Vpliv krepitve mišic kolka na bolečino in funkcijsko sposobnost pri osebah z osteoartrozo kolena - pregled literature : diplomsko delo

Petrović, Tanja (author), Kacin, Alan (mentor), Brezovar, Tjaž (comentor), Grapar Žargi, Tina (reviewer)

Uvod: Osteoartroza kolenskega sklepa je kronična degenerativna bolezen, pri kateri pride do obrabe in postopne izgube sklepnega hrustanca, prizadene pa lahko tudi ostale obsklepne strukture. Je ena glavnih vzrokov bolečine in funkcijske nezmožnosti pri starejši odraslih. Za proces bolezni je značilna zmanjšana mišična jakost v različnih mišičnih skupinah, kar pa lahko posledično vpliva na biomehaniko kolenskega sklepa. S krepitvijo mišic želimo izboljšati absorpcijo obremenitev, ki delujejo na sklep, ter tako vplivati na boljšo biomehaniko spodnjega uda. Namen: Na podlagi izsledkov pregledane literature predstaviti učinke krepitve mišic kolka na bolečino in funkcijsko sposobnost pri osebah z osteoartrozo kolena. Metode dela: Literatura je bila iskana v podatkovnih zbirkah PEDro in EBSCO na osnovi ključnih besed knee osteoarthritis AND hip strengthening; knee osteoarthritis AND hip abductor; knee osteoarthritis AND hip muscle strengthening. Rezultati: Analizirali smo sedem raziskav. Vadbeni programi so bili usmerjeni predvsem v krepitev abduktorjev in adduktorjev kolka v kombinaciji s krepitvijo mišice quadriceps femoris. Progresivna vadba proti uporu, ki se izvaja vsaj dva do trikrat na teden v dveh do štirih setih po osem do dvanajst ponovitev ter intenzivnosti 50–70 % 1 RM, kratkoročno pozitivno vpliva na zmanjšanje bolečine (p < 0,05) pri osebah z osteoartrozo kolena. V dveh raziskavah so merili dolgoročne učinke, v eni šest tednov, v drugi šest mesecev po opravljenih intervencijah ter ugotovili, da so pozitivni učinki na bolečino izzveneli. Statistično značilne razlike so bile prisotne tudi pri merjenih izidih funkcijskega stanja, boljši rezultati so bili zabeleženi v skupini, ki je poleg krepitve mišice quadriceps femoris krepila tudi mišice kolka. Razprava in zaključek: Na podlagi izsledkov raziskav lahko trdimo, da ima progresivna vadba proti uporu za krepitev mišic kolka predvsem abduktorjev v kombinaciji s krepitvijo mišice quadriceps femoris pozitivne učinke na bolečino, funkcijsko sposobnost ter kakovost življenja pri osebah z OA kolena. Tudi krepitev adduktorjev kolka bi lahko imela pozitivne učinke na bolečino in funkcijsko sposobnost oseb z OA kolena, vendar bi bilo potrebno to področje še raziskati. Za lažjo primerjavo rezultatov bi bila v prihodnje potrebna uporaba enakih ocenjevalnih protokolov in enotnejših vadbenih programov, smiselno bi bilo uporabiti večje vzorce preiskovancev.

• Language: Slovenian
• Keywords: diplomska dela, fizioterapija, osteoartroza kolena, mišice kolka, vadba proti uporu, bolečina, funkcijska sposobnost
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [T. Petrović]
• Year: 2024
• Number of pages: 34 str., [16] str. pril.
• PID: 20.500.12556/RUL-165120
• UDC: 615.8
• COBISS.SI-ID: 216268803
• Publication date in RUL: 23.11.2024

Secondary language

• Language: English
• Title: Effect of hip muscle strengthening on pain and functional ability in people with knee osteoarthritis - literature review : diploma work

Abstract

Introduction: Osteoarthritis of the knee is a chronic degenerative disease in which the articular cartilage is worn away and gradually lost, other surrounding structures can also be affected. It is one of the main causes of pain and functional disability in older adults. The disease process is characterised by reduced muscle strength in various muscle groups, which in turn can affect the biomechanics of the knee joint itself. By strengthening the muscles, we aim to improve the absorption of the loads acting on the joint and thus lead to better protection of the cartilage. Purpose: To present the effects of hip muscle strengthening on pain and functional capacity in people with osteoarthritis of the knee, based on a review of the literature. Methods: The literature was searched in PEDro and EBSCO databases based on the keywords knee osteoarthritis AND hip strengthening; knee osteoarthritis AND hip abductor; knee osteoarthritis AND hip muscle strengthening. Results: We analysed seven studies. The exercise programs mainly focused on strengthening the hip abductors and adductors in combination with strengthening the quadriceps femoris. Progressive resistance exercise performed at least two to three times a week, in two to four sets of eight to twelve repetitions, and at an intensity of 50-70 % 1 RM, had a positive short-term effect on pain reduction (p < 0,05) in subjects with osteoarthritis of the knee. Two studies measured long-term effects, one six weeks and the other six months after the interventions and found that the positive effects on pain had disappeared. Statistically significant differences were also present in the measured functional status outcomes, with better results in the group that strengthened the hip muscles in addition to strengthening the quadriceps femoris. Discussion and conclusion: Based on the results of the studies, it can be concluded that progressive resistance training to strengthen the hip muscles, especially the abductors, in combination with strengthening of the quadriceps femoris, has positive effects on pain, functional ability and quality of life in people with knee OA. Strengthening of the hip adductors could also have positive effects on pain and functional ability in people with knee OA, but this is an area that should be further investigated. To facilitate comparison of results in the future, it would be necessary to use the same assessment protocols and more uniform exercise programs, and it would be reasonable to use larger samples of subjects.

• Keywords: diploma theses, physiotherapy, knee osteoarthritis, hip muscles, resistance training, pain, functional ability