Vadba za ravnotežje in premičnost kot telerehabilitacija pri pacientih po možganski kapi v kroničnem obdobju : magistrsko delo

Močilar, Metka (author), Puh, Urška (mentor), Bizovičar, Nataša (comentor), Kovačič, Tine (reviewer)

Uvod: Vadba za izboljšanje ravnotežja in premičnosti je priporočena pri pacientih v kroničnem obdobju po možganski kapi. Ena od možnosti je telerehabilitacija, ki omogoča fizioterapevtsko obravnavo na daljavo v domačem okolju. Namen: Namen raziskave je bil pri pacientih v kroničnem obdobju po možganski kapi, ki živijo v domačem okolju, hodijo samostojno v zunanjem okolju in imajo blage motnje ravnotežja, ugotoviti učinke fizioterapevtske skupinske vadbe na daljavo na izboljšanje ravnotežja in premičnosti ter ugotoviti, ali obstaja povezanost med izidi na kliničnih testih s časom od nastanka možganske kapi. Metode dela: V raziskavo smo v dveh skupinah vključili skupno 13 preiskovancev (starih od 43 do 70 let) v kroničnem obdobju po možganski kapi. Skupinska vadba je potekala šest tednov, dvakrat na teden, z namenom izboljšanja ravnotežja in premičnosti. Ocenjevanje je potekalo pred vadbo in po njej na daljavo ter šest tednov po končani vadbi. Zajemalo je meritve simetrije obremenjevanja spodnjih udov, stabilometrijo stoje z odprtimi in zaprtimi očmi, meje stabilnosti, krajšo različico testa za oceno sistemov, udeleženih pri uravnavanju ravnotežja (Mini-BESTest), test petih vstajanj s stola, test hitrosti hoje na 10 metrov, lestvico za oceno zaupanja pri dejavnostih, povezanih z ravnotežjem, in oceno zadovoljstva z vadbo. Rezultati: Po vadbi je prišlo do izboljšanja izidov Mini-BESTesta, vstajanja s stola in hitrosti hitre hoje. Navedeno izboljšanje sodi na raven dejavnosti. Sprememb pri ravnotežju na ravni okvar nismo zaznali. Doseženi napredek so preiskovanci ohranili tudi šest tednov po končanju vodene vadbe. Ugotovili smo visoko negativno povezanost med napredkom pri hitrosti hitre hoje in časom od nastanka možganske kapi. Preiskovanci so z vadbo izrazili zelo visoko zadovoljstvo, do morebitnih zdravstvenih zapletov ali stranskih učinkov ni prišlo. Sklep: Šesttedenska skupinska vadba pri pacientih v kroničnem obdobju po možganski kapi je vplivala na izboljšanje ravnotežja in premičnosti na ravni izboljšanja dejavnosti. Udeleženci so bili z vadbo zadovoljni, prav tako pa je vadba na daljavo pri tako zmogljivih pacientih varna in izvedljiva.

• Language: Slovenian
• Keywords: magistrska dela, fizioterapija, možganska kap, telerehabilitacija, ravnotežje, premičnost
• Work type: Master's thesis/paper
• Typology: 2.09 - Master's Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [M. Močilar]
• Year: 2023
• Number of pages: 71 str., [8] str. pril.
• PID: 20.500.12556/RUL-150513
• UDC: 615.8
• COBISS.SI-ID: 165335043
• Publication date in RUL: 20.09.2023

Secondary language

• Language: English
• Title: Telerehabilitation for balance and mobility training in chronic stroke patients : master thesis

Abstract

Introduction: Exercise to improve balance and mobility is recommended in chronic stroke patients. Telerehabilitation may enable patients to receive physiotherapy remotely in their home. Purpose: The aim of this study was to determine the short-term and long-term effects of remote physiotherapeutic group exercise on balance and mobility in chronic stroke patients, and to determine the associations between the outcomes of the clinical tests and time since stroke. Methods: Study included 13 chronic stroke patients aged from 43 to 70 years and was conducted in two groups. Remote physiotherapeutic group exercise with the aim of improving balance and mobility took place biweekly for six weeks. The evaluation was conducted before and after the remote group exercise and also six weeks after the training period. The effects were measured as weight bearing symmetry, standing stabilometry with eyes opened and closed, limits of stability, Mini-Balance Evaluation Systems Test (Mini-BESTest), 5 Times Sit to Stand, 10 Meter Walk Test, Activities-Specific Balance Confidence Scale and also patients’ statisfaction. Results: Patients improved on Mini-BESTest, 5 Times Sit to Stand and 10 Meter Walk Test fast walking speed. The improvements were maintained six weeks after remote exercise ended. Improvements measured on previously noted tests were due to an improvement in activities. Recovery of body systems involved in balance was not detected. A high negative correlation was found between the improvement of fast walking speed and time since stroke. Patients expressed very high satisfaction with remote physiotherapy exercise and no health complications or side effects were noted. Conclusion: Six-week group remote exercise in chronic stroke patients had long-term effects on the improvement of balance and mobility due to an improvement in activities. Patients were satisfied with the remote exercise. Remote group physiotherapeutic exercise is safe and feasible in chronic stroke patients.

• Keywords: master's theses, physiotherapy, stroke, telerehabilitation, balance, mobility