Kvaliteta življenja in ortotična oskrba pacienta z osteoartrozo kolenskega sklepa : poročilo o primeru

Jemec, Miha (author), Divjak, Mojca (mentor), Boltežar, Žane (comentor)

Uvod: Osteoartroza kolena ima pomemben negativni vpliv na kvaliteto življenja povezano z zdravjem. Z odkrivanjem terapij, ki izboljšajo kvaliteto življenja pri pacientih z osteoartrozo kolena, bi lahko zmanjšali klinično, ekonomsko in socialno breme te bolezni. Namen: Glavni namen našega dela, je bil poročati o kvaliteti življenja in ortotični oskrbi pacienta z osteoartrozo kolena in ugotoviti, katera ortoza najbolj izboljša kvaliteto življenja po osmih dneh uporabe. Metode dela: V poročilo o primeru smo vključili 59-letnega pacienta z osteoartrozo in spremljajočo varusno deformacijo. Odločili smo se, da bomo preizkusili in primerjali tri različne ortoze. Izdelali smo ortozo za stopalo in ortozo za gleženj in stopalo, kolensko ortozo pa smo uporabili serijsko štiri točkovno (Medi-protect.4 evo). Primarni izid smo merili s pomočjo Knee injury and Osteoarthritis Outcome Score vprašalnika, sekundarnega pa s pomočjo Testa hoje na 10 m in z merjenjem lateralnih odklonov goleni v frontalni ravnini z merilno napravo MotionPod. Rezultati: Izid Knee injury and Osteoarthritis Outcome Score vprašalnika je bil najboljši pri ortozi za gleženj in stopalo, nato pri ortozi za stopalo in nazadnje pri kolenski ortozi, kjer so se rezultati celo nekoliko poslabšali v primerjavi z začetnim stanjem. Pri Testu hoje na 10 m se je statistično izboljšala hitrost sproščene hoje z uporabo ortoze za gleženj in stopalo. Pri hitri hoji nismo zaznali pomembnih razlik. Merjenje lateralnih odklonov je pokazalo največje zmanjšanje kotov z uporabo ortoze za gleženj in stopalo, sledila ji je ortoza za stopalo in nazadnje kolenska ortoza, vendar razlike niso statistično pomembne. Razprava in zaključek: Kvaliteto življenja našega pacienta je najbolj izboljšala ortoza za gleženj in stopalo, ki je tudi najbolj primerna za vsakodnevne aktivnosti, za športne aktivnosti pa ortoza za stopalo. Kolenska ortoza se je za našega pacienta izkazala kot neučinkovita, preveč okorna in neudobna. V prihodnje bi bilo dobro vključevati kvaliteto življenja v vse raziskave, ki temeljijo na pacientih z osteoartrozo kolenskega sklepa. Čeprav so nekatere ortoze mehansko učinkovite in zmanjšujejo bolečine, pa jih pacienti zaradi neudobja in okornosti zavračajo. Z vključevanjem tovrstnih vidikov bi morda lahko pripomogli k boljšim rezultatom ortotične oskrbe in kvaliteti življenja pacientov z osteoartrozo kolenskega sklepa.

• Language: Slovenian
• Keywords: kvaliteta življenja, osteoartroza, varus kolena, ortoze, Knee injury and Osteoarthritis Outcome Score, Test hoje na 10 m
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2018
• PID: 20.500.12556/RUL-102946
• COBISS.SI-ID: 5483115
• Publication date in RUL: 12.09.2018

Secondary language

• Language: English
• Title: Quality of life and orthotic care of a patient with knee osteoarthritis : case report

Abstract

Introduction: Knee osteoarthritis has a significant adverse impact on health related quality of life. Recognizing therapies that improve health related quality of life in patients sufering from knee osteoarthritis may reduce the clinical, economic and social burden of this disease. Purpose: The primary aim of this study was to report on quality of life and orthotic care of a patient with knee related osteoarthritis and determining which orthotic is the most efficient at improving quality of life after eight days of use. Methods: A 59-year old male patient with knee osteoarthritis and varus deformity was included in this report. Three different types of orthoses were compared during the study. Foot orthosis and ankle foot orthosis used in this study were custom made and knee orthosis was of the shelf four point system brace (Medi-protect.4 evo). The primary outcome was assesed with Knee injury and Osteoarthritis Outcome Score questionnaire. Timed 10 m walk test was evaluated and angular measurements of thigh's lateral thrust during walking were made using MotioPod as a part of the secondary outcome. Results: Most of the Knee injury and Osteoarthritis Outcome Score subscales were improved by both ankle foot orthosis and foot orthosis but not the knee brace. Evaluation of relaxed timed 10 m walk test showed significant improvements in walking speed compared with initial measurements using ankle foot orthosis. On the other hand fast pace showed no differences between conditions whatsoever. The angles of lateral thrust were most reduced by ankle foot orthosis, following by foot orthosis and the knee brace, however no reduction was statistically significant. Discussion and conclusion: The custom made ankle foot orthosis improved quality of life of our patient and is the most suitable for activities of daily living. Foot orthosis would be recomended for sport activities in addition. Knee brace, however was found inapropriate due to the lack of improvement, bulkiness and discomfort alltogether. Future studies involving patients with knee osteoarthritis may want to consider including quality of life as a part of orthotic treatment outcome. In spite of mechanical effectiveness and success at reducing pain, some orthoses may have poor patient's compliance due to the lack of comfort and bulkiness thus reducing quality of life. Including this perspective in orthotic care may improve quality of life and treatment outcomes of patients with knee osteoarthritis.

• Keywords: quality of life, osteoarthritis, knee varus, orthoses, Knee injury and Osteoarthritis Outcome Score, 10 m walk test