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Title:UČINKOVITOST MOBILIZACIJE PERIFERNEGA ŽIVČEVJA PRI PACIENTIH Z UTESNITVENIMI NEVROPATIJAMI
Authors:ID Novak, Sebastjan (Author)
ID Omejec, Gregor (Mentor) More about this mentor... New window
Files:.pdf 2624$$sebastjan_novak,_42300153_pdf_a1b.pdf (1,83 MB)
MD5: FA682D63681584622249A5C06D438504
 
Language:Slovenian
Work type:Bachelor thesis/paper
Organization:FIZIOTERAPEVTIKA - PHYSIOTHERAPEUTICA
Abstract:Pritisk, raztezanje, strig in/ali trenje so mehanizmi nastanka utesnitvenih nevropatij. Simptomi in znaki utesnitvenih nevropatij nastanejo kot posledica poškodbe živčno krvne pregrade, ishemije, edema, spremembe vezivnega tkiva, motenj v aksonskem transportu, nevroinflamacije, demielinizacije in degeneracije aksona. Simptomi in znaki so navadno senzorične in motorične narave, ki se kažejo z zmanjšano funkcijo in bolečino, možna je tudi asimptomatska prezentacija. Utesnitvene nevropatije diagnosticiramo s pomočjo anamneze, kjer povprašamo po vrsti simptomov in času trajanja ter usmerjenega kliničnega pregleda, kjer te simptome s pomočjo specialnih testov izzovemo. Za potrditev diagnoze in v primeru težjih oblik se poslužujemo eletrofizoloških preiskav, ultrazvoka in magnetne resonance. V diplomskem delu smo pregledali literaturo o vzdolžnem in prečnem drsenju perifernih živcev in o učinkovitosti mobilizacije perifernih živcev pri utesnitvenih nevropatijah. Ugotovili smo, da je vzdolžno drsenje na mestu utesnitve omejeno in da enako ne velja vedno za prečno drsenje. Prečno drsenje se v nekaterih primerih celo poveča, vendar je to gibanje patološko. V primeru SZP smo ugotovili spremenjeno pot gibanja tetiv fleksorjev prsta, ki tvori drsno enoto z medialnim živcem in kaže na prisotnost patologije. V nadaljnjih raziskavah bi bilo smiselno raziskati možnost dinamike drsenja med medialnim živcem in tetivami za diagnostiko. Obenem smo ugotovili, da obstaja dovolj z dokazi podprtih študij, ki kažejo patofiziološko izboljšanje markerjev in simptomov ter znakov utesnitev pri uporabi mobilizacijskih tehnik, kot samostojno terapijo ali kot so-modaliteto. Navkljub pritrdilni hipotezi H2, je pri uporabi mobilizacije živčevja potrebna previdnost in razumevanje biomehanike, za pozitiven rezultat terapije so potrebni pravilno izvajanje, količina, dolžina, vrsta in položaj tehnike. Glede na trenutno literaturo je najprimernejša za kronične bolnike z utesnitvami v hrbtenici, previdnost je potrebna pri akutnih stanjih, njen učinek pa je viden tudi pri zdravi populaciji.
Keywords:Utesnitvene nevropatije, drsenje, pomičnost, mobilizacija živčevja.
Year of publishing:2026
PID:20.500.12556/ReVIS-13027 New window
Publication date in ReVIS:20.01.2026
Views:33
Downloads:0
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Secondary language

Language:English
Title:Efficacy of neural mobilization in patients with entrapment neuropathies
Abstract:Entrapment neuropathies are caused by mechanism of action which involve pressure, streching, friction or angulation of the nerve. The signs and symptoms of entrapment neuropathies are caused by ischemia, blood-nerve barrier changes, edema, connective tissue changes and axonal transport blockage. Signs and simptoms are sensory and motor in nature and usually present as pain and loss of function, although the presentation can also be asimptomatic. A diagnosis contains an accurate medical history that focuses on type/duration of symptoms, paired with a clinical examination that containes special tests, which reproduce the symptoms. In the case of severe pathologies and for confirming the diagnosis, imaging modalities such as ultrasound and magnetic imaging paired with electrodiagnostics are used. The focus of this thesis was to review the literature for longitudinal and transversal gliding of the peripheral nerves, combined with the efficacy of neural mobilisation techniques for treatment of entrapment neuropathies. We concluded that longitudinal gliding is impaired at the site of the entrapment, which is not always the case for transverse gliding. In the case of carpal tunnel syndome we noticed a deviating pattern of movement of the finger flexor tendons compared to the general population which is considered pathological. This dynamic between the medial nerve and the tendons should be investigated, due to its implication for diagnostics. At the same time we found enough evidence based studies that show patophysiological improvemnt in markers and symptoms of entrapment neuropathies when neural mobilisation was used as the primary therapy or in conjuction with other modalities. Despite the confirmation of the hypothesis H2, we advise caution is used while using the techniques, as the positive outcomes depend on proper implementation, quantity, length, type and position. Based on the current literature the mobilisation is best suited for chronic patients with back entrapments while caution is requiered with acute patients. Benefits have also been seen in otherwise healthy population.
Keywords:Entrapment neuropathy, nerve gliding, excursion, neural mobilisation.


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