Učinek udarnih globinskih valov pri pacientih s kronično bolečino v spodnjem delu hrbta - pregled literature : diplomsko delo

Doler, Nejc (author), Kacin, Alan (mentor), Hlebš, Sonja (reviewer)

Uvod: Kronična bolečina v spodnjem delu hrbta (KBSH) je najpogostejša mišično-skeletna okvara pri odraslih ljudeh. Definirana je kot bolečina ali nelagodje, lokalizirano pod rebrnim robom in nad zadnjičnim gubam, z ali brez spremljajoče bolečine v nogi, ki traja vsaj 12 tednov. Pacienti s KBSH predstavljajo skoraj tretjino vseh pacientov napotenih na fizioterapijo. Fizioterapija KBSH vključuje zlasti kinezioterapijo in manualno terapijo, ki se ju dopolnjuje z različnimi tehnikami protibolečinske terapije s fizikalnimi agensi. Ena izmed obetavnih novih tehnik fizikalne terapije mišično-skeletnih okvar je aplikacija izven-telesnih udarnih globinskih valov. Namen: Namen diplomskega dela je s pomočjo strokovne literature ugotoviti učinkovitost uporabe fokusnih ali radialnih udarnih globinskih valov pri pacientih s KBSH. Metode dela: Izveden je bil pregled literature z analizo znanstvene in strokovne literature z uporabo podatkovnih zbirk PubMed, PEDro, ScienceDirect, Cochrane in raziskovalnega omrežja ResearchGate. Glavni vključitveni kriteriji so bili: preiskovanci stari nad 18 let s KBSH, prosto dostopni članki v celotnem obsegu, članki v angleškem jeziku in uporaba fokusnih ali radialnih udarnih globinskih valov. Rezultati: V pregled literature je bilo glede na vključitvene kriterije vključenih šest raziskav. Avtorji raziskav so merili predvsem učinek na bolečino, v večini raziskav pa tudi vpliv na telesne zmožnosti in kakovost življenja. Rezultati so v vseh šestih raziskavah pokazali statistično pomembno zmanjšanje bolečine. Ocena bolečine po vizualni analogni lestvici se je izboljšala od 38 do 71 % ob zadnjem merjenju. Prav tako je bilo izmerjeno tudi izboljšanje funkcijskega stanja pacientov. Izboljšale so se vrednosti merjenja telesne zmožnosti, depresije, kakovosti življenja, obsega gibljivosti ledvene hrbtenice in ravnotežja. Razprava in zaključek: Udarni globinski valovi lahko predstavljajo varno in učinkovito tehniko zdravljenja kronične bolečine v spodnjem delu hrbta. Kaže se potreba po standardizaciji protokola aplikacije udarnih globinskih valov pri tovrstnih pacientih. Za dokončno uveljavitev te fizioterapevtske tehnike so potrebne nadaljnje raziskave na večjih vzorcih in z daljšim časom spremljanja učinkov terapije.

• Language: Slovenian
• Keywords: diplomska dela, fizioterapija, udarni globinski valovi, kronična bolečina, bolečina v križu
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [N. Doler]
• Year: 2022
• Number of pages: 31 str.
• PID: 20.500.12556/RUL-141182
• UDC: 615.8
• COBISS.SI-ID: 122876419
• Publication date in RUL: 24.09.2022

Secondary language

• Language: English
• Title: Effects of extracorporeal shock wave therapy in patients with chronic low back pain - literature review : diploma work

Abstract

Introduction: Low back pain is the most common musculoskeletal condition affecting the adult population. It is defined as pain or discomfort localized below the costal margin and above the inferior gluteal folds, with or without referred leg pain, and pain that lasts for at least twelve weeks. Almost a third of all physiotherapy sessions consist of patients with chronic low back pain. Physical therapy for these patients most commonly consist of kinesitherapy and manual therapy, and complemented with different physical agents. One of the promising new techniques of physical therapy for the treatment of musculoskeletal impairments is extracorporeal shock wave therapy. Purpose: The purpose of this diploma work is to assess effects of focused and radial extracorporeal shock wave therapy in patients with chronic low back pain using scientific literature. Methods: Literature for the systematic review was searched on databases PubMed, PEDro, ScienceDirect, Cochrane and research network ResearchGate. The main inclusion criteria were patients over the age of 18 with chronic low back pain, fully accessible articles in English language and use the use of radial or focused extracorporeal shock wave therapy. Results: Six articles were included in the systematic review based on the inclusion criteria. Authors of the articles mostly assessed effects on pain and in most studies also on physical function and quality of life. Results in all six articles showed statistically significant improvements in pain intensity. Pain intensity reduced from 38% to 71% on the visual analogue scale. Functional efficiency also improved. There was an improvement in physical ability, depression, quality of life, range of motion of the lumbar spine and balance. Discussion and conclusion: Extracorporeal shock wave therapy can present a safe and effective method for the treatment of chronic low back pain. Further studies are needed to determine a standard protocol of the application of extracorporeal shockwave therapy for these patients. Studies with larger sample sizes and long-term observations also need to be conducted.

• Keywords: diploma theses, physiotherapy, ESWT, chronic pain, lumbar pain