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Povzetek: Background Deep brain stimulation of the subthalamic nucleus (STN-DBS) is a widely applied therapy in Parkinson’s disease (PD). Occasionally, postoperative worsening of gait or balance occurs, even in the face of a persistently gratifying appendicular symptom improvement. The characteristics vary considerably, and the risk factors for this postoperative gait or balance worsening are largely unknown. We systematically investigated the literature for all cases of gait or balance worsening after STN-DBS in PD and explored its characteristics and determinants. In consecutive populations with best medical treatment as the control group, we also explored its incidence. Methods We searched PubMed, Embase and Cochrane. We considered all cases occurring between 1 month after surgery (to exclude immediate postoperative complications as most likely cause) and 12 months after surgery (to exclude disease progression). Results From 2719 entries, we included 20 studies (n=1010 operated patients). Freezing of gait and falls were the most commonly reported symptoms. The first worsening of symptoms occurred between 3 and 6 months after surgery. Modulation of pedunculopontine afferents was more likely associated with worsening of gait and balance. In controlled trials with consecutive patients, 24 cases (15.9%) were reported, compared with 5.8% with best medical treatment (p=0.0013). Conclusions Gait or balance worsening after STN-DBS is a complex phenomenon that cannot readily be explained by mere disease progression. The multifactorial nature warrants further study in gait labs and through advanced imaging techniques. Future studies should also estimate the actual incidence, which we could not establish as we excluded cohorts without any reported cases.
Ključne besede: Parkinson's disease, deep-brain stimulation, gait, balance
Objavljeno v DiRROS: 27.02.2026; Ogledov: 164; Prenosov: 88
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Povzetek: Social innovation has emerged as a strategic tool to foster development in disadvantaged areas. The study analyzes the spatial distribution and temporal changes of social innovation potential and its link to population dynamics in two disadvantaged Hungarian counties. Using indicators classified into input, output, and impact categories, a composite index was constructed for municipalities over three census years (2001, 2011, 2022). Moran I statistics and clustering tested spatial dependence of social innovation potential and the relationship between clusters and migration balance. Findings show positive spatial autocorrelation weakened over time. A strong link exists between social innovation potential and migration balance, with innovative settlements showing lower outmigration.
Ključne besede: social innovation potential, population changes, migration balance, Moran I statistic, disadvantaged area, Hungary
Objavljeno v DiRROS: 08.02.2026; Ogledov: 420; Prenosov: 163
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Povzetek: Introduction: Postural control impairments are common in patients with multiple sclerosis (MS), resulting in postural instability and increased fall risk. Sensory inputs are crucial to maintain balance adequately. Additionally, fatigue is one of the common and most disabling symptoms of MS, possibly contributing to postural deficits. Previous studies have examined the effects of fatigue and altered sensory conditions on postural control in patients with MS. The present study aimed to extend this knowledge by jointly assessing these factors within the same experimental framework, providing additional insight into how fatigue modulates sensory contributions to balance. Methods: A total of 21 patients with MS (age = 41.1 ± 10.1 years; EDSS = 1.9 ± 1.0; disease duration = 6.8 ± 4.9 years) completed balance assessments on firm and compliant surfaces with both eyes open and eyes closed, before and after a 6-min walk test used to induce fatigue. Postural sway was quantified using sway velocity and root mean square (RMS). Results: There was a significant effect of surface on sway velocity (p < 0.001, η2 = 0.60), with a greater sway on the compliant surface compared to the firm surface. Fatigue significantly increased sway RMS (p = 0.023, η2 = 0.23) but did not affect sway velocity (p > 0.05). The absence of visual input (eyes closed) also significantly increased sway RMS (p = 0.001, η2 = 0.46). There was a significant interaction between surface and vision for sway RMS (p < 0.001, η2 = 0.54), with a larger effect of surface instability in the eyes-closed condition. Discussion: Patients with MS face increased challenges in maintaining postural control under conditions of fatigue, surface instability, and lack of visual input. Sway RMS may be more sensitive to these effects than sway velocity.
Ključne besede: balance control, sensory integration, proprioception, motor impairments, fall prevention, neurological disorders, physical fatigue
Objavljeno v DiRROS: 11.12.2025; Ogledov: 390; Prenosov: 165
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Povzetek: Climate is a primary, but non-stationary, driver of tree growth. Climate change is altering the sensitivity of forest growth to water availability and temperature over time. It is considered that pedunculate oak (Quercus robur L.) will cope with the changing climatic conditions in Europe in the near future. However, while species distribution models project expansion zones, they also identify reductions in occurrence at the dry and warm distribution margins. Whereas species distribution models primarily rely on occurrence data, tree rings—given their long-term perspective and their use in empirical models—can provide a mechanistic view of forest growth dynamics, including temporally changing climate responses. Increased climate sensitivity and growth synchrony are key dendroecological indicators of tree stress. Here, we used an unprecedented network of 150 Q. robur sites (over 3300 trees), covering the full projected range of contracting to persistent areas across Europe, to assess the dendroecological indicators over recent decades in relation to species distribution model predictions. We reveal that oaks in areas projected to experience range contraction exhibited greater sensitivity to current growing season climatic conditions, whereas those in persistence areas responded more strongly to previous season conditions. Growth synchrony among trees was higher in the contraction areas, but showed no significant increasing trend over the last 70 years, as expected from ecotone theory. Temporal shifts in climate sensitivity were stronger for temperature and vapor pressure deficit in the persistence areas, whereas the climatic water balance gained importance in the contraction zones. These findings suggest that Q. robur growth is not yet being severely affected by climate change, and that the species is currently coping well with the climate changes, even in regions with projected range contractions, thereby challenging statistically derived scenarios of range shift based on species distribution models.
Ključne besede: climate change scenarios, climate–growth relationships, climatic water balance, growth synchrony, range contraction, vapor pressure deficit
Objavljeno v DiRROS: 04.11.2025; Ogledov: 388; Prenosov: 203
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Povzetek: This study evaluated the effects of a neuromuscular training (NMT) warm-up program on injury incidence,neuromuscular function, and program adherence, maintenance and acceptance in adolescent basketballplayers. A total of 275 players from 20 Slovenian teams (15 ± 1.7 years of age), were randomized into anintervention group (IG, n=129) and a control group (CG, n=146). Over three months, the IG incorporatedNMT into their warm-ups, while the CG followed their usual practice. Measurements of body anthro-pometry, muscle contractile properties, and balance were taken before and after the intervention. Also,the injury incidence, training adherence and maintenance were reported. Both groups showed improvedbalance, with no significant difference between them. However, IG demonstrated reduced delay times inspecific muscles, indicating improved neuromuscular function. Injury prevalence proportion (%) duringthe whole study period was higher in the control group compared to intervention (IG: 10.9% vs. CG:23.3%), and incidence rate. Moreover, the incidence rate ratio for sustaining an injury was 2.6 on average(ranging from 0.88 to 7.07 for tendon and muscle injuries, respectively), indicating significantly lowerinjury risk in IG than CG. These findings highlight the effectiveness of NMT warm-ups in reducing injuryrisk and enhancing neuromuscular function, emphasizing the value of structured injury preventionstrategies in youth sports.
Ključne besede: muscle contractile properties, balance, injury prevalence, training adherence
Objavljeno v DiRROS: 18.11.2024; Ogledov: 1042; Prenosov: 567
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