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The histomorphometry of the rabbit bone tissue from the lower jaw was done. Authors hypothesized that local enhancement with biphasic calcium phosphate ceramic materials in the femur trochanter major area increase the trabecular bone volume outside the implantation zone in vivo. Twenty-two California female rabbits were included in this study and were divided into four groups. Four healthy rabbits composed a control group (A group), while other eighteen underwent ovariectomy. Bone defects were created in femur trochanter major region. Sham surgery group (B group) consisted of four female rabbits with osteoporosis and bone defect, but no biomaterials were implanted. In C group (seven rabbits) created defects were filled with granules of biphasic calcium phosphate ceramic (hydroxyapatite (HAP) and tricalcium phosphate (TCP) 30/70); in D group (seven rabbits) defects were filled with the same granules (HAP/TCP 30/70) together with strontium (5% by mass). Twenty-two bone samples were taken from lower jaw premolar region. Trabecular bone area was measured using Image Pro Plus 7 program, where three equal fields (0.975 mm2) of view were at random chosen in all bone samples. Results have shown that the trabecular bone area in A group was 0.201 mm2 (0.176-0.233), which is statistically significantly higher (p 2 (0.118 – 0.149), C group 0.136 mm2 (0.108 – 0.166) and D group 0.135 mm2 (0.126 – 0.164), respectively. Statistically significant differences between B, C and D groups were not found (p > 0.05).

Background Longitudinal cohort studies provide important information about the clinical effectiveness of an intervention in the routine clinical setting, and are an opportunity to understand how a population presents for treatment and is managed. Methods INTEREST IN CD2 (NCT01753349) is a prospective, international, 3-year, longitudinal, observational study following the course of adult idiopathic cervical dystonia (CD) treated with botulinum neurotoxin type A (BoNT-A). The primary objective is to document long-term patient satisfaction with BoNT-A treatment. Here we report baseline data. Results This analysis includes 1036 subjects (67.4% of subjects were female; mean age was 54.7 years old; mean TWSTRS Total score was 31.7). BoNT-A injections were usually given in line with BoNT-A prescribing information. The most commonly injected muscles were splenius capitis (87.3%), sternocleidomastoid (82.6%), trapezius (64.3%), levator scapulae (40.9%) and semispinalis capitis (26.9%); 35.5% of subjects were injected using a guidance technique. Most subjects (87.8%) had been previously treated with BoNT-A (median interval between last pre-study injection and study baseline was 4 months); of these 84.8% reported satisfaction with BoNT-A treatment at peak effect during their previous treatment cycle and 51.5% remained satisfied at the end of the treatment. Analyses by geographical region revealed heterogeneity in the clinical characteristics and BoNT-A injection practice of CD subjects presenting for routine treatment. Conclusions These baseline analyses provide sizeable data regarding the epidemiology and clinical presentation of CD, and demonstrate an international heterogeneity of clinical practice. Future longitudinal analyses of the full 3-year study will explore how these factors impact treatment satisfaction. Electronic supplementary material The online version of this article (10.1007/s00415-017-8698-2) contains supplementary material, which is available to authorized users.

Cerebral palsy (CP) is a group of the most common developmental disorders affecting movement and posture of the body, causing activity limitations and participation restrictions. The motor disorders of persons with CP are often accompanied by disturbances of sensation, cognition, communication and perception. The symptoms of CP are very diverse and persons with CP are usually presented with a mixed type of symptoms. The non-progressive disturbances can be attributed to disorders that were developed during pregnancy, birth and/or infant stage. The aim of this study was to improve physicians' professional practice of Physical and Rehabilitation Medicine for persons with cerebral palsy in order to improve their functionality, social and community integration, and to reduce activity limitations and/or participation restrictions. A systematic review of the literature including an 18-year period and consensus procedure by means of a Delphi process was performed and involved the delegates of all European countries represented in the Union of European Medical Specialists Physical and Rehabilitation Medicine (UEMS PRM) Section. As the result of a Consensus Delphi procedure, 74 recommendations are presented together with the systematic literature review. The PRM physician's role for persons with cerebral palsy is to lead and coordinate the multiprofessional team, working in an interdisciplinary way. They should propose and manage the complex but individual PRM program developed in conjunction with other health professionals, medical specialists and importantly in agreement with the patient, their family and care giver. This should be, according to the specific medical diagnosis to improve patients' health, functioning, social and education status, considering all impairments, comorbidities and complications, activity limitations and participation restrictions. This evidence-based position paper is representing the official position of The European Union through the UEMS PRM Section and designates the professional role of PRM physicians in persons with cerebral palsy.

Background and Objectives: Oral anticoagulants are the hallmark of cardioembolic stroke prevention, but they are frequently underused, especially in elderly patients and patients with paroxysmal atrial fibrillation. In our paper, we analyzed the long-term outcome of severely disabled cardioembolic stroke survivors depending on the prescribed antithrombotic secondary prevention medication. Materials and Methods: In our study, we retrospectively collected data for ischemic stroke (IS) patients treated in P. Stradins Clinical University hospital, Riga, Latvia, from 2014 until 2017. Patients&rsquo, clinical data were collected using local stroke registry, including patients&rsquo, demographic data, vascular risk factors, clinical findings, and laboratory results. Severely disabled stroke survivors were followed up by phone at 30/90/180/365 days after discharge. Patients&rsquo, functional outcomes were assessed using the adapted version of The Rankin Focused Assessment&ndash, Ambulation. The collected data were compared in 4 groups according to prescribed secondary prevention medication. Results: A total of 682 (91.42%) patients were followed up and included in data analysis. The median age of patients was 80 (IQR = 75&ndash, 85) years. Of these patients, 231 (31%) were males and 515 (69%) were females. One-year probability of survival of patients not taking any preventive medication was 53% (IQR = 29&ndash, 76), while in patients taking antiplatelet agents it was 57% (IQR = 37&ndash, 78), 78% (IQR = 68&ndash, 88) of patients on Vitamin K antagonists (VKA) and 81% (IQR = 72&ndash, 90) in patients on direct oral anticoagulants (DOACs). One year after discharge 73 (31%) had mRS 0&ndash, 2, 50 (20.9%), 29 (12.1%) were still severely disabled, and 87 (36.4%) had died. Conclusions: Anticoagulant use in secondary prevention predicts better functional outcome and higher survival rate in patients with severe cardioembolic stroke due to non-valvular atrial fibrillation (NVAF), therefore severe neurological deficit must not be a reason of restriction of anticoagulation.

Background Patients with cervical dystonia (CD) typically require regular injections of botulinum toxin to maintain symptomatic control. We aimed to document long-term patient satisfaction with CD symptom control in a large cohort of patients treated in routine practice. Methods This was a prospective, international, observational study (NCT01753349) following the course of adult CD treated with botulinum neurotoxin type A (BoNT-A) over 3 years. A comprehensive clinical assessment status was performed at each injection visit and subjects reported satisfaction in two ways: satisfaction with symptom control at peak effect and at the end of treatment cycle. Results Subject satisfaction remained relatively stable from the first to the last injection visit. At 3 years, 89.9% of subjects reported satisfaction with symptom control at peak effect and 55.6% reported satisfaction with symptom control at end of treatment cycle. By contrast, objective ratings of CD severity showed an overall reduction over 3 years. Mean ± SD Toronto Western Spasmodic Rating Scale (TWSTRS) Total scores (clinician assessed at end of treatment cycle) decreased from 31.59 ± 13.04 at baseline to 24.49 ± 12.43 at 3 years (mean ± SD reduction from baseline of − 6.97 ± 11.56 points). Tsui scale scores also showed gradual improvement; the percent of subjects with a tremor component score of 4 reduced from 12.4% at baseline to 8.1% at 3 years. Conclusions Despite objective clinical improvements over 3 years, subject satisfaction with symptom control remained relatively constant, indicating that factors other than symptom control also play a role in patient satisfaction.

Breast cancer treatment may cause unfavourable side effects that directly or indirectly influence the cardio-respiratory capacity among breast cancer survivors, thus affecting physical functioning and the quality of life. Mounting evidence supports that Maximal oxygen uptake (VO2max) is a strong predictor of all-cause mortality and cardiovascular disease, and low VO2max is associated with increased mortality from breast cancer. The aim of the study was to measure cardio-respiratory fitness in breast cancer survivors and determine to what extent VO2max levels are lower compared with healthy counterparts from population. The study included 11 women with a history of breast cancer, the average time after breast surgery being 2–3 years. Aerobic capacity was determined by the Cardiopulmonary exercise test. HUNT3 study was used to define aerobic capacity for healthy women in population. Mean Age for participatns 50 ± 4 years (M ± SD). The comparison of the results from Cardiopulmonary exercise test indicated that breast cancer survivors display VO2max values significantly lower 27.1 ml/kg/min (27%) than healthy counterparts from population, i.e., 34.4 ml/kg/min (P = 0.001). Recognizing the increasing number of breast cancer patients worldwide and the physical reconditioning among the survivors, aerobic exercise training is suitable for improving cardio-respiratory health, functionality, and quality of life.

Muscle function around the shoulder girdle can be impaired by pain, which leads to abnormal movement e.g. elevation. Movement faults should be assessed specifically, therefore individual sport rehabilitation strategies can be implemented. Smart garments are efficient for upper body movement assessment. There is a lack of literature stating that smart textile garments are reliable and valid for shoulder gridle elevation. The purpose of the study was to examine reliability and validity of the DAid smart shirt during shoulder girdle elevation. Twenty-one female volunteers aged 24.3. (SD3.3), body mass index 19.3 (SD 0.5) were recruited. The DAid smart shirt and 2D movement video analysis software Quintic Biomechanics v26, UK were the assessment tools utilized. Cronbach alpha coefficient and Interclass Correlation Coefficient were calculated to assess the within-session test-retest reliability. Bland – Altman analysis was applied to determine validity. Results: reliability for the right side measures: Cronbach alpha coefficient α ≥ 0.9, ICC ≥ 0.9. Reliability for the left side measures: Cronbach alpha coefficient α ≥ 0.9, ICC ≥ 0.91. Bland -Altman analysis presents that DAid smart shirt measures are valid during shoulder girdle elevation. Conclusion: smart shirt measures are reliable and valid during shoulder girdle elevation movements.

Wearable technologies provide many possibilities for applications in medicine, and especially in physiotherapy, where tracking and evaluation of body motion are of utmost importance. Despite the existence of multiple smart garments produced for applications in physiotherapy, there is limited information available on the actual impact of these technologies on the clinical outcomes. The objective of this paper is to evaluate the impact of the Double Aid (DAid) smart shirt, a purely textile-based system, on the training process of patients with subacromial pain syndrome. A randomized controlled trial was performed where patients with subacromial pain syndrome had to perform the assigned training exercises while employing the DAid smart shirt system. The core point of each exercise was to perform a movement while holding the shoulders stationary. The smart shirt was designed to sense even slight shoulder motion thus providing the patient with feedback on the accuracy of the motion, and allowing the patient to adjust the movement. The appropriate muscles should be strengthened through an increased effort to control the shoulder motion. The recovery of patients using the feedback system at the end of the treatment was compared to that of a reference group through standardized tests—the Disabilities of the Arm, Shoulder, and Hand score (DASH score), Closed Kinetic Chain Upper Extremity Stability test (CKCUES test), and internal/external rotation ratio. The test group that used the DAid system demonstrated significantly better results of the performed tests for all applied outcome measures compared to the reference group (p < 0.001). An overall positive impact on the patient recovery was observed from the DAid smart shirt system when applied for rehabilitation training of patients with subacromial pain syndrome.

BACKGROUND Low back pain (LBP) is the most common type of musculoskeletal pain, thus it is one of the most commonly encountered conditions in Physical and Rehabilitation Medicine. The physicians who are primarily responsible for the nonsurgical management of LBP are physiatrists. OBJECTIVE The present study aimed to investigate the approaches of physiatrists to low back pain across Europe. Preferences, tendencies, and priorities in the diagnosis, management, and treatment of LBP, as well as the epidemiological data pertaining to LBP in PRM practice were evaluated in this Europe-wide study. METHODS The study was conducted under the control of the European Society of Physical and Rehabilitation Medicine (ESPRM) Musculoskeletal Disorders Research Committee. A total of 576 physiatrists from most European countries participated in the survey. RESULTS The results show that physiatrists frequently deal with patients with LBP in their daily practice. Most patients are not referred to other departments and are treated with various conservative methods. Less than one-fifth of patients are primarily referred for surgery. The physiatrists believe that a clear diagnosis to account for cases of low back pain is rarely established. The most common diagnosis is discopathy. History and physical examination remain the most valuable clinical evaluation tools for low back pain according to physiatrists. Less than half the patients require a magnetic resonance imaging. Non-steroidal anti-inflammatory drugs are the most commonly prescribed drugs for low back pain. Exercise, back care information, and physical therapy are the preferred conservative treatments. More than half of the physiatrists offer interventional treatments to patients with low back pain. CONCLUSION The present study is a preliminary report that presents the attitudes of European physiatrists in the management of low back pain. Further researches are warranted to standardize the conservative management of LBP.

Shoulder impingement is the most common cause of shoulder pain. The ability to control the orientation and movement of the scapula is essential for optimal arm function and pain reduction in young adults with shoulder impingement signs. Smart garments find wide range of healthcare applications, including rehabilitation. One of the main parts of smart garment is the sensing system which can include one or several sensing elements for posture and joint motion control. The aim of present research was to verify the possibility of using DAid Smart shirt to capture and monitor shoulder gridle motion during motor control exercises and during training sessions out of laboratory environment for ballerina with shoulder impingement syndrome. Another aim was to develop method of this Smart shirt using in addition to conventional physiotherapy to reduce right side shoulder girdle elevation. As a monitoring tool, specially designed DAid Smart Shirt had been used. Specifically, embodied textile strain sensors gave possibility to capture spatiotemporally motion, but acquisition system provided visual feedback on the screen of remote electronic device. Conclusions: Designed DAid Smart shirt can be objective and convenient tool for shoulder motion monitoring for both: patient and physiotherapist. Thus, it can be used as effective assisting device to conventional physiotherapy for shoulder girdle motion control.

The White Book (WB) of Physical and Rehabilitation Medicine (PRM) in Europe is produced by the 4 European PRM Bodies (European Academy of Rehabilitation Medicine - EARM, European Society of PRM - ESPRM, European Union of Medical Specialists - PRM Section, European College of PRM-ECPRM served by the European Union of Medical Specialists-PRM Board) and constitutes the reference book for PRM physicians in Europe. It has now reached its third edition; the first was published in 1989 and the second in 2006/2007. The WB has multiple purposes, including providing a unifying framework for European countries, to inform decision-makers on European and national level, to offer educational material for PRM trainees and physicians and information about PRM to the medical community, other rehabilitation professionals and the public. The WB states the importance of PRM, a primary medical specialty that is present all over Europe, with a specific corpus disciplinae, a common background and history throughout Europe. PRM is internationally recognized and a partner of major international bodies, including the World Health Organization (WHO). PRM activities are strongly based on the documents of the United Nations (UN) and WHO, such as the Convention of the Rights of Persons with Disabilities (2006), the World Report on Disability (2011), the WHO Global Disability Action Plan 2014-2021 (2014) and the WHO initiative "Rehabilitation 2030: a call for action" (2017). The WB is organized in 4 sections, 11 chapters and some appendices. The WB starts with basic definitions and concepts of PRM and continues with why rehabilitation is needed by individuals and society. Rehabilitation focuses not only on health conditions but also on functioning. Accordingly. PRM is the medical specialty that strives to improve functioning of people with a health condition or experiencing disability. The fundamentals of PRM, the history of the PRM specialty, and the structure and activities of PRM organizations in Europe are presented, followed by a thorough presentation of the practice of PRM, i.e. knowledge and skills of PRM physicians, the clinical field of competence of PRM, the place of the PRM specialty in the healthcare system and society, education and continuous professional development of PRM physicians, specificities and challenges of science and research in PRM. The WB concludes with the way forward for the specialty: challenges and perspectives for the future of PRM.

In the context of the White Book of Physical and Rehabilitation Medicine (PRM) in Europe, this paper deals with the core concepts at the base of the PRM specialty. These are the essential constituents that make PRM a primary medical specialty, different from all the other medical specialties, and PRM physician the primary medical specialist among the rehabilitation professionals. The core concepts that will be discussed in this Section include: - PRM is a person/functioning oriented specialty, and this makes the specialty different from the organ/disease oriented, or treatment/age specific medical specialties. - PRM physicians have medical responsibilities, like all the other medical specialists, but with an additional specificity of making a functional assessment. - Like the other specialists, PRM physicians provide direct treatments, but they also work leading the multi-professional rehabilitation team, that works in a collaborative way with other professionals and medical specialists. - Due to its function oriented approach, PRM has a multimodal approach including a wide variety of treatment tools (frequently provided by other rehabilitation professionals) and manages all persons’ morbidities (health conditions), since it focuses on decreasing impairments and activity limitations to allow the best possible participation of patients. - As PRM bases its work on functioning, it has a transversal role to other specialties: it overlaps with several of them, sharing part of their knowledge, but it is also totally independent from all of them, since it is based on a different and transversal body of knowledge. - PRM is focused on the person and neither on the disease nor on the setting ; in fact, PRM is not only transversal to specialties, but also to the settings of care, and PRM physicians should know these different realities: persons with disabilities and those with long-term health conditions in fact move inside the national health systems between various facilities to obtain the best possible functioning and participation through an appropriate rehabilitation process.

Study design A single centre retrospective study. Objectives To collect data and analyse the epidemiological profile of traumatic spinal cord injury and its medical complications during the subacute rehabilitation period. Setting Spinal Cord Injury Rehabilitation Programme of the National Rehabilitation Centre, ‘Vaivari’, Jurmala, Latvia. Methods Information was collected in 2015 from the medical records of 134 patients with a traumatic spinal cord injury admitted for primary rehabilitation between January 2011 and December 2014. Results During this period, the median age of patients with a traumatic spinal cord injury was 39.5 years, and the male to female ratio was 5:1. The leading causes of traumatic spinal cord injuries were falls (37%), road traffic accidents (29%), sport and leisure activities (19%), other cause (8%), unidentified causes (5%), and assault (2%). The most common medical complications were pain (77%), spasticity (48%), urinary tract infections (45%), pressure ulcers (25%), and orthostatic hypotension (14%). Conclusions Preventive measures in Latvia should be aimed primarily to address falls, road traffic accidents, and sport and leisure activities in the young male population. Medical complications are varied, and they are an important factor following traumatic spinal cord injury. The results obtained in this study comply with the data from studies in countries of the Baltic and North Sea regions of Europe.

Background and objective: An understanding of the needs of families of preschool children with cerebral palsy (CP) is of essential importance if efficient and cost-effective services are to be provided to them. The aims of this study were to identify the most frequently expressed needs of families with preschool children with CP, differences in the amount and types of family needs based on the child's gross motor function and communication function level, and the impact of the child's gross motor function and communication function level on the type and amount of family needs. Materials and methods: A total of 227 parents of preschool children with CP completed a modified version of the Family Needs Survey and a demographic questionnaire. Children's gross motor function level and communication function level was classified using the Gross Motor Function Classification System (GMFCS) and the Communication Function Classification System (CFCS), respectively. Results: The total number of family needs differed based on GMFCS and CFCS levels. Children's GMFCS and CFCS level were not significant predictors of overall family needs (adjusted R2 = 0.163). In this model the GMFCS level of children did not account for the total number of family needs, while the CFCS level did. Conclusions: Child's limitations in terms of communication and gross motor functions must be taken into consideration when planning services for families with preschool children with CP.

In the world's developed countries, demographic changes, such as aging societies and increased numbers of diabetes patients, have led to an increase in amputations (11), and it is believed that as society ages, the number of people who are older than 65 will face as much as two times more amputations [3]. Of great importance after the amputation of a lower limb is the selection and adaptation of prostheses that allow patients to move around, thus achieving rehabilitation goals much more quickly [5]. A 20090-study of the rehabilitation of people with lower limb amputations in Latvia found that among 183 patients, 50% use their prostheses actively for more than 6 hours a day, 30% did not use them at all or used them for less than 3 hours a day, and 20% used them for 3-6 hours a day. The study included 173 patients with lower limb amputations who were evaluated in 2012 in relation with whether primary prosthesis should be provided. Of 173 patients who were evaluated, only 109 received a decision on primary prostheses, while in 51 cases the process was delayed for 1–3 months, in 12 cases, it was decided that prostheses would not be purposeful. More than 25% of those who followed the recommended treatment and rehabilitation programme to prepare the amputation stump, reduced contracture and enhanced physical working abilities were declared to be appropriate for further prostheses. This indicates serious shortcomings in medical treatments during the early post-amputation period.

The objective is to examine and compare the usability of two physiotherapy programmes, analyzing respiratory function in patients before and after cardiac surgery in hospital during seven postoperative days (POD). Quantitative randomized prospective study of 157 patients before and after the valve replacement surgery, coronary artery bypass graft and combined surgeries, who moved independently. Participants were randomized into two groups (1 and 2) with different physiotherapy programmes. The routine physiotherapy of breath-enhancing techniques, micro-circulation improvement were used for the first group, for the second group - modified physiotherapy – the improvement of inspiration muscles, mm. quadriceps. gluteus max strength. Anthropometric measurements were defined for both groups on the day before surgery and during spirography - dynamic indicators - forced vital capacity (FVC), forced expiratory volume in the 2nd second (FEV1), Tiffeneau index (FEV1 / VC (%)), peak expiratory flow (PEF), operation parameters. By comparing the postoperative respiratory parameters between the two groups and using independent samples t test, it was found out that the difference in FVC between groups is 1.71 [95% CI: −8.25 to 4.8] and it is not statistically significant (t (155) = −0.52; p = 0.60). Based on the Leuven test results FVC the distribution variance is not statistically notably different for group 1 and group 2 (F = 0.27, p=0.60). Using routine and modified physiotherapy and comparing postoperative dynamic respiratory performance of the two groups, there was no statistically significant difference, proving that the two models are equally effective.

Little is known of cancer rehabilitation needs in Europe. EUROCHIP-3 organised a group of experts to propose a list of population-based indicators used for describing cancer rehabilitation across Europe. The aim of this study is to present and discuss these indicators. A EUROCHIP-3 expert panel reached agreement on two types of indicators. (a) Cancer prevalence indicators. These were proposed as a means of characterising the burden of cancer rehabilitation needs by time from diagnosis and patient health status. These indicators can be estimated from cancer registry data or by collecting data on follow-up and treatments for samples of cases archived in cancer registries. (b) Indicators of rehabilitation success. These include: return to work, quality of life, and satisfaction of specific rehabilitation needs. Studies can be performed to estimate these indicators in individual countries, but to obtain comparable data across European countries it will be necessary to administer a questionnaire to randomly selected samples of patients from population-based cancer registry databases. However, three factors complicate questionnaire studies: patients may not be aware that they have cancer; incomplete participation in surveys could lead to bias; and national confidentiality laws in some cases prohibit cancer registries from approaching patients. Although these studies are expensive and difficult to perform, but as the number of cancer survivors increases, it is important to document their needs in order to provide information on cancer control. (C) 2012 Elsevier Ltd. All rights reserved.

There are many clinical and objectively defined parameters that are used to evaluate a person's disability. Since the World Health Organisation has presented the WHODAS II as a means of objectively measuring subjectively defined functions, greater attention has been focused on self-rated health. Only a few studies, however, have been conducted about differences between self-rated health and objectively defined parameters. The survey for this study was conducted on the basis of WHODAS II and the population in Latvia with spinal cord injury. Respondents were between 18 and 65, and 98 questionnaires were analysed. The results show that people with spinal cord injury on average rate their functioning as limited (33–40 points of 100). Most respondents have been declared to be disabled, which is defined as very serious or severe functional disorders. More than 40% have paid jobs, while one-third do not work for reasons of health. The research shows that there is a close coherence (p< 0.05) between individual, objectively and clinically defined indicators on the one hand and the aspects of the questionnaire in which physical functioning was an important factor on the other hand. In order to understand the real functional abilities of patients and the individual factors that influence those abilities, it is necessary to define functional self-rated health in addition to objectively defined indicators.

Background/Objective: Shoulder overuse due weight-bearing loads – wheelchair propulsion and transfers – are supposed to cause shoulder pain in active wheelchair users. Consequently, shoulder pain has been found to have a high prevalence in the spinal cord-injured population. Severity of pain levels in individuals with spinal cord injury has been shown to impact quality of life. Aim of this study was to describe the consequences of shoulder pain intensity on quality of life, physical activity, and community activities in spinal cord-injured paraplegic wheelchair users. Materials and Methods: It was a qualitative, analytical one moment study where was involved persons after spinal cord injury below Th1 with lower paraplegia, who used manually operated wheelchairs for mobility at least 50% of the time. Main outcomes measure: SF-36textregistered Health Survey, Physical Activity Scale for Individuals With Physical Disabilities, Community Activities Checklist, Wheelchair User’s Shoulder Pain Index, Functional Independence Measure, Goniometry for shoulder joint. Results and analysis: 40 participants (9 female, 31 male) after spinal cord injury (SCI), mean age – 30,8 years, one to twenty years after spinal cord injury. 20 participants had pain in shoulder, 20 participants without pain in shoulder. The intensity of shoulder pain was not related to duration of SCI or the duration of shoulder pain. Shoulder pain intensity scores were inversely related to quality of life. There was a moderate, inverse relationship between shoulder pain intensity and physical activity. There was no relationship, however, between shoulder pain intensity and community activities. The level of community activity was positively related to quality of life. Conclusions: Persons with spinal cord injury who reported lower subjective quality of life and physical activity scores experienced significantly higher levels of shoulder pain. Shoulder pain intensity did not relate to their participation in community activities.

Urinary incontinence is one of the medical problems, which may develop as a result of a stroke, and, according to several authors, its occurrence frequency may reach up to 80%. Clinical symptoms of urinary incontinence are considered to be one of the symptoms, which, along with the severity of the stroke and the level of functional limitations, allows to develop reliable predictions and to make targeted use of resources. Aim of the study, materials and methods. The aim of the study is to explore whether post-stroke urinary incontinence correlates with localization of lesion and clinical symptoms. The study includes 180 patients after a stroke, who have received treatment at Riga Eastern Clinic University Hospital Stroke Unit. All had a comprehensive clinical and functional assessment and cerebral computed tomography (CT). The examination took place at the hospital a few days after the stroke had occurred. Results. There are 180 participants to the study. Symptoms of urinary incontinence were reported for 70.6% of study participants. In 64% of cases new incontinence problems had developed, while in 6.5% of cases the previous symptoms of urinary incontinence (prior to the stroke) had worsened. The most common types of urinary incontinence in the acute period were urge and mixed incontinence (functional and urge incontinence). Patients with low Barthel Index showed higher frequency of urinary incontinence. A comparison of patient groups with and without symptoms of urinary incontinence showed that patients older than 75 years showed more symptoms of urinary incontinence (p = 0.013), and the same can be said about patients with low indicators of Barthel (p = 0.001) and patients with cognitive disorders (p = 0.001). Severity of paresis, aphasia and sensory disorders show a reliable correlation with the type of urinary incontinence. Conclusion. Symptoms of post-stroke urinary incontinence are linked both to a person's age, and functional and cognitive disorders. Urinary incontinence develops more frequently among patients with anterior circulation of the brain and subcortical brain lesion. There is a reliable correlation between severity of neurological lesion and urinary incontinence.

Better knowledge of clinical epidemiology and course of aneurysmal subarachnoid hemorrhage (ASAH) is essential for dedicated planning of the need for services. The aim of the study was to obtain a picture of epidemiology and clinical course of ASAH in Riga City (the capital of Latvia). A retrospective population-based study included residents of Riga City who suffered their first ASAH during a 5-year period from the beginning of 1996 till the end of 2000. The total number of ASAH events in the population during the study period was 292, of which 56 (19%) were fatal before reaching the hospital. There was no significant difference between age-specific incidence rates in men and women. The mean ASAH rates per 100 000 per year were 10.3 for age-adjusted incidence (in the population aged 20-79 years) and 7.2 for crude incidence. The mean age-adjusted case fatality rates were 57% for all ASAH events and 45% for those who survived admission. Our data suggest that incidence of ASAH in Baltic population can be recognized as average compared with other European regions. However, the case fatality rate of ASAH in the study population was higher than those of SAH reported from MONICA Collaborating Centers.

Background Improvement of patients quality of life is one of the main goals in the treatment of AIS. There are well known instruments to estimate the treatment outcomes for patients with AIS, such as SRS questionnaires. Although widely used with patients with AIS, there are still some important aspects of QOL less covered in those instruments. The KIDSCREEN-52 quality-of-life (KIDSCREEN-52-HRQOL) is a relevant, worldwide tool used for assessing the health-related quality of life in children and adolescents, and to compare the QOL of treated patients with healthy peers at the same age. Aim To describe and characterize health-related quality of life in girls with idiopathic scoliosis, after spine surgery, with the KIDSCREEN-52-HRQOL questionnaire. Methods Patients with idiopathic scoliosis completed an ageappropriate health-related quality of life questionnaire KIDSCREEN-52 test approved at country the research provided. The study involved 50 patients with AIS. Patients were 12-16 years old girls, post surgery. The results from this sample were compared with general population norms, taken from freely chosen peers without any orthopedic condition. Results

The effect of altered thyroid status and food-deprivation on palmitic acid oxidation in isolated rat liver mitochondria was studied in the absence and presence of digitonin. Mitochondria prepared from triiodothyronine-treated (hyperthyroid) and food-deprived rats metabolized palmitic acid at the same rate as the untreated controls (euthyroid). Mitochondria prepared from thyroidectomized (hypothyroid) rats metabolized palmitic acid at a rate lower than was that seen with mitochondria from euthyroid controls in either the fed or fasted state. Fasting had no effect on palmitic acid oxidation by mitochondria prepared from euthyroid rats but diminished the rates seen in both hyper- and hypothyroid states. Digitonin (0.04 mg/mg mitochondrial protein) increased the sensitivity of the rate of fatty acid oxidation to inhibition by alpha-bromopalmitic acid. The addition of digitonin to the incubation mixture resulted in two-fold increases in the rate of palmitic acid oxidation in all states. This study shows that the limitations imposed by hypothyroidism on fatty acid oxidation in intact liver are preserved in isolated mitochondria.

Muscular asymmetry is considered as important etiological factor of idiopathic scoliosis. The present study analyses pathomechanisms leading to progression of scoliotic deformation as the result of asymmetric paraspinal muscular activity irrespective of the primary trigger.