Učinkovitost terapije z ogledalom v rehabilitaciji okvarjenega zgornjega uda oseb po možganski kapi : diplomsko delo

Smolič, Patricija (author), Ocepek, Julija (mentor), Sicherl, Zorana (reviewer)

Uvod: Možganska kap vsako leto prizadene veliko število ljudi. Je tretji najpogostejši vzrok smrtnosti in eden izmed vodilnih vzrokov telesne in kognitivne oviranosti, ki posamezniku in njegovi družini spremeni kakovost življenja. Njene posledice uporabnikom spremenijo izvajanje vsakodnevnih aktivnosti s področja skrbi zase, dela in prostega časa, zato je za ustrezno preprečitev nadaljnjih zapletov ključnega pomena akutna rehabilitacija s strani rehabilitacijskega tima. Kot relativno nova in neinvazivna metoda z opazovanjem odseva gibanja neprizadetega uda v ogledalu, se v rehabilitaciji uporablja tudi terapija z ogledalom. Namen: Namen diplomskega dela je bil zbrati dokaze o učinkovitosti uporabe terapije z ogledalom za okvarjen zgornji ud pri osebah po možganski kapi. Metode: Uporabljen je bil sistematični pregled literature, ki je bila objavljena med leti 2009 in 2019. V analizo so bili vključeni članki v angleškem in slovenskem jeziku, s ključnimi besedami mirror therapy, effectiveness of mirror therapy, stroke patients, upper extremity function, occupational therapy, iskanimi v spletnih podatkovnih bazah Dikul, Sciencedirect, Cochrane library in Google učenjak. V analizo je bilo vključenih 14 člankov s pomočjo metode GRADE, ki temelji na ocenjevanju kvalitete in moči dokazov raziskav. Rezultati: Terapija z ogledalom je statistično pomembno izboljšala učinkovitost zgornjega uda z boljšim motoričnim načrtovanjem in tekočim gibanjem uda, boljšo koordinacijo ter manipulacijo s predmeti. Bolj kot gibanje proksimalnega dela, je bilo opazno izboljšanje gibanja distalnega dela uda, in sicer zapestnih ekstenzorjev, izvedba radialnih in ulnarnih deviacij ter fleksija in ekstenzija prstov. Terapija z ogledalom je zvišala okvarjeno raven senzibilitete dlani in prstov. Nekateri avtorji so ugotavljali tudi izboljšano mišično moč zgornjega uda. Pri dnevnih aktivnostih je bila opazna večja uporaba okvarjenega zgornjega uda in boljša kakovost izvedbe aktivnosti. Razprava in zaključek: Najučinkovitejša metoda terapije z ogledalom je izvajanje ponavljajočih se, na nalogo usmerjenih gibanj v povezavi z dnevnimi aktivnostmi, skupaj s programom standardne rehabilitacije. Terapija z ogledalom vpliva tudi na odpravo apraksije, personalnega in ekstrapersonalnega neglekta ter depresije. Uporaba terapije z ogledalom je najučinkovitejša 3–12 mesecev po možganski kapi. Delovnoterapevtska obravnava z uporabo kreativnega razmišljanja in pripravo individualnih nalog za uporabnike pripomore, da so koncentrirani in motivirani za izvedbo terapije z ogledalom.

• Language: Slovenian
• Keywords: diplomska dela, delovna terapija, terapija z ogledalom, učinkovitost terapije, osebe po možganski kapi, funkcija zgornjega uda, rehabilitacija
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [P. Smolič]
• Year: 2020
• Number of pages: 45 str., [7] str. pril
• PID: 20.500.12556/RUL-120527
• UDC: 615.851
• COBISS.SI-ID: 29153539
• Publication date in RUL: 21.09.2020

Secondary language

• Language: English
• Title: Effectiveness of mirror therapy on upper extremity rehabilitation in stroke patients : diploma work

Abstract

Introduction: Every year stroke affects a large amount of people by beeing the third most common cause of mortality and one of the leading causes of physical and cognitive imparement. It significantly changes the quality of life for an individual and his family. Its consequences hinders different aspects of daily living, such as: self-care, work and leisure. Acute rehabilitation with a team of experts is the key to prevent further complications of person's condition. Mirror therapy is known as relatively new and non-invasive method of rehabilitation where patient observes mirror reflection while moving his unaffected upper extremity. Purpose: The purpose of the work was to review the literature of the affectiveness of mirror therapy on upper extremity in stroke patients. Methods: A systematic review of the literature, published between 2009 and 2019 was conducted. The analysis included English and Slovenian articles with key words: mirror therapy, effectiveness of therapy, stroke patients, upper extremity function, occupational therapy. Literature was searched in online databases Dikul, Sciencedirect, Cochrane library and Google Scholar. Based on the GRADE method we reviewed 14 articles regarding to mirror therapy. Results: Mirror therapy significantlly improved upper limb efficacy with beneficial effects on motor planning, movement performance, coordination and manipulation with objects. More than movement of proximal parts, there was significantly improved movement of distal parts, such as wrist extensors, radial and ulnar deviators and finger flexors and extensors. Mirror therapy increased impared level of sensation of the palms and fingers. Furthermore, improvement of muscle strength in upper limb was found in few studies. There was observed increased use and quality of performance of more affected upper extremity in daily activities. Discussion and Conclusion: The most effective mirror therapy method would be performing repetative, task-oriented movements, referring to daily activities along with standard rehabilitation program. Mirror therapy also affects the elimination of apraxia, personal and extrapersonal neglect and depression. Aplication of mirror therapy was found to be most effective within 3–12 months after stroke. Occupational therapy using creative and individual tasks for patients allows them to be concentrated and motivated during therapy.

• Keywords: diploma theses, occupational therapy, mirror therapy, effectiveness of therapy, stroke patients, upper extremity function, rehabilitation