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Z dokazi podprti fizioterapevtski postopki po nihajni poškodbi vratne hrbtenice - pregled literature : diplomsko delo
Dolenc, Larisa (Author), Hlebš, Sonja (Mentor) More about this mentor... This link opens in a new window, Ipavec, Matej (Co-mentor)

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Abstract
Uvod: Nihajna poškodba vratne hrbtenice v svetu predstavlja velik problem. Poškodba najpogosteje nastane pri prometnih nesrečah ob naletu avtomobila od zadaj ali s strani. Pri tem pride do zanihanja glave in vratne hrbtenice naprej ter nazaj, kar lahko vodi do različnih mehko-tkivnih poškodb vratnega dela. Prisotni so lahko simptomi, kot so vrtoglavica, vratna bolečina, mišična napetost itd. Zdravljenje nihajne poškodbe je lahko dolgotrajno. O prisotni vratni bolečini po enem letu od poškodbe poroča še približno polovica poškodovancev. Ustrezno rehabilitacijo s primernimi fizioterapevtskimi postopki določimo s kliničnim pregledom poškodovanca. Namen: Predstaviti smo želeli z dokazi podprte fizioterapevtske postopke pri rehabilitaciji nihajne poškodbe vratne hrbtenice. Metode dela: S podatkovnimi bazami preko oddaljenega dostopa smo pridobili 9 ustreznih raziskav z radomiziranim kontroliranim poskusom. Raziskave so bile objavljene med leti 2010 in 2016 ter so vključevale poskuse glede učinkovitosti nekaterih fizioterapevtskih postopkov. Rezultati: Glavni rezultati kažejo, da s tehniko manualne terapije lahko vplivamo na modulacijo fleksorskega refleksa, s tem da lahko povečamo prag fleksornega refleksa. Pri nekaterih poškodovancih z nihajno poškodbo vratne hrbtenice ustrezno učinkuje celostna fizioterapevtska obravnava. Pri nekaterih poškodovancih pa k izboljšanju nihajne poškodbe pripomore že ustrezna zdravstvena vzgoja poškodovanca s strani fizioterapevta glede primernih domačih telesnih aktivnosti in samooskrbe. S primernimi vestibularnimi vajami lahko zmanjšamo vratno bolečino in izboljšamo vratne gibljivosti. Razprava in sklep: Pri rehabilitaciji nihajne poškodbe je za pozitiven izid poleg obravnave mišično-skeletnih težav potrebno vključiti še obravnavo možnih prisotnih psihološko-osebnostnih težav, ki največkrat izvirajo iz posttravmatskega stresa. Pri teh poškodovancih se je za najbolj učinkovito izkazala fizioterapevtska obravnava z vedenjskim pristopom. Ker se zdravljenje nihajne poškodbe začne že na urgentnem oddelku, naj bi ustrezen prvi kontakt s poškodovancem pozitivno vplival na izid rehabilitacije. Za učinkovito fizioterapevtsko obravnavo je nujno potrebno vključevanje kvalitetne in primerne zdravstvene vzgoje poškodovanca, s strani fizioterapevtov glede domače samooskrbe. Še vedno je potrebno raziskati tudi dodatne možnosti, ki bi na izid rehabilitacije še pozitivneje vplivale.

Language:Slovenian
Keywords:nihajna poškodba, fizioterapija, rehabilitacija, vratna bolečina, prometne nesreče
Work type:Bachelor thesis/paper (mb11)
Organization:ZF - University College of Health Studies
Year:2017
COBISS.SI-ID:5236587 Link is opened in a new window
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Downloads:995
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Secondary language

Language:English
Title:Evidence-based physiotherapy for cervical whiplash - literature review : graduation thesis
Abstract:
Introduction: Whiplash injury represents a great issue in the world. The injury most commonly occurs as a result of a side- or a rear-impact car collision. The sudden jolting movement of the head and the resulting strain on the cervical vertebrae can lead to various soft tissue injuries in the neck area. Some of the symptoms are dizziness, neck pain, and muscle stiffness. Treatment of the whiplash injury can often be time–consuming. About a half of the patients report neck pain even a year after the initial injury. Adequate rehabilitation with physiotherapy procedures is determined through clinical examination. Purpose: We wanted to present factually supported physiotherapy procedures in the process of whiplash rehabilitation. Methods: We remotely accessed relevant databases and acquired 9 appropriate studies that were based on a randomised controlled experiment. Studies were published between years 2010 and 2016. They included tests regarding the effectiveness of certain physiotherapy procedures. Results: The main results show that we can influence the modulation of flexor reflex with manual therapy. Complete physiotherapy treatment is efficient in the injured patients, though some already benefit greatly from individual physiotherapy education about the injury and physical activity in their home environment. Exercises for stimulation of the vestibular balance may cause a pain reduction of the present cervical spine injury and improve neck flexibility. Discussion and Conclusion: In the rehabilitation of whiplash injury not only a treatment of musculoskeletal problems, but also consideration of a possible presence of psychological-personal problems that often originate from post-traumatic stress, are needed for a positive result. Physiotherapy treatment with a behavioural approach proved to be most efficient in these cases. Since the treatment of whiplash injury starts in the emergency room, a positive first contact with the injured person supposedly positively affects the outcome of rehabilitation. However, for effective physiotherapy treatment, integration of adequate physiotherapy lessons about appropriate domestic activity is necessary. That being said, it is still necessary to explore additional options that positively impact outcome of the rehabilitation.

Keywords:whiplash injury, physiotherapy, rehabilitation, neck pain, car accidents

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