Fizikalna terapija bolesnika s osteoartritisom koljena

master's thesis

• Title (english): Physical therapy in patient with knee osteoarthritis
• Author: Filip Ernoić
• Mentor: Đurđa Babić-Naglić (mentor)
• Committee member: Porin Perić (predsjednik povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Committee member: Đurđa Babić-Naglić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Physical Medicine and General Rehabilitation); Zagreb
• Defense date and country: 2014-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Physical Medicine and Rehabilitation

Abstract

Osteoartritis (OA) je najčešća reumatska bolest, a koljeno najčešća lokalizacija OA. Radi se o kroničnoj, postupno progresivnoj, degenerativnoj bolesti zglobova koja se najčešće javlja u starijoj životnoj dobi. Bolest prvenstveno zahvaća zglobnu hrskavicu, ali i sve druge zglobne strukture odgovorne za funkciju zgloba te se danas promatra kao bolest ili „zatajenje“ organa za kretanje. Osteoartritis je posljedica mehaničkih i bioloških zbivanja u zglobu koja narušavaju ravnotežu razgradnje i izgradnje zglobne hrskavice i subhondralne kosti, a zahvaća sva tkiva diartrodijalnih zglobova. Glavni simptomi OA su bol i gubitak funkcije zahvaćenog zgloba.
Dijagnoza OA postavlja se na temelju subjektivnih tegoba bolesnika i objektivnog kliničkog nalaza, a potvrđuje radiološkom pretragom koljena. Prema NICE (eng. National Institute for Care and Excellence) preporukama za liječenje OA, klinička dijagnoza OA bez ikakve druge obrade dozvoljena je ako osoba ima više od 45 godina, poteškoće s izvršenjem dnevnih radnji zbog boli u zglobu i jutarnju zakočenost kraću od 30 minuta ili ju uopće nema.
Liječenje OA koljena je farmakološko i nefarmakološko. Nefarmakološko može biti konzervativno i kirurško liječenje. U nefarmakološko konzervativno liječenje uključujemo promjenu načina života i fizikalnu terapiju. Kirurško liječenje OA koljena podrazumijeva palijativne artroskopske i klasične kirurške zahvate, ugradnju endoproteza i artrodezu za uznapredovale slučajeve OA rezistentne na konzervativnu terapiju.
Zlatni standard za liječenje OA koljena i dalje čini fizikalna terapija. Kineziterapija i hidroterapija su aktivne metode fizikalne terapije, a u obzir dolaze i sve pasivne metode fizikalne terapije kao što su ultrazvuk, kriomasaža i svi elektroterapijski modaliteti. Medicinska gimnastika ili kineziterapija je najbitnija metoda fizikalne terapije kod OA koljena dok su sve ostale metode samo priprema koljena za vježbu.

Abstract (english)

Osteoarthritis (OA) is the most common rheumatic disease, and the knee is the most common sites OA. It is a chronic, gradually progressive, degenerative joint disease that is most common in the elderly population. The disease primarily affects the articular cartilage, but also all other articular structures responsible for joint function and is today regarded as a disease or a 'failure' of movement. Osteoarthritis is the result of mechanical and biological events in the wrist, which distort the balance of degradation and construction of articular cartilage and subchondral bone, and affects all tissues diartrodial joints. The main symptoms of OA is pain and loss of function of the affected joint.
The diagnosis of OA is made based on subjective complaints of patients and objective clinical findings and confirmed by radiographic examination of the knee. According to NICE (National Institute for Care and Excellence) recommendations for the treatment of OA, the clinical diagnosis of OA without any other processing is permitted if a person has more than 45 years, has difficulties with the execution of daily activities due to pain in the joints and has morning stiffness less than 30 minutes or no stiffness at all.
Treatment of OA of the knee can be pharmacological and non-pharmacological. The non-pharmacological treatment can be conservative and/or surgical. The non-pharmacological conservative treatment includes lifestyle modification and physical therapy. Surgical treatment of knee OA involves palliative and classical arthroscopic surgery, arthroplasty and arthrodesis for advanced cases of OA resistant to conservative therapy.
The gold standard for the treatment of OA of the knee is still physical therapy. Kinesitheraphy and hydrotherapy are active methods of physical therapy, and also all the passive methods of physical therapy such as ultrasound, cryomassage all electrotherapy can be considered modalities. Medical gymnastics or kinesitherapy is the most important method of physical therapy in OA of the knee while all other methods only prepare the knee for exercise.

• Keywords: osteoartritis koljena; modaliteti fizikalne terapije; kineziterapija VI
• Keywords (english): osteoarthritis; knee; physical therapy modalities; exercise therapy
• Language: croatian
• URN:NBN: urn:nbn:hr:105:225992
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2015-10-13 12:13:10