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Title: Učinkovitost fizioterapevtskih postopkov pri zdravljenju nevropatske bolečine Authors: Turnšek, Alja (Author) Omejec, Gregor (Mentor) More about this co-author... Language: Slovenian Work type: Bachelor thesis/paper Tipology: 2.11 - Undergraduate Thesis Organization: FIZIOTERAPEVTIKA - PHYSIOTHERAPEUTICA Abstract: Nevropatska bolečina je povzročena s strani lezije ali bolezni, ki prizadene somatosenzorični živčni sistem, vključujoč periferna vlakna (A beta, A delta in C vlakna) in centralne nevrone. Nevropatska bolečina prizadene med 8 in 10 odstotkov splošne populacije. Incidenca nevropatske bolečine bo najverjetneje zaradi staranja prebivalstva, povečanja incidence diabetesa mellitusa ter preživetja raka zaradi kemoterapije naraščala. Simptomi in klinični znaki nevropatske bolečine vključujejo alodinijo, hiperalgezijo, spontano bolečino, občasno kavzalgijo ali neprestano pekočo bolečino. Med pomembnejšimi mehanizmi v ozadju nevropatske bolečine poznamo neravnovesje med ekscitatornim in inhibitornim somatosenzoričnim signaliziranjem, spremembe v ionskih kanalčkih in raznolikost načinov spremembe bolečinskih signalov v centralnem živčnem sistemu. Pri pacientih z nevropatsko bolečino je prizadeta njihova kakovost življenja zaradi morbidnosti nevropatske bolečine, spopadanja z boleznijo ter farmakološkega zdravljenja. Ker ima farmakološko zdravljenje slabe rezultate tudi pri velikih dozah zdravil in vključuje veliko stranskih učinkov, se vedno bolj raziskuje učinkovitost uporabe fizioterapevtskih postopkov zdravljenja pri pacientih z nevropatsko bolečino. Med najbolj perspektivnimi in raziskanimi postopki sta TENS in kinezioterapija, vendar so rezultati nekonsistentni, učinki pa zgolj kratkoročni. Ostale metode vključujejo še nizkointenzitetno lasersko terapijo, ultrazvočno terapijo, transkranialno magnetno stimulacijo, kranialno elektroterapevtsko stimulacijo, trakcijo, manipulacijske in mobilizacijske tehnike. Zaenkrat rezultati sistematičnega pregleda literature ne dajejo nobenih trdnih dokazov zaradi slabe kakovosti študij in nekonsistentnih rezultatov (premajhni vzorci, kratoročno sledenje preiskovancev, subjektivnost metod ocenjevanja). V prihodnosti je potrebnih več visoko kakovostnih študij preučevanja učinkovitosti uporabe fizioterapevtskih postopkov pri zdravljenju nevropatske bolečine, le tako lahko takšne postopke vpeljemo v klinično prakso na dokazih temelječe medicine. Keywords: nevropatska bolečina, fizioterapevtski postopki, učinkovitost Year of publishing: 2020 COBISS_ID: 42936579  VisID: 2481 Views: 1867 Downloads: 374 Files:  555$$dn_alja_turnsek.pdf (512,50 KB)   Metadata:

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Secondary language

Language:	English
Title:	Efficiency of physiotherapy modalities for the treatment of neuropathic pain
Abstract:	Neuropathic pain is caused by a lesion or disease affecting the somatosensory nervous system, including peripheral fibers (A delta, A gama and C fibers) and central neurons. Neuropathic pain affects between 8 and 10 percent of the general population. The incidence of neuropathic pain is likely to grow due to aging of the population, increased incidence of diabetes mellitus and increased survival of cancer due to chemotherapy. Clinical signs and symptoms of neuropathic pain include allodynia, hyperalgesia, spontaneous pain, causalgia or constant burning pain. Patophysiology behind neuropathic pain includes the imbalance between excitatory and inhibitory somatosensoric signalling, changes in the ion channels and difference in the way that pain messages are modulated in the central nervous system. In the patients with neuropathic pain their quality of life is greatly affected due to morbidity of pain, the consequences of the disease and pharmacological treatment. Beacuse pharmacological treatment does not give good results even with higher doses of medication and has many side effects there is more and more research regarding the efficiency of physiotherapeutic modalities for treatment of patients with neuropathic pain. The most perspective and researched modalities are TENS and kinseiotherapy, but the results are inconsistent and the effects only short-term. Other physiotherapeutic modalities include low-level laser therapy, shock wave therapy, transcranial magnetic stimulation, cranial electrotherapy stimulation, traction, manipulation and mobilization techniques. The results of the systematic literature review do not give any conclusive evidence due to low quality of the studies and inconsistent results (small sample size, short-term following period, subjective testing methods). In the future there are more high quality studies needed researching use of physiotherapeutic modalities for treatment of neuropathic pain, so that we can bring the most effective ones into clinical practice of the Evidence based medicine.
Keywords:	neuropathic pain, physiotherapeutic modalities, efficiency

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