Hashimoto’s thyroiditis (HT) is a prevalent autoimmune disorder in which clinical expression is defined not only by immunological mechanisms but also by lifestyle and socioeconomic determinants. These factors may be particularly influential in newly diagnosed, untreated patients, where autoimmune activity reflects the natural course of the disease. Understanding how behavioral and social variables relate to subjective health and autoantibody levels may support early, non-pharmacological interventions.Aim: to assess the relationship between health behaviors, socioeconomic indicators, subjective health, and autoantibody levels in newly diagnosed, untreated HT patients.A case-control study was conducted among 105 newly diagnosed HT patients and 25 healthy controls. Sociodemographic characteristics, lifestyle behaviors, and dietary patterns were assessed using the validated KomPAN questionnaire. Thyroid function (thyroid-stimulating hormone,free thyroxine (TSH, fT4)) and serum anti-TPO(thyroid peroxidase) and anti-TG (thyroglobulin) concentrations were measured. Correlation analyses were performed to assess relationships between questionnaire-derived numerical scores of lifestyle and socioeconomic variables and autoimmune markers.HT patients exhibited significantly higher TSH and autoantibody levels and lower fT4 compared with controls. Diet quality, physical activity, and financial status showed significant correlations with anti-TPO antibody concentrations. Socioeconomic indicators demonstrated significant inverse associations with anti-TG antibody levels: financial status (r= -0.232), education (r= -0.182), and employment (r= -0.260) were inversely correlated with anti-TG levels (all p<0.01). Patients more frequently rated their health as “worse than peers,” reflecting the psychosocial burden of early disease stages.Lifestyle behaviors were closely linked to subjective health, while socioeconomic vulnerability was associated with higher anti-TG antibody levels in untreated HT patients. These findings suggest that financial insecurity, lower level of education, and unstable employment may be related to increased autoimmune reactivity, potentially through mechanisms involving chronic stress and limited access to healthcare. Early lifestyle optimization and multidisciplinary support may improve well-being even before hormone therapy is initiated. Larger prospective studies are needed to confirm these associations and clarify the pathways through which behavioral and social determinants influence autoimmune activity.
Low back pain is one of the most common reasons for seeking medical care and the leading cause of years lived with disability worldwide. Therapeutic exercise is a key component of rehabilitation; however, its effectiveness depends not only on the selection of exercises but also on the quality of their performance. Incorrect exercise technique may reduce therapeutic effectiveness and contribute to the development of compensatory movement patterns. One of the most widely used stabilization exercise programs for low back pain is the McGill Big Three, which is recommended in international clinical guidelines (NICE, ACP) and is widely implemented in physical therapy because of its safety, simplicity, and ability to improve trunk stability. Currently, the quality of exercise performance within this program is assessed primarily through subjective observation, with no standardized quantitative evaluation criteria. The lack of objective assessment tools highlights the need for the development of a standardized system for analyzing exercise performance in patients with dorsalgia. The aim of this study was to develop a method for assessing the quality of McGill Big Three exercise performance in patients with dorsalgia based on angular-temporal movement analysis using digital technologies. Based on a review of the scientific literature, we developed a system for evaluating the quality of McGill Big Three exercise performance using three angular-temporal assessment scales. The proposed method includes video recording of the exercises, measurement of angular deviations of anatomical body segments from the neutral position, and expert assessment using digital measurement tools. The assessment includes analysis of the position of the head, shoulder girdle, lumbar spine, pelvis, and lower extremities, depending on the specific exercise, as well as the duration of correct position maintenance. Four assessment parameters were selected, each rated on a 4-point scale (0-3 points), with a maximum total score of 12 points. Standardized conditions for video acquisition and a structured scoring algorithm were developed to ensure reproducibility of the assessment. The developed scales enable quantitative evaluation of exercise performance quality, identification of technical errors, and monitoring of rehabilitation progress. An angular-temporal model for assessing the technique of McGill Big Three exercises in patients with dorsalgia was developed. This instrument provides an objective approach to movement assessment, standardizes exercise quality control, and may be applied in clinical practice, educational settings, and scientific research.
International professional organisations note a steady increase in the demand for paediatric physiotherapy services, emphasising the need to improve the quality of education and training for specialists in this field of rehabilitation. Postgraduate education is becoming increasingly important as a means of developing specialised training for physiotherapists in paediatrics and enhancing the human resource capacity of the rehabilitation system. The aim of the study was to assess the impact of a comprehensive, competence-based postgraduate training programme in paediatric physiotherapy on the level of attainment of the intended learning outcomes. This study employed a single-group quasi-experimental design with pre- and post-tests and an eight-month follow-up. The training involved the implementation of a comprehensive postgraduate training programme for paediatric physiotherapists, and changes in self-assessed learning outcomes were assessed before and after completion of the programme. The impact of the comprehensive, competence-based postgraduate training programme for paediatric physiotherapists was assessed in three stages: before the training, after the training, and eight months after completion of the training. The evaluation methodology was based on the Kirkpatrick model. Empirical data were collected using a questionnaire. Descriptive statistical methods (mean, standard deviation of the difference, percentage increase) were used to analyse the results. The Wilcoxon signed-rank test was used to assess statistically significant differences. The study found an increase in the overall level of self-assessment of competences following completion of the programme: the average score rose from 3.59 to 4.30 points. The highest increases were observed in the topics concerning the use of assessment tools for children with ASD (+47.66 per cent), the classification and developmental characteristics of children with ASD (+43.88 per cent), and physiotherapy methods for working with children with ASD (+40.67 per cent). Participants’ satisfaction with the programme was high: the learning environment was rated at an average of 4.89 points, and the organisation of the programme at 4.78 points. A comprehensive, competence-based postgraduate training programme for physiotherapists specialising in paediatrics was associated with a statistically significant increase in participants’ self-assessment of their learning outcomes (p<0.05). The fact that these positive changes were maintained eight months later indicates the programme’s potential to support participants’ professional development.
Genetic predisposition, sex, and age at disease onset play an important role in the pathogenesis of atopic dermatitis (AD) and the effectiveness of its treatment in children. To date, insufficient data are available regarding the influence of these factors on changes in clinical symptoms’ dynamics (CSD) of AD during standard therapy (ST). The aim of this study was to determine the role of different genotypes of the single nucleotide variant (SNV) rs7927894 of the filaggrin (FLG) gene, sex, and age in the effectiveness of standard therapy, as assessed by changes in CSD across different phenotypic trajectories (PhT) of atopic dermatitis in children. The study group comprised 29 children divided into three subgroups: 9 children with a mono-organ PhT (MOPhT) of AD, 10 children with a poly-organ PhT (POPhT) of AD + allergic rhinitis/rhinoconjunctivitis (AR/ARC), and 10 children with a poly-organ POPhT representing a completed atopic march (AD + AR/ARC + bronchial asthma (BA)). All children in the three subgroups underwent genotyping of buccal swab samples using real-time polymerase chain reaction (qPCR) to determine the C/T, C/C, and T/T genotypes of the SNV rs7927894 of the FLG gene. The Scoring Atopic Dermatitis (SCORAD) index was used to assess clinical symptoms dynamics at the beginning and at the end of follow-up (FU), with values presented as medians and interquartile ranges – Me [LQ-HQ]. The mean FU duration was 1.5 [1.1; 2.0] years (range, 1-2.4 years). Improvement (a decrease in the SCORAD index) during ST for AD was observed significantly more frequently in children aged 7-11 years (86%, p=0.008) and in carriers of the heterozygous C/T genotype of the SNV rs7927894 FLG (75%, p=0.005). In patients with AD MOPhT, whose baseline SCORAD values did not differ significantly (32.2 [14.2; 45.8] and 32.5 [31.4; 43.3], p=0.796), worsening of CSD was observed as an increase of 8.0 points (p=0.108), whereas improvement was detected by a significant decrease in the index of 8.5 points (p=0.043). The final significant difference between worsening and improvement in CSD, as assessed by SCORAD, was 16.8 points (p=0.020).In patients with POPhT of AD + AR/ARC, whose baseline SCORAD values did not differ significantly (29.9 [23.2; 34.8] and 37.2 [27.1; 39.4], p=0.336), worsening of CSD was detected as an increase of 3.4 points (p=0.144), while improvement was detected by a significant decrease in the index of 14.7 points (p=0.028). Following ST, the difference between worsening and improvement in CSD for this PhT of AD was 10.8 points (p=0.055). In patients with POPhT of AD + AR/ARC + BA, whose baseline SCORAD values did not differ significantly (22.8 [14.2; 29.7] and 26.6 [18.5; 51.2], p=0.569), worsening of CSD was detected as an increase in the index of 6.3 points (p=0.109), whereas improvement was demonstrated by a significant decrease of 12.3 points (p=0.028). Following ST, the difference between worsening and improvement in CSD for this PhT of AD was statistically significant at 14.8 points (p=0.038). Standard therapy for AD is most frequently effective in improving the clinical symptoms dynamics among patients aged 7-11 years. The heterozygous C/T genotype of the SNV rs7927894 FLG is most frequently associated with the effectiveness of standard therapy in improving the clinical symptoms dynamics of AD, in 75% of patients. A more precise assessment of the effectiveness of standard therapy on the clinical symptoms dynamics in children with mono-organ and poly-organ phenotypic trajectories of AD requires investigation of the maximal spectrum of genotypic and demographic factors in larger patient cohorts, at the background of using the combinations of follow-up assessment tools.
In recent years, the focus of rehabilitation for patients with non-small cell lung cancer (NSCLC) has shifted toward restoring social, communicative, occupational, and recreational activities, highlighting the need for further scientific substantiation of rehabilitation approaches. Of particular interest is the potential for predicting disability in patients with NSCLC during the long-term rehabilitation period. The aim of the study was to develop a predictive model and investigate the level of disability in patients with NSCLC during the long-term rehabilitation period. The study included 84 patients with NSCLC aged 49-74 years. In 58 patients of the main group (MG), therapeutic intervention programs were prescribed during the preoperative period and from the fifth week after surgery for a period of three months. Patients in the MG were divided into two subgroups: MG1 and MG2, with 29 patients in each subgroup. Patients in MG1 were prescribed moderate-intensity aerobic continuous cycling exercise on a cycle ergometer, whereas patients in MG2 underwent high-intensity interval training on a cycle ergometer. The control group (CG) comprised 26 patients who declined participation in the therapeutic intervention programs. Assessments were performed 14 days and 1 day before surgery, in 7 days, 1 month and 4 months after surgery. The following parameters were assessed: forced expiratory volume in one second (FEV1), overall endurance using the 6-minute walk test (6MWT) and disability using the 36-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). The greatest negative impact in patients with NSCLC was observed in the domains of getting along with people, life activities, and participation in society, which demonstrated a close interrelationship. A reduction in the overall level of disability according to WHODAS 2.0 was observed in the MG. Specifically, the disability score was 26.9 (11.4)% in MG1 and 23.2 (12.0)% in MG2, which was significantly lower than that observed in the CG – 42.0 (8.6)% (p<0.05). A predictive model for activity limitation based on the WHODAS 2.0 score in patients with non-small cell lung cancer (NSCLC) was developed; the most significant factors identified were the change in 6-minute walk test (6MWT) distance one month post-surgery compared to the preoperative level (regression coefficient B= -0.62), the 6MWT distance 14 days prior to surgery (B= -0.33), and FEV1 one month after surgery (B= -0.32) (p<0.05). According to the model, the most significant predictors were the change in 6MWT distance one month after surgery compared with the preoperative level (regression coefficient B= -0.62), 6MWT distance 14 days before surgery (B= -0.33), and FEV1 one month after surgery (B= -0.32; p<0.05). Thus, the implementation of therapeutic exercise during the prehabilitation period and following surgical intervention in patients with NSCLC is associated with a reduction in disability. FEV1and 6MWT performance are significant predictors of the level of disability during the long-term rehabilitation period.
