Učinkovitost vadbe hoje v zunanjem okolju pri pacientih po možganski kapi : diplomsko delo

Sinožič, Jana (author), Puh, Urška (mentor), Rugelj, Darja (reviewer)

Uvod: Po možganski kapi je pogosto zmanjšana sposobnost hoje, zato je v času rehabilitacije eden izmed glavnih ciljev povrnitev funkcijske hoje, ki lahko pomeni tudi zmožnost hoje v zunanjem okolju. Za doseganje tega cilja in uspešno vrnitev pacientov v vsakodnevno življenje pa je poleg osnovne vadbe hoje v predvidljivem okolju potrebna še vadba hoje v realnem, nepredvidljivem okolju. Vadba hoje v zunanjem okolju se uporablja kot terapevtski postopek za izboljšanje sposobnosti hoje pri pacientih po možganski kapi, pripomore pa lahko tudi k povečanju motivacije za intenzivnejše sodelovanje pri terapiji, kar bi lahko pomagalo pri dodatnem izboljšanju sposobnosti hoje in sodelovanja. Namen: Namen diplomskega dela je bil pregledati izsledke raziskav o učinkovitosti vadbe hoje v zunanjem okolju pri pacientih po možganski kapi. Metode dela: Randomizirane kontrolirane poskuse smo iskali v podatkovnih zbirkah PubMed (MEDLINE), PEDro in Cochrane library. Rezultati: V pregled smo vključili pet randomiziranih kontroliranih poskusov, objavljenih med letoma 2008 in 2019. V štirih raziskavah so sodelovali preiskovanci v kroničnem obdobju po možganski kapi, v eni pa v subakutnem obdobju. Štiri raziskave so preiskovale učinkovitost vadbe hoje v zunanjem okolju in ena raziskava učinkovitost vadbe hoje v zunanjem okolju, simulirane z navidezno resničnostjo. Zaključek: Rezultati pregledanih raziskav kažejo na učinkovitost vadbe hoje v zunanjem okolju. V treh raziskavah so ugotovili statistično značilno višjo hitrost, v dveh pa daljšo prehojeno razdaljo med skupinama v prid eksperimentalni. Kljub temu pa preiskovanci v štirih raziskavah na testih niso dosegli minimalnih pogojev (0,8 m/s; 300 m), ki so potrebni za samostojno hojo v zunanjem okolju. V treh raziskavah, ki so po obdobju vadbe s testom hoje v zunanje okolju ugotovili statistično značilno razliko med skupinama v prid eksperimentalni. Pri preiskovancih eksperimentalnih skupin je imela vadba hoje v zunanjem okolju pozitiven vpliv na samozaupanje. V treh raziskavah je bila razlika med skupinama statistično značilna. Potrebnih je več raziskav na tem področju z večjim številom preiskovancev in enotnejšimi ocenjevalnimi orodij.

• Language: Slovenian
• Keywords: diplomska dela, fizioterapija, možganska kap, hoja, vadba v zunanjem okolju, sodelovanje, rehabilitacija
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [J. Sinožić]
• Year: 2020
• Number of pages: 28 str.
• PID: 20.500.12556/RUL-114114
• UDC: 615.8
• COBISS.SI-ID: 5779307
• Publication date in RUL: 16.02.2020

Secondary language

• Language: English
• Title: Effectivness of community walking training in patients after stroke : diploma work

Abstract

Introduction: Walking ability is often impaired in patients after stroke, so improving functional walking is one of the main goals during rehabilitation. In addition to basic walking exercise in a predictable environment, everyday life also requires walking in a real, unpredictable environment. The ability to walk in the patient's everyday environment is the ultimate goal of their rehabilitation. In recent years, community-based walking training has been used as a therapeutic procedure for improving walking ability of patients after stroke, this approach can enhance the patient's motivation to participate more intensively in therapy, which could help to further improve functional walking and participation. Purpose: The purpose of the diploma work was to review randomized controlled trials the effectiveness of community-based walking training in patients after stroke. Methods: Randomized controlled trials were searched in the PubMed (MEDLINE), PEDro, and Cochrane library databases. Results: We included five randomized controlled trials published between 2008 and 2019. Four studies included subjects in the chronic post-stroke period and one study included subjects in the subacute period. Four studies investigated the effectiveness of community-based walking training and one study investigated the effectiveness of virtual reality-based training on improving community ambulation. Conclusion: Research findings suggest that community-based walking training after a stroke has a better impact on community walking and participation. Walking speed has improved in all of the studies and in four of them, authors discovered a statistically significant difference between experimental and control groups. In two studies, subjects also improved the walking distance, and in three of them, Community walk test also showed a statistically significant difference, with the experimental groups being better than the control ones. Authors have also discovered that community-based walking training, positively affects persons fall-related self-efficacy. Participation has also improved in three of the studies, with the experimental groups being the better ones. More research is needed in this area, with larger number of subjects and more uniform assessment tools.

• Keywords: diploma theses, physiotherapy, stroke, walking, community ambulation, participation, rehabilitation