Vpliv predoperativne vadbe na pooperativne izide pri pacientih po totalni artroplastiki kolena - pregled literature : diplomsko delo

Indof, Petra (author), Vauhnik, Renata (mentor), Grapar Žargi, Tina (comentor), Jakovljević, Miroljub (reviewer)

Uvod: Osteoartroza je vnetna bolezen sinovialnih sklepov in trenutno velja za neozdravljivo. Simptomi vključujejo bolečino, otekanje, omejen obseg gibljivosti sklepa, jutranjo okorelost in zmanjšanje mišične jakosti. S predoperativno telesno vadbo želimo izboljšati mišično zmogljivost z namenom vplivati na hitrejšo pooperativno rehabilitacijo in hitrejše vračanje v funkcijo. Namen: Namen diplomskega dela je bil na podlagi pregleda literature ugotoviti, ali ima predoperativna telesna vadba vpliv na pooperativne izide pri pacientih po operaciji totalne artroplastike kolena. Metode dela: V diplomskem delu smo uporabili metodo pregleda literature. Iskanje literature je potekalo v podatkovni bazi PubMed. Za iskanje raziskav smo uporabili kombinacije ključnih besed v angleškem jeziku in jih izbrali s pomočjo vključitvenih in izključitvenih kriterijev. Rezultati: Od šestih vključenih raziskav, kjer so pacienti izvajali različne oblike predoperativnih telesnih vadb, v petih raziskavah so avtorji poročali o pozitivnih učinkih na pooperativne izide. V dveh raziskavah so potrdili pozitivne učinke predoperativne telesne vadbe na jakost mišice quadriceps, tri mesece po operaciji totalne artroplastike kolena se je jakost mišice quadriceps vrnila na začetno vrednost v skupini z intervencijo, medtem ko je bilo po treh mesecih v primerjalni skupini do 40 % zmanjšanje jakosti mišice quadriceps glede na začetne meritve. V dveh raziskavah so potrdili pozitivne učinke predoperativne telesne vadbe na obseg gibljivosti kolenskega sklepa in v štirih raziskavah na intenzivnost bolečine takoj po intervenciji in do treh mesecev po operaciji. Uporabljeni so bili različni vadbeni protokoli, trajajoči od treh do osmih tednov. Razprava in zaključek: Boljši rezultat so se pokazali v raziskavah z daljšim trajanjem intervencije in višjo frekvenco vadbe. Rezultati pregledanih raziskav nakazujejo na smiselno izvajanje predoperativne telesne vadbe pri pacientih z osteoartrozo kolena pred operacijo totalne artroplastike kolena. Predoperativna telesna vadba pripomore k zmanjšanem subjektivnem občutenju intenzivnosti bolečine, izboljšanju obsega gibljivosti kolena, povečanju jakosti mišice quadriceps prizadetega spodnjega uda in izboljšanju telesnih funkcij. Za lažjo primerjavo rezultatov bi bila smiselna uporaba enake kombinacije ocenjevalnih protokolov v različnih raziskavah.

• Language: Slovenian
• Keywords: diplomska dela, fizioterapija, osteoartroza, kolenski sklep, predoperativna vadba, totalna artroplastika kolena
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [P. Indof]
• Year: 2023
• Number of pages: 26 str.
• PID: 20.500.12556/RUL-148140
• UDC: 615.8
• COBISS.SI-ID: 161717763
• Publication date in RUL: 27.07.2023

Secondary language

• Language: English
• Title: The effects of preoperative exercises on postoperative outcomes in patients after total knee arthroplasty - literature review : diploma work

Abstract

Introduction: Osteoarthritis is an inflammatory disease of the synovial joints that is currently considered incurable. Symptoms include pain, swelling, limited range of motion, morning stiffness and reduced muscle strength. We aim to improve muscle performance with preoperative training to achieve faster postoperative rehabilitation and return to function. Purpose: The purpose was to review the literature to determine whether preoperative training affects postoperative outcomes in patients undergoing total knee arthroplasty. Purpose: The aim of this diploma work was to determine, based on a literature review, whether preoperative training has an impact on postoperative outcomes in patients undergoing total knee arthroplasty. Methods: The literature review method was used. The literature search was performed in the PubMed database. We used combinations of keywords in English language to search for studies and selected them based on inclusion and exclusion criteria. Results: Of the six included studies in which patients completed various forms of preoperative training, the authors reported positive effects on postoperative outcomes in five of the studies. Two studies confirmed the positive effects of preoperative training on quadriceps strength. Three months after total knee arthroplasty, quadriceps strength in the intervention group returned to baseline, while quadriceps muscle strength in the control group decreased by up to 40% after three months compared to baseline measurements. Two studies confirmed positive effects on knee joint range of motion and in four studies on pain intensity immediately after the intervention and up to three months after surgery. Discussion and conclusion: Better results were found in studies with longer intervention duration and higher exercise frequency. The results of the evaluated studies suggest that it is useful to perform preoperative exercise training in patients with knee osteoarthritis before total knee arthroplasty. Preoperative training helps to reduce subjective pain intensity, improve knee range of motion, increase quadriceps strength in the affected lower limb and improve physical function. To facilitate comparison of results, it would be useful to use the same combination of assessment protocols in different studies.

• Keywords: diploma theses, physiotherapy, osteoarthritis, knee joint, preoperative exercise, total knee arthroplasty