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Title:Pomen fizioterapevtske obravnave za ohranjanje kakovosti življenja pacientov z amiotrofično lateralno sklerozo
Authors:ID Bahar, Tina (Author)
ID Omejec, Gregor (Mentor) More about this mentor... New window
Files:.pdf 1709$$diplomska_naloga_tina_bahar.pdf (547,06 KB)
MD5: 6DDAD771BB1C42B2597BA97592DA3308
 
Language:Slovenian
Work type:Bachelor thesis/paper
Typology:2.11 - Undergraduate Thesis
Organization:FIZIOTERAPEVTIKA - PHYSIOTHERAPEUTICA
Abstract:Amiotrofična lateralna skleroza je nevrodegenerativna, progresivna, neozdravljiva in smrtna bolezen. V ospredju obravnave pacientov je reševanje težav motenj dihanja, gibanja, hranjenja, govora in požiranja. V multidisciplinarnem zdravstvenem timu ima fizioterapija ključno vlogo pri celostnem zdravljenju pacientov z ALS. Fizioterapevtska obravnava vpliva na funkcionalni status pacienta, bolečino in gibljivost pacienta z ALS in preko tega na kakovost njegovega življenja. Izbor vaj obsega: raztezne vaje, vaje za izboljšanje gibljivosti in mobilizacijo sklepov, vaje za ravnotežje, vaje za moč neprizadetih mišic, vaje za moč prizadetih mišic ter aerobno aktivnost. Kombinirani program aerobne vadbe, vaj za moč in standardne rehabilitacije ima največji vpliv na izboljšanje kakovosti življenja in zmanjšanje utrujenosti pri pacientih z ALS. Vse oblike vadbe so za paciente varne, če se izvajajo prilagojeno stanju, z vsemi previdnostnimi ukrepi in preventivo padcev. Terapevtska telesna vadba pripomore k upočasnitvi propadanja mišic in funkcionalnosti pacientov z ALS in jim tako olajša opravljanje vsakodnevnih življenjskih aktivnosti, četudi ne podaljša preživetja. Vaje inspiratornih in ekspiratornih mišic vodijo v izboljšanje funkcije respiratornih mišic, a kljub kljub temu preživetja pacientov ne podaljšajo, izboljša se kakovost življenja do konca bolezni. Zaenkrat veljavna priporočila za vadbo pacientov z ALS so: 20 do 60 minut aerobne aktivnosti, 3 do 5 dni v tednu, z intenziteto 40 do 85 odstotkov maksimalne srčne frekvence. Vaje za moč naj pacienti izvajajo dvakrat tedensko, zmerne intenzitete. Visoko intenzivni trening priporočila odsvetujejo. Pacienti z ALS so deležni različne podporne terapije. NIV najbolj pripomore k podaljšanju preživetja in večji kakovosti življenja. Zdravljenje sialoreje z botulinskim toksinom izboljša kakovost življenja pacientov z ALS. Hranjenje po gastrostomi izboljša tako preživetje kot kakovost življenja. Izjemnega pomena je uvedba nadomestne komunikacije. Zdravljenje psiholoških težav, anksioznosti in depresije s pomočjo VKT, psihoterapije in zdravil močno izboljšajo kakovost življenja pacientov z ALS. Kakovost življenja pacienta z ALS je povezana z individualnim dojemanjem samega sebe, le to pa je kljub različnim oblikam pomoči slabo, zaradi same narave in napredovanja bolezni.
Keywords:amiotrofična lateralna skleroza, fizioterapevtska obravnava, kakovost življenja
Year of publishing:2023
PID:20.500.12556/ReVIS-9806 New window
COBISS.SI-ID:157720579 New window
Publication date in ReVIS:04.07.2023
Views:1071
Downloads:88
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Secondary language

Language:English
Title:The importance of physiotherapy for maintaining the quality of life in patients with amyotrophic lateral sclerosis
Abstract:Amyotrophic lateral sclerosis is a neurodegenerative, progressive, incurable and fatal disease. The focus of patient care is to address problems of breathing, movement, feeding, speech and swallowing. In a multidisciplinary healthcare team, physiotherapy plays a key role in the holistic treatment of ALS patients. Physiotherapy treatment has an impact on the patient's functional status, pain and mobility in ALS and, through this, on the patient's quality of life. The range of exercises includes: stretching exercises, exercises to improve joint mobility and mobilization, balance exercises, exercises for the strength of unaffected muscles, exercises for the strength of affected muscles, and aerobic activity. A combined program of aerobic exercise, strength exercises, and standard rehabilitation has the greatest impact on improving the quality of life and reducing fatigue in ALS patients. All forms of exercise are safe for patients if performed in a condition-specific manner, with all precautions and fall prevention. Therapeutic exercise helps to slow down muscle deterioration and functional decline in ALS patients, making it easier for them to perform activities of daily living, even if it does not prolong survival. Exercising inspiratory and expiratory muscles leads to improved respiratory muscle function, yet it does not prolong survival but improves the quality of life until the end of the disease. The current recommendations for exercise in ALS patients are 20 to 60 minutes of aerobic activity, 3 to 5 days per week, at an intensity of 40 to 85 percent of maximal heart rate. Patients should perform strength training twice a week, at moderate intensity. High-intensity training is discouraged. ALS patients receive a variety of supportive therapies. NIV is most helpful in prolonging survival and improving quality of life. Treatment of sialorrhoea with botulinum toxin improves the quality of life of ALS patients. Gastrostomy feeding improves both survival and quality of life. The introduction of alternative communication is of paramount importance. Treatment of psychological problems, anxiety, and depression through BCT, psychotherapy, and medication greatly improves the quality of life of ALS patients. But the quality of life of an ALS patient is linked to the individual's self-perception, which is poor, despite various forms of support, due to the nature and progression of the disease.
Keywords:amyotrophic lateral sclerosis, physiotherapy treatment, quality of life


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