diplomsko delo
Povzetek
Uvod: Multipla skleroza je kronična avtoimuna nevrodegenerativna bolezen osrednjega
živčnega sistema, ki najpogosteje prizadene mlajše odrasle. Zanjo so značilne vnetne
demielinizacije z aksonskimi okvarami, ki lahko vodijo v zelo kompleksne in nepredvidljive
nevrološke izpade. Motnje v hoji predstavljajo enega izmed najbolj omejujočih vidikov
bolezni, zato je usmerjanje rehabilitacije k izboljšanju mobilnosti pri tovrstni populaciji
ključnega pomena. Pri pacientih s hujšimi omejitvami je še posebej obetavna robotsko
podprta vadba, ki je pogosto opredeljena kot v nalogo usmerjena metoda. Tovrstno vadbo
hoje omogoča Lokomat, ki je definiran kot pristop z eksoskeletom, kjer sta nadzirana
medenica in kinematika kolenskega sklepa, telesna teža pa je razbremenjena. Namenjen je
intenzivni rehabilitacijski terapiji hoje pri odraslih in pediatričnih bolnikih s hudo do zmerno
prizadetostjo hoje in funkcionalne mobilnosti. Namen: Namen diplomskega dela je bil na
podlagi pregleda znanstvene in strokovne literature ugotoviti učinkovitost robotsko podprte
vadbe hoje z uporabo Lokomata pri pacientih z multiplo sklerozo v primerjavi s
konvencionalnimi pristopi. Metode dela: Uporabljena je bila deskriptivna metoda pregleda
literature. Znanstveni članki so bili iskani v podatkovni bazi PubMed v novembru 2023.
Vključeni so bili članki kontroliranih kliničnih raziskav in randomiziranih kontroliranih
kliničnih raziskav, ki so preučevali vpliv uporabe Lokomata pri pacientih z multiplo
sklerozo. Rezultati: V pregled smo vključili osem raziskav, v katere so zajeli 321
preiskovancev. Sedem raziskav je preiskovalno skupino primerjalo s kontrolno, ki je izvajala
konvencionalno terapijo hoje ali pa prejemala fizioterapevtsko obravnavo v kombinaciji z
vadbo hoje. Primerjava med skupinama je v treh raziskavah pokazala statistično značilnejše
izboljšanje hitrosti in vzdržljivosti hoje za Lokomat. Le v eni raziskavi so to zabeležili na
področju ravnotežja. Lokomat je v primerjavi s konvencionalnim pristopom prikazal tudi
statistično značilno izboljšanje moči ekstenzorjev kolena ter kadence in dolžine koraka.
Razprava in zaključek: Na podlagi rezultatov lahko zaključimo, da robotsko podprta vadba
hoje z Lokomatom lahko vpliva na izboljšanje hitrosti, vzdržljivosti in ostalih parametrov
hoje pri bolnikih z multiplo sklerozo. Pozitivne učinke je prikazal tudi konvencionalni
pristop, vseeno pa je lahko vključevanje vadbe hoje z Lokomatom v program rehabilitacije
učinkovita izbira pri bolnikih z MS. Potrebne so nadaljnje raziskave za določitev optimalne
kombinacije parametrov vadbe z Lokomatom.
Ključne besede
diplomska dela;fizioterapija;multipla skleroza;Lokomat;hoja;
Podatki
Jezik: |
Slovenski jezik |
Leto izida: |
2024 |
Tipologija: |
2.11 - Diplomsko delo |
Organizacija: |
UL ZF - Zdravstvena fakulteta |
Založnik: |
[L. Zavec] |
UDK: |
615.8 |
COBISS: |
200071939
|
Št. ogledov: |
57 |
Št. prenosov: |
18 |
Ocena: |
0 (0 glasov) |
Metapodatki: |
|
Ostali podatki
Sekundarni jezik: |
Angleški jezik |
Sekundarni naslov: |
Effects of robot-assisted gait training in multiple sclerosis patients – literature review |
Sekundarni povzetek: |
Introduction: Multiple sclerosis is a chronic autoimmune neurodegenerative disease of the
central nervous system, most commonly affecting young adults. It is characterized by
inflammatory demyelination with axonal damage, which can lead to highly complex and
unpredictable neurological deficits. Gait disturbances represent one of the most limiting
aspects of the disease, making directing rehabilitation towards improving mobility in this
population crucial. For patients with severe limitations, robot-assisted training, often defined
as task-oriented, holds particular promise. Such gait training is facilitated by the Lokomat,
defined as an exoskeleton approach where pelvis and knee kinematics are controlled, and
the patient's weight is supported. It is designed for intensive gait rehabilitation therapy in
adults and pediatric patients with severe to moderate gait impairments and functional
mobility. Purpose: The purpose of this diploma work was to determine the effectiveness of
robot-assisted gait training using the Lokomat compared to conventional approaches in
patients with multiple sclerosis based on a review of scientific and professional literature.
Methods: A descriptive method of literature review was used in this diploma. Scientific
articles were searched in the PubMed database in November 2023. Included were articles of
controlled clinical trials and randomized controlled clinical trials examining the impact of
Lokomat use in patients with multiple sclerosis. Results: Eight studies involving a total of
321 subjects were included in this review. Seven studies compared the intervention group
with a control group that underwent conventional gait therapy or received physiotherapy
combined with gait training. In three studies, Lokomat showed statistically significant
improvements in gait speed and endurance compared to the control group, one study reported
such improvements in balance. Lokomat also demonstrated statistically significant
improvements in knee extensor strength, cadence and step length compared to conventional
approaches. Discussion and Conclusion: Based on results, it can be concluded that robot-assisted gait training with Lokomat can improve speed, endurance, and other gait parameters
in patients with multiple sclerosis. Positive effects were also demonstrated with conventional
approaches; however, incorporating Lokomat gait training into rehabilitation programs can
be an effective choice for MS patients. Further research is needed to determine the optimal
combination of Lokomat training parameters. |
Sekundarne ključne besede: |
diploma theses;physiotherapy;multiple sclerosis;Lokomat;gait; |
Vrsta dela (COBISS): |
Diplomsko delo/naloga |
Študijski program: |
0 |
Komentar na gradivo: |
Univ. v Ljubljani, Zdravstvena fak., Oddelek za fizioterapijo |
Strani: |
26 str., [3] str. pril. |
ID: |
24473709 |