Učinki lokalne vibracijske terapije pri pisarniških delavcih s sumom na utesnitveni sindrom zapestnega prehoda : diplomsko delo

Mravinc, Domen (avtor), Potočnik, Nejka (mentor), Jakovljević, Miroljub (recenzent)

Uvod: Delavci v pisarnah se pri delu z računalniško miško pogosto soočajo s simptomi, povzročenimi zaradi zožitve zapestnega prehoda. Lajšanje teh težav je možno tudi z lokalno mehansko vibracijo. Namen: Namen diplomskega dela je bil preučiti učinke lokalne vibracije na več fizioloških parametrov v predelu roke, in sicer na kožni pretok, temperaturo kože, transkutani parcialni tlak kisika, srednji arterijski krvni tlak in na prevodnost živca medianus. Metode dela: V raziskavo je bilo vključenih osem preiskovancev (sedem žensk in en moški). Po namestitvi senzorjev in aparata za aplikacijo lokalnih vibracij s frekvencama 64 Hz in 82 Hz, je vsak začel uporabljati računalnik z računalniško miško. Fiziološke parametre smo najprej izmerili v mirovanju, nato po petih minutah vibracij na prvi stopnji ter še po petih minutah z vibracijami na drugi stopnji. Postopek smo ponovili po enem mesecu redne uporabe vibracijske naprave. Rezultati: Statistično pomembne razlike smo zaznali pri pretoku krvi v koži podlakti vibrirane roke, in sicer se je iz 8,56 (1,20) PU povečal na 27,62 (6,61) PU (p = 0,015) in nato na 42,42 (9,33) PU (p = 0,005) tekom prvih meritev. Ta se je spremenil tudi na primerjalni roki, pred redno uporabo s 4,46 (0,48) PU na 8,59 (0,89) PU (p = 0,003) ter nato na 8,46 (1,08) PU (p = 0,007), po redni uporabi pa s 7,90 (1,84) PU na 11,26 (2,12) PU (p = 0,008) ter nato na 13,68 (3,36) PU (p = 0,018). Transkutani parcialni tlak kisika vibrirane roke se je distalno od zapestnega prehoda v primerjavi z mirovanjem povišal, tako pred redno uporabo na prvi (p ? 0,001) in drugi stopnji vibracij (p ? 0,001) kot tudi po redni uporabi na prvi (p = 0,005) in drugi stopnji (p ? 0,001). Prav tako so bile pomembne razlike v primerjavi s stanjem pred redno uporabo vibracij in po njej: v mirovanju (p = 0,001), na prvi (p ? 0,001) in drugi stopnji (p ? 0,001). Proksimalno od mesta vibracij se je tcpO2 med uporabo nižje in višje frekvence v primerjavi s stanjem brez vibracij povečal, tako pred redno uporabo (p ? 0,001 in p ? 0,001) kot tudi po njej (p ? 0,001 in p ? 0.001). Pomembna razlika je bila tudi ob medsebojni primerjavi tcpO2 pri nižji in višji frekvenci vibracije, in sicer pred redno uporabo (p = 0,006) ter po njej (p = 0,017). Prevodnosti živca medianus se je povečala po redni uporabi vibracijske terapije, čas prevajanja se je namreč zmanjšal s 5,10 (0,48) ms na 4,22 (0,32) ms (p = 0,046). Razprava in zaključek: Na podlagi rezultatov smo ugotovili, da lokalna vibracija pozitivno vpliva na pretok krvi v koži, oksigenacijo tkiva in prevodnost živca medianus. V prihodnje bi bilo smiselno preverjanje učinka pri preiskovancih z že diagnosticiranim sindromom zapestnega prehoda, ocenjevanje senzorike, upoštevanje subjektivnih mnenj preiskovancev pri uporabi vibracijske naprave ter tudi upoštevanje morebitne sistemske napake merjenj zaradi vibracije senzorjev.

• Jezik: Slovenski jezik
• Ključne besede: diplomska dela, fizioterapija, lokalna vibracija, zapestni prehod, kožni pretok, temperatura kože, oksigenacija, prevodnost medianusa
• Vrsta gradiva: Diplomsko delo/naloga
• Tipologija: 2.11 - Diplomsko delo
• Organizacija: ZF - Zdravstvena fakulteta
• Kraj izida: Ljubljana
• Založnik: [D. Mravinc]
• Leto izida: 2022
• Št. strani: 34 str., [2] str. pril.
• PID: 20.500.12556/RUL-140456
• UDK: 615.8
• COBISS.SI-ID: 121608195
• Datum objave v RUL: 15.09.2022

Sekundarni jezik

• Jezik: Angleški jezik
• Naslov: The effects of local vibration therapy in office workers with suspected carpal tunnel syndrome : diploma work

Izvleček

Introduction: Office workers are often faced with symptoms, associated with compressed carpal tunnel, during their use of computer mouse. One of the options for relieving those symptoms is by local vibration. Purpose: The purpose of this diploma work was to investigate the effects of local vibration on the arm area, namely on blood flow, skin temperature, tissue oxygenation, mean arterial pressure and nerve conduction of the n. medianus. Methods: The study focused on eight subjects (seven women and one man). After the placement of the sensors and the vibration-emitting device (frequency of 64 and 82 Hz), each individual started to use the computer mouse, simulating their typical use during work. Physiological parameters were first measured at resting phase, then after five minutes of local vibration on level one, and then again after five minutes of vibration on level two. The process was repeated after a month of individual regular use of the device. Results: Statistically significant increase occured in the skin blood flow of the forearm of the vibrated hand, as it increased from 8.56 (1.20) PU to 27.62 (6.61) PU (p = 0.015) and then to 42.42 (9.33) PU (p = 0.005) during the first measurements. It also changed on the non-vibrating arm, before regular use from 4.46 (0.48) PU to 8.59 (0.89) PU (p = 0.003) and then to 8.46 (1.08) PU (p = 0.007). After regular use it rose from 7.90 (1.84) PU to 11.26 (2.12) PU (p = 0.008) and then to 13.68 (3.36) PU (p = 0.018). The transcutaneous oxygen pressure of the vibrated hand increased distally of the carpal tunnel compared to resting phase: at the first level of vibration (p ⡤ 0.001) and second (p ⡤ 0.001), as well as after regular use at the first (p = 0.005) and the second level (p ⡤ 0.001). There were also significant differences in comparison of before and after the regular use: at resting phase (p = 0.001), at the first (p ⡤ 0.001) and second stage (p ⡤ 0.001). Proximally of the vibrating site, the tcpO2 increased during use of lower and higher frequency, compared to the non-vibration condition, both before (p ⡤ 0.001 and p ⡤ 0.001) and after regular use (p ⡤ 0.001 and p ⡤ 0.001). Increase also occured when comparing tcpO2 between first and second level of vibration: before regular use (p = 0.006) and after (p = 0.017). Median nerve conduction improved after regular use of vibration therapy, as conduction time decreased from 5.10 (0.48) ms to 4.22 (0.32) ms (p = 0.046). Discussion and conclusion: Upon review of the results, we have concluded that local vibration has positive effect on skin blood flow, oxygenation and median nerve conduction. In the future, it would be make sense to conduct studies, which would also include patients with already diagnosed carpal tunnel syndrome, to monitor sensory response, to take into consideration the possibility of measurement errors due to vibrations of the sensors and also to consider patient’s subjective thoughts of the vibration application and make changes to the procedure accordingly.

• Ključne besede: diploma theses, physiotherapy, local vibration, carpal tunnel, skin blood flow, skin temperature, oxygenation, median nerve conduction