Fizioterapevtski pristopi pri zdravljenju sindroma mišice piriformis : diplomsko delo

Mikolič, Janez (author), Divjak, Mojca (mentor)

Uvod: Sindrom mišice piriformis je nevromuskularna motnja s številnimi simptomi. Značilna je bolečina v zadnjici, ki lahko seva posteriorno po spodnjem udu. Najpogosteje se pojavi v četrtem in petem desetletju posameznikovega življenja, letno pa se z njim sooči od 6-8% bolnikov z bolečinami v križu. Stanje se zaradi značilnosti medenice večkrat pojavi pri ženskah. Največkrat se pojavi po travmatski poškodbi ali lokalni ishemiji. Pri zaznavanju sindroma mišice piriformis sta ključna anamneza in klinični pregled. Stanje poslabša sedeči položaj za obdobje, daljše od 20 min. Diagnostične preiskave se uporabljajo za izključevanje diferencialnih diagnoz. Najučinkovitejša zdravstvena disciplina pri zdravljenju je fizioterapija, ki temelji na raztezanju in sproščanju mišice piriformis. Namen: Namen diplomskega dela je s pregledom literature ugotoviti uspešnost fizioterapevtskih pristopov pri zdravljenju sindroma mišice piriformis. Metode dela: Opravljen je bil pregled strokovne literature, objavljene med leti 2000 in 2017. Za iskanje ustrezne literature so bile uporabljene podatkovne baze MEDLINE, CINAHL in PubMed. Uporabljene ključne besede so bile: sindrom mišice piriformis, fizioterapija, zdravljenje, tehnike raztezanja in sproščanja mišice, dekompresija živca. Rezultati: V pregled literature je bilo glede na izključitvene in vključitvene kriterije vključenih sedem raziskav. Fizioterapevtski postopki so bili predstavljeni in ovrednoteni v petih raziskavah. Zaradi pomanjkanja raziskav, boljše primerljivosti in pogostosti načina zdravljenja, smo vključili še dve raziskavi, ki obravnavata zdravljenje s terapevtskimi blokadami. Raziskave, ki so vključevale fizioterapevtski pristop in postopke so pokazale znatno in dolgotrajno izboljšanje. Terapevtske blokade so se pokazale kot učinkovit način zdravljenja, vendar niso beležile dolgotrajno olajšanje simptomov. Razprava in zaključek: Glede na rezultate pregleda literature, lahko potrdimo, da je fizioterapija najučinkovitejša zdravstvena disciplina pri zdravljenju sindroma mišice piriformis, ki mora biti usmerjena v raztezanje in sproščanje m. piriformis, saj s tem povzroči dekompresijo n. ischiadicusa.

• Language: Slovenian
• Keywords: sindrom mišice piriformis, fizioterapija, zdravljenje, tehnike raztezanja in sproščanja mišice, dekompresija živca
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2018
• PID: 20.500.12556/RUL-105417
• COBISS.SI-ID: 5540459
• Publication date in RUL: 28.11.2018

Secondary language

• Language: English
• Title: Physiotherapeutic approaches in the treatment of piriformis muscle syndrome : diploma work

Abstract

Introduction: Piriformis muscle syndrome is a neuromuscular disorder with many symptoms. The most common symptom is back pain which can radiate posteriorly to the lower limb. It most often occurs in the fourth and fifth decade of an individual's life, and affects 6-8% back pain patients anually. Due to the characteristics of the pelvis, the condition mostly affects women and is often brought on by traumatic injury or local ischaemia. When detecting piriformis muscle syndrome, anamnesis and clinical examination are the most valuable tools. Diagnostic tests are used to exclude differential diagnoses. The most effective medical discipline in treatment is physiotherapy, which is based on the stretching and relaxation of the piriformis muscle. Purpose: The purpose of this diploma thesis is to determine the success of physiotherapeutic approaches in the treatment of piriformis muscle syndrome. Methods: A review of the literature published between 2000 and 2017 was performed. The databases CINAHL, MEDLINE were used, together with PubMed to identify the appropriate studies. The key words used were: piriformis muscle syndrome, physiotherapy, treatment, stretching techniques, relaxation techniques, nerve decompression. Results: Seven studies were included in the literature review according to exclusion and inclusion criteria. Physiotherapy procedures have been presented and evaluated in five studies. Due to lack of research, better comparability and frequency of treatment, two other studies that involve treatment with therapeutic blockages have been included. Research involving a physiotherapeutic approach and procedures has shown a significant and lasting improvement. Therapeutic blockages have proven to be an effective method of treatment but did not record any long-term symptoms of relief. Discussion and conclusion: According to the results of the review, it can be confirmed that physiotherapy is the most effective medical discipline in the treatment of piriformis muscle syndrome, which must be aimed at stretching and relaxation of the piriformis muscle, as this causes decompression of the sciatic nerve.

• Keywords: piriformis muscle syndrome, physiotherapy, rehabilitation, stretching techniques, relaxation techniques, nerve decompression