Snježana Schuster

Background: Chronic low back pain (CLBP) with sciatica caused by lumbar disc herniation is a common and disabling condition. Combined therapeutic protocols that include high force machine spinal decompression therapy (SDT), infrared therapy, and interferential therapy are increasingly used in clinical practice, although evidence in chronic populations remains limited. Because this study did not include a control group, only observed pre–post changes can be reported. This study primarily aimed to assess observed changes in pain intensity following a multimodal therapy protocol in adults with chronic lumbar radiculopathy. Methods: A pre–post observational study was conducted in 234 adults with chronic lumbar radiculopathy lasting ≥12 weeks and MRI confirmed disc herniation at L4–L5 and/or L5–S1. Participants completed ten treatment sessions delivered twice weekly over five weeks. Each session included infrared therapy, high force SDT, and interferential therapy. Pain intensity (VAS 0–10) was measured before the first and before the tenth session. Results: Pain intensity decreased significantly after treatment (Wilcoxon W = 18,830, p < 0.001), with a mean reduction of 2.5 points, exceeding the minimal clinically important change threshold, and with a very large effect size (rank biserial correlation = 0.991). No significant gender differences were observed. Baseline pain (β = 0.312, p < 0.001) and age (β = 0.145, p = 0.020) independently predicted post-treatment pain (R² = 0.129). Conclusion: A reduction in pain intensity was observed after five-week combined therapy protocol. Due to the absence of a control group and the simultaneous use of multiple modalities, no causal conclusions can be drawn, nor can improvements be attributed to SDT alone. Randomized controlled trials with functional outcomes and long-term follow-up are warranted.

Background: Urinary incontinence (UI) is commonly reported among female athletes, yet its determinants remain insufficiently understood. This study aimed to examine whether daily training duration contributes to the likelihood of UI beyond previously observed associations with smoking. Methods: A secondary analysis of cross-sectional data from 70 Croatian female athletes was conducted. Multivariable logistic regression models were used to assess associations between UI and age, body mass index (BMI), smoking, and daily training duration as a simplified proxy for external training load, including an exploratory interaction between smoking and training duration. Results: Smoking was the only variable significantly associated with UI in the main-effects model (odds ratio [OR] = 4.18, 95% CI 1.05–16.69). Age, BMI, and training duration were not independently associated with UI. In the exploratory interaction model, smoking was associated with higher odds of UI, although with limited precision (OR = 8.26, 95% CI 1.00–68.18), while the interaction between smoking and training duration showed a positive but statistically nonsignificant association (OR = 14.72, 95% CI 0.89–243.95), indicating substantial uncertainty in the estimate. Conclusions: These findings suggest that behavioral factors may play a more relevant role in UI among female athletes than training duration alone. Although the exploratory interaction pattern should be interpreted with caution, it may suggest a possible difference in the relationship between training duration and UI according to behavioral factors such as smoking. Further studies with larger samples and multidimensional measures of training exposure are needed.

Introduction. Recovery of respiratory function after median sternotomy is essential for successful outcomes in cardiac surgical procedures. Physical therapy, particularly early mobilization in the intensive care unit (ICU), is increasingly recognized as a key component in accelerating postoperative recovery. This study involved patients with coronary artery disease undergoing coronary artery bypass grafting (CABG) and heart valve replacement. The aim was to determine the impact of early mobilization on respiratory parameters during the acute phase of recovery. Regression analysis was used to quantify the effectiveness of physical therapy in improving respiratory function. Methods. The sample consisted of 38 women and 62 men. Data analysis was conducted using the bootstrap method and the Wilcoxon test to examine the effects of physical therapy on arterial blood gases (PCO₂, PO₂) and to compare outcomes between groups receiving therapy on the first postoperative day (POD1) versus the second postoperative day (POD2). Predictors of respiratory function improvement were assessed using regression analysis. Discussion. Early mobilization demonstrated a significant positive effect on respiratory parameters across all patients. Earlier initiation of physical therapy was associated with better outcomes. Body mass index (BMI) emerged as a risk factor negatively influencing PCO₂ improvement and was correlated with prolonged ICU stays. The surgical procedure type influenced better PCO₂ values. Conclusion. Early mobilization underscores the importance of enhancing postoperative respiratory status.

Purpose: Adherence to therapeutic exercises for low back pain can significantly impact longevity, quality of life, and health care costs. There is insufficient research describing the nature and relationship between specific patient characteristics and exercise adherence in non-specific low back pain (NSLBP). This research aimed to examine: (i) the relationship between education and adherence, (ii) the relationship between perceived pain level and adherence, and (iii) whether education and pain level are significant predictors of adherence. Methods: Observational analytic research was conducted in a physiotherapy outpatient setting on a sample of 50 subjects with NSLBP. Data collected were: sociodemographic, pain level according to the visual analogue scale (VAS) and adherence measured by the Exercise Adherence Rating Scale (EARS). For hypotheses testing, statistical methods used were; t-test for small independent samples (i), Pearson correlation coefficient (ii) and linear regression analysis (iii). Results: The results show that: (i) people with a college education are more adherent, (ii) increasing adherence reduces pain level, and (iii) education and pain level are significant in predicting adherence, where education is a stronger predictor. Conclusion: College-educated persons are more prone to therapeutic exercise, and adherence determines physiotherapy outcomes. The contribution of research to clinical practice is reflected in the findings of the nature and relationship between education level and exercise adherence in NSLBP and its significant impact on physiotherapy outcomes.

Introduction: Urinary incontinence (UI) in female athletes (FA) is a globally concerning but neglected topic in Croatia. The purpose was to examine the occurrence and severity of UI in Croatian FA and occurrence-associated factors. Methods: In May 2022, an anonymous online survey collecting general sports characteristics and the Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) were sent to individual FA. Obtained data were analysed with the PSPP program: chi-square test, t-test and analysis of variance with a defined significance level of p < 0.05. Results: The presence of UI in the total sample of 70 FA competing in 12 different sports is 24.3 %: 8 (29.6 %) handball players, 3 (42.9 %) tennis players, 2 (40 %) water polo players, one (14.3 %) synchronised swimmer, seven soccer players (14.3 %), one weightlifter (50 %) and the only swimmer (100 %). According to ICIQ-UI SF, in 70.59 % of FA with UI, a small amount of urine leaks approximately once a week or less often, mainly after urination and dressing up (35.29 %). The UI interference with quality of life is mild (70.59 %) and moderately severe (29.41 %), and the UI severity is slight (47 %) to moderate (53 %). Smokers report UI to a greater extent (χ2(1, n = 70) = 4.666, p < 0.05), while other sports and FA characteristics did not yield significant findings. Conclusions: UI is present in a quarter of examined Croatian FA, with mild to moderate severity. It mildly interferes with the quality of life and seems to be associated with smoking. Our findings contribute to preserving women's health in sports and apply to UI assessment in FA and counselling on smoking cessation as a proven UI risk.

Introduction: Research on low back pain (LBP) indicates sex differences in the prevalence and degree of disability, which is more significant in females and shows possible balance deficiencies. This study aimed to answer the following research questions: (i) is there a difference in static balance between healthy and females with LBP, (ii) is there a correlation between pain and static balance in females with LBP, and (iii) is there a correlation between static balance and disability in females with LBP. Methods: A cross-sectional research was conducted in a physiotherapy outpatient setting on a sample of 50 subjects, females with LBP and healthy volunteers, divided into two equal groups. Data collected from all respondents were: age, weight and height, the centre of pressure path length and rectangle area, Romberg area quotient and space quotient measured via a stabilometric force platform. In the LBP group, the pain was assessed using the Numeric Pain Rating Scale, and disability was assessed using the 24-item Roland Morris Disability Questionnaire. Nonparametric statistical tests were used: the Mann-Whitney test (i) and the Spearman correlation coefficient (ii and iii) with a defined significance level set at p<0.05. Results: Statistical analysis revealed (i) a difference in static balance between healthy females and those with LBP, (iii) a correlation between disability and static balance and (ii) no correlation between pain and static balance in LBP. Conclusion: Females with LBP have static balance deficiencies, which are correlated with their disability but not with pain which should be considered during physiotherapy.

Introduction: Research shows that urinary and sexual dysfunction is very common neurological sequelae of stroke with a markedly significant impact on body self-image and quality of life. Still, there is a lack of recent research to address this problem in female stroke survivors. The study aimed to examine the existence and level of urinary and sexual dysfunction, quality of life, and self-reported body image in a group of women after stroke and compare findings with those found in a group of women with other chronic non-neurological diseases. Methods: This study’s sample consisted of 30 females; two groups composed of 15. The stroke group consisted of subjects after stroke and the non-neurological group with different chronic non-neurological, mainly muscle-skeletal conditions. This study’s specific interest data were collected from respondents through pelvic floor distress inventory (PFDI-20), the pelvic floor impact questionnaire (PFIQ-7), female sexual function index (FSFI), and an eight-item body image scale (BIS). The SPSS v.26 program was used for statistical processing. Results: Results show a statistically higher scores in stroke group (M = 219.65 ± 34.573) on PFDI-20 than in non-neurological group (M = 118.54 ± 27.734). Furthermore, statistically significant higher scores were found in stroke group in PFIQ-7 (Mdn = 233.33) and BIS (Mdn = 16.00) than in non- neurological group (Mdn = 28.57) – PFIQ-7; (Mdn = 11.00) – BIS. Also, statistically significant lower scores were found in stroke group (Mdn=10.40) on FSFI index than in non-neurological group (Mdn=24.60). Conclusions: Women after stroke show significantly more urinary and sexual dysfunction, lower quality of life, and poorer body self-image than the non-neurological group of chronic non-neurological conditions. There is a clear need for research on this issue in women after stroke.

The aim of this study was to examine the association between sleep disturbances, as an indicator of sleep quality, Body Mass Index, and age in adult participants. The study involved 73 participants (62 women and 11 men) with an average age of 35.74 years. Through an online questionnaire, we collected the data on participants’ height, body mass, gender, and sleep disturbances. Based on their height and mass, we calculated the Body Mass Index as an indicator of body fat for each participant. We used items from a shorter version of the Pittsburgh Sleep Quality Index to assess sleep disturbances. Participants were asked to answer how often they experienced different disturbances while falling asleep or sleeping in the last month. The results of the study indicated an association between sleep disturbances and Body Mass Index. Compared to participants who rarely experienced sleep disturbances, participants with frequent disturbances were more likely to have a high Body Mass Index (indicating excess mass or obesity). Although older participants in most cases had a high Body Mass Index compared to younger participants, no significant association was found between sleep disturbances and age. The results of the study also suggest that the association between sleep disturbances and Body Mass Index did not depend on the age of the participants. The research findings indicate that in addressing the issues of obesity and excess mass, public health attention should also be given to sleep quality issues.

Physical activity (PA) during normal pregnancy has various positive effects on pregnant women’s health. Determination of the relationship between PA and health outcomes requires accurate measurement of PA in pregnant women. The purpose...