Abstract | Zglob kuka je najveći zglob u ljudskom tijelu i to je zglob koji se nalazi između bedrene i zdjelične kosti. U njemu se nalaze ukupno 5 sveza. Pokreti koji se vrše u zglobu su: fleksija i ekstenzija, abdukcija i adukcija, te vanjska i unutarnja rotacija natkoljenice. Normalna pokretljivost u zglobu kuka omogućuje i normalan hod. Artroza kuka je degenerativna bolest koja je karakterizirana promjenama na zglobnim hrskavicama glave i acetabuluma. Artroza kuka najčešće nastaje u starijoj životnoj dobi, nakon 55 godine života. Tegobe nestaju nakon odmaranja, a nakon opterećenja opet se pojavljuju. Pravi uzrok koksartroze nije sasvim poznat, međutim neki od njih bili bi: dob, genetski čimbenici, hormonska i metabolička oštećenja, poremećaj lokalne cirkulacije, enzimske promjene te neki mehanički razlozi. Postoje dvije vrste artroze kuka, to su sekundarna i primarna, i dva oblika artroze, a to su atrofički i hipertrofički. Dijagnoza artroze kuka donosi se na temelju anamneze i kliničkog pregleda, a ponekad je potrebno raditi laboratorijske testove i RTG dijagnostiku. Važno je provesti fizioterapijsku procjenu kuka kako bi se mogao napraviti plan i program terapije. Fizioterapijska procjena uključuje subjektivni pregled, objektivni pregled, uzimanje anamneze te klinički pregled kuka. Subjektivnim pregledom uzimamo anamnezu, dijagnosticiramo prisutnost bola, postoji li ili ne, te ako postoji kakva je ona, da li se javlja više noću kada je bolesnik miran ili tijekom dana kada se izvode neke aktivnosti, pa se tako i kroz subjektivni pregled rade razni testovi. U objektivnom kliničkom pregledu kuka izvode se: inspekcija, palpacija, funkcionalno testiranje pomoću kojeg dobivamo procjenu mišićne jakosti, mobilnosti, ravnoteže, koordinacije i stabilnosti bolesnika. Koriste se mjerni instrumenti za procjenu kao što su: manualni mišićni test (MMT), vizualno analogna skala (VAS), goniometrija i dinamometrija. Također je potrebno izvesti mjerenje dužine ekstremiteta, mjerenje opseg pokreta, pregled hoda i pregled stabilnost zdjelice. Nakon fizioterapijske procjene određuje se fizioterapijski pristup. |
Abstract (english) | The hip joint is the largest joint in the human body and it is the joint located between the femur bone and the pelvis. There are a total of 5 bundles in it. In the hip joint there are a total of five bundes in it. The movements performed in the joint are: flexion and extension, abduction and adduction, and external and internal rotation of the thigh. Normal mobility in the hip joint also allows for normal walk. Hip osteoarthritis is a degenerative disease characterized by changes in the articular cartilage of the head and acetabulum. Hip osteoarthritis most often occurs in old age, after 55 years. Difficulties disappear after resting, and after the load they reappear again. The true cause of coxarthrosis is not completely known, but some of them would be: age, genetic factors, hormonal and metabolic damages, local circulatory disorders, enzymatic changes and some mechanical reasons. There are two types of hip osteoarthritis that are secondary and primary, and two forms of osteoarthritis, and these are the atrophic and hypertrophic form of osteoarthritis. The diagnosis of hip osteoarthritis is made on the basis of anamnesis and clinical examination, and sometimes laboratory tests and X-ray diagnostics must be performed. It is important to conduct a physiotherapy assessment of the hip so that a treatment plan and program can be developed. Physiotherapy assessment includes subjective examination, objective examination, taking a medical history and clinical examination of the hip. With a subjective examination we diagnose whether the pain exists or not, and if there is any, whether it occurs more at night when the patient is calm or during the day when some activities are performed, so through a subjective examination various tests are performed. In the Objective and clinical examination of the hip: inspection, palpation, functional testing are performed, with which we obtain an assessment of muscle strength, mobility, balance, coordination and stability of the patient. Then measuring instruments are used to assess the patient's health problem, such as: MMT, visual analog scale (VAS), goniometry and dynamometry. It is also necessary to perform limb length measurement, range of motion measurement, walk review, and pelvic stability review. If conservative treatment does not help, surgical treatment is resorted to. After physiotherapy assessment, physiotherapy approach is determined. |