers assays, by capturing the essence of the bone remodelling, registered a great progress during latest years, thus show-ing an enhanced index of applicability in daily practice (despite being known and studied for more than three decades). Irisin, a novel player in the muscle-bone-metabolism cross-talk, represents a muscle-derivate hormone that is expected to highlight the interplay between physical exercise and bone formation. Other concurrent signal transduction pathways include recently described biomarkers such as preptin or the spectrum associated with serotonin-LRP5-Wnt/beta catenin canonical and non-canonical loops. Current pitfalls of the topic include the personalized recommendation of physical activity due to severe co-morbidities, the lack of homogenous studies to measure the intervention and the consecutive bone health and great variations of using the bone turnover markers amid daily practice in different centers. To conclude, part of the monitoring protocol in osteoporotic patients under specific medication against osteoporosis or during bisphosphonates drug holiday, bone turnover markers assays stands for a practical insight in every day practice. The contributing role of physical exercise to boost bone formation as reflected by these biomolecules is well understood across a multitude of signal transduction pathways. However, a current gap in practical use and surveillance of the prescription of physical activity, mechanical load and rehabilitation programs in these patients is confirmed so far.tice in different centers. To conclude, part of the monitoring protocol in osteoporotic patients under specific medication against osteoporosis or during bisphosphonates drug holiday, bone turnover markers assays stands for a practical insight in every day practice. The contributing role of physical exercise to boost bone formation as reflected by these biomolecules is well understood across a multitude of signal transduction pathways. However, a current gap in practical use and surveillance of the prescription of physical activity, mechanical load and rehabilitation programs in these patients is confirmed so far.

694 Vitamin D Supplementation Improves Physical Performance in Athletes and Healthy Aging in Physically Active Adults

2024-08-23T07:51:25+03:00

Vitamin D deficiency is a significant global public health issue, even in regions with all year sun exposure. Currently, the scientific community has not yet reached a unanimous agreement regarding the optimum levels of vitamin D and the precise threshold values. Additional efforts are required to standardize the evaluation of vitamin D insufficiency and deficiency and to provide uniform treatment guidelines. Epidemiological studies have identified a broad spectrum of estimated prevalences in athletes. Their performance when participating in sports. depend on their muscles, heart and lung function. It seems that athletes have significantly lower levels of vitamin D compared to the general population. However, there is a lack of comprehensive studies and systematic reviews on this subject, making it challenging to reach conclusions due to variations in laboratory techniques and cut-off values. While there is an abundant of research on the supplementation of vitamin D and its benefits, it is challenging to provide general recommendations for athletes due to the limitations of extrapolation. However, there is a rather high occurrence of Vitamin D deficiency among individuals who engage in regular physical activity. Supplementing with Vitamin D helps prevents osteoporosis, bone fractures, enhances muscle strength, avoids lung infections, heart failure, and arrhythmias. It is generally safe when used in appropriate quantities, given its wide therapeutic range. Athletes can decrease the occurrence of training dropouts caused by infection, arrhythmias, muscular weakness and potentially prevent the inability to participate in competitions through correct nutrition and vitamin D supplementation.

695 Prognostic value of physical activity, gender, and age versus ECG in localizing the idiopathic ventricular outflow tract arrhythmias

2024-08-23T07:58:32+03:00

Background: The idiopathic ventricular outflow tract arrhythmias may arise either from the right ventricular outflow tract or the left ventricular outflow tract. It is paramount to establish the precise location, based on the 12 lead ECG, to recommend the proper treatment for the patients. Methods: Based on the 12 lead ECG evaluation, the origin of the arrhythmias was established to be either in the RVOT or LVOT. The level of physical activity, gender, and sex were noted for each patient. Further, we evaluated the accuracy of the arrhythmia’s location based on ECG versus the patient characteristics described earlier. Results: The clinical score based on these parameters presented a 71% sensitivity level and, 69% specificity level. The overall accuracy of predicting the right versus left outflow tract origin of arrhythmias based on the QRS morphology in lead V1 and the subsequent R wave transition in the precordial leads was 96.72%, with a 100% sensitivity and 88.89% specificity. Conclusion: Our clinical score, encompassing older age, sedentarism, and hypertension for the prediction of OT origin presents a lower sensitivity and specificity when compared to the ECG for differentiating the right versus left OT arrhythmias.

696 Adherence to physical exercise program in patients with hypertension

2024-08-23T08:24:32+03:00

The study aims to assess adherence to a physical exercise program in patients with hyper-tension. 120 hypertensive patients were included in a 3-month physical exercise program (first 2 weeks, 10 daily sessions, under the supervision of a physical therapist in a rehabili-tation center, continued at home, 5 sessions per week). After the 3-month exercise program 108 patients completed an adherence questionnaire. All patients considered the physical exercise program important for their physical health; 82% of them also considered the program important for their mental health. 94% of patients admitted as necessary to con-tinue the physical exercise program after the end of the study. The lowest percentages of patients (47%) admitted the fitting of the physical exercise sessions performed in a rehabil-itation center with their daily program. Adherence to a 3-month physical exercise was beneficial for physical and mental health status of patients with hypertension. The pro-moting factors for a good adherence to rehabilitation were involvement and availability of patients, living in the city or nearby villages, free of charge exercise sessions and quality of physical therapy. The assessment of adherence by an easy-to-use tool can provide im-portant data for adapting the rehabilitation program to patients’ need and expectations.

697 The muscle strength of the hip joint can be used as a criterion of quality rehabilitation patients after total hip arthroplasty

2024-08-23T09:07:07+03:00

The primary aim of this study is to evaluate the efficacy of rehabilitation following total hip arthroplasty (THA) through the assessment of hip joint mobility parameters, namely abduction, extension, and flexion, at 2, 4, and 6 weeks post-surgery. These evaluations coincide with the implementation of rehabilitation exercises recommended by the physiotherapist. The study intends to analyze the progression of hip mobility during these specific time intervals in conjunction with the prescribed rehabilitation program. By examining the relationship between the performed exercises and the observed improvements in hip mobility, the research aims to provide valuable insights into the effectiveness of the rehabilitation protocol in facilitating post-THA rehabilitation. Material and method: The evaluation of hip joint mobility encompassed measurements of abduction, extension, and flexion utilizing a "Active Force 2" digital dynamometer. In tandem, the functional assessment of patients' health status was conducted through the utilization of the WOMAC index (Western Ontario and McMaster Universities Osteoarthritis Index). Results: The experimental data acquired in the measurement joint mobility during abduction, extension and flexion at 2, 4 and 6 weeks of exercises performed after THA are presented. Pain: mean score decreased from 3.08 to 1.18 (38.31% improvement); physical difficulties: mean score decreased from 3.10 to 1.01 (32.25% improvement) and joint stiffness: mean score decreased from 3.41 to 0.65 (19.06% improvement). These findings highlight the effectiveness of the recovery exercises in reducing pain, improving physical function, and decreasing joint stiffness post-THA. Conclusions: Our research emphasizes the essential contri-bution of physiotherapists to achieving positive outcomes for patients post-THA surgery. Through a personalized physiotherapy regimen administered during follow-up appointments, patients undergoing THA exhibited notable functional improvements. The study's results high-light the efficacy of this approach in alleviating discomfort, expediting recovery, and enhancing patients' overall quality of life, enabling a smoother transition back to normal daily activities.

698 Analysis of oscillations of the center of pressure in postural control

2024-08-23T09:11:49+03:00

Posture results from intricate interactions between the central nervous system's control mechanisms, sensory integration, and musculoskeletal responses, encompassing two levels: sustaining tonic muscle activity for posture and making adjustments to maintain balance in response to disturbances. Due to its complexity, assessing posture with simple methods is challenging, necessitating the use of advanced techniques like stabilometric platforms to measure postural stability through the center of pressure oscillations, akin to an inverted pendulum concept, offering a comprehensive understanding of postural control mechanisms. Materials and Methods: The study aims to analyze the trajectory of the center of pressure (COP) in relation to the gender of the subjects, through directional indices (DI) and oscillation ratio (OR), in the process of posture maintenance. The study included a sample of 50 young subjects (21-24 years), sports practitioners, divided into two equal groups. Results: The study findings indicate that gender does not influence COP DI. However, there's a significant disparity between anteroposterior (AP) DI values (0.70) and mediolateral (ML) DI values (0.54). The results suggest a predominant reliance on AP control mechanisms for maintaining balance, regardless of gender. When visual input is absent, there's a slight increase in AP DI (0.72) and a decrease in ML DI (0.52), indicating a shift in balance strategies. In terms of OR, significant differences are observed based on gender, oscillation direction, and visual input. Female subjects exhibit higher AP OR (6.5) compared to males (5.1). Under closed eyes conditions, both genders show decreased AP OR (6.0 for females, 4.7 for males), indicating a reliance on alternative balance strategies in the absence of visual cues. Conclusion: The study highlights the complexity of postural control and empha-sizes the influence of factors like gender and visual input on postural stability metrics, providing valuable insights for further research and clinical practice. The analysis reveals that around 60% of COP oscillations occur in the AP direction, regardless of visual input changes. This underscores the critical role of AP control in maintaining balance, suggesting targeted interventions to enhance stability should prioritize this aspect.

699 Correlations Between Imaging and Clinical, Functional and Biological Features in Knee Osteoarthritis

2024-08-23T09:14:31+03:00

: Background: For knee osteoarthritis (OA) pathogeny, cartilage damage is important, and ultrasonography (US) is helpful in assessing specific joint issues. Objectives: We intend to find correlations between functionality, pain level, serum glucose, cholesterol, triglycer-ides, uric acid, systemic inflammation and US findings for patients with knee OA. Meth-ods: For 50 consecutive subjects with symptomatic bilateral knee OA staged according to the scale Kellgren-Laurence(K-L) noted anamnestic data, Body Mass Index (BMI), func-tionality evaluated by Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and pain’ intensity through Visual Analogue Scale (VAS). Using the US, the cartilage, meniscal and tendon changes, osteophytes, and fluid collections were assessed for 100 knee joints. SPSS 29.0.2.0 was used for statistical analysis. Results: In our group, with an average age of 60.54 years, there was observed a weak direct correlation between WOMAC and K-L grading (r=0.34) and a negative correlation between BMI and the carti-lage size on the external femoral condyle (r=-0.28). Its thickness on this site was directly correlated with lateral osteophyte severity. Smokers' injuries on the intercondylar groove were increased. Conclusion: Lateral femoral condyle cartilage thickness is inversely asso-ciated with BMI, and K-L grading directly correlates with dysfunctionality. The smokers had higher intercondylar cartilage injuries.

700 Kinetic methods used in the postoperative recovery of a patient diagnosed with a puncture wound and foreign body retention in the middle third of the posterior face of the left forearm

2024-08-23T09:20:06+03:00

Due to its superficial positioning, the muscle is more frequently exposed to trauma than bone or joint elements. Muscle injuries can occur either as a result of external forces, such as a traumatic agent, or internal forces that affect muscle function.

This paper presents a patient diagnosed with a puncture wound and retention of a for-eign body in the middle third of the posterior aspect of the left forearm, with its extraction following three surgical interventions. This type of injury presents an increased risk of af-fecting daily life activities.

The patient was functionally assessed post-operatively upon inclusion in the rehabili-tation program, during the program to observe progress, and at the end of kinetic treat-ment. The rehabilitation plan must be preceded by an adequate assessment, followed by setting goals according to the patient's needs and test results. Consequently, the patient rigorously followed the initial kinetic exercise plan established by the physiotherapist, leading to an improvement in muscle strength, joint mobility, and motor control. This re-sulted in an increase in the quality of life and social-professional reintegration.

701 Non-pharmacological methods and techniques used in the therapy of children diagnosed with adhd. Study of literature

2024-08-23T09:49:17+03:00

Attention deficit and hyperactivity disorder (ADHD) is seen as a long-lasting and chal-lenging condition that affects various areas of life, such as academic and career success, relationships, and daily activities. Both the mind and the muscles jump from one task to another, failing to complete the activity, and thus difficulties arise in carrying out activities such as writing, tying shoelaces, riding a bicycle and more. Banal activities we would say, but essential for a normal lifestyle.

Medical recovery has a signifiant contribution in relieving symptoms and treating many pathologies, in both physical and mental relaxation. Moreover, it has been shown countless times that physical activity reduces stress, mainly based on muscle relaxation and improving cognitive and motor function through the development of neural functions. More and more children are diagnosed with this disorder, but, not enough attention is paid to these cases, which is one of the reasons why we chose to address this topic.

The paper aims to analyze studies carried out in recent years in different countries on motor impairments and other complications that can present children with ADHD, but also the way that balneophysiokinetotherapy has a positive effect in their therapy, being an essential form of therapy, alongside the psychological or medicinal one.

The studies analyzed confirm the benefits of physical exercise for children diagnosed with ADHD, showing visible effects on both the motor skills of the children and their lev-els of agitation and attention deficit. Although movement therapy is widely used in this condition, there are no protocols standardizing the type, duration, and intensity of exer-cise programs used. Occupational therapy, massage, and yoga have been noted for their beneficial effects on patients diagnosed with ADHD.

702 Biological Evaluation of Balneotherapeutic Mud and Sulfurous Mineral Waters: Insights from In Vivo and In Vitro Studies

2024-08-23T10:01:44+03:00

Balneotherapy, treating diseases by bathing in mineral-rich waters and mud, has a long historical application across various cultures. Despite its widespread use, comprehensive studies on its biological impacts are scant, particularly in quantifying effects at the cellular and systemic levels. This study aims to rigorously investigate the biological effects of therapeutic mud and mineral waters, providing a scientific basis for their clinical application. We focused on elucidating the mechanisms behind the observed therapeutic effects and determining these natural resources' safety profiles. Employing a dual approach, we conducted both in vitro and in vivo studies. For the in vitro experiments, human fibroblast cells were treated with different concentrations of mud extracts to assess cytotoxicity, proliferation, and apoptosis pathways. For the in vivo assessments, Wistar rats were exposed to mud and mineral water treatments, with subsequent evaluations of biochemical markers in blood and urine indicative of systemic physiological changes. Our findings reveal that mud extracts exert a dose-dependent influence on cell viability, with low concentrations promoting cellular proliferation while higher concentrations induce apoptosis. In vivo treatments demonstrated significant modulation of inflammatory markers and oxidative stress parameters without evident systemic toxicity. The therapeutic mud and mineral waters demonstrate pronounced biological effects, enhancing cellular health and modulating systemic physiological responses without adverse side effects.

703 A trans-generation conundrum with implications in rehabilitation programs – what factors influence non-specific back pain in children?

2024-08-23T10:04:52+03:00

Back pain in children and adolescents is one of the most frequent reasons for seeing a medical specialist worldwide. Many factors have been incriminated when it comes to influencing the appearance of non-specific back pain in children as well as in adults. For the younger population, some of the culprits seem to be sitting for long periods, us-ing harmful postural patterns, a forward head posture determined by incorrect positioning during prolonged studying hours, and carrying a too-heavy backpack, but do they really influence non-specific back pain in children? These ques-tions are valid for all generations and countries.

This paper aimed to review the published literature to determine whether the factors mentioned above, sitting in mismatched school furniture, carrying heavy backpacks, and forward head posture, influence the incidence of non-specific back pain in children and whether there are any data or differences between the general population and Roma-nian students. For this purpose, we conducted database research using the keywords “non-specific back pain in chil-dren, sitting, school furniture, forward head posture, backpack carrying” and various combinations of these terms, which returned 37 eligible articles for this paper in PubMed - Center for Biotechnology Information (NCBI) and Sci-enceDirect. There was no time limit on the researched articles, and they had to refer to the pediatric population, be open-access and in extenso articles, and be written in English, French, or Spanish.

After analyzing the results from these articles, the conclusion is that there is no evident or spe-cific connection between non-specific back pain in pediatric populations and harmful posture patterns while sitting or carrying a backpack. Also, more multicentered research using fewer variables and more objective measurement instruments is needed.

704 Zoledronic acid: challenges and pitfalls amid rehabilitation in primary osteoporosis and beyond

2024-08-23T10:07:27+03:00

Zoledronate (or zoledronic acid) represents a standard (guideline-based) approach in the area of anti-resorptive medication (namely, an annual 15-minute perfusion of 5 mg for os-teoporosis treatment), while the same drug (with doses/regimes variations) is used for other bone metabolic conditions such as Paget’s disease of the bone or skeleton metastasis originating from different cancers. The objective of this narrative review was to highlight the most recent published data with respect to zoledronic acid use as part of the complex clinical management amid primary osteoporosis in addition to other osteo-metabolic clin-ical entities. This was a research based on exploring PubMed database with respect to the search words “zoledronic acid” and “primary osteoporosis”. We included highly relevant (from the clinical perspective), English-published, full-length articles that have been re-cently published (between January 2023 and March 2024). From 249 results, 31 articles met the inclusion timeline criteria across the 15-month analysis and the final results were based on data provided from 16 articles. Important insights concern not only the zoledronic acid administration, the efficacy and the safety profile, but, also, an extension on daily indications with concern to diabetic bone disease, liver osteodystrophy, osteogen-esis imperfecta or Paget’s disease of the bone.

705 Non-invasive neuromodulatory therapies applied in trigeminal neuralgia

2024-08-23T12:17:02+03:00

Background: Estimates reveal that about 1 in 15,000 patients suffer from pain impulses from trigeminal neuralgia. Annually there are 5-6 new cases registered per 100,000 inhab-itants, with an increased frequency in women with a ratio of 3/2:W/M. It is revealed that the first manifestations appear at the ages between 40 and 60, but in recent decades cases have appeared at younger ages, starting even with 21. Given the high intensity of pain in the trigeminal pathology, significantly disabling pain for long periods of time, effective noninvasive approaches are required to reduce pain, reduce the frequency of exac-erbations and bring patients to a functioning state as close as possible to the physiological limit. Material and method: A low frequency pulsatile magnetic field is a non-pharmacological and non-invasive method which is widely used in a multitude of medi-cal conditions by medical and paramedical professionals for the management of chronic or acute pain. This original research aims to provide an insight view into the review of evi-dence available for the analgesic non-invasive therapy uses of the pulsed magnetic field. The before and after examinations the therapy have included a general assessment of the functional status, an assessment of pain severity. Result: With this study we hope to demonstrate the increased efficiency of the non-invasive rehabilitation methods with ap-plication in trigeminal neuralgia pathology that qualitatively affects the daily life of the pa-tients experiencing trigeminal neuralgia. Conclusion: Non-invasive rehabilitation in trigem-inal neuralgia registers remarkable results, similar to drug approaches, the major benefit being the absence of adverse effects both during treatment and late, in the long term. It in-creases the quality of life of patients, the frequency of relapses and the intensity of the pain-ful stimulus from the first treatment sessions..

706 Assessment of knowledge about the doping in the rehabilitation assistance of performance and recreational athletes

2024-08-23T12:35:50+03:00

Background: During the activity of performance and recreational athletes can arise critical situations that imply medical rehabilitation treatments. In the process of functional recovery, the applied methods can be sometimes aggressive and intense. The lack of knowledge of forbidden substances may pose a threat for the athlete’s health and performance. It is of utmost importance that the medical personnel that care for athletes take into consideration the risks and effects of doping substances.

Methods: A group of 53 physicians - specialists in the field of physical medicine and sports medicine participated in the written study. The investigation was carried out according to the Questionnaire for the evaluation of anti-doping knowledge. By means of 14 categories of simple introductory questions, the questionnaire allowed the collection of data on the doctor's seniority and job, age, gender and general knowledge about substances and methods of interest in sports. The data of the participants in the questionnaires were collected and entered into a Microsoft Excel database and were analyzed in the MEDCALC statistical software program version 12.7.0. The data were analyzed using the SPSS program, version 21. Descriptive analysis was performed using the means and standard deviations of PEAS Instrument variables and mean difference tests were performed on two-response variables along with analysis of variance (ANOVA).

Results: The majority of doctors (40/75.48%) do not have information about test procedures for inert substances and almost half of them (25/47.17%) do not know the anti-doping rules and standards developed within World Anti-Doping Agency (WADA). Of the people surveyed all (53/100%) positively noted the effectiveness of anti-doping programs, but 18 (33.96%) of the respondents distinguished exaggerated actions in the mass media regarding the issue of doping and 35 (66.04%) of the respondents did not have accusations against mediating the issue of doping. Of all the people investigated, the majority (49/92.45%) are ready to report on cases of doping in the anti-doping organization or the sports federation. 24 (45.28%) marked agreement in these actions and total agreement - 25 (47.17%) physicians.

Conclusion: In the evaluation of the knowledge of specialist doctors involved in the assistance of people who practice performance and recreational sports, a discrepancy in the knowledge about doping was determined. The development of strategies and policies by informing doctors from medical rehabilitation and sports medicine in the field of sports doping will offer athletes access to quality medical services and safe professional activity.

707 Cardiac rehabilitation centers in Romania: Where are we now?

2024-08-23T13:01:54+03:00

Purpose: In 2024, Romania is still facing a critical challenge with high cardiovascular disease mortality rates despite extensive research and policy initiatives. Our study sought to examine the actual state of cardiac rehabilitation in Romania by identifying the healthcare facilities that provide and deliver cardiac rehabilitation services.

Methods: The research began with a comprehensive investigation into cardiac rehabilitation centers across Romania. This involved leveraging search engines to identify these facilities. Keywords like “cardiac rehabilitation”, “cardiovascular rehabilitation”, and “cardiac rehabilitation centers” were instrumental in pinpointing relevant information, which included names, geographical locations, and contact details of the centers. Upon identification of potential centers, our research team initiated direct engagement with these facilities via telephonic interviews.

Results: The data collected in 2024 was compared to previous findings from a 2017 research report to evaluate the progress and impact of prevention efforts over time. While the number of cardiac rehabilitation centers has grown (69.2% increase in the nationwide count of cardiac rehabilitation centers/facilities), an uneven geographic distribution persists, exacerbated by disruptions during the COVID-19 pandemic. Among the cardiac rehabilitation centers identified, 23% are located in balneoclimatic resorts, but the majority of cardiac rehabilitation centers are located in Bucharest.

Overall, 65.3% of all identified centers in Romania belong to the private healthcare sector. Among these private centers, 41.1% offer cardiac rehabilitation programs as continuous inpatient care, with durations ranging from 5 to 16 days. All cardiac rehabilitation centers are equipped with the necessary equipment to perform basic cardiological investigations as well as physio-kinesiological rehabilitative procedures, in addition to aerobic physical training (53.8%). In 33.3% of the identified centers, diabetologists and psychologists/psychotherapists are integral members of the multidisciplinary cardiac rehabilitation team, while only 19.2% of the centers include a dietitian/nutritionist.

Regarding costs, there is significant variation depending on the geographical area. In Bucharest, a single rehabilitation session costs between 100 to 400 lei (20 to 80 €), and a rehabilitation program spanning 4-6 weeks can cost up to 3350 lei. Comparing costs identified in 2017, we have observed an increase ranging from 47% to 188% in 2024.

Conclusions: Despite an increase in the number of cardiac rehabilitation centers, their prevalence remains inadequate to fulfill the demands of the population. Telerehabilitation emerges as a promising solution, with limited adoption in only one center. Cost variations across regions pose a barrier to patient participation. Our article proposes strategies including decision algorithms for personalized recommendations, expanding cardiac rehabilitation centers, and advocating for comprehensive cost reimbursement. The urgent need for collaborative efforts is emphasized, envisioning innovative solutions like mobile applications to foster a sense of community and optimize cardiac rehabilitation, ultimately improving cardiovascular health outcomes in Romania.

708 A Deep Learning Approach for Classification of Physiotherapy Exercises Using Segmentation of Techniques

2024-08-23T13:05:41+03:00

Physiotherapy exercises are necessary to patients to restore their functional abilities in many cases as disabilities, injury, or basic with complementary approach as balneotherapy. Different type of exercised and different template sessions are used depending on the medical diagnostics. The evaluation of effectiveness of these exercises are important for patient’s rehabilitation process as time and level of recovery of locomotor skills. A dataset publicly available (Physical Therapy Exercises) is used for classification of session of repeated exercises that includes movement executed correct (C), fast execution (F) and low-amplitude execution (L). A novel approach is proposed by using segmentation of signal using deep learning neural network followed by a convolutional neural network for classification of sequence of the labeled classes L,C, F, and N (a new class introduced to label the noise of sensor of exercised or incorrect movement of the patient. The signal is extensively analyzed in order to made and corresponding labeling for analyzing using sliding window with a drive user selected length. The accuracy of classification is greater than 96% and sensitivity is greater than 95% but the results can be better if the labelling of N class is more restrictive and the effect of imbalanced dataset is reduced.

709 Comprehensive Approach of the Diagnosis, Treatment, and Medical Rehabilitation of Patients with Spondylolisthesis

2024-08-23T13:22:08+03:00

Spondylolisthesis represents the slippage of one vertebra over another, and is widely diagnosed among patients accusing low back pain. Despite most patients being asymptomatic, spondylolisthesis can be the cause of extremely severe, irreversible, and invalidating symptoms. The most frequent types of spondylolisthesis are isthmic, degenerative, dysplastic, traumatic, pathologic, and iatrogenic. While numerous classification systems have been used to describe spondylolisthesis, the descriptive Wiltse classification and the Meyerding classification based on the severity of slippage are the most commonly used in current practice. The clinical evaluation is focused on the degree of pain, the presence of radiculopathy, and other neurological deficits, and is followed by diagnostic imaging, including standing anteroposterior and lateral spine radiographs, computed tomography, and magnetic resonance imaging. Therapeutic options include conserva-tive methods comprising symptomatic medication and physical therapy for lowgrade spondy-lolisthesis with good to excellent results in the long term, as well as surgical treatment with a variety of possible techniques that allow for the reduction of the grade of slippage and obtaining the fusion of the affected level, followed by a well-tailored physical therapy program. The most important role for a patient’s long-term satisfactory result is adequate medical rehabilitation, with consequent and properly designed regimens that the patients will adhere to for the rest of their lives.

710 The impact of comorbidities on the physical and psychological dimension in heart failure patients

2024-08-23T15:13:48+03:00

Assessing patients' quality of life is frequently used in medical research. Patients di-agnosed with heart failure (HF) have reduced exercise tolerance and reduced quality of life due to reduced heart pump function. The objectives of the study are (i) to assess quality of life and comorbidities in HF patients; (ii) to compare quality of life in the physical and psychological do-mains according to drug treatment followed and (iii) to identify predictors of the two domains as-sessed. Methods. A cross-sectional study was conducted between February 2023 and May 2024. A total of 169 patients with HF were included and were distributed into two groups: the HF -S/V group (N=64) who received treatment with sacubitril/valsartan and the HF -CT group (N=105) received treatment with conventional therapy. Two questionnaires were used to assess patients: the World Health Organization's Quality of Life Questionnaire (WHOQOL-BREF) questionnaire and the Charlson Comorbidity Index (CCI). Results: The values determined for physical and psy-chological health were significantly lower for Group HF - S/V (51.391 ± 22.232 vs. 61.79 ± 20.04, p=0.002, respectively 59.203 ± 16.871 vs. 64.933 ± 17.448, p=0.038). Approximately 25% of all re-cruited patients distributed in the 2nd CCI category (CCI score 3-4) have an overall poor and moderately poor perception of quality of life vs. 35.5% of patients distributed in the 3rd CCI cate-gory (CCI ≤ 5); 55% of them belong to the HF - S/V group. A good perception of health status is held by 29 (17.16% of the HF group) of the patients distributed in the 2nd CCI category and 28 (16.56%) have a low and moderate perception. Conclusions: The values for the Physical health domain are moderately low, while the values obtained for the psychological domain show that this domain is less affected. Predictors identified for physical health and psychological well-being are patient age, weight, CCI.

711 Pluridisciplinary approaches in global postural rehabilitation

2024-08-23T15:16:55+03:00

The global postural imbalances relationship is frequently encountered in recent medical practice, requiring multidisciplinary approaches to bring patients to function as close as possible according to the physiological limit. About half of the world’s population experi-ences pain and dysfunction induced by postural imbalances during their lifetime. This re-port aimed to assess the nonpainfull and currative effect of the electropuncture technique complemented by massage and active postural kinetotherapy of global posture imbalances and acute or chronical pain at various levels. This research provide an insight into the re-port of evidence available for the analgesic uses of TENS in postural defects. Correlations regarding imbalances at various levels was found in various studies regarding analyze or diagnosis, without addressing the non-invasive multidisciplinary treatment. In these stud-ies, we are hoping to raise the non-invasive reabilitation treatment and increase their use in pathologies with involves global postural imbalances. The discomfort and pain experi-enced by people with generalized postural disorder on a daily basis can have a negative impact on quality of life and, if left untreated, can lead to significant worsening of the con-dition over time. Global rehabilitation with non-invasive and non-pharmacological meth-ods, without adverse effects, including electropuncture (TENS) applied to the refferal points in conjunction with proprioceptive kinetotherapy techniques, massage and psycho-therapy is the path to the success of occlusion-postural rehabilitation with significant re-sults on painful suffering global postural imbalances.

712 Particularities of rhythm and conduction disorders in heart failure patients with preserved ejection fraction admitted to a rehabilitation hospital

2024-04-08T18:59:38+03:00

(1) Background: The mortality and prognosis of patients with heart failure with preserved ejection fraction have shown minimal improvement over the past 20 years, possibly since this condition is often accompanied by various other cardiovascular risk factors and comorbidities, the correlation with various rhythm and conduction disorders being yet to be elucidated. (2) Methods: This study investigated 134 patients with heart failure with preserved and reduced ejection fraction, analyzing the presence and clinical impact of rhythm and conduction disorders in this groups of patients.; (3) Results: Atrial fibrillation is the most common arrhythmia in patients with heart failure with preserved ejection fraction and rhythm and conduction disturbances are significantly associated with essential hypertension (p = 0,005) and chronic pulmonary heart disease (p = 0,016) in this patients; (4) Conclusions: heart failure with preserved ejection fraction is an intensely arrhythmogenic condition that requires optimal treatment strategies which are adapted to the multiple possibly associated comorbidities.

713 Poststroke Spasticity: Pathophysiology and Management An Accurate Evaluation of Spasticity

2024-05-16T20:20:06+03:00

Stroke is a major contributor to long-term impairment and disability, affecting up to one-third of survivors and almost half of patients showing neurological deficit at six months. Spasticity affects approximately 25% of individuals within two weeks of a stroke and increases to 44% in patients who have had a second stroke. Severe or incapacitating spasticity affects 15% of post-stroke individuals. Poststroke spasticity is also linked to additional signs and symptoms of the upper motor neuron syndrome, such as simultaneous contraction of agonist and antagonist muscles, weakness of the muscles, and a lack of coordination. Spasticity arises due to aberrant neuroplasticity that develops after a stroke and there is currently no specific intervention method designed to address and correct this abnormal plasticity that takes place during the acute phase. Just before implementing any measures to deal with spasticity, it is crucial to evaluate the influence on the quality of life and level of severity. Several grading scales are used to measure spasticity such as the MAS and modified Tardieu scale.There are various therapeutic approaches that may be categorized into three main classes: physical, pharmaceutical, and surgical. Each class has a distinct purpose and is used at the appropriate moment to reduce the level of spasticity and improve the patient's health. Physiotherapy serves as a base of improving the patient's condition and facilitating the development of brain networks. The objective of post stroke spasticity management must include not only the reduction of muscle hypertonia, but also the evaluation of how post stroke influences functionality and overall mental health. Improper treatment or non-compliance may result in increased pain, joint contraction, and further disability. The goal is to assist the patient in achieving the best possible quality of life.

714 The connections between meteorological conditions and the health status of the population of Suceava municipality. A case study on respiratory afflictions throughout the years 2019-2020 in Suceava

2024-08-23T15:23:01+03:00

Background: The present study addresses the real necessity of covering the gaps related to the actual understanding of the relationships established between weather patterns and the health status of the population. The urban area of Suceava is representative of medium-sized cities in Romania.

Methods: Respiratory pathologies manifest with a temporal offset when compared to intervals with severe weather conditions. The consultation program is one that does not take into account the severity of weather conditions. Through statistical and graphical correlations, strong direct or inverse proportional relationships were identified between meteorological elements, the multitude of meteorological elements represented by bioclimatic indices, and the number of consultations provided to patients with respiratory afflictions.

Results: In the winter season when t°C, THI, and TPr have minimum values and Pr has maximum values, the number of consultations for respiratory conditions is at an all-time high. The value of the coefficient of determination R2 between the monthly values of t°C and THI, respectively, the number of consultations for respiratory conditions exceeds the threshold of 0.7, and between the monthly values of Pr and the number of consultations for respiratory afflictions was 0.66. On days when t°C was ≤ 0°C, the average number of consultations for respiratory conditions was 6.1, decreasing to 3 on days when t°C was > 23°C.

Conclusions: Respiratory diseases have the most favorable temporal framework for occurrence in the months of the cold season. In winter in Suceava, respiratory conditions affect twice as many people as in summer.