Browsing by Author "Stojkovic, Jasna"

Pediatric stroke (PS) is an injury caused by the occlusion or rupture of a blood vessel in the central nervous system (CNS) of children, before or after birth. Hemiparesis is the most common motoric deficit associated with PS in children. Therefore, it is important to emphasize that PS is a significant challenge for rehabilitation, especially since the consequences may also appear during the child's growth and development, reducing functional capacity. The plasticity of the child's CNS is an important predecessor of recovery, but disruption of the neural network, specific to an immature brain, can have harmful and potentially devastating consequences. In this review, we summarize the complexity of the consequences associated with PS and the possibilities and role of modern rehabilitation. An analysis of the current literature reveals that Constraint-Induced Movement Therapy, forced-use therapy, repetitive transcranial magnetic stimulation, functional electrical stimulation and robot-assisted therapy have demonstrated at least partial improvements in motor domains related to hemiparesis or hemiplegia caused by PS, but they are supported with different levels of evidence. Due to the lack of randomized controlled studies, the optimal rehabilitation treatment is still debatable, and therefore, most recommendations are primarily based on expert consensuses, opinions and an insufficient level of evidence.

: Dysfunctional voiding (DV) presents relatively frequent problem in pediatric urologist practice. The necessity for implementation of DV evaluation in the pediatric population is of particular importance, since there is no clear consensus on the clinical assessment of such condition. The aims of our study were to evaluate the test/retest reliability and reproducibility of dysfunctional voiding and incontinence scoring system: Serbian version (DVISS) in patients with voiding and incontinence dysfunctions without structural deformities, and to estimate cut-off value for DVISS. The cross-sectional study included 57 children with voiding and incontinence dysfunctions and 30 healthy pediatric controls. For the evaluation of voiding and incontinence dysfunction we used DVISS. The forward-backward method was applied for translation of the DVISS questionnaire from English into Serbian language. Reproducibility was analyzed by Interclass Correlation Coefficient (ICC). Sensitivity and specificity of DVISS scores was done by receiver operating curve (ROC) curve. There was a significant difference in DVISS score between patients and controls ( < 0.001). For reliability and reproducibility of the questionnaire, there was no significant difference between repeated measurements ( = 0.141), and strong reliability (ICC = 0.957; < 0.001). We have demonstrated successful translation and validation of the DVISS score. Moreover, a reliable scoring system of children with voiding dysfunctions should include evaluations of symptom scoring systems at the multicentric level.

Cerebral palsy (CP) is a nonprogressive neurological disorder characterized by permanent developmental disorders of movement and posture. One of the most common goals of rehabilitation is the treatment of gait disorders. Ataxic gait disorder tends to worsen in the adolescent period. Research indicates a positive therapeutic effect of the combined application of conventional rehabilitation, robotic neurorehabilitation (RNR) and virtual reality, but there is no consensus on the length of treatment and frequency of application. The aim of this case report was to contribute to the definition of the RNR protocol for the treatment of ataxic gait disorder in adolescents with CP. In a female child with an ataxic form of CP who was on regular conventional kinesitherapy in the age period between 13 to 15 years, robotic-assisted gait training (RAGT) was applied for the treatment of gait disorders. The rehabilitation protocol lasted 10 weeks, 5 times a week, and included individual, conventional kinesitherapy for 30 min and RAGT for 30 min. Combined RNR treatment was conducted once a year in the period between July and September. The results of the therapeutic evaluation revealed that the functional motor level remained unchanged, while the improved functional motor status for the category of standing and gait was maintained during treatment between the patient's 13 and 15 years age. In their 15th year, independent gait over a shorter distance (14 m) was achieved, as well as a normal gait frequency (83 steps/minute), with a desirable duration of the left leg support phase of 65% and 70% for the right leg support phase. The results of our research indicate that the application of conventional kinesitherapy and RAGT, over the period of 10 weeks a year, can have a positive effect on improving the postural and locomotor functions of ataxic gait in adolescents with CP.

Nowadays, children are able to enrich their reality via the Internet. Unfortunately, this may increase their risk of becoming victims of cyberbullying. We analyzed the health characteristics and risk behavior of two cohorts of children in Serbia; those who reported being exposed to cyberbullying and those who did not. The statistical differences and logistic regression models were applied to the data on 3267 students collected from 64 schools participating in the 2017 Serbian Study on health behavior in school-age children (HBSC). Children exposed to cyberbullying reported having the following health problems on a daily basis: headache (18.5%), back pain (19.5%), depression (21.6%), irritability or bad mood (17.7%), nervousness (16.0%), sleep problems (16.1%), and dizziness (21.2%). As for the different types of risk behavior, cigarette smoking ranging from six to nine days ever was the most prevalent (26.9%). It was followed closely by getting drunk more than 10 times ever (24.1%). Compared to non-victims, victims were found to be at a higher risk of perceived back pain (OR = 2.27), depression (OR = 1.43), irritability or bad mood (OR = 2.07), nervousness (OR = 2.23), and dizziness (OR = 2.43) as well as being injured once or twice (OR = 1.98) or three or more times (OR = 4.09). Victims were associated with further risk factors: having smoked more than five cigarettes ever in life (OR = 1.73) and having gotten drunk two to three times (OR = 1.71) or four or more times (OR = 1.65). As the number of school-age children using social media continues to rise, we must prioritize educating them about self-help and community resources for addressing related health issues with greater speed and intensity. The findings from Serbia suggest that while children may be aware of their health issues, they may be unaware of their link to cyberbullying, which could hinder their ability to address these issues promptly. The respondents' attention to the health implications of cyberbullying could be increased by reformulating the survey questions used in the HBSC study.

Background and objectives: Pediatric Outcome Data Collection Instrument (PODCI) is among the most described scales developed to evaluate the physical status of children and adolescents with various musculoskeletal disorders. We aimed to translate PODCI from English to Serbian, culturally adopt items and domains, evaluate the temporal stability, internal consistency and the test−retest reliability of PODCISR in children with obstetrical brachial plexus lesion (OBPL), and finally, to test the construct validity of PODCISR against muscular manual test (MMT) Materials and Methods: The study included 48 eligible participants aged between 2 and 10 years with OBPL. The MMT was used to test the construct validity. Results: There were no significant differences (p > 0.05) between test and retest for all PODCISR domains. Correlations for all tested domains with MMT were statistically significant except for biceps muscle and domains II and IV. Cronbach’s alpha value of the Global Functioning Scale was good and equaled 0.838 for test and 0.832 for retest session. Cronbach’s α was more than 0.600 for all PODCISR domains except for Domain II and for Domain IV. The observed Test−Retest ICC for all PODCISR domains scores ranged from 0.899 to 0.996. Conclusion: The Serbian version of PODCI (PODCISR) was successfully translated and transculturally adopted. It has satisfactory temporal stability, construct validity and test−retest reliability as well as relevant internal consistency.