Vpliv proprioceptivne nevromuskularne facilitacije na ravnotežje in hojo pri bolnikih po možganski kapi - pregled literature : diplomsko delo

Šadek, Ivana (author), Palma, Polona (mentor), Kovačič, Tine (reviewer)

Uvod: Možganska kap je posledica prekinitve dotoka krvi v možgane zaradi rupture ali zapore krvne žile, kar pripelje do poškodbe možganovine. Pri bolnikih po možganski kapi je tipično prisoten asimetričen vzorec hoje, pri čemer obstaja korelacija med stopnjo izraženosti asimetrije, slabšanjem ravnotežja ter upadom hitrosti hoje. Izboljšanje sposobnosti ravnotežja in povrnitev funkcije hoje so pomemben cilj zdravljenja bolnikov po možganski kapi. Proprioceptivna nevromuskularna facilitacija je koncept, ki preko stimulacije različnih receptorjev v telesu izboljšuje bolnikove sposobnosti za zadrževanje položaja ali izvajanje gibanja, zato se pri bolnikih pogosto uporablja za izboljšanje ravnotežja in hoje. Namen: Namen diplomskega dela je bil na podlagi pregleda literature ugotoviti učinkovitost uporabe vzorcev proprioceptivne nevromuskularne facilitacije za medenico in/ali spodnje ude na izboljšanje ravnotežja in hoje pri bolnikih po možganski kapi. Metode dela: V diplomskem delu smo uporabili deskriptivno metodo na podlagi pregleda literature. Iskanje literature je potekalo v podatkovnih zbirkah Cinahl, Cochrane library, PEDro, Pubmed in Science Direct s ključnimi besedami ali besednimi zvezami v angleškem jeziku: proprioceptive neuromuscular facilitation AND stroke AND (balance OR gait). Rezultati: V pregled literature je bilo vključenih 6 randomiziranih kontroliranih raziskav, ki so bile ocenjene po PEDro lestvici z ocenami v razponu 5 do 9. Od vključenih 6 raziskav je 5 raziskav preučevalo učinek proprioceptivne nevromuskularne facilitacije na ravnotežje, v štirih od šestih raziskav pa so preučevali učinek proprioceptivne nevromuskularne facilitacije na hojo. V vseh 5 raziskavah, ki so preučevale učinkovitost proprioceptivne nevromuskularne facilitacije na ravnotežje pri bolnikih po možganski kapi, je prišlo do izboljšanja, ki je bilo statistično pomembno v štirih raziskavah. V raziskavah, ki so preučevale vpliv proprioceptivne nevromuskularne facilitacije na hojo pri bolnikih po možganski kapi, v eni raziskavi ni prišlo do sprememb, v ostalih treh je prišlo do statistično pomembnega izboljšanja. Razprava in zaključek: Rezultati kažejo, da je izvajanje vzorcev proprioceptivne nevromuskularne facilitacije za medenico in/ali spodnji ud smiselno vključiti v fizioterapevtsko obravnavo bolnikov po možganski kapi, saj izboljšajo ravnotežje in hojo. V prihodnje bi bilo potrebno še raziskati dolgoročne učinke izvajanja vzorcev proprioceptivne nevromuskularne facilitacije pri bolnikih po možganski kapi.

• Language: Slovenian
• Keywords: diplomska dela, fizioterapija, proprioceptivna nevromuskularna facilitacija, možganska kap, ravnotežje, hoja
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [I. Šadek]
• Year: 2023
• Number of pages: 28 str., [7] str. pril.
• PID: 20.500.12556/RUL-151647
• UDC: 615.8
• COBISS.SI-ID: 168464131
• Publication date in RUL: 14.10.2023

Secondary language

• Language: English
• Title: The effect of the proprioceptive neuromuscular facilitation on balance and walking in stroke patients – literature review : diploma work

Abstract

Introduction: Stroke results from interruption of blood supply to the brain due to rupture or blockage of a blood vessel, which leads to brain damage. Post-stroke patients typically exhibit an asymmetric gait pattern, with a correlation between the degree of asymmetry, the deterioration of balance and the decline in gait velocity. Improving balance and regaining walking function are important treatment goals for stroke patients. Proprioceptive neuromuscular facilitation is a concept that improves a patient's ability to hold a position or perform a movement by stimulating different receptors in the body, which is why it is often used to improve balance and gait in patients. Purpose: This thesis aims to review the literature to determine the effectiveness of proprioceptive neuromuscular facilitation patterns for the pelvis and/or lower limbs in improving balance and gait in post-stroke patients. Methods: In the diploma thesis, we used a descriptive method based on a literature review. The literature search was conducted in the Cinahl, Cochrane Library, PEDro, Pubmed and Science Direct databases using the following keywords or phrases in English: proprioceptive neuromuscular facilitation AND stroke AND (balance OR gait). Results: The literature review included six randomized controlled trials rated on the PEDro scale with scores ranging from 5 to 9. Of the six studies included, 5 investigated the effect of proprioceptive neuromuscular facilitation on balance, and 4 of the 6 investigated the effect of proprioceptive neuromuscular facilitation on walking. All five studies that examined the effectiveness of proprioceptive neuromuscular facilitation on balance in stroke patients showed change, which was statistically significant in four of them. In the studies examining the effect of proprioceptive neuromuscular facilitation on walking in stroke patients, one study showed no change, while the other three showed a statistically significant improvement. Discussion and Conclusion: The results suggest that it is reasonable to include proprioceptive neuromuscular facilitation patterns for the pelvis and/or lower limb in the physiotherapy treatment of post-stroke patients, as they improve balance and gait. Future research should further investigate the long-term effects of proprioceptive neuromuscular facilitation patterns in post-stroke patients.

• Keywords: diploma theses, physiotherapy, proprioceptive neuromuscular facilitation, stroke, balance, gait