Ortotična oskrba skolioze pri pacientih s cerebralno paralizo : diplomsko delo

Brglez, Polona (author), Lampe, Tomaž (mentor), Horvat, Josip (co-mentor), Fošnarič, Miha (reviewer)

Uvod: Skolioza, ki nastane kot posledica mišičnega neravnovesja, se definira kot neuromuskularna skolioza. Zdravljenje je kompleksen proces, za katerega je primeren multidisciplinaren pristop. Cilj konservativnega zdravljenja pri pacientu s cerebralno paralizo je izboljšanje kontrole pri sedenju in zmanjšanje krivljenja hrbtenice. Pri neoperativnem zdravljenju se uporablja kombinacija spinalnih ortoz in prilagojenega sedeža v invalidskem vozičku. Namen: Namen naloge je opisati postopek odvzema mere in izdelave dvokalupne torakolumbosakralne ortoze, primerne za pacienta s cerebralno paralizo, ki ima nevromuskularno skoliozo, ter pregledati literaturo s tega področja s ciljem ugotavljanja kombinacije ortotičnega zdravljenja in prilagojenega sedeža v invalidskem vozičku. Metode dela: S pomočjo deskriptivne metode smo opravili pregled novejše domače in tuje literature, napisane v slovenskem ali angleškem jeziku, ter opisali postopek odvzema mere in izdelave dvokalupne torakolumbosakralne ortoze, ki je bil narejen na podlagi opazovanja inženirja ortotike in protetike pri delu. Rezultati: Pri pregledu literature je bilo uporabljenih 15 člankov, ki so se navezovali na konservativno zdravljenje neuromuskularne skolioze. Prav tako sta bila v celoti tehnično opisana odvzem mere in izdelava dvokalupne torakolumbosakralne ortoze, ki je najpogosteje uporabljena spinalna ortoza pri ortotičnem zdravljenju neuromuskularne skolioze. S članki je bilo ugotovljeno, da je ortotična oskrba pri zgodnjem zdravljenju neuromuskularne skolioze dokaj uspešna. Razprava in zaključek: Pri procesu zdravljenja neuromuskularne skolioze pri pacientih s cerebralno paralizo je pomembno pričeti z zdravljenjem čim prej, saj se krivine, ki še niso zatrjene, lažje zdravi. Kombinacija oskrbe s spinalno ortozo in prilagojenim sedežem v invalidskem vozičku je do neke mere uspešna, vendar je odvisno od obsega krivine in možnega napredovanja skolioze, ali bo potrebno operativno zdravljenje. Nujno bi bilo potrebno nadaljnje raziskovanje te teme, saj bi s tem tudi pripomogli k razvoju naše stroke.

• Language: Slovenian
• Keywords: diplomska dela, ortotika in protetika, cerebralna paraliza, neuromuskularna skolioza, TLSO, spinalne ortoze
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [P. Brglez]
• Year: 2020
• Number of pages: 34 str.
• PID: 20.500.12556/RUL-114798
• UDC: 617.3
• COBISS.SI-ID: 5786731
• Publication date in RUL: 12.03.2020

Secondary language

• Language: English
• Title: Orthotic treatment of scoliosis in patients with cerebral palsy : diploma work

Abstract

Introduction: Scoliosis that develops as a result of a muscular imbalance is defined as neuromuscular scoliosis. Its medical treatment is a complex process, in which a multidisciplinary approach is the most appropriate. The goal of conservative treatment in a patient with cerebral palsy is to improve sitting stability and reduce spinal curvature, which is achieved with the combination of using spinal orthosis and an adaptive seating system in a wheelchair. Purpose: To describe the measurement and fabrication of a custom-made thoracolumbosacral orthosis suitable for a patient with cerebral palsy and neuromuscular scoliosis, and to do a review of literature from this field to determine the successfulness of treatment with thoracolumbosacral orthosis combined with an adaptive seating system in a wheelchair. Methods: Using the descriptive method, we reviewed recent domestic and foreign literature, written in Slovene or English, and described the procedure of measurement and fabrication of a thoracolumbosacral orthosis, which was made based on observing an engineer of orthotics and prosthetics at work. Results: In the review of literature, we used 15 articles related to the conservative treatment of neuromuscular scoliosis. Furthermore, we also described in detail the technical procedure of fabricating the thoracolumbosacral orthosis, which is the most commonly used spinal orthosis for the orthotic treatment of neuromuscular scoliosis. With the help of the articles, we found that orthotic treatment is quite successful in the early treatment of neuromuscular scoliosis. Discussion and conclusion: It is important to begin treatment of neuromuscular scoliosis in the patients with cerebral palsy as soon as possible, since it is easier to manage the curves that are not yet rigid. The combination of spinal orthotics and a custom wheelchair seating is successful to some extent, as this depends on the extent of the curve and the possible progression of the scoliosis in case surgical treatment will be necessary. Further research on this topic would be needed to help develop our discipline.

• Keywords: diploma theses, orthotics and prosthetics, cerebral palsy, neuromuscular scoliosis, TLSO, spinal orthoses