Izvedbena utrudljivost in občutenje utrujenosti ter povezanost s funkcijskimi testi pri spinalni mišični atrofiji : diplomsko delo

Pretnar, Laura (author), Leonardis, Lea (mentor), Puh, Urška (reviewer)

Uvod: Spinalna mišična atrofija je genetska živčno-mišična bolezen, ki prizadene alfa motorične nevrone sprednjega roga hrbtenjače. Kaže se kot mišična atrofija ter oslabelost. Bolniki s spinalno mišično atrofijo so glede na starost ob nastopu bolezni in njihove najvišje dosežene funkcijske sposobnosti razdeljeni v pet podtipov. Namen: Z desetkratnim izvajanjem testa devetih zatičev smo želeli ugotoviti, ali so bolniki s spinalno mišično atrofijo bolj dovzetni za izvedbeno utrudljivost mišic roke v primerjavi z zdravimi preiskovanci. Zanimalo nas je ali obstaja razlika v občutenju utrujenosti med omenjenima skupinama ter ali pri bolnikih s spinalno mišično atrofijo obstaja povezanost funkcijskih lestvic gibalnih sposobnosti z izvedbeno utrudljivostjo mišic roke. Metode dela: V raziskavi je sodelovalo 20 odraslih bolnikov s spinalno mišično atrofijo in 20 zdravih preiskovancev s podobnimi demografskimi podatki. Vsi so za namen ocene izvedbene utrudljivosti desetkrat neprekinjeno z dominantno roko izvedli test devetih zatičev, nato pa izpolnili Lestvico izražene utrujenosti. Poleg tega smo pridobili že zbrane podatke dveh funkcijskih lestvic in sicer Razširjene Hammersmithove lestvice gibalnih sposobnosti in Revidiranega testa modula zgornjih udov. Rezultati: Ugotovili smo, da imajo bolniki s spinalno mišično atrofijo pri vseh desetih izvedbah testa devetih zatičev daljši čas izvajanja posamezne izvedbe v primerjavi z zdravimi preiskovanci. Bolniki s spinalno mišično atrofijo tipa 2 so bolj dovzetni za izvedbeno utrudljivost mišic roke v primerjavi z bolniki s spinalno mišično atrofijo tipa 3/4. Bolniki s spinalno mišično atrofijo so na Lestvici izražene utrujenosti dosegli večje število točk kot zdravi preiskovanci. Pri bolnikih s spinalno mišično atrofijo obstaja zelo visoka do odlična negativna povezanost časa izvajanja 10 izvedb testa devetih zatičev s funkcijskima lestvicama gibalnih sposobnosti. Razprava in zaključek: Bolniki s spinalno mišično atrofijo so dovzetni za izvedbeno utrudljivost in navajajo večjo občuteno utrujenost. Oboje pomembno vpliva na kakovost življenja, zato bi v prihodnje morali pri spremljanju učinka novih zdravil ocenjevati tudi vpliv na izvedbeno utrudljivost in občutenje utrujenosti. Prav tako bi ju morali upoštevati tudi pri načrtovanju fizioterapevtske obravnave.

• Language: Slovenian
• Keywords: diplomska dela, fizioterapija, spinalna mišična atrofija, test devetih zatičev, izvedbena utrudljivost, občutena utrujenost
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [L. Pretnar]
• Year: 2023
• Number of pages: 42 str., [3] str. pril.
• PID: 20.500.12556/RUL-144054
• UDC: 615.8
• COBISS.SI-ID: 139873795
• Publication date in RUL: 29.01.2023

Secondary language

• Language: English
• Title: Performance fatigability and perceived fatigue and the correlation with functional tests in spinal muscular atrophy : diploma work

Abstract

Introduction: Spinal muscular atrophy is a genetic neuromuscular disease affecting the alpha motor neurons of the anterior horn of the spinal cord. It manifests as muscle atrophy and weakness. Patients with spinal muscular atrophy are divided into five subtypes according to their age at onset and their peak functional ability. Purpose: We aimed to determine whether patients with spinal muscular atrophy are more susceptible to performance fatigability of the arm muscles compared with healthy subjects by performing the Nine-Hole Peg Test ten times. We were interested in whether there was a difference in perceived fatigue between the two aforementioned groups and whether there was a correlation between the functional scales and performance fatigability of arm muscles in patients with spinal muscular atrophy. Methods: The study included 20 adult patients with spinal muscular atrophy and 20 healthy subjects with similar demographics. All of them performed the Nine-Hole Peg 10 times continuously with the dominant hand to assess performance fatigability and then completed the Fatigue Severity Scale. In addition, we obtained previously collected data from two functional scales, namely the Expanded Hammersmith Functional Motor Scale and the Revised Upper Limb Module. Results: We found that patients with spinal muscular atrophy had a longer time to perform each execution of the Nine-Hole Peg Test compared to healthy subjects. Patients with spinal muscular atrophy type 2 are more susceptible to performance fatigability of the arm muscles compared to patients with spinal muscular atrophy type 3/4. Patients with spinal muscular atrophy had higher score on the Fatigue Severity Scale than healthy subjects. In patients with spinal muscular atrophy, there is a strong negative correlation between the time of performing 10 executions of the Nine-Hole Peg Test and the functional scales. Discussion and conclusion: Patients with spinal muscular atrophy are susceptible to performance fatigability and report greater perceived fatigue. Both have a significant impact on the quality of life, and future monitoring of the effects of new medications should also assess the impact on performance fatigability and perceived fatigue. They should also be included in the planning of physiotherapy treatment.

• Keywords: diploma theses, physiotherapy, spinal muscular atrophy, nine-hole peg test, performance fatigability, perceived fatigue