diplomsko delo
Povzetek
Uvod: Poškodbi in rekonstrukciji sprednje križne vezi sledi šibkost mišice quadriceps
femoris. K šibkosti mišice naj bi bistveno prispevali njena atrofija in zmanjšana sposobnost
hotene aktivacije. Slednja se pojavi zaradi zmanjšanja centralnih prilivov v mišico, ki so
posledica sprememb v spinalnorefleksni in kortikospinalni živčni poti. Zmanjšana
centralna aktivacija mišice naj bi bila predvsem zaščitni mehanizem telesa pred nadaljnjimi
poškodbami, vendar žal preprečuje učinkovito rehabilitacijo in vrnitev v aktivnosti
oziroma šport. Vztrajala naj bi tudi več let po poškodbi. Namen: Namen diplomskega dela
je ugotoviti učinek rehabilitacije in ustreznih terapevtskih postopkov na spremembo
centralne aktivacije ter inhibicijo mišice quadriceps femoris pri osebah po poškodbi
sprednje križne vezi. Metode dela: Diplomsko delo je izvedeno z metodo sistematskega
pregleda strokovne in znanstvene literature. Iskanje literature je potekalo v podatkovni bazi
PubMed s pomočjo ključnih besed. Iskanje člankov ni bilo omejeno z letom objave ali
specifično terapevtsko obravnavo oziroma rehabilitacijskim protokolom. Rezultati: V
diplomsko delo smo vključili osem člankov. V štirih raziskavah so ugotavljali spremembo
centralne aktivacije mišice quadriceps femoris po splošnem rehabilitacijskem protokolu, v
štirih pa po specifičnih fizioterapevtskih protokolih. Rezultati raziskav glede vpliva
splošnega rehabilitacijskega protokola so precej različni, celo nasprotujoči. Nekatere
raziskave ugotavljajo izboljšanje centralne aktivacije mišice po rehabilitaciji, nekatere pa
njeno poslabšanje. Rezultati raziskav, ki so preiskovale vpliv specifičnih fizioterapevtskih
protokolov, nakazujejo na veliko učinkovitost ekscentrične vadbe pri pacientih z deficitom
v centralni aktivaciji po poškodbi sprednje križne vezi. Do precejšnjega izboljšanja
centralne aktivacije mišice privedejo tudi kombinacije fizioterapevtskih postopkov, kot sta
krioterapija pred vadbo in transkutana električna živčna stimulacija (TENS) med vadbo.
Žal pri slednjih dveh protokolih avtorji niso izmerili statistično pomembne razlike v
primerjavi z zgolj vadbo, vendar pa je razlika klinično pomembna. Razprava in sklep: Za
čim večje izboljšanje mišične jakosti in centralne aktivacije mišice quadriceps femoris pri
posameznikih po poškodbi sprednje križne vezi se predlaga v rehabilitacijski oziroma
fizioterapevtski program vključiti ekscentrično vadbo, krioterapijo pred vadbo in
transkutano električno stimulacijo med vadbo (TENS). Za trdnejše ugotovitve bi bilo
potrebno v pregled literature vključiti večje število raziskav. Ostaja potreba po večjem
številu raziskav, ki bi preiskovale učinek fizioterapevtskih postopkov pri osebah po
pretrganju sprednje križne vezi.
Ključne besede
diplomska dela;fizioterapija;sprednja križna vez;centralna aktivacija;mišična inhibicija;krioterapija;TENS;ekscentrična vadba;
Podatki
Jezik: |
Slovenski jezik |
Leto izida: |
2018 |
Tipologija: |
2.11 - Diplomsko delo |
Organizacija: |
UL ZF - Zdravstvena fakulteta |
Založnik: |
[M. Špenko] |
UDK: |
615.8 |
COBISS: |
5475691
|
Št. ogledov: |
915 |
Št. prenosov: |
531 |
Ocena: |
0 (0 glasov) |
Metapodatki: |
|
Ostali podatki
Sekundarni jezik: |
Angleški jezik |
Sekundarni naslov: |
ǂThe ǂinfluence of various methods of physiotherapy on volitional muscle activation of the quadriceps femoris muscle after anterior cruciate ligament rupture |
Sekundarni povzetek: |
Introduction: The weakness of quadriceps femoris muscle is a common occurrence after
rupture and reconstruction of the anterior cruciate ligament. Muscle atrophy and reduced
ability of voluntary activation substantially contribute to the muscle weakness. Reduced
muscle activation occurs due to a decrease in central inflows to the muscle resulting from
changes in spinal-reflex and corticospinal neural pathways. Reduced central muscle
activation should primarily be the protective mechanism of the body against further
injuries, but unfortunately it prevents effective rehabilitation and return to activity or sport.
It also persists for several years after the injury. Purpose: To determine the effect of
rehabilitation and appropriate therapeutic procedures on the change in central activation
and inhibition of quadriceps femoris muscle in individuals after anterior cruciate ligament
injury. Methods: The method that we used was a systematic review of technical and
scientific literature. The literature search was conducted in the PubMed database using
keywords. Results: We have included eight articles. Four studies observed a change in the
central activation of quadriceps according to a general rehabilitation protocol, while four
studies observed a change according to specific physiotherapeutic protocols. The results of
studies where the general rehabilitation protocol was used are quite different, even
contradictory. Some studies have found improvement in central muscle activation after
rehabilitation, while some have found its decrease. Results of studies that investigated the
effect of specific physiotherapeutic protocols indicate high efficacy of eccentric exercise in
patients with a deficiency in central muscle activation after anterior cruciate ligament
rupture. Considerable improvements in central muscle activation were also measured after
therapies where combinations of physiotherapy procedures, such as cryotherapy before
exercise and transcutaneous electrical nerve stimulation (TENS) during exercise, were
used. Unfortunately in the latter two protocols authors did not measure statistically
significant differences compared to mere exercise, but the difference is clinically relevant.
Discussion and conclusion: In order to improve muscle strength and central activation of
quadriceps femoris muscle in individuals after anterior cruciate ligament rupture a
rehabilitation or physiotherapeutic program is proposed to include eccentric exercise,
cryotherapy before exercise or transcutaneous electrical nerve stimulation (TENS) during
exercise. For more solid findings greater number of studies should be included in the
literature review. The need for further studies that would investigate the effect of certain
physiotherapy procedures in subjects after anterior cruciate ligament rupture still remains. |
Sekundarne ključne besede: |
diploma theses;physiotherapy;anterior cruciate ligament;central activation;muscle inhibition;cryotherapy;TENS;eccentric exercise; |
Vrsta dela (COBISS): |
Diplomsko delo/naloga |
Študijski program: |
0 |
Komentar na gradivo: |
Univ. v Ljubljani, Zdravstvena fak., Oddelek za fizioterapijo |
Strani: |
38 str., [4] str. pril. |
ID: |
10958787 |