poročilo o primeru
Miličević Sara (Author), Sonja Hlebš (Reviewer), Mojca Divjak (Mentor)

Abstract

Uvod: Travmatska možganska poškodba (TMP) je velik zdravstveni problem po vsem svetu. TMP lahko definiramo kot »poškodbo žive možganovine, ki jo izzove zunanja mehanska sila«. Torej je TMP vsaka nedegenerativna in neprirojena poškodba možganov do katere pride zaradi delovanja zunanje sile. Namen: diplomskega dela je preko poročila o primeru ugotoviti kakšno vlogo in vpliv ima fizioterapevtska obravnava po nezgodni travmatski poškodbi možganov. Metode: Uporabljena je bila opisna metoda s pregledom literature in s prikazom poročila o primeru s fizioterapevtsko oceno ter obravnavo. Na podlagi pridobljenih podatkov iz medicinske dokumentacije in anamneze smo ocenili stanje bolnika. Nadaljevali smo s fizikalnim pregledom, goniometričnimi meritvami obsegov gibljivosti zgornjih in spodnjih udov ter meritvami obsegov udov s pomočjo merilnega traka. Sledila je ocena bolečine, ki smo jo pridobili z vizualno analogno lestvico, manualno mišično testiranje ter ocena povrhnje in globoke senzibilitete. Za konec smo izvedli še naslednje funkcijske teste: modificiran test senzorične interakcije, test funcijskega dosega in Bergovo lestvico ravnotežja. Kombinacijo vaj smo izbrali glede na zastavljene cilje, pripravljenost bolnika za sodelovanje in njegovega splošnega počutja. Fizioterapevtska obravnava se je skozi celoten čas rehabilitacije stopnjevala. Rezultati: po dvanajst tedenski fizioterapevtski obravnavi so bili rezultati uspešno vidni. Obseg gibljivosti se je izboljšal tako v ramenskem obroču/sklepu, kakor tudi v kolčnem, kolenskem in zgornjem skočnem sklepu. Obseg nadlakti se je povečal za 8 cm na desnem udu in 5,5 cm na levem udu, obseg podlakti se je povečal na desni strani za 8,5 cm in na levi strani za 7 cm. Pri spodnjih udih se je pravtako povečal obseg stegna in meča. Mišična moč se je močno izboljšala tako pri zgornjih udih, kakor tudi pri spodnjih udih ter trupu. Bolečina se je po dvanajst tedenski fizioterapevtski obravnavi po vizualni-analogni lestvici zmanjšala za 4 ocene. Izboljšani so bili tudi rezultati pri časovno merjenem testu modificirane senzorične interakcije, kjer se je najdaljši čas izvedbe določene naloge izboljšal za minimalno 10 ali več sekund. Izboljšanje se je pokazalo tudi pri rezultatih testov dinamičnega ravnotežja, pri testiranju funkcijskega dosega se je povprečna vrednost izboljšala za 9 cm, pri Bergovi lestvici pa se je bolnikov rezultat v primerjavi z začetnimi meritvami izboljšal za 27 točk. Razprava in sklep: S fizioterapevtsko obravnavo, ki je trajala dvanajst tednov, smo pri bolniku želeli izboljšati mišični tonus in mišično moč, povečati obseg sklepne gibljivosti, izboljšati ravnotežje ter prehajanje med položaji, obenem pa izboljšati tudi telesno funkcijo in s tem kvaliteto življenja. Rezultati uporabljenih merilnih orodij so pokazali izboljšanje pri vseh testih. Poleg vsega zgoraj naštetega smo vplivali na bolnikovo samostojnost, povečala pa se je tudi motivacija za nadaljnjo sodelovanje v procesu rehabilitacije. Dosegli smo vse zastavljene cilje. Napredek bolnika povezujemo z učinki fizioterapije, spontanim okrevanjem in predvsem njegovo motivacijo in željo po učinkoviti in čimbolj uspešni rehabilitaciji.

Keywords

diplomska dela;fizioterapija;travmatske poškodbe;glava;možgani;rehabilitacija;

Data

Language: Slovenian
Year of publishing:
Typology: 2.11 - Undergraduate Thesis
Organization: UL ZF - University College of Health Studies
Publisher: [S. Miličević]
UDC: 615.8
COBISS: 5572715 Link will open in a new window
Views: 1181
Downloads: 382
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Other data

Secondary language: English
Secondary title: Physiotherapy treatment in patient after incidental traumatic brain injury in home enviroment
Secondary abstract: Introduction: Traumatic brain injury (TMP) is a major health problem worldwide. TMP can be defined as a "damage of the living brain induced by an external mechanical force". Therefore, TMP is every non-degenerative and un-genetic brain damage which occurs by the action of an external force. Purpose: of the diploma thesis was to determine through the case what role and influence does physiotherapy have on patients after traumatic brain injury. Methods: We used a descriptive method with a literature review and a report on the case with physiotherapy assessment and treatment. On the basis of the data obtained from the medical documentation and history, we assessed the condition of the patient. We continued with physical examination, goniometric measurements of the ranges of the motion for upper and lower limbs and measures of limb volume using a measure tape. This was followed by an evaluation of the pain that we obtained with a visual analog scale, manual muscular testing, and evaluation of the surface and deep sensitivity. In the end we performed: a modified sensory interaction test, a functional range test, and a Berg balance scale. We selected the combination of exercises according to the set goals, the willingness of the patient to participate and his general well-being. Throughout the rehabilitation process the physiotherapeutic treatment has been enhancing. Results: After twelve weeks of physiotherapy treatments the results were successfully visible. The range of motion has improved in the shoulder joints as well as in the hip, knee and upper ankle joint. The volume of the upper arm has increased by 8 centimeters on the right extremity and 5,5 centimeters on the left, the volume of forearm has increased on the right extremity by 8,5 centimeters and on the left extremity by 7 centimeters. Muscle strength has significantly improved both on the upper limbs, as well as lower limbs and trunk. After twelve weeks of physiotherapy treatments pain has decreased by 4 points on the VAL scale. Improved results were also achieved with a time-measured test of modified sensory interaction, where the maximum execution time of a particular task has improved for a minimum of 10 seconds or more. The results also improved in dynamic balance tests, while testing the functional reach, the mean value improved by 9 centimeters, while in the Berg scale the patients score improved by 27 points compared to the initial measurements. Discussion and conclusion: With a physiotherapeutic treatment which lasted twelve weeks we wanted to improve muscle tone and muscle strength, increase the range of motion, improve balance and transitions between positions, and at the same time improve the physical function and thus the quality of life. The results of the used measuring tools showed improvement in all tests. In addition to all of the above, we have influenced the patient’s independence and the motivation for further participation in the rehabilitation process has also increased. We have achieved all the set goals. The patient's progress is associated with the effects of physiotherapy, spontaneous recovery and, in particular, his motivation and the desire for effective and successful rehabilitation.
Secondary keywords: diploma theses;physiotherapy;traumatic injuries;head;brain;rehabilitation;
Type (COBISS): Bachelor thesis/paper
Study programme: 0
Thesis comment: Dipl. delo (bolonjski študij), Univ. v Ljubljani, Zdravstvena fak., Oddelek za fizioterapijo
Pages: 29 str.
ID: 11004709