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Muris Pecar

Vanredni profesor, Faculty of Health Studies, University of Sarajevo

Društvene mreže:

Eldad Kaljić, Demir Džaferović, Bakir Katana, Muris Pecar, Samir Bojičić, Namik Trtak

Uvod: Lumbalni bolni sindrom podrazumijeva tegobe koje se javljaju u donjem dijelu leđa. Najčešći razlog je disfunkcija lumbosakralnog dijela kičme i zaštitna mišićna reakcija na bol. Tegobe koje nastaju u lumbalnom dijelu kičme u rasponu od nespecifičnog do diskogenog porijekla nose zajednički naziv lumbalni bolni sindrom. Cilj istraživanja je bio ispitati efikasnost dry needling tehnike uz ostale modalitete fizikalne terapije na intenzitet i katastrofiziranje bola i stepen onesposobljenja osoba s lumablnim bolnim sindromom. Metode istraživanja: Istraživanje je dizajnirano kao prospektivna randomizirana studija koja je upoređivala stanje ispitanika prije i nakon provedenog tretmana. Istraživanje je obuvatilo 35 ispitanika s lumbalnim bolnim sindromom oba spola, dobi od 25 do 83 godine i različitih zanimanja. Ispitanici su nakon provedenog fizikalnog pregleda započeli proces fizioterapijske rehabilitacije koja je obuhvatila Dry needling tehniku uz standardne modalitete fizikalne terapije: Interferentnu struju, terapijski ultrazvuk, LASER i kratkotalasnu dijatermiju. Terapijski protokol je trajao 10 dana u vremenskom periodu od dvije sedmice. Rezultati istraživanja: Analiza srednjih vrijednosti Vizualne analogne skale (VAS) i skale katastrofizacije bola (PCS) je pokazala značajno poboljšanje u odnosu na period prije terapije; VAS prije terapije 8,17, nakon terapije 3,06, PCS prije terapije 25,66, nakon terapije 9,11. Analiza Oswestry Disibility Index skale (ODI) je također pokazala značajno smanjenje srednjih vrijednosti stepena onesposobljenja ispitanika nakon provedenog terapijskog protokola; ODI prije terapije 52,00. nakon terapije 22,00. Zaključak: Dry needling tehnika uz standardne fizikalne procedure dovodi do smanjenja intenziteta i katastrofizacije bola, te smanjenja stepena onesposobljenja osoba s lumbalnim bolnim sindromom.

Vanda Zovko Omeragić, E. Tanović, Edin Mešanović, Muris Pecar

SUMMARY The aim of the study was to analyze the values of Foot and Ankle Disability Index (FADI) after kinesitherapy in subjects with bimalleolar or trimalleolar fracture of the ankle after surgery treatment and the obtained values of manual muscle test (MMT) and range of motion (ROM) after rehabilitation, compared with the obtained values of FADI index and on that basis evaluate its possibility in assessing the functionality of the respondents after surgery for bimalleolar or trimalleolar fracture of the ankle. The sample included 60 subjects over the age of 18 who underwent surgery for osteosynthesis due to bimalleolar or trimalleolar fracture of the ankle. All subjects were treated with kinesitherapy as part of the postoperative rehabilitation program. The research was conducted from 2013 to 2018 at the Department of Orthopedics of Dr. Safet MujiÊ Cantonal Hospital in Mostar and Mostar University Clinical Hospital. A statistically significant correlation was found between FADI index values per group and average percentage recovery per MMT (p<0.05), as well as a statistically significant correlation between FADI score values per group and mean percentage ROM value (p<0.05). A statistically significant association was found between mean percentage recovery per ROM and MMT (p<0.05). The conducted research confirmed the working hypothesis of the conducted study. The effects of kinesitherapy after ankle surgery can be evaluated using the FADI index, as well as by manual muscle test and ROM measurement.

S. Šegalo, Arzija Pašalić, Amra Mačak-Hadžiomerović, Daniel Maestro, Muris Pecar, B. Katana

Background: Musculoskeletal disorders (MSDs) are a wide group of diseases that severely affect work productivity and quality of life. Objective: The aim of this study was to examine the differences in the prevalence of MSDs among laboratory professionals (LPs) and to assess their association with individual, psychosocial, and occupational risk factors. Methods: In a multicenter, cross-sectional study, a questionnaire was distributed online through professional association networks. Participants were divided into two groups based on their territorial affiliation - European Union (EU) and non-EU member states. Descriptive and inferential statistics were included in the analysis, and statistical significance was set at ≤0.05. Results: A total of 640 LPs from 20 European countries participated in the study, predominantly females (78.4%), with university degree (59.4%) and a mean age of 41.2 ± 10.1 years. Statistically significant differences between groups were confirmed for several variables studied: neck flexion > 15° (p = 0.008), hands at chest level (p = 0.000), prolonged screen time, and sitting (p = 0.000). One-third of participants reported wrist (35.6%), shoulder (32.7%), and elbow (31.6%) pain, while low back pain was more common (48.9%). A statistically significant association was confirmed between the incidence of MSDs and stress at work, repetitive motions, and prolonged standing (p = 0.000). Several variables showed significant correlations with MSDs in different body parts (p <0.05). Conclusion: Our results show a higher prevalence of MSDs in LPs and we recommend urgent development of targeted prevention programs and additional measures to modify the work environment and organizational activities.

Eldad Kaljić, Edina Hadžipašić, Amila Jaganjac, Namik Trtak, B. Katana, Muris Pecar

Introduction: Cervical pain syndrome (CPS), or pain in the neck, is defined as a set of symptoms that limit performing movements in the upper part of the back and last more than 1 day. When the mentioned symptoms last for more than 12 weeks, we talk about chronic CPS. It often represents the condition that results from disability. It is associated with poor posture, work in sitting position, stress, and long-lasting and repetitive movements. The aim of the study was to examine the effect of physical therapy on the degree of disability, pain intensity, and daily life and work activities of persons with chronic CPS.Methods: The research was conducted in the health spa center “Reumal” Fojnica from June 2020 until July 2020. It included 50 subjects of both genders, more than 18 years old, and of all occupations, treated with physiotherapy procedures (transcutaneous electrical nerve stimulation, magnetotherapy, therapeutic ultrasound, and kinesitherapy in the form of McKenzie exercises). In addition, a pre- and post-treatment study analyzed the condition of the respondents at the first examination and the control examination after completion of treatment.Results: By analyzing the results, we established that of the total number of respondents, 74% were female, and the average age was 57.36 years. At the end of the study, the degree of disability caused by neck pain was significantly lower (p < 0.05) than the degree of disability before the therapy. Discomfort caused by symptoms of CPS that occurred and interference with work before the therapy was significantly lower (p < 0.05) after the treatment program. Therapeutic procedures have reduced the pain intensity and improved the activities of everyday life.Conclusion: The treatment with physical therapy procedures effectively reduces the degree of disability and pain intensity and improves people’s daily life and work activities with chronic CPS.

In the study, the development of physiotherapy was described through the history and education in Bosnia and Herzegovina (BiH) with a special review on the significance of physiotherapy as a health-care discipline and the display of its development to the academic level of education in BiH.

Introduction: Inadequate vitamin B 12, folate status and B6 are associated with an increased risk for chronic diseases that may have a negative impact on the health. Aim: The aim of our study was to investigate dietary intake of vitamin B12, B6 and folates from various foods among the university students. Methods: Dietary intake of foods having vitamins B12, B6 and folate was assessed among the students of University of Sarajevo, 19-22 years old, from 2017 to 2018. The participants were interviewed to collect information regarding age, socioeconomic status, B12, folate, B6 vitamin, and usual food intake during one week. Results: The main sources of vitamin B12 and B6 in the students’ diet were chicken white meat (51.8-53.7 %), beef (45-63 %), cream (62.2 -72.1 %), sardines in oil (47.9-52.2 %), tuna (55.2 -60.4 %), cheese edamer (80.1%) and cheese feta (67.4%-73%). The foods with a high source of vitamin B12 and B6 but rarely consumed were fish, shellfish, salmon, roasted trout and mackerel. Sufficient folate intake was mainly achieved through dietary intake of beans (48.5-57.2%) and oatmeal (46.3-48.2%), while folate-insufficient diet resulted from intake of spinach (30.9-35 %), turkey (26.2-33.4 %), lentils (16.9-19.7 %) and soy (9.4-15.5%). Conclusion: Our results show that there is an important percentage of the students in Canton Sarajevo that do not meet the recommended intakes for vitamin B12 and B6 and folate. Additional research is needed to establish the best cost-effective public health approach to achieve sufficient intake of these vitamins.

N. Serdarević, Arzija Pašalić, Eldina Smječanin, Vedran Đido, R. Gojak, Muris Pecar, Fatima Jusupović, D. Avdić, Namik Trtak et al.

Introduction: Dietary supplements are an important source of vitamins and minerals that may help prevent several disease-causing biological pathways involved in one-carbon metabolism, including the suppression of cell proliferation, oxidative stress, nitric oxide synthesis, and angiogenesis. The present study aimed to assess the association between the intake of folate, Vitamin B6, Vitamin B12, and minerals and the consumption of alcohol among university students. Methods: This study was participated by students aged 19-22 years from the University of Sarajevo between 2017 and 2018. Using a questionnaire, we interviewed in a week them to collect information regarding age, socio-economic status, alcohol consumption, and dietary supplement intake. Then, we investigated the association between the baseline intake of folate, B vitamins, and minerals and that of alcohol consumption. Results: Most students consumed Vitamin B supplements (32%) and folic acid (10%). Dietary multivitamins and minerals were less prevalent in more than a year, accounting for 186 (23.9%) and 174 (24.3%) students, respectively, than those in less than a year. In a year, <20% of students consumed multivitamins 129 (16.6%) and minerals 116 (15.3%). Meanwhile, 256 (27.1%) students consumed alcohol. The Chi-square test of independence showed that drinking habits and the intake of such dietary supplements had no association (p > 0.05). Conclusion: An extremely low percentage of the participating students in Canton Sarajevo used dietary supplements of Vitamin B, folate, multivitamins, and minerals. Moreover, alcohol consumption and dietary supplement intake were not associated. Further research is needed to establish the best cost-effective public health system to achieve a sufficient intake of dietary supplements.

Introduction:  Identification of the risk factors that can be modified is an essential aspect in the development of the effective strategy for therapeutic intervention with the purpose to improve mobility and injury prevention and post-fall consequences. This research aimed to analyze the impact of programmed therapeutic exercises on the fall risk factors in the elderly. Methods: We included 260 patients older than 65 years, and assigned them randomly into three groups. Group A: 65 patients subjected to therapeutic exercises for moderate-intensity muscle strengthening with Theraband stretch straps (corresponding to 11-14 on the Borg rating of perceived exertion scale). Group B: 65 patients subjected to therapeutic anti-gravity exercises. Control group: 130 patients not participating in programmed therapeutic exercises. Presence of fall risk factors was assessed in all three groups with standardized Fast Evaluation of Mobility, Balance, and Fear test (FEMBAF) before the initiation of therapy, after three and after six months of treatment. Results: At the end of the study, the subjects of the group A had significantly fewer limitations in performing basic life activities at home compared to the patients of the control and Group B, p = 0.037. The control group subjects were statistically significantly more likely to complain of vertigo than subjects of the experimental groups, p = 0.021. The subjects of the experimental groups had more than two falls than the control group subjects, p = 0.003 statistically. In the control group, the number of fractures after the fall at the end of the study increased significantly, statistically higher than in the subjects of the experimental groups, P = 0.037. Conclusion: Programmed therapeutic exercise significantly reduces the risk of falling factors, and significant effects have been achieved among subjects who have exercised with elastic strips.

Introduction: Dry needling is a therapeutic procedure using the insertion of thin needles through the skin into myofascial trigger points (MTrPs), muscular or connective tissue with the aim to reduce pain intensity. The objective of this systematic review is to analyze the literature for the efficacy of the dry needle technique in pain reduction in conditions of musculoskeletal pain caused by MTrPs. Reference Sources: Web of Science, Scopus and EBSCOhost database were searched for studies and e-books published from January 2010 to December 2018. Studies Selection: We included randomized controlled studies, prospective and longitudinal studies, and case studies which analyzed the efficacy of dry needling for musculoskeletal pain reduction. Data Extraction Method: The studies, which satisfied criteria for inclusion were further analyzed. The primary instrument of the evaluation was pain intensity analyses. Results: Dry needling treatment is efficient in pain intensity reduction in patients who suffer musculoskeletal pain and is more efficient compared to sham dry needling treatment. In addition, different techniques of dry needling are efficient in the treatment of myofascial pain syndrome. Conclusion: Based on systematic review of the literature, dry needling, independently or as an addition to other intervention, is recommended for treatment of musculoskeletal pain conditions caused by myofascial trigger points. Various techniques of dry needling treatment are almost equally efficient in myofascial pain intensity reduction.

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