| Abstract | Svrha ovog rada je prikaz metoda fizikalne terapije osteoartritisa kuka, njihove učinkovitosti, načina provođenja i mehanizma djelovanja. Osteoartritis (OA) je najčešća zglobna bolest odraslih koja ima veliko medicinsko i ekonomsko značenje. Nastaje kao rezultat interakcije mehaničkih i bioloških čimbenika, a zahvaća sva tkiva koja sačinjavaju zglob: hrskavicu, subhondralnu kost, ligamente, periartikularne mišiće, sinoviju i zglobnu kapsulu. OA kuka uzrokuje bol i dovodi do smanjenja opsega pokreta, slabosti mišića i ukočenosti zgloba, što smanjuje funkciju zgloba i uzrokuje onesposobljenost. Lijek za OA ne postoji, stoga je jedina terapijska mogućnost suzbijanje simptoma. Svrha terapije OA je smanjenje boli, povratak ili održanje funkcije zgloba i usporenje progresije bolesti. Liječenje OA može biti farmakološko, nefarmakološko (edukacija, tjelovježba, fizikalna terapija) i kirurško, međutim od posebnog je značaja fizikalna terapija. Metode fizikalne terapije mogu biti aktivne i pasivne. Aktivne metode podrazumijevaju kineziterapiju, odnosno korištenje pokreta u svrhu liječenja, dok se pasivnim metodama postiže smanjenje boli. Aktivne kineziterapijske metode imaju posebnu važnost jer djeluju na čimbenike bitne za funkciju zgloba i pokretljivost – povećanje opsega pokreta, mišićne snage i izdržljivosti, koji se postižu specifičnim vježbama propisanim od strane fizijatra ili fizioterapeuta. Također, kineziterapija ima pozitivan utjecaj na bol i progresiju bolesti. Od pasivnih metoda terapije najčešće se koriste krio i termoterapija, TENS, terapijski ultrazvuk, magnetoterapija i balneoterapija. Sve postojeće smjernice za liječenje OA kuka preporučuju kineziterapiju i fizičku aktivnost kao glavnu terapijsku mjeru za OA kuka. |
| Abstract (english) | The main objective of this thesis was to present current methods of physical therapy for hip osteoarthritis, and to show their effectiveness, methods of administration and mechanisms of action. Osteoarthritis (OA) is the most common joint disease in adults, with great medical and economic impact. It is caused by interaction of biological and mechanical factors, involving all joint structures, including cartillage, subchondral bone, ligaments, periarticular muscles, capsule, and synovium. Hip OA causes pain, joint stifness, and leads to reduced range of motion and muscle weakness, which in turn compromise joint function and cause disability. There is no known cure for OA, therefore the main thrapeutic goal is to reduce symptoms. OA treatment can be pharmacological, nonpharmacological (education, exercise, physical therapy) and surgical. Physical therapy is of great significance in treating OA, and involves active and passive methods. Active methods include kinesitherapy, using appropriate muscular exercise to treat desease, while passive methods are aimed to reduce pain. The most common passive methods in OA therapy are cryo/thermotherapy, TENS, therapeutic ultrasound, electromagnetic fields and balneotherapy. The active kinesitherapeutic methods are especially important as they improve key factors of joint stability and function – range of motion, muscle strength and endurance, that are achieved with specific exercises prescribed by physiatrist or physiotherapist. Moreover, kinesitherapy has a positive effect on pain and progression of desease. Evidence for effectiveness of kinesitherapy in OA are abundant, however, studies exploring exclusively hip OA are rare, with inconsistent results. Nevertheless, all current guidelines recommend kinesitherapy and physical exercise as primary therapeutic measures for hip osteoarthritis. |
