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Title:Učinkovitost fizioterapevtskih metod in tehnik pri obravnavi pacienta z boleznijo motoričnega nevrona
Authors:ID Vodopivec, Jure (Author)
ID Omejec, Gregor (Mentor) More about this mentor... New window
Files:.pdf 1657$$diplomska_naloga_jure_vodopivec__2023.pdf (1,43 MB)
MD5: 454286610F834BAC95C12CA72A743FC1
 
Language:Slovenian
Work type:Bachelor thesis/paper
Typology:2.11 - Undergraduate Thesis
Organization:FIZIOTERAPEVTIKA - PHYSIOTHERAPEUTICA
Abstract:Skupino pacientov z BMN izraža paleta najrazličnejših potekov bolezni, ki jim je skupna mišična oslabelost in posledično težave pri opravljanju vsakodnevnih aktivnosti, kar ob koncu rezultira v odvisnosti od tuje pomoči. Postavitev diagnoze je izjemno zapletena in dolgotrajna, saj specifičnega testa v tem trenutku ne poznamo, zato se lahko nevrolog zanaša zgolj na klinični pregled, slikovno diagnostiko, laboratorijske preiskave in svoje izkušnje Za obravnavo številnih simptomov, ki spremljajo te bolezni, je zadolžen multidisciplinaren tim, v katerem pomembno vlogo igra tudi fizioterapevt. V Sloveniji so pacienti takšne obravnave deležni v UKC Ljubljana v sodelovanju z URI RS – Soča in Domom dva topola. Ker so bolezni v tem trenutku neozdravljive, zdravljenje poteka simptomatsko (farmakološko in nefarmakološko). Farmakološko zdravljenje lahko upočasni napredovanje bolezni, medtem ko nefarmakološke intervencije lahko pripomorejo k izboljšanju kakovosti življenja pacientov z BMN. Fizioterapija predstavlja nefarmakološki, torej podporni del zdravljenja, pri delu pa si fizioterapevt lahko pomaga z RFT, fizioterapevtsko vadbo in fizikalnimi modalitetami. V diplomski nalogi smo poskušali izpostaviti vlogo fizioterapevta znotraj multidisciplinarnega tima in njegov vpliv na samo obravnavo. Kljub izjemno majhnemu vzorcu kakovostnih raziskav in delitvi mnenj smo v diplomskem delu terapevtsko vadbo pod nadzorom in navodili fizioterapevta prepoznali kot varno in učinkovito. Kot najučinkovitejši vadbeni protokol se je pokazala kombinacija aerobne vadbe z vadbo proti uporu, izvedena pri submaksimalni obremenitvi. Zgodnji začetek izvajanja terapevtske vadbe kaže boljše rezultate kot začetek izvajanja pozno, predvsem pri oblikah bolezni, katerih progresija ni tako intenzivna. Podobno velja za tehnike RFT, ki ne izboljšajo le kakovosti življenja, temveč ga v primeru NIMV lahko tudi podaljšajo. Najpomembnejše je, da je fizioterapevtska obravnava celostna, popolnoma individualizirana in prilagojena pacientovim potrebam/ciljem. Fizioterapevt je dolžan ves čas obravnave evalvirati program dela in ga prilagajati zmožnostim in ciljem pacienta.
Keywords:bolezen motoričnega nevrona, simptomatsko zdravljenje, fizioterapevtska vadba, respiratorna fizioterapija
Year of publishing:2023
PID:20.500.12556/ReVIS-9682 New window
COBISS.SI-ID:152471299 New window
Publication date in ReVIS:12.05.2023
Views:817
Downloads:75
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Secondary language

Language:English
Title:TThe effectiveness of physiotherapeutical methods and techniques in treatment of patient with motor neurone disease
Abstract:The MND patient group reflects a range of different disease processes, all of which share muscle weakness and consequent difficulty in performing daily activities, which ultimately results in dependence on assistance from others. The diagnosis itself is extremely complex and time-consuming, as there is no specific test available at the moment, so neurologists can only rely on clinical examination, diagnostic imaging, laboratory tests, and their experience. A multidisciplinary team, including a physiotherapist, is responsible for managing the many symptoms that accompany these diseases. In Slovenia, patients receive such treatment at UKC Ljubljana in collaboration with URI Soča and Dom Dva Topola. As the diseases are currently incurable, treatment is symptomatic (pharmacological and non-pharmacological). Pharmacological treatment can slow down the progression of the disease, while non-pharmacological interventions can help to improve the quality of life of patients with MND. Physiotherapy is a non-pharmacological, i.e., supportive, part of the treatment, and the physiotherapist can use respiratory physiotherapy, physiotherapy exercises, and physical modalities in his/her work. In this thesis we have tried to highlight the role of the physiotherapist within the multidisciplinary team and his/her influence on the treatment itself. Despite the extremely small sample of qualitative research and the division of opinions, the thesis identified therapeutic exercise under the supervision and guidance of a physiotherapist as safe and effective. The most effective exercise protocol was found to be a combination of aerobic exercise with resistance exercise performed at submaximal load. An early beginning of therapeutic exercise shows better results than a late beginning, especially in disease forms whose progression is less intense. Similarly, the respiratory physiotherapy techniques not only improve the quality of life but, in the case of NIV, can also prolong it. Most importantly, physiotherapy treatment should be holistic, fully individualised and tailored to the patient's needs/objectives. The physiotherapist is obliged to evaluate the work programme throughout the treatment and adapt it to the patient's abilities and goals.
Keywords:motor neurone disease, simptomatic treatment, physiotherapy exercise, respiratory therapy


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