sistematični pregled literature
Abstract
Uvod: Skrajšave mehkih tkiv so pogoste sekundarne posledice možganske kapi, ki povzročijo zmanjšanje obsega sklepne gibljivosti in vplivajo na življenjski slog posameznika. Njihovo nastajanje se prične že zgodaj po kapi. Raztezanje je fizioterapevtski postopek, katerega namen je izboljšati prožnost in obseg sklepne gibljivosti s povečanjem raztegljivosti mehkih tkiv in je pogosto uporabljena metoda za preprečevanje in zmanjševanje nastanka skrajšav mehkih tkiv pri pacientih po možganski kapi. V uporabi so različne metode raztezanja. Namen: Ugotoviti in primerjati učinkovitost različnih metod raztezanja pri obravnavi skrajšav mehkih tkiv pri pacientih po možganski kapi. Metode dela: Izveden je bil sistematični pregled randomiziranih kontroliranih poskusov po podatkovnih zbirkah CINAHL, MEDLINE, PEDro in Ceochrane Library. Rezultati: Analiziranih je bilo deset raziskav z obdobjem raztezanja od štiri do 14 tednov, na področju zgornjega uda. V petih raziskavah so ugotavljali vpliv postavljanja v položaje, v štirih uporabe opornic in v eni vpliv uporabe naprave za raztezanje na skrajšave mehkih tkiv pri pacientih po možganski kapi. Postavljanje v položaje se ni izkazalo za učinkovitejše pri zmanjševanju bolečine, spastičnosti in povečanju neodvisnosti pri opravljanju dejavnosti vsakdanjega življenja, v primerjavi z obravnavo primerjalne skupine v vseh petih raziskavah. Izsledki teh raziskav o vplivu na obseg sklepne gibljivosti in izboljšanje funkcije zgornjega uda so si nasprotujoči. Tudi izsledki vpliva uporabe opornic na obseg sklepne gibljivosti in zmanjševanje bolečino so si nasprotujoči. Do statistično pomembnega zmanjšanja spastičnosti ter izboljšanja funkcije in povečanja neodvisnosti pri opravljanju dejavnosti vsakdanjega življenja ni prišlo v nobeni od teh štirih raziskav. Raztezanje z napravo se je izkazalo za učinkovito pri zmanjševanju spastičnosti ter izboljšanju funkcije zgornjega uda, medtem ko ni imelo vpliva na obseg sklepne gibljivosti. Zaključek: Zaradi nizkega števila raziskav za posamezne metode raztezanja, nasprotujočih se rezultatov in drugih dejavnikov (na primer različnost obravnave poskusne ali primerjalne skupine), je težko sklepati o dejanski učinkovitosti posamezne metode pri obravnavi skrajšav mehkih tkiv pri pacientih po možganski kapi. Glede na to, da so se posamezne metode raztezanja na zgornjem udu izkazale za učinkovite na posameznih področjih izidov v krajšem časovnem obdobju, bi bilo smiselno raziskati učinkovitost njihovih kombinacij. Nujne so raziskave visoke kakovosti o učinkovitosti raztezanja pri pacientih po možganski kapi na spodnjem udu.
Keywords
diplomska dela;fizioterapija;možganska kap;skrajšave mehkih tkiv;obseg sklepne gibljivosti;funkcijska sposobnost;raztezanje;
Data
Language: |
Slovenian |
Year of publishing: |
2018 |
Typology: |
2.11 - Undergraduate Thesis |
Organization: |
UL ZF - University College of Health Studies |
Publisher: |
[A. Skubic] |
UDC: |
615.8 |
COBISS: |
5461867
|
Views: |
796 |
Downloads: |
338 |
Average score: |
0 (0 votes) |
Metadata: |
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Other data
Secondary language: |
English |
Secondary title: |
ǂThe ǂeffectiveness of stretching in treating contractures of soft tissue in patients after stroke |
Secondary abstract: |
Introduction: Contractures are common secondary consequence of stroke which cause a decrease of range of motion and affects the lifestyle of an individual. Their formation begins early after stroke. Stretching is a physiotherapeutic procedure designed to improve flexibility and range of motion by increasing soft tissue extensibility and is a commonly used method for the prevention and reduction of contracture in post stroke patients. Different methods of stretching are used. Purpose: To determine and compare effectiveness of different methods of stretching for the prevention and reduction of contracture in patients post stroke. Methods: A systematic review of randomized controlled trials was conducted in databases CINAHL, MEDLINE, PEDro and Ceochrane Library. Results: Ten studies were analyzed with a period of stretching of four to 14 weeks in upper limb. In five studies was observed the effect of positioning, in four the effect of use of splints and in one study the effect of stretching device on contracture in post stroke patients. Positioning did not prove to be more effective for reducing pain, spasticity and increasing independence in activity of daily living compared to the treatment of the comparative group in all five studies. The results of these studies on the effectiveness on range of motion and functional abilities of upper limb are contradictory. Also, the results of use of splints at the effect on range of motion and reducing pain are contradictory. There is no statistically significant result in reduction of spasticity and increasing independence in activities of dailyliving in none of these four studies. Stretching with the device has been shown to be effective for reducing spasticity and improving functional abilities, while it have no effect on range of motion. Conclusion: Due to the low number of studies for individual methods of stretching, and other factors (for example, the difference in the treatment of experimental and comparative group) it is difficult to conclude on the actual efficacy of a particular method when treating the contracture in post stroke patients. Given that individual methods have proven to be effective in individual areas of outcomes in a shorter period of time, it would be wise to investigate the effectiveness of their combinations. High-quality studies on the effectiveness of stretching in lower limb in post stroke patients are necessary. |
Secondary keywords: |
diploma theses;physiotherapy;stroke;contracture;range of motion;fuctional ability;stretching; |
Type (COBISS): |
Bachelor thesis/paper |
Study programme: |
0 |
Thesis comment: |
Dipl. delo (bolonjski študij), Univ. v Ljubljani, Zdravstvena fak., Oddelek za fizioterapijo |
Pages: |
37 str., [5] str. pril. |
ID: |
10944509 |