diplomsko delo
Petra Križanič (Author), Renata Vauhnik (Reviewer), Alan Kacin (Mentor), Polona Palma (Co-mentor)

Abstract

Uvod: Subakromialni utesnitveni sindrom je definiran kot utesnitev mehkotkivnih struktur, ki se nahajajo pod akromialnim lokom, ko je roka v elevaciji, predvsem v položajih nad glavo. Pojavi se lahko zaradi strukturnih sprememb, ki zmanjšajo subakromialni prostor, in funkcionalnih motenj pri centriranju glave humerusa (npr. mišično neravnovesje), lahko pa ga povzročijo tudi travma, preobremenitev kit rotatorne manšete, skapularna diskinezija in tesen posteriornen del kapsule ramenskega sklepa. Namen: Želeli smo ugotoviti učinkovitost različnih terapevtskih vadbenih programov na zmanjšanje bolečine, povečanje obsega giba v ramenskem sklepu, povečanje mišične jakosti mišic ramenskega sklepa in izboljšanje funkcije zgornjega uda pri bolnikih s subakromialnim utesnitvenim sindromom. Metode dela: Iskanje literature je potekalo preko sistema COBISS ter elektronskih podatkovnih zbirk PubMed in Cinahl. Uporabljene so bile naslednje besedne zveze v angleškem jeziku: subacromial impingement syndrome, exercise therapy, physiotherapy exercises ter njihove kombinacije. Rezultati: Osem člankov je ustrezalo vključitvenim kriterijem. V raziskavah so izvajali vadbo za izboljšanje stabilizacije lopatice, vadbo krepitve mišic rotatorne manšete, proprioceptivno vadbo in vadbo za povečanje obsega giba. V vseh raziskavah so ocenjevali bolečino in funkcijo ramenskega sklepa. Obseg gibov v ramenskem sklepu so merili v treh raziskavah, mišično jakost pa v petih. Bolečina se je zmanjšala pri izvajanju vseh pregledanih vrst terapevtskih vadb. Funkcija ramenskega sklepa se je izboljšala v vseh skupinah, le v eni raziskavi je prišlo do statistično pomembne razlike med skupinama. Povečanje obsega giba so ugotovili v vseh treh raziskavah. V eni raziskavi so ugotovili pomembne razlike med skupinama pri merjenju jakosti izometrične kontrakcije abdkutorjev pri 90° abdukcije. Ostali avtorji, ki so merili mišično jakost, so ugotovili izboljšanje mišične jakosti znotraj posamezne skupine, razlik med skupinama pa niso ugotovili. Razprava in zaključek: Rezultati kažejo na majhne razlike med skupinami v bolečini, mišični jakosti, obsegu giba in funkciji. Vadba za stabilizacijo lopatice in vadba za krepitev mišic rotatorne manšete zmanjšata bolečino, izboljšata mišično jakost, povečata obseg giba ter izboljšata funkcijo ramenskega sklepa. Specifične vaje za krepitev mišic rotatorne manšete ter stabilizacijskih mišic lopatice bolj vplivajo na bolečino in funkcijo ramenskega sklepa kot nespecifične vaje. Večjih vplivov drugih vrst vadbe na bolečino, mišično jakost, obseg giba in funkcijo niso ugotovili.

Keywords

diplomska dela;fizioterapija;ramenski sklep;subakromialni utesnitveni sindrom;terapevtska vadba;

Data

Language: Slovenian
Year of publishing:
Typology: 2.11 - Undergraduate Thesis
Organization: UL ZF - University College of Health Studies
Publisher: [P. Križanič]
UDC: 615.8
COBISS: 52900099 Link will open in a new window
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Other data

Secondary language: English
Secondary title: Effect of therapeutic exercise on patients with subacromial impingement syndrome - literature review
Secondary abstract: Introduction: Subacromial impingement syndrome is defined as the compression of soft tissue structures located below the acromial arc when the arm is in elevation, especially when positioned above the head. It can occur due to structural changes that reduce the subacromial space and functional disorders in the centering of the humeral head (eg. muscle imbalance), but it can also be caused by trauma, overuse of rotator cuff muscle tendons, scapular dyskinesia and the narrow posterior part of the glenohumeral joint capsule. Purpose: Our aim was to determine the effectiveness of various therapeutic exercise programs on reducing pain, increasing range of motion in the shoulder joint, increasing muscle strength of shoulder muscles and improving upper limb function in patients with subacromial impingement syndrome. Methods: The literature has been searched through the COBISS system and the electronic databases PubMed and Cinahl. The following phrases have been used in English: subacromial impingement syndrome, exercise therapy, physiotherapy exercises and their combinations.Results: Eight articles met the inclusion criteria. Patients performed exercieses to improve scapular stabilization, strengthening rotator cuff muscles, proprioceptive exercises for shoulder joint and exercises to increase range of motion. Pain and function of the shoulder joint were evaluated in all studies. The range of motion in the shoulder joint was measured in three studies and muscle strength in five. Pain was reduced when performing all types of the therapeutic exercises. Shoulder joint function improved in all groups, but only one study showed a statistically significant difference between the groups. An increase in range of motion was found in all three studies. In one study, significant differences were found between the groups in measuring the isometric muscle strength at the abduction of 90°. Other authors who measured muscle strength found an improvement in muscle strength within each group, but no differences between the groups were found. Discussion and conclusion: The results show small differences between the groups in pain, muscle strength, range of motion and shoulder joint function. Scapular stabilization exercises and strengthening rotator cuff exercises reduce pain, improve in muscle strength, increase range of motion, and improve shoulder joint function. Specific exercises impact shoulder joint pain and function more than non-specific exercises. Bigger impact of other exercises on pain, muscle strength, range of motion and shoulder joint function wasn't found.
Secondary keywords: diploma theses;physiotherapy;shoulder joint;subacromial impingement syndrome;therapeutic exercise;
Type (COBISS): Bachelor thesis/paper
Study programme: 0
Thesis comment: Univ. v Ljubljani, Zdravstvena fak., Oddelek za fizioterapijo
Pages: 22 str., [4] str. pril.
ID: 12585541