Abstract | Ankilozantni spondilitis, to jest Morbus Bechterew je progresivna upalna reumatska bolest koja ne zahvaća samo zglobove, već cijeli organizam, a javlja se upalna bol u leđima. Javljaju se promjene na unutarnjim organima, no glavna karakteristika je okoštavanje mekih vezivnih struktura. Kako bolest napreduje, javljaju se i fleksijske kontrakture, a fiziološke krivine prelaze u patološke promjene te oboljeli zauzima „stav skijaša“. Uzroci nastanka bolesti još nisu otkriveni, no postoji povezanost pojave ankilozantnog spondilitisa s prisutnosti antigena HLA-B27 koji je prisutan kod velike većine oboljelih. Spol oboljelog također ima veliku ulogu, stoga što muškarci obolijevaju češće od žena, a prvi znakovi bolesti se najčešće javljaju u ranoj odrasloj dobi. Dijagnoza ankilozantnog spondilitisa postavlja se provođenjem detaljne anamneze i funkcionalnog pregleda. Provode se razne pretrage poput rendgenskih snimki, laboratorijskih pretraga, magnetske rezonance, kompjuterizirane tomografije i dijagnoze na temelju New York kriterija. U rehabilitaciji je važno upoznati oboljelu osobu s prirodom i tijekom bolesti te joj objasniti važnost provođenja vježbi i održavanja pravilne posture. Prije određivanja plana fizioterapije, provode se razni testovi i mjerenja kako bi se ustanovilo da li su prisutne određene karakteristike i ograničenja pokretljivosti kralježnice. Plan se postavlja sukladno ciljevima koji se postavljaju nakon evaluacije, a podrazumijeva terapiju pokretom, hidroterapiju, elektroterapiju, termoterapiju, krioterapiju, terapijski ultrazvuk, dijatermiju te manualnu terapiju. Bolest svakog oboljelog zahvaća drugačije te je iz tog razloga ključno imati individualni pristup svakom pacijentu i raditi plan fizioterapije ovisno o mogućnostima i nemogućnostima oboljelog. |
Abstract (english) | Ankylosing spondylitis, Morbus Bechterew, is an progressive inflammatory rheumatic disease which doesn't affect only joints, but the whole organism as well while inflammatory back pain occurs. Changes occur in the internal organs, but the main characteristic is the ossification of soft connective structures. As the disease progresses, flexion contractures may also appear while the physiological curves of the spine turn into pathological changes, and the patient develops the „skier's stance“. The causes of the disease haven't yet been discovered, but there is a connection between the occurrence of ankylosin spondylitis and the presence of the HLA-B27 antigen, which is present in the vast majority of patients. The gender of the patient also plays a big role, due to men getting diagnosed with ankylosing spondylitis more often than women, and the first signs of the disease usually appear in early adulthood. The diagnosis of ankylosing spondylitis is established by carrying out a detailed anamnesis and functional examination. Various tests are performed, such as X-rays, laboratory tests, magnetic resonance imaging, computed tomography and diagnosis based on the New York criteria. While in rehabilitation, the very education of the patient is important, therefore it is important to familiarize him with the nature of the disease and explain to him the importance of carrying out exercises and maintaining correct posture. Before determining a physiotherapy plan, various tests and measurements are carried out to determine whether certain characteristics and limitations of spinal mobility are present. The plan is set according to the goals set after the evaluation and includes movement therapy, hydrotherapy, electrotherapy, thermotherapy, cryotherapy, therapeutic ultrasound, diathermy and manual therapy. The disease affects each patient differently, and for this reason it is crucial to have an individual approach to each patient and work out a physitherapy plan depending on the patient's possibilities and inabilities. |