Fizioterapevtska obravnava pacientov z izpahom pogačice

pregled literature

Mirjan Šebek (Avtor), Alan Kacin (Recenzent), Renata Vauhnik (Mentor), Polona Palma (Komentor)

Povzetek

Uvod: Akutni izpah pogačice predstavlja približno 3 % poškodb kolenskega sklepa ter je drugi najpogostejši vzrok za nastanek hemartroze kolenskega sklepa. Pri izpahu pogačica zdrsne iz stegneničnega žleba, najpogosteje lateralno. Izpahi pogačice so pogostejši pri osebah, ki so izpostavljene velikim fizičnim obremenitvam, pri mlajših ter pri ženskah. Namen: Na podlagi pregleda strokovne in znanstvene literature smo proučili najpogosteje uporabljene metode fizioterapije, ki se izvajajo pri pacientih z operativno ali konzervativno zdravljenim izpahom pogačice. Metode dela: Za iskanje literature je bila uporabljena podatkovna zbirka PubMed. Uporabljeni so bili naslednji vključitveni kriteriji: izpah pogačice, primerjava operativnega in konzervativnega zdravljenja, randomizirana kontrolna raziskava (RCT), dostop do celotnega besedila, besedilo v slovenskem in angleškem jeziku. Izključili smo vse raziskave starejše od 10 let. Rezultati: Med iskanjem literature je bilo pregledanih trideset strokovnih člankov. V pregled literature je bilo vključenih sedem člankov, objavljenih med letoma 2008 in 2016. Rezultati raziskav kažejo, da se kolenski sklep po izpahu pogačice za tri tedne imobilizira, oziroma se za šest tednov omeji njegova gibljivost. V akutni fazi se svetuje izvajanje krioterapije. V procesu zdravljenja je najpogosteje uporabljena kinezioterapija, in sicer vadba za krepitev mišice kvadriceps. Pri krepitvi začnemo z vajami z izometrično kontrakcijo, sledi vadba v zaprti ter odprti kinetični verigi. Nekaj avtorjev v procesu zdravljenja svetuje poudarjeno krepitev mišice vastus medialis, to so storili le v eni od sedmih randomiziranih kontrolnih raziskav. Uporaba elektroterapije je zelo redka. Razprava in zaključek: Čeprav so v vseh sedmih randomiziranih kontrolnih raziskavah kolenski sklep pri konzervativno zdravljenem izpahu pogačice imobilizirali oziroma omejili njegovo gibljivost, raziskav, ki bi dokazale, da so rezultati zdravljenja s tem boljši, ni. Pogosto vprašanje je, ali v procesu zdravljenja krepiti celotno mišico kvadriceps ali poudarjeno krepiti mišico vastus medialis. Raziskava, ki je to ugotavljala, kaže v prid krepitve celotne mišice kvadriceps.

Ključne besede

diplomska dela;fizioterapija;pogačica;izpah;operativno zdravljenje;

Podatki

Jezik:	Slovenski jezik
Leto izida:	2017
Tipologija:	2.11 - Diplomsko delo
Organizacija:	UL ZF - Zdravstvena fakulteta
Založnik:	[M. Šebek]
UDK:	615.8
COBISS:	5348715
Št. ogledov:	2677
Št. prenosov:	1694
Ocena:	0 (0 glasov)
Metapodatki:

Ostali podatki

Sekundarni jezik:	Angleški jezik
Sekundarni naslov:	Physiotherapy treatment for patients with patellar dislocation
Sekundarni povzetek:	Introduction: The acute patellar dislocation represents approximately 3 % of knee injuries and is the second most common cause of hemarthrosis of the knee. When a dislocation occurs, the patella slips from the trochlear groove, most often laterally. Patellar dislocations are more common in people who are exposed to severe physical strains, younger people and women. Purpose: By reviewing the professional and scientific literature, we examined the most frequently used methods of physiotherapy carried out on patients with operatively or conservatively treated patellar dislocation. Methods: A PubMed database was used to find literature. The following inclusion criteria were used: patellar dislocation, comparison of operative and conservative treatment, randomized controlled trial (RCT), access to the full text, and text in Slovene and English. We excluded studies older than 10 years. Results: During the search for literature, thirty articles were reviewed. Seven randomized controlled trials published between 2008 and 2016 have been included in the literature review. Research results show that, after patellar dislocation, the knee joint is immobilized for 3 weeks or its range of motion is limited for 6 weeks. In the acute phase, cryotherapy is recommended. Kinesiotherapy is the most commonly used method of physiotherapy in the treatment process, more precisely, strengthening of the quadriceps muscle. In the process of strengthening, we begin with exercises with isometric contraction, followed by exercises in a closed and in an open kinetic chain. Some authors recommend strengthening of the vastus medialis muscle, which was done only in one of the seven randomized controlled trial. Electrotherapy is used very rarely. Discussion and conclusion: Although the knee joint was immobilized or its range of motion was limited in all seven randomized control studies in conservatively treated patellar dislocations, there is no research to prove that the results of treatment are better that way. There often arises the question of whether it is better to strengthen the whole quadriceps muscle or should there be greater focus on the vastus medialis muscle. The research that explored this dilemma leans in favour of strengthening the whole quadriceps muscle.
Sekundarne ključne besede:	diploma theses;physiotherapy;patellar;dislocation;operative treatment;
Vrsta dela (COBISS):	Diplomsko delo/naloga
Študijski program:	0
Komentar na gradivo:	Dipl. delo (bolonjski študij), Univ. v Ljubljani, Zdravstvena fak., Oddelek za fizioterapijo
Strani:	24 str.
ID:	10911908