Pregled ortoz pri bolnikih z amiotrofično lateralno sklerozo : diplomsko delo

Šilc, Nastja (author), Lampe, Tomaž (mentor), Pavlović, Monika (comentor), Levec, Tina (reviewer)

Uvod: Amiotrofična lateralna skleroza je progresivna bolezen zgornjega in spodnjega motoričnega nevrona, ki se kaže s togostjo mišic, izgubo mišične kontrole, nenadzorovanim trzanjem udov, mišično atrofijo in spastičnostjo. Deli se na tri faze in sicer na zgodnjo, srednjo in končno fazo. Bolezen se pogosteje pojavi pri moških kot pri ženskah in traja približno tri leta od pojava prvih simptomov do smrti, saj zanj ni zdravila. Zdravljenje je usmerjeno k obvladovanju in lajšanju simptomov s ciljem izboljšanja kakovosti življenja. Eden od načinov konservativnega zdravljenja je tudi uporaba ortoz za zgornje in spodnje ude ter spinalnih ortoz. Namen: Namen diplomskega dela je bil opraviti pregled strokovne in znanstvene literature na temo ortoz, ki se uporabljajo pri bolnikih z ALS s ciljem ugotovitve njihove učinkovitosti. Metode dela: Literaturo smo iskali v angleškem jeziku s pomočjo podatkovnih baz PubMed in ScienceDirect. Uporabili smo ključne besede: (als OR amyotrophic lateral sclerosis) AND (orthosis OR brace OR hand orthosis OR cervical orthosis). Vključene so bile prosto dostopne raziskave, objavljene v zadnjih 10 letih, ki so vključevale uporabo ortoz pri bolnikih z amiotrofično lateralno sklerozo. Rezultati: Na podlagi vključitvenih in izključitvenih kriterijev smo vključili 10 raziskav. V petih raziskavah so opisovali vratne ortoze; tri raziskave so vključevale ortoze za zgornje ude in dve raziskavi ortoze za spodnje ude. V teh študijah so se raziskovali in opisovali funkcije in učinkovitost posameznih ortoz. Skupni pozitivni učinki, ki jih ortoze zagotavljajo, so: povečana opora, boljša gibljivost in bolj nadzorovano gibanje. Razprava in zaključek: Ugotovili smo, da so pri bolnikih z amiotrofično lateralno sklerozo najbolj pogosto uporabljene in učinkovite vratne ortoze. Vratne ortoze nudijo podporo pri osnovnih življenjskih potrebah (dihanje in prehranjevanje); poleg tega lahko izboljšajo tudi komunikacijo in govor. Zaradi hitre progresivnosti bolezni je potrebno ortoze pogosto prilagajati in prav vratne ortoze se najlažje in najučinkovitejše prilagajajo. Na tem področju je opravljenih malo raziskav, zato bi bilo za boljše razumevanje ortotične oskrbe v prihodnje priporočljivo izvesti obsežnejše raziskave na to temo.

• Language: Slovenian
• Keywords: diplomska dela, ortotika in protetika, bolezen motoričnega nevrona, ortotična oskrba, ortoze za zgornje ude, ortoze za spodnje ude, spinalne ortoze
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [N. Šilc]
• Year: 2020
• Number of pages: 34 str.
• PID: 20.500.12556/RUL-116976
• UDC: 617.3
• COBISS.SI-ID: 20051715
• Publication date in RUL: 18.06.2020

Secondary language

• Language: English
• Title: Review of orthoses in patients with amyotrophic lateral sclerosis : diploma work

Abstract

Introduction: Amyotrophic lateral sclerosis is a progressive upper and lower motor neuron disease manifested by muscle stiffness, loss of muscle control, uncontrolled twitching of limbs, muscle atrophy, and spasticity. It is divided into three phases: the early, the middle, and the final. The disease is more common in men and lasts about three years from the onset of the first symptoms as there is no cure. The treatment aims to control and relieve symptoms to improve the quality of life. Methods of conservative treatment include the use of orthoses for the upper and lower limbs and spinal orthoses. Purpose: This diploma work aimed to review the scientific literature on orthoses used in patients with amyotrophic lateral sclerosis concerning to determine their effectiveness. Methods: The literature search was carried out in English using the online databases PubMed and ScienceDirect. The keywords used were (als OR amyotrophic lateral sclerosis) AND (orthosis OR brace OR hand orthosis OR cervical orthosis). Full-text articles published in the last 10 years that included the use of orthoses in patients with ALS were included. Studies older than 10 years were excluded. Results: Based on the inclusion and exclusion criteria, 10 studies were included. Five studies described cervical orthoses. Three studies included orthoses for the upper limbs and two studies included orthoses for the lower limbs. These studies investigated and described the function and efficiency of orthoses. The overall positive effects that orthoses provide are increased support, better mobility, and improved motion control. Discussion and conclusion: We found that cervical orthoses are most commonly used and most effective in patients with amyotrophic lateral sclerosis. They provide support for basic human needs (breathing and nutrition) and can also improve communication and speech. Due to the rapid progression of the disease, the orthoses often need to be adjusted. Therefore, neck orthoses are the easiest to adjust and are considered to be the most effective. Small number of research has been done in this field so far. For a better understanding of orthotic care, however, more complex research on this topic is recommended for the future.

• Keywords: diploma theses, orthotics and prosthetics, motor neuron disease, orthotic care, upper limb orthoses, lower limb orthoses, spinal orthoses