Balneo and PRM Research Journal

716 Improving lower body muscle power indicators for non-athlete university students through plyometric exercise

George Danut Mocanu, Carmen Parvu, Gabriel Murariu, Dan Alexandru Szabo — Fri, 20 Sep 2024 00:00:00 +0300

Muscle power (FxV, explosive strength or explosive power) is an element of fitness level that influences the quality and efficiency of movements. Most of the studies that address plyometrics identify the effectiveness of this method at the level of performance athletes with different specializations and muscle power requirements. We considered that we can also study the possibility of using plyometrics in physical education lessons. The research identifies the benefits of implementing plyometric exercises for non-athlete university students on lower body muscle power indicators in curricular physical activities. The group of analyzed students (327 subjects/undergraduate level, of which 143 female and 184 male) participated in physical education lessons during one academic year (1 activity per week). The plyometric exercises used were jumping variants, diversified and adapted in dosage to the motor possibilities of the non-athlete students (on one or both legs, lateral, on ladder rungs or boxes, over hurdles, over cones, vertical and horizontal jumps). Their usefulness and effectiveness were verified by 3 successive tests: at the beginning, middle, and end of the academic year, through a battery of 7 lower body muscle power tests. The statistical calculation identifies significant increases in performance for both genders for all tests applied, both between the initial and final tests (T1-T3) and over the shorter time intervals/T1-T2 and T2-T3 (p <0.05). For males, we found greater progress in the second semester of the year (T2-T3) for 5 of the 7 tests, so their adaptation is better and they respond to plyometric training better in the second part of the academic year. For females better progress in semester 2 (T2-T3) for 3 of the tests, respectively greater differences at the end of semester 1 (T1-T2) for 3 tests, especially for endurance power and 10 m acceleration. The research results confirm the effectiveness of plyometric exercises in increasing muscle power indicators for the studied student groups and are a useful option for improving fitness levels. The attractiveness and diversity of the used exercises ensured good student engagement in the lessons. Although the improvements are statistically significant, the results do not indicate spectacular increases and are still weaker than the values recorded in most other research. This is because the students involved in our study are not at all concerned about engaging in leisure time physical activities, except for curricular physical education activities, sedentarism being a major problem among young people.

717 The role of physical exercise in modifying cardiovascular parameters in hypertensive patients

Fri, 20 Sep 2024 00:00:00 +0300

Hypertension is among the top risk factors for cardiovascular diseases. Diversified rehabilitation programs are needed to limit the progression of the high blood pressure condition. The welfare of aquatic therapy is acknowledged, but hydrotherapeutic procedures are rarely used in cardiovascular diseases. The study aims to assess the impact of an exhaustive hydro-kinetic thermo therapeutic program compared to other methods of treatment, i.e., cardiovascular rehabilitation program, recommendation for a healthy life, and antihypertensive medication. Four groups of patients (46 years ±0,32) diagnosed with hypertension participated in four different rehabilitation programs to analyze the impact on their effort capacity. Their ability to achieve average effort without the appearance of fatigue symptoms was studied for a period of eight weeks by monitoring six parameters: systolic blood pressure (SBP), diastolic blood pressure (DBP), Borg Scale, Medical Research Council Dyspnoea Scale (MRC-DS), pulse (P) and oxygen saturation (O2). Group A, which benefited only of recommendations for a healthy life, didn’t register any significant p values between the initial and final evaluation; group B, which had medications and recommendations for a healthy life, registered significant p values for 2 parameters (SBP and P have p<0.0001); group C, which took part in a cardiovascular rehabilitation program, obtained significant p values for 5 parameters (SBP, DBP, Borg, MRC-DS and O2 have p<0.0001); Group D, the recipient of hydrotherapeutic program, registered significant p values for all statistically 6 monitored parameters (SBP, DBP, Borg, MRC-DS, P and O2 have p<0.0001). Physical activity in water performed regularly within a controlled therapeutic program with the thermal and electrotherapy components, leading to improved capacity for the effort by decreasing blood pressure values and dyspnea parameters.

718 The importance of physical therapy and occupational therapy on the quality of life and bone health in patients with osteoporosis

Fri, 20 Sep 2024 00:00:00 +0300

This study aims to evaluate. in the course of one year. the role of physical therapy and occupational therapy intervention. in association of specific drug therapy versus only drug therapy. in patients with osteoporosis. The study was carried out between April 2022 and June 2024, on 94 patients with osteoporosis. selected from the Clinical Rehabilitation Hospital in Băile Felix. All subjects signed an informed consent form 46 subjects followed drug therapy, physical therapy and occupational therapy (study group) and 46 subjects had only drug therapy (control group). The following parameters were assessed: the decrease in height. bone mineral density (BMD) - the T score and the Qualeffo test for the quality of life. Between groups analysis showed that in the study group. The post-test values of the total Qualeffo score decrease significantly and showed a smaller decrease in height compared to control group. Regarding BMD there is no significant difference between the study group compared to control group. The results of the study suggest that a specific physiotherapy can cause significant improvements both of quality of life and vertebral static disorders. As far as BMD is concerned rehabilitation has only a limiting effect of braking its decrease.

719 Effects of Physical Activity on Patients With Diabetes Type 2: A Systematic Review

Fri, 20 Sep 2024 00:00:00 +0300

The aim of the research was to collect and to examine the positive effects of various physical activity (PA) programs on individuals with type 2 diabetes mellitus (T2DM). This included a combination of aerobic exercises and resistance training, with varying intensities, in order to compare which approach yielded better outcomes for T2DM management; This systematic review was conducted in line with PRISMA guidelines, focusing on the period from 1991 to 2024. Studies included in this review involved both experimental procedures and questionnaire-based surveys to assess the impact of PA on T2DM patients. The primary outcome was the effect of PA on T2DM, with secondary outcomes including changes in blood pressure, cholesterol levels, and glycemic control; A total of 23 studies, encompassing 1752 participants (515 men, 546 women, and 691 unspecified), met the inclusion criteria. The studies highlighted the positive effects of exercise, such as improvements in glycemic control, insulin sensitivity, and lipid profiles. Most studies recommended a combination of aerobic and resistance exercises performed 3-4 times per week for 30-60 minutes per session; This systematic review confirms that regular PA is instrumental in managing T2DM. Health care providers should integrate PA programs into treatment plans for T2DM patients to optimize glycemic control and overall health outcomes.

720 Hip and shoulder flexibility in novice rhythmic gymnasts and age-matched controls: Inter-limb asymmetry

Fri, 20 Sep 2024 00:00:00 +0300

Rhythmic gymnastics is a sport of asymmetry and lateral preferences, so the main objective of this study was to examine and compare hip and shoulder range of motion (ROM) and inter-limb asymmetry in 44 rhythmic gymnasts (RGs) and 51 age-matched non-athletes (NAs), i.e. controls. The baseline characteristics of 95 female participants, divided into two age-group categories (U8: 6–8 years, N=36; U11: 8–11 years, N=59) were established, as well as their hip (right/left hip flexion, right/left hip extension, right/left hip abduction, in °) and shoulder ROM (right/left shoulder flexion, right/left shoulder extension, in °), and asymmetry index (ASI, in %) was calculated. Significant differences between RGs and NAs were established (the exception is hip and shoulder extension in U8s, p>0.05), with greater ROM values recorded in RGs. Significant age differences were recorded among RGs in hip flexion and left hip abduction (p<0.05), in favor of U11s, and within NAs only in the case of right hip flexion (p=0.017), but in favor of U8s. The presence of asymmetries (ASI>15%), as well as its absence, is established in both RGs and NAs, but statistically significant side-to-side differences were recorded in U8 NAs (shoulder flexion, p=0.044) and U11 NAs (shoulder extension, p=0.057).

721 How Are FIM Gains Improved after Intensive Rehabilitation for Cerebrovascular Diseases?

Fri, 20 Sep 2024 00:00:00 +0300

The purpose of this study was to determine functional independence measure (FIM) gains based on clinical factors after rehabilitation for cerebrovascular diseases, and to determine how FIM scores and FIM gains can predict rehabilitation outcomes. Of the 181 patients in the study 161 suffered strokes (cerebral infarction 107, cerebral hemorrhage 41, subarachnoid hemorrhage 12, subdural hematoma 1). There were also 12 traumatic brain injuries, and 8 other miscellaneous cases. Dementia, higher brain dysfunction, etiology, sex, age, history of cerebrovascular diseases, location involvement, disability severity, duration of hospitalization and period from onset to rehabilitation were analyzed using FIM. FIM gains decreased in relation to an increase in age. Patients with intermediate disability (FIM 41-80) on admission showed significantly higher FIM-total gain on discharge than others. Factors influencing FIM gain were revealed to be age, duration of hospitalization, FIM gain 4 weeks after admission, etiology, disability severity, dementia and past history of cerebrovascular diseases. Multiple regression analysis determined that significant factors to contribute FIM gain were duration of hospitalization, FIM gain at 4 weeks after admission, age, and disability severity. FIM scores and FIM gains could predict rehabilitation outcomes.

722 Association of the echocardiographic parameters with the physical dimension of quality of life

Fri, 20 Sep 2024 00:00:00 +0300

Heart failure (HF) is determined by pathophysiologic changes in the left ventricle (LV) that occur before the onset of clinical symptoms; these changes can lead to mitral insufficiency that will maintain and favor ventricular dysfunction. An associated change in contractility occurs which will maintain the vicious circle. 252 patients with HF were included in this cross-sectional analysis. Patients were divided into two groups, Group I-S/V (n = 55) and Group II-CT (n = 197) to comparatively assess cardi-ac parameters according to the administered therapy and to determine their correlation with quality of life domains. 2D measurements were performed to determine ultrasound parameters. The WHOQOL-BREF questionnaire was used to assess the quality of life. When analyzing the mean values of the determined echocardiographic parame-ters, significant differences in LV ejection fraction (LVEF) (p < 0.03) Results: Analysing the mean values of the echocardiographic parameters determined, significant differences in LV ejection fraction (LV ejection fraction (LVEF) (p < 0.001) and right ventricular diameter (p = 0.030) were found between the two study groups. The incidence of aortic regurgitation and tricuspid regurgitation was higher in the I-S/V group (40% vs. 25%, p = 0.001, respec-tively 47% vs. 35%, p = 0.03). Mitral regurgitation was present in relatively similar per-centages. Testing the association of echocardiographic parameters with quality of life do-mains showed a significant association of LVEF with physical health and relationship with the environment (p = 0.002, r = 0.143, respectively p = 0.041, r = 0.129). Physical dimension and relationship with the environment are more affected in pa-tients with low LVEF. Routine echocardiographic evaluation is essential in the global as-sessment of the HF patient and may suggest a low quality of life with impaired physical dimension.

723 The impact of Cardiac Rehabilitation on Quality of Life in Elderly Heart Failure Patients- Literature Review

Fri, 20 Sep 2024 00:00:00 +0300

The research investigates how cardiac rehabilitation impacts life quality in elderly heart failure patients. Older patients often encounter distinctive issues, such as other health conditions and age-linked frailty, affecting their ability to join and gain from rehab programs. This study examines customized rehab plans to meet these needs, which entail using both traditional and new methods like telerehabilitation and activities such as Tai Chi and yoga. Results show that specific rehab programs notably improve functional ability and cut hospital stays for elderly heart failure patients. Also, home-based rehab plans, like the REACH-HF program, appear cost-effective, boosting life quality and reducing health problems. Telerehabilitation has shown to expand access to rehab services, especially aiding elderly patients who struggle to attend on-site programs. This study also asseses the improvement in quality of life, namely the physical and psychological health, such as the augmentation/improvement of patients’ exercise tolerance, participation in social activities or even the increased desire of taking care of themselves. The research highlights the significance of including risk understanding, precise nursing activities, and diverse physical exercises to enhance involvement and commitment, improving results and patient happiness. These findings support the ongoing creation and execution of patient-focused cardiac rehab strategies to better the overall health and well-being of elderly heart failure patients.

724 Severity of the neurological deficit of high spinal cord lesions assessed according to etiology

Fri, 20 Sep 2024 00:00:00 +0300

Spinal cord injury (SCI) represents a major health problem, having significant consequences on motor and sensory function, as well as on the quality of life of affected patients. The objective of this study is to assess the severity of high post-traumatic spinal cord injuries depending on the age and gender of the patients and the manner of their etiology. We used useful tools for evaluating and classifying the severity of spinal cord injuries: ASIA classification, MAS and MTS score. This is a retrospective observational study included a number of 146 patients with various high spinal cord injuries whose diagnosis was confirmed by imaging. The mean age of the cohort was 42.97 ± 15.9 years, with a range of 18 to 83 years. The severity of the ASIA score was inversely proportional to the age of the patients. Patients with ASIA A were younger than those with ASIA D. Regarding the etiology of the trauma, most patients, 39.7%, were traumatized following a road accident. The etiology of trauma has a significant influence on the severity of spinal cord injury. Accidents are the leading cause of injury, followed by falls and diving trauma. There is a correlation between the ASIA score and muscle tone/spasticity, which may influence the therapeutic approach and patient management.

725 Eficacy of sulphurous water from Mangalia in Helicobacter Pylori infection: a clinical study

Fri, 20 Sep 2024 00:00:00 +0300

Mangalia balneary resort is situated in the south of the Black Sea and uses sulphurous water springs for rehabilitation therapy. The purpose of this study is to demonstrate the effectiveness of Mangalia sulphurous water on Helicobacter Pylori (H. Pylori) infection. Considering that sulfurous water has a bacteriostatic effect and that most gastritis are caused by H. Pylori infection, we propose that a group of 27 H. Pylori positive patients with or without digestive symptoms ingest sulfurous water daily, for a few days. At the end of the study, 15 of the patients tested negative for H pylori antigen. The curative effects are due to the bacteriostatic effect of sulfurous water and its stimulating action on the digestive tube.

726 The role of a medium-term physical exercise program in improving cardiovascular parameters in hypertensive patients

Fri, 20 Sep 2024 00:00:00 +0300

The objective of our study was to evaluate the changes in cardiovascular parameters in patients with hypertension who completed a 3-month physical exercise program. 229 sub-jects with high normal values of blood pressure and stage 1 hypertension (group 1) and 120 patients with stage 2 hypertension (group 2) followed a 3-month physical exercise program. The following parameters were measured: systolic blood pressure, diastolic blood pressure, pulse pressure, heart rate, pulse wave velocity. For group 1 there were sta-tistically significant differences for all the tested parameters after the 3-month program (decreased systolic blood pressure, heart rate, pulse pressure and pulse wave velocity, p< 0.0001; lower diastolic blood pressure, p=0.018)). In group 2 all the tested parameters had decreased values after the 3-month rehabilitation program. However, only for the pulse wave velocity there was recorded a statistically significant reduction after the exercise program (p< 0.001). There were significant direct correlations between total cholesterol and pulse wave velocity for group 1 at both initial (p=0.024) and final assessments (p=0.03), and for group 2 patients at the 3-month assessment (p=0.001). A medium-term physical exercise program improved the cardiovascular parameters (blood pressure, arte-rial stiffness) in hypertensive patients.

727 The long-term impact of rehabilitation in upper limb plexopathies

Fri, 20 Sep 2024 00:00:00 +0300

The main objective of the research consists in providing evidence that a long-term rehabilitation protocol is favorable for the patient. In adult brachial plexus (BP) palsies, after several surgical attempts, the lack of results in the upper limb’s functionality leads to less compliance to rehabilitation therapy. The upper limb’s functionality of 22 patients with posttraumatic operated chronic BP paresis (either on the right or left, regardless the dominant limb) was assessed retrospectively. The patients were evaluated regarding MRC scaling, dynamometric tests and electroneuromyographic examination. All patients have gone through at least one rehabilitation interval (10 days) after an initial evaluation, and were evaluated again, by same methods, at a second session, at least 6 months later, but no more than one year.. Mild and inconstant improvements were obtained in a total of 9 patients, especially in better dynamometric results and improved amplitudes of motor and sensory action potentials. The electrodiagnosis correlates with dynamometric parameters (muscle strength) and slight amelioration of the motor deficit. Given the small sample size as a limitation, as well as no standardized therapeutic protocol, it should be noted that the 9 patients were the only ones who either attended more than one interval or did more procedures as frequency in time (more often meaning 3 times weekly for 6 months, in 6 patients). Although the most frequent procedures were neuromuscular electrical stimulation (NMES) and proprioceptive neuromuscular facilitation (PNF), the results suggest that regardless of the techniques, the more active patients had better results. Proving the need for long-term rehabilitation, even contrary to the less visible results, can be the trigger point for future research and therapy strategies, as the results suggest central mechanisms involved, adding the cortical ongoing plasticity into the equation.

728 The use of the 360 MD Huber platform in rehabilitation of lumbar radiculopathies, chronic period

Fri, 20 Sep 2024 00:00:00 +0300

Low back pain (LBP) is a common medical condition with a negative impact on quality of life and work. It also leads to financial costs for the health system by increasing the costs of medical treatment. Numerous studies have focused on the effects of exercise, with some highlighting the role of protective studies in LBP while other studies have shown no beneficial. There is moderate-certainty evidence that therapeutic exercise is beneficial in the treatment of chronic low back pain compared with other treatment modalities. Muscle strengthening and the creation of spinal mobility through specific exercise is a recognized therapeutic approach to the prevention and treatment of LBP. The main objecvtive is to evaluate the effectiveness of a physi-cal therapy program utilizing the 360 Huber platform on the quality of life for individuals with chronic lumbar radiculopathy. A randomized controlled trial was conducted with 30 participants diagnosed with chronic lumbar radiculopathy. Participants were divided into an ex-perimental group (n=20) receiving the 360 Huber platform-based rehabilitation protocol, and a control group (n=10) continuing standard care. The intervention included 15 sessions of physical therapy on the 360 Huber platform, complemented by electrotherapy and therapeutic massage. The Oswestry Disability Index (ODI) was administered pre- and post-intervention to assess changes in functional outcomes and quality of life. The experimental group demonstrat-ed a significant reduction in ODI scores, with an average decrease of 1.85 points (10.11%) from 18.30 to 16.45. The paired t-test analysis revealed a statistically significant difference (p < 0.001) and a very large effect size (1.11), indicating substantial improvements in functional outcomes. The control group showed no significant changes. The rehabilitation protocol using the 360 Huber platform, combined with electrotherapy and therapeutic massage, effectively im-proves functional outcomes and quality of life for patients with chronic lumbar radiculopathy. The study highlights the potential of integrating advanced technology with traditional physical therapy methods to enhance treatment efficacy. Future research with larger sample sizes and longer follow-up periods is recommended to confirm these findings and explore additional therapeutic modalities.

729 Perineal Rehabilitation in Pelvic Floor Dysfunction: The Benefits of Vaginal Cone Training

Fri, 20 Sep 2024 00:00:00 +0300

Pelvic floor dysfunctions (PFD) are prevalent conditions that affect millions of women worldwide, encompassing a range of issues severely affecting women's quality of life. Pelvic floor muscle strength and function are fundamental to the management and prevention of PFD, and pelvic rehabilitation is a non-invasive approach that effectively improves symptoms, restores function, and prevents complications. This study aimed to evaluate the impact of pelvic floor muscle training program using weighted vaginal cones, on pelvic floor muscle function and quality of life in women with pelvic floor dysfunction (PFD). Fifty-four women aged 26-62 years, with different type of urinary incontinence, cystocele, and prolapse participated in this pre-post intervention comparative analysis. Pelvic floor muscle function was assessed using the PC test, which measures strength, endurance and fatigability, while the impact on patients' quality of life was assessed with the PFIQ 7. A three-month vaginal cone training regimen was implemented, with as-sessments conducted before the intervention (T0), one month later (T1), and three months later (T2). Data analysis showed a change with significant differences between the PC test score values at the level of each parameter and at each assessment (p<0.05, ES=0.254-511). The scores for bladder and urinary problems (UIQ-7) significantly de-creased from 38.901 ± 1.268 at T0 to 29.366 ± 2.493 at T2 (W = 1082.000, p < 0.001, ES=0.570). In contrast, the scores for vaginal or pelvic problems (POPIQ-7) showed a slight, insignificant decrease from 12.699 ± 1.128 at T0 to 10.499 ± 2.362 at T2 (W = 278.000, p = 0.800, ES=0.053). fVaginal cone training significantly improves pelvic floor mus-cle function and reduces urynary symptoms in women with PFD.

730 Physical Rehabilitation in Multiple Myeloma - A Retrospective Analysis and Future Perspectives

Fri, 20 Sep 2024 00:00:00 +0300

Multiple Myeloma is a malignancy characterized by multisystem involvement, including multiple osteolytic lesions, anemia, and renal insufficiency. The debilitating course of this disease highlights the importance of exploring the therapeutic potential of physical rehabilitation in improving patients' quality of life and providing meaningful clinical outcomes. The aim of this study is to investigate the benefits and challenges associated with the implementation of physical rehabilitation programs for patients with multiple myeloma, analyzing the evolution and characteristics of multiple myeloma cases in a medical clinic in Romania. Through this, we seek to contribute to the development of new approaches and protocols in physical rehabilitation, which may improve the therapeutic management and quality of life for patients with this complex condition. A retrospective analysis was conducted on newly diagnosed multiple myeloma patients over a 7-year period (2017-2023) at a clinic in Romania. The collected data included the time of initial diagnosis, patient age, residence (rural or urban), multiple myeloma subtype,treatments initiated, hematological parameters, presence of bone lesions, and comorbidities. We reviewed the existing literature on physical rehabilitation in multiple myeloma and assessed the associated advantages and challenges. Statistical analysis was performed to identify trends and correlations within our cohort. Out of a total of 255 patients diagnosed with multiple myeloma at a medical center in Romania, the majority were men from urban areas. It was observed that the average age at diagnosis was lower among patients from urban areas. Additionally, 69.8% of patients presented with bone lesions, while pancytopenias were rarely encountered at the time of diagnosis. Personalization of physical exercises is essential to maximize rehabilitation benefits for patients with multiple myeloma. Complications such as pancytopenias and frequently encountered bone lesions should not discourage the recommendation of rehabilitation. Decisions must be individually tailored and coordinated by a multidisciplinary team to ensure the rehabilitation program's safety and efficacy.

731 Predicting 6-month modified Rankin Scale score in stroke patients

Fri, 20 Sep 2024 00:00:00 +0300

The study aimed to identify predictors of 6-month outcomes in acute ischemic stroke (AIS) patients using the modified Rankin Scale (mRS). A prospective observational cohort study was conducted on 277 AIS patients admitted to the Neurology Departments of Cluj-Napoca Emergency County Clinical Hospital between December 2020 and July 2021. After excluding those lost to follow-up or who withdrew due to COVID-19 concerns, 121 patients were followed for six months. Data collected included demographic details, clinical assessments (including NIHSS and mRS scores), laboratory tests, and imaging results. The study found significant differences between patients with mild/moderate disability (mRS 0-3) and those with severe disability (mRS 4-5) at six months. Age, heart failure, NIHSS score, resistin levels, C-reactive protein, and lesion volume were significantly associated with worse outcomes. Multivariate logistic regression revealed that heart failure was an independent predictor of severe disability, increasing the risk by over seven times. Specific clinical and biochemical markers at admission may be able to predict long-term functional outcomes in AIS patients, which may inform individualized patient management and rehabilitation strategies.

732 The relationship between myotonometry parameters and spinal mobility in ankylosing spondylitis patients included in a physical exercise program

Fri, 20 Sep 2024 00:00:00 +0300

Studies showed that the mechanical properties of spinal muscles in patients with ankylosing spondylitis (AS) differ from healthy controls; the continued disease duration alters elasticity and stiffness. Our research focused on analyzing the myotonometry parameters of the longissimus capitis and lumbar erector spinae muscles and spinal mobility in AS patients who followed an 8-week physical exercise program. 34 AS patients were evaluatedevaluated at the beginning of the physical exercise program and after 8 weeks by MyotonPRO (the device measures frequency, stiffness, decrement, relaxation time, and creep) and cervical and lumbar spine assessments. Significantly higher frequency was noted for right and left longissimus capitis muscle after rehabilitation. We recorded statistically significant decreasedstiffness and higher decrement for the right lumbar erector spinae muscle at the second assessment. After the physical exercise program, the cervical spine range of motionmotion improved significantly for all the tested movements. The Schober test had significantly increased values, while the finger-to-floor test decreased significantly. Significant correlations were noted between stiffness and right lumbar rotation and right lumbar lateral flexion at both baseline and 8-week assessments. Improvements in cervical and lumbar spinal motions can be analyzed in relation to mechanical muscles properties in AS pa-tients who have followed a physical exercise program.

733 Multi-faced profile of PTH excess-related secondary osteoporosis: customized therapy and rehabilitation approach

Fri, 20 Sep 2024 00:00:00 +0300

Many causes of secondary osteoporosis have been identified; endocrine types (such as those linked to male hypogonadism, Cushing’s syndrome, acromegaly, thyrotoxicosis, primary hyperparathyroidism, etc.) represent one of the most challenging ailments since a personalized approach of the endocrine disease is simultaneous required. We aimed to introduce the case of a senior lady who was diagnosed with secondary osteoporosis that was associated with primary hyperparathyroidism and a conservative approach was decided, from anti-osteoporosis drug and calcium lowering agents to the physical rehabilitation and lifestyle recommendations. She also presented double unilateral adrenal incidentaloma and a pituitary incidentaloma as well as a suspected ovarian cyst that she further declined to investigate. Mitigating the non-surgical management in primary hyperparathyroidism showcase (in addition to the zoledronic acid for both osteoporosis and hypercalcemia) a complex program of rehabilitation that included a diet intervention in terms of an adequate hydration and a personalized nutrition for kidney stones primary and secondary prevention, mild physical exercise, avoidance of calcium supplements and keeping a daily chole-calciferol replacement.

734 Postoperative anticipatory anxiety between women and men in patients with spinal cord injury

Ioana Tanase, Simona-Isabelle Stoica, Gabriel-Ioan Prada — Fri, 20 Sep 2024 00:00:00 +0300

The subtleties involved in the post-surgical recovery of people suffering from spinal cord injuries involve notable psychological issues that require further examination. (1) Background: people affected by spinal cord injuries may experience severe symptoms, as motor skill deficits, sensory processing irregularities, and pain, all of which can have a negative impact on their quality of life and mental health.; (2) Methods: we studied 264 patients hospitalized in the Neurosurgery Clinic 2 of the "Bagdar Arseni" Hospital for acute spinal cord injuries, in 2 groups of patients with and without CBT psychotherapy; (3) Results: we studied 97 women and 167 men; average anxiety was lower in women compared to men, showing a decreasing trend after psychotherapy for both sexes (4) Conclusions: we discovered that anticipatory anxiety after spinal cord injuries is high, especially in male patients. And psychotherapy brings benefits in reducing anxiety for both categories of patients, regardless of the age group they belong to.

735 Role of psychological intervention on the quality of life of the patient with spinal cord injury undergoing Magnetic Resonance Imaging examination

Ioana Tanase, Simona-Isabelle Stoica, Ioan Gabriel Prada — Fri, 20 Sep 2024 00:00:00 +0300

In the modern world, technological progress has also been accompanied by an increase in traumatic suffering, including those followed by spinal cord injury. The severity of spinal cord injury requires an understanding of the physiological and psychological aspects of patient management. Spinal cord lesions impair physical capabilities and tend to reduce the quality of life, thus creating the need for psychological intervention. In order to do the magnetic resonance imaging (MRI), it has been observed that patients frequently experience distress (1) Background: The research highlights the significant influence that psychological interventions have on improving the quality of life of patients undergoing MRI, who have sustained spinal cord injury; (2) Methods: we studied 78 patients hospitalized in the Neurosurgery Clinic 2 of the "Bagdasar Arseni" Hospital for acute spinal cord injuries, in 2 groups of patients with and without psychotherapy, for which we later applied the quality of life test; (3) Results: We observe how, in 2017, SCI were more frequent in the adult male population and psychotherapeutic treatment was slightly more effective in improving QOL in male patients.; (4) Conclusions: For the 27 patients investigated by MRI and operated for SCI in the Neurosurgery Clinic 2 of the "Bagdasar Arseni" Hospital, the average quality of life was higher after the psychotherapy, both for female patients and for male patients and. The psychotherapeutic response and improved quality of life were higher in male patients.

736 Update in exploring the connection and clinical implications between vitamin D and knee osteoarthritis

Fri, 20 Sep 2024 00:00:00 +0300

Knee osteoarthritis is a prevalent joint disorder characterized by cartilage degeneration, pain, and impaired physical function. Vitamin D might be implicated in the management of knee osteoarthritis through its effects on bone health, cartilage preservation, inflammation modulation, and muscle function. This literature review aims to synthesize the current state of literature to provide information about the correlation between vitamin D and knee osteoarthritis. Methods: We conducted a comprehensive literature search in databases such as PubMed, Web of Science, Scopus, and Google Scholar to identify studies published in the last ten years investigating the association between vitamin D and knee osteoarthritis. Vitamin D deficiency has been linked to cartilage degeneration and more severe symptomatology of knee osteoarthritis. The evidence supports an association between vitamin D levels and knee osteoarthritis, but with some studies showing mixed results, there is a need for further research.

737 Complex case of multiple sclerosis with multiple demyelinating locations

Fri, 20 Sep 2024 00:00:00 +0300

Multiple sclerosis (MS) is a chronic inflammatory disorder with an unpredictable progression that affects the central nervous system and has significant emotional, social, and professional implications. The therapeutic approach is multifactorial and requires complex management coordinated by a specialized, multidisciplinary team over the long term. Current non-pharmacological treatment strategies under study, which may improve the course of the disease, focus on the gut microbiome and include the administration of probiotics and fecal transplantation. This study presents a case of secondary progressive multiple sclerosis in a young patient, with rapidly progressive evolution despite ongoing background therapy. The study analyzed literature data regarding both medical rehabilitation programs used in secondary progressive multiple sclerosis and other therapeutic strategies that can improve the quality of life. Medical rehabilitation has no proven impact on disease progression but can enhance the quality of life for patients with multiple sclerosis through spasticity management, improved mental health, increased mobility, and muscle strength. These therapeutic strategies can improve involvement in professional activities and participation in social and family life for patients with multiple sclerosis.

738 Spa Center as the Economic Engine of the Municipal Busi-ness Ecosystem: Case of Banja Koviljača Organizational Network

Aleksandar Jokić, Mladen Čudanov — Fri, 20 Sep 2024 00:00:00 +0300

This paper addresses the role of the Spa Health Resort as the Economic Engine of the Mu-nicipal Business Ecosystem. Usualy a single larger enterprise drives the local economy at the municipal level, and in the case of Serbia that company has often been from heavy in-dustries. For many transitional economies, local communities have been supported by the main municipal organization, identified in the literature under the terms economic engine, anchor, driver, powerhouse, catalyst, hub or lifeline. Most literature defines it as a compa-ny that plays a pivotal role in propelling municipal economic growth and development, acting as the source of economic stability and resilience within the municipality. Our re-search is based on dataset gathered from the Serbian Chamber of Commerce, extracted from the annual financial and business reports of 80,737 companies and sole entrepre-neurs in Serbia from 2013 to 2022 and supplemented by detailed insights into business reports of hypothesized economic engine. Our findings support the hypothesis that Spe-cialized Rehabilitation Hospital Banja Koviljaca's acts as economic engine for the region. Conclusion is that investment in balneo industry returns mutlifold benefits of different categories to the community and the state.

739 Ozone therapy vs. classical treatment in musculoskeletal disorders

Maricela Dragomir, Claudiu Mereuță, Carmen Gheorghe — Fri, 20 Sep 2024 00:00:00 +0300

With aging and weight gain, the population is significantly overweight and faces additional pressure on vertebral and peripheral joints (ankles, knees, hips, shoulders), which affects muscles, tendons, ligaments, and nerves. Muscle contraction, translated by pain, sends the patient to the doctor. Lumbar and cervical spine disorders occur in 70-80% of the world's population during their lifetime. They are a major problem because they reduce the quality of life and increase the costs borne by health services and patients. There are multiple therapeutic options, both classic medication and alternative treatment, to combat pain for a longer or shorter period. Relief or suppression of pain, the dominant symptom in the manifestations of degenerative arthritic diseases, is an important goal of treatment, ultimately improving the quality of life. Patients, for various reasons, frequently seek alternative therapies, especially to surgical treatment. Finding the most comprehensive treatment is often a challenge. If we consider the benefit that a treatment (therapy) should bring to the health condition, then an individualized therapeutic plan must be chosen. A retrospective study on the effects of ozone and platelet-rich plasma (PRP) treatment compared to classic medication shows the role of ozone therapy in pain relief and the beneficial effect of this therapy, especially in combination with PRP, over a longer period.

740 Interesting, oftentimes even trendy! Attitudes of medical students regarding spa medicine

Alexander M. Rapp, David Lerch — Fri, 20 Sep 2024 00:00:00 +0300

The popularity of balneology and medical climatology among medical students has scarcely been investigated but may represent a pertinent topic for the field. Methods: A survey was conducted among 53 German medical students (80% female; mean age 22.5 years; 39% pre-clinical stage) on attitudes and interest in spa medicine, their associations with the German terms ‘Kur’ (cure) and ‘Kurortmedizin’ (spa medicine; health resort medicine) and their own health behaviour. Associations with cures were recorded using a visual analogue scale (vas). Results: A majority (72%) of the sample indicated support for the inclusion of more information about spa medicine in university curricula. Spa medicine is associated with older individuals, but with less association to overweight and psychiatric patients. The data for the statements "a spa treatment is up-to-date" and "spa treatment is effective" exhibited a normal distribution in the sample. A significant proportion of respondents reported practicing thermal baths, healthy nutrition, sauna, and Kneipp medicine themselves. Implications: The majority of medical students classified spa medicine as interesting and relevant and do not see it as old-fashioned. This interest should be encouraged in university teaching. Interesting points of reference also arise in relation to predictors of career choice among future physicians.

741 Hippotherapy Used in Medical Recovery

Fri, 20 Sep 2024 00:00:00 +0300

Hippotherapy, also known as equine-assisted therapy, falls into the category of alternative therapies that involve human-horse interaction for therapeutic purposes. Horse therapies are especially used for children with various physical, cognitive, and emotional disorders. They can also be successfully used with adults and the elderly. The horse's movement is what stimulates the development of motor skills, balance, and coordination. Direct interaction with the horse, including caring for it, riding, and other related activities, is effective in developing social, emotional, and cognitive skills in both children and adults, as well as in the elderly. Hippotherapy encourages self-confidence, concentration, and motor coordination, making it suitable for people who are anxious, antisocial, depressed, have language difficulties, or low self-esteem. Studies highlight that the presence of horses changes the frequency of the human brain, with subjects becoming more aware and focused when around horses. Horses help therapy beneficiaries stay connected to the present, becoming more aware of their experiences. Additionally, patients learn to pay more attention to the feelings and nonverbal language transmitted by the being they come into contact with. Numerous studies show that horseback riding improves balance, coordination, and reflexes, induces muscle relaxation, reduces spasticity, increases joint mobility, and improves respiratory function and blood circulation. The main objective of the paper is to identify therapies that use horses for patients diagnosed with various conditions, the benefits of these therapies on patients' motor skills, and their effects on patients' mental state. Additionally, we aim to identify horse-related activities that enhance concentration, help address behavioral issues, and facilitate patients' integration into social groups.

742 Effects of acupuncture and related techniques in temporomandibular disorders (TMD): A systematic review

Fri, 20 Sep 2024 00:00:00 +0300

Acupuncture has shown promise as a therapeutic option in temporomandibular disorders (TMD). Its benefits include pain relief, reduction of muscle tension and improvement of jaw function. Several alternative approaches, including dry needling and laser acupuncture, were also reported to improve TMD symptoms. This review aims to summarise the most recent studies available on these alternative therapies for TMD. An electronic literature search was conducted in 3 databases, PubMed, Web of Science, and Scopus, in order to identify articles on acupuncture, dry needling, or laser acupuncture. Search development, process, and two-step article selection were conducted by independent researchers. Data was extracted regarding study characteristics, population characteristics, acupuncture points or techniques used, and assessment methods for diagnosis and effects. Out of 431 identified results, 20 were selected for inclusion. We identified 11 studies on acupuncture, 3 studies on laser acupuncture and 6 studies on dry needling. Most studies showed improvement of TMD symptoms post-intervention, assessed by pain scales and maximum mouth opening. Overall, most studies showed promising results for acupuncture as an alternative, minimally invasive treatment method for TMD. When compared to controls or placebo, acupuncture, and related techniques result in significant relief of TMD symptoms.