Vpliv ekscentrične vadbe pri osebah s tendinopatijo rotatorne manšete: pregled literature : diplomsko delo

Borovnik, Aleksandra (author), Kacin, Alan (mentor), Palma, Polona (comentor), Hlebš, Sonja (reviewer)

Uvod: Tendinopatija je splošen izraz, ki se nanaša na poškodbe kit, nastalih zaradi prevelike mehanske obremenitve. Najpogostejši vzrok za nastanek tendinopatije rotatorne manšete je kombinacija mehanične kompresije in izvajanje ponavljajočih se gibov nad glavo. Posledica tega je prisotnost bolečine in šibkost mišic ramenskega obroča, še posebej med gibi elevacije in zunanje rotacije ramenskega sklepa. Najboljša z dokazi podprta izbira zdravljenja tendinopatije je vadba. Ekscentrična vadba vsebuje ekscentrično kontrakcijo, kjer pride do fizičnega podaljševanja mišice, ki nadzoruje obremenitev. Ekscentrična vadba je uspešna za zmanjševanje bolečine in izboljšanje funkcije pri zdravljenju tendinopatije Ahilove kite. Namen: Namen diplomskega dela je na podlagi pregleda literature ugotoviti vpliv ekscentrične vadbe na zmanjšanje bolečine, povečevanje jakosti mišic ramenskega obroča in izboljšanje funkcije rame pri tendinopatiji rotatorne manšete. Metode dela: V diplomskem delu smo uporabili deskriptivno metodo s pregledom literature. Literatura je bila iskana v podatkovnih zbirkah PubMed, PEDro in DiKUL v angleškem jeziku. Iskali smo s ključnimi besedami: eccentric exercise, phsyiotherapy, tendinopathy, rotator cuff. Rezultati: V analizo je bilo vključenih pet raziskav, v katerih so primerjali ekscentrično vadbo z ostalimi oblikami vadbe za zdravljenje tendinopatije rotatorne manšete. V dveh raziskavah so preiskovanci v eksperimentalni skupini izvajali ekscentrično vadbo skupaj z nespecifičnimi vajami za mišice rotatorne manšete, medtem ko so v treh raziskavah preiskovanci v eksperimentalni skupini izvajali samo ekscentrično vadbo. Preiskovanci so v raziskavah izvajali vaje od 8 do 12 tednov. Intenziteta vadbe se je v raziskavah razlikovala. Analiza rezultatov je pokazala, da izolirana ekscentrična vadba ne doprinese k boljšim rezultatom zmanjšanja bolečine, povečanju obsega gibljivosti in izboljšanju funkcije v rami v primerjavi s koncentrično vadbo. Razprava in zaključek: Kombinacija ekscentričnih in koncentričnih vaj zmanjša bolečino, izboljša funkcijo rame in obseg gibljivosti v rami pri osebah s tendinopatijo rotatorne manšete. V prihodnje bi bilo treba opraviti še dodatne raziskave, da bi ocenili učinkovitost kombinirane vadbe, ekscentrične in koncentrične vadbe, ugotovili, kakšen je dolgoročni učinek posamezne vadbe, ter določili optimalne parametre za najboljši izid vadbe.

• Language: Slovenian
• Keywords: diplomska dela, fizioterapija, tendinopatija rotatorne manšete, ekscentrična vadba
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [A. Borovnik]
• Year: 2022
• Number of pages: 25 str., [4] str. pril.
• PID: 20.500.12556/RUL-139546
• UDC: 615.8
• COBISS.SI-ID: 120313347
• Publication date in RUL: 04.09.2022

Secondary language

• Language: English
• Title: The effect of eccentric exercise at patients with rotator cuff tendinopathy: literature review : diploma work

Abstract

Introduction: Tendinopathy is a general term referring to tendon injuries caused by excessive mechanical stress. The main cause of rotator cuff tendinopathy is a combination of mechanical compression and repetitive overhead movements. The consequences may be pain and weakness of the shoulder muscles, especially during lifting and external rotation of the shoulder. The best evidence-based treatment is exercise. Eccentric exercises involve an eccentric contraction where there is a physical stretch of the muscle that controls the load. Eccentric exercises successfully reduce pain and improve function in the treatment of patellar tendinopathy and Achilles’s tendinopathy. Purpose: The purpose of this thesis was to investigate the effect of eccentric exercises on reducing pain, increasing rotator cuff muscle strength, and improving shoulder function in patients with rotator cuff tendinopathy by literature review. Methods: The literature search was performed in English in PubMEd, PEDro, and DiKUL databases using keywords: eccentric exercises, physiotherapy, tendinopathy, rotator cuff a. Results: Five studies comparing eccentric exercises with other exercises for the treatment of rotator cuff tendinopathy were analysed. In two studies, patients in the experimental group performed eccentric exercises along with nonspecific rotator cuff exercises, whereas in three studies, patients in the experimental group performed only eccentric exercises. In all studies, patients performed the exercises from week 8 to week 12. The intensity of the exercises was different in each study. Analysis of all results showed that isolated eccentric exercise compared with concentric exercise did not reduce pain, increase rotator cuff muscle strength, or improve shoulder function in patients with rotator cuff tendinopathy. Discussion and Conclusion: Combining concentric and eccentric exercises reduced pain, increased rotator cuff muscle strength, and improved shoulder function in patients with rotator cuff tendinopathy. In the future, the efficacy of combined concentric and eccentric exercise, as well as isolated concentric and eccentric exercise, could be studied to determine long-term efficacy and optimal parameters for the best outcome with each type of exercise.

• Keywords: diploma theses, physiotherapy, rotator cuff tendinopathy, eccentric exercise