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Dzemal Pecar

Publications and source records attributed to Dzemal Pecar.

8 recordsLinked to original sources

Osteoarthritis, application of physical therapy proceduers.

Osteoarthritis (OA) is a group of overlapping disorders, which may have different aetiology but similar biological, morphologic and clinical outcome. In osteoarthritis, process will not encompass the joint cartilage only, but the entire joint, including sub-hondral bone, ligaments, capsule, and sinovial membrane and surrounding muscles. Osteoarthritis is a multi-factor disorder of sinovial joints, which occurs as result of mechanical and biological factors, which destabilise normal hondrocyte function, partitioning of cartilage, extra-cellular matrix and sub-hondral bone. The earliest changes, which are restricted to the joint cartilage surface only, do not cause any subjective feeling. The pain in arthrosis occurs (or re-occurs) a bit later, Diagnosis will be determined based on clinical exam as well as signs and symptoms present. Symptomatic and functional treatment of osteoarthritis as one of rheumatic disorders must be taken throughout years, sometimes throughout a lifetime. It encompasses application of many medications and physical therapy procedures.

Humans↗

Significance of specificity of Tinetti B-POMA test and fall risk factor in third age of life.

As for the third age, psychophysical abilities of humans gradually decrease, while the ability of adaptation to endogenous and exogenous burdens is going down. In 1987, "Harada" et al. (1) have found out that 9.5 million persons in USA have difficulties running daily activities, while 59% of them (which is 5.6 million) are older than 65 years in age. The study has encompassed 77 questioned persons of both sexes with their average age 71.73 +/- 5.63 (scope of 65-90 years in age), chosen by random sampling. Each patient has been questioned in his/her own home and familiar to great extent with the methodology and aims of the questionnaire. Percentage of questioned women was 64.94% (50 patients) while the percentage for men was 35.06% (27 patients). As for the value of risk factor score achieved conducting the questionnaire and B-POMA test, there are statistically significant differences between men and women, as well as between patients who fell and those who never did. As for the way of life (alone or in the community), there are no significant statistical differences. Average results gained through B-POMA test in this study are statistically significantly higher in men and patients who did not provide data about falling, while there was no statistically significant difference in the way of life. In relation to the percentage of maximum number of positive answers to particular questions, regarding gender, way of life and the data about falling, there were no statistically significant differences between the value of B-POMA test and the risk factor score (the questionnaire).

Accidental Falls↗

Sore shoulder in physical practice.

Sore shoulder or shoulder region is frequently encountered in general population. According to reference data prevalence ranges between 15 and 20% in 40-45 age group. A weak bone support enables extensive excursions of this joint and simultaneously reduces its stability. We analyzed successfulness of sore shoulder treatment in a sample of 1115 patients treated in the Center for physical medicine and rehabilitation between 1996 and 2004. All the patients reported to the Center either in acute phase or in the phase of chronic state exacerbation, with limited function that was graded on the scale 0 to 5. Type and kind of sore shoulder cause was determined by clinical examination and, where needed, by X-ray. Of the total number of cases, 33 patients did not report for follow up examination, 166 patients were forwarded to other physical therapy centers for treatment so the final analysis included 916 patients (82%) whose treatment success was evaluated on the scale 0 to 5. In 659 (58%) patients the inflammation of musculus biceps long tendon was identified as a cause of sore shoulder. The least frequent cause was the blow syndrome (impingement)--20 (2%). In 666 patients (73%) the problem was resolved by local instillation of depo corticosteroids (Betamethason 7 mg) so the physical treatment was not required.

Adolescent↗

Risk factors of fall in elderly people.

Falls are the leading accidental cause of death among elderly people in their homes. Falls and their consequences are the primary reason in 40% of admissions to hospitals for people older than 65 years. The study population consisted of 77 randomly selected patients of both genders older then 65 years. Each patient was tested in his/her home and was completely informed about the methodology and the goals of investigation. Based on the exclusion criteria, three patients were excluded from the study, which means the investigation was conducted on 27 males (35.06%) and 50 females (64.94%) with the average age being 71.23 +/- 5.63 years. For each patient, a specially prepared questionnaire about risk factors was filled in. The sum of affirmative answers represented a relative index of fall risk. All patients were evaluated through Folstein's Mini-Mental State Examination Test that is suitable for on-sight use in patient's home. The score value over 20 excludes dementias, delirium, schizophrenia and affective disorders. Considering the values of the risk factor, scores obtained by the questionnaire and MMSE test scores, statistically significant differences were found between males and females (p < 0.005, respectively p < 0.01), "fallers" and "non-fallers" (p < 0.001, respectively p < 0.01), while considering the relation to the way of living (alone or with family), there were no statistically significant differences (p > 0.05).

Accidental Falls↗

Rehabilitation of extremity war injuries with lesion of peripheral nerves in "PRAXIS" Centre for Physical Medicine and Rehabilitation, Sarajevo.

Polytrauma with significant lesion of peripheral nerves is a specific war injury. It is also one of the most delicate problems in rehabilitation treatment because it requires a close cooperation with surgeon and timely surgical interventions. Based on our experience, the best results in the treatment of injured persons with lesion of peripheral nerves have been accomplished after the surgical treatment. Results in the neurolysis were better than those accomplished in neurorrhaphy. Total of 436 patients with lesion of peripheral nerves were recorded and 56 patients with plexus lesion. Out of this number, 78 patients (about 15%) had surgical treatment (41 neurorrhaphy and 37 neurolysis). Due to lack of adequate ENMG diagnostics, the objective valorisation of treatment outcome was not possible.

Journal Article↗

Effects of the treatment of acute lumbar painful syndrome (ALPS) by "PRAXIS METHOD" during the period from 1996 to 2000.

Acute lumbar syndrome occurs suddenly and is accompanied with strong pain in the lower part of the back. The most frequent APLS causes are vertebral (herniation of intervertebral disc, subluxation of intervertebral disc, subluxation of intervertebral joint, fracture of vertebra--traumatic or pathological), or extravertebral (subluxation of sacroiliac joint, acute bursitis of iliolumbar segment, muscle injuries or injuries of tendo-ligamentous apparatus of lumbosacral region). The treatment of acute lumbar painful syndrome is classified as medical, alternatively medical, surgical and combined. On the basis of durable experience, "Praxis method" as a treatment of lumbar pain (general and acute) is being applied in the Centre for Physical Medicine and Rehabilitation "Praxis" in Sarajevo. During the period from 1996 to 2000, the total number of 5.663 patients were examined in the centre "Praxis". Out of that number, 17.7% (1.003) of patients had acute lumbar painful syndrome (ALPS). Immediately after the therapeutic manipulation, which included "Praxis method, 31.5% (317) patients experienced the cessation of pains followed by ending of the treatment. The length of treatment for the rest of patients lasted: 1-7 days in 412 or 41.07 % of patients, 8-21 days in 195 or 19.48% of patients, and more than 21 days in 79 or 7.88% of patients. For all patients (1.003) the average treatment duration was 6.6 days. The recidivation occurred in 127 patients (12.66%). Throughout the treatment successfulness estimation according to clinical results scaled from 0 to 5, it was confirmed that out of the total number of 831 patients (82.85%) results were excellent in 459 patients (45.76%) or very good in 372 patients (35.09%). The average age of patients was ranging between 35 and 45 years (621 patients or 61.9%). The male/female distribution was 2:1.

Journal Article↗

[Treatment of lumbar pain syndrome of disk etiology at the Physical Medicine and Rehabilitation Clinic (Praxis) 1996-2000].

In this paper is valoriziaed the successfulness of the treatment of 1,431 patients with the verification disc hernia (CT, MRI) in the surgery for the physical medicine and the rehabilitation in the period from 1966 till 2000 year, by "Praxis method". It is established that in the structure of the treated patients by the structure of the treated patients by the application of this method the best results were achieved by disc hernia in the level L4-L5 without the motor deficiency (567 patients), with the average treatment length 24.38 days and the average estimation of the results 4.06 and then in patients with the disc hernia L5-S1. In disc hernia without diagnostic verified disorder of the motorics, the result of the physical therapy and the rehabilitation was better. This can be observed from the treatment successfulness estimation and the treatment length and number of days of the treatment. The longest treatment was by hernia L5-S1 with the motor disorderly (43.10 days), and the shortest in the disc lesion at the level L4-L5 (24.38 days). Among the patients with disc hernia which in this period were treated was operated only 58 or 4.05%. The age structure of the treated patients with disc hernia amounted averagelly 49.95 years, and the greatest number of the treated belonged to the age group 35 to 44 years.

Adolescent↗

[Rehabilitation of war injuries of the upper extremities with peripheral nerve lesions at the and Praxis Clinic for physical medicine and rehabilitation in Sarajevo].

The war injuries are the most frequent multiple, with the difficult distructions of the tissue and the lesions of the peripheral nerves. By the injuries, the lesions of the nerv system represent the delicate problem for the physical medicine and the rehabilitation during the siege of Sarajevo (1992-1995), in the injuries with the lesions of the peripheral nerves, if they are not treated in the frame of the multiple las urgent, they are postponed the operative treatments longer than three months. This is from the aspect of the successfullness, prognostically and therapeutically, the limiting moment. The successfullness of the operative treatment of the lesions of the peripheral nerves significantly depends on that whether the operation was performed incide tree months. The more difficult consequences in these injuries can appear if simultaneously with the taking care of war injuries does not perform adequately surgical treatment adn the in time physical therapy trough the sufficient long time period. On the four year sample was analyzed the success fullness of the rehabilitation of the injuries of the upper extremities with the lesions of the peripheral nerves. Clinically, uniform, we valorized the success fullness of the treatment of all the patients by the marks from 0.5. In the complete sample the excellent success of the rehabilitation we confirmed in more than a half of patients. The better results show the group of the operated patients, in which is performed neuropathia or neurolisis. The capability of the regeneration of the injured peripheral nerves offers the real possibility for extraordinary recovery also in the most difficult injuries, then the preventions of the significant number of the consequences.

Arm↗