| Abstract | Parkinsonova bolest spada pod hipokinetičke poremećaje pokreta, rezultat je oštećenja mnogih živčanih stanica u mozgu, a počinje u donjem dijelu moždanog debla te se zatim širi prema velikom mozgu. Četiri glavna simptoma koji se javljaju jesu bradikinezija, rigor, tremor i posturalna nestabilnost. Ekstrapiramidni sustav zadužen je za održavanje postruralnog tonusa, regulaciju motorike i koordinacije većih mišićnih skupina, odnosno kontrolira nesvjesnu komponentu voljne motorne aktivnosti. Sposobnost mozga na promjene ili prilagodbe na novonastale situacije naziva se neuroplastičnost mozga. PB je bolest koja se javlja u svih etničkih skupina, rasa i u oba spola, no muškarci imaju 1.5 puta veće šanse za oboljenje nego žene. Etiologija PB-a još uvijek nije u cijelosti pojašnjena, no glavnu ulogu vodi međusobna interakcija okolišnih i genskih čimbenika. PB može se podijeliti u tri glavne skupine: tip A (tremor dominantni tip), tip B (akinetički tip) i tip C (mješoviti tip). Još ne postoji specifična određena metoda kojom bi se mogla dijagnosticirati PB, pa se na temelju detaljnog kliničkog pregleda neurologa postavlja dijagnoza bolesti. Lijeka za potpuno izlječenje PB nema, pa se liječenje fokusira na poboljšanje kvalitete života bolesnika, a najčešće se koristi medikamentno liječenje gdje se najčešće primjenjuju levodopa, amantadin, antikolinergici i agonisti dopamina i neurokirurško liječenje kod kojeg se primjenjuje duboka mozgovna stimulacija (DBS), talamotomija i palidotomija. Prije planiranja terapije za pacijenta važno je procijeniti njegovo stanje na samom početku pa se fizioterapeut može koristiti prema S.O.A.P. modelu planiranja gdje uzima pacijentovu anamnezu, provodi razne testove i mjerenja i na kraju analizira podatke i slaže plan rehabilitacije. Glavni cilj jest olakšati svakodnevnicu života bolesnika pa terapijske vježbe koje koristi su vježbe istezanja, disanja, jačanja i koordinacije te elektroterapija, masaža, Bobath, PNF te rekreativne aktivnosti. |
| Abstract (english) | Parkinson’s disease falls under the category of hypokinetic movement disorders, resulting from damage to many nerve cells in the brain, starting in the lower part of the brainstem and then spreading to the cerebrum. The four main symptoms that occur are bradykinesia, rigidity, tremor, and postural instability. The extrapyramidal system is responsible for maintaining postural tone, regulating motor skills and coordination of larger muscle groups, i.e. it controls the unconscious component of voluntary motor activity. The ability of the brain to change or adapt to new situations is called brain neuroplasticity. PD is a disease that occurs in all ethnic groups, races and both sexes, but men have a 1.5 times greater chance of developing the disease than women. The etiology of PD is still not fully explained, but the main role is played by the interaction between environmental and genetic factors. PD can be divided into three main groups: type A (tremor dominant type), type B (akinetic type) and type C (mixed type). There is still no specific method for diagnosing PD, so the diagnosis of the disease is based on a detailed clinical examination by a neurologist. There is no cure for complete recovery from PD, so treatment focuses on improving the quality of life of patients, and medication treatment is most commonly used where levodopa, amantadine, anticholinergics and dopamine agonists are most commonly used and neurosurgical treatment where deep brain stimulation (DBS), thalamotomy and pallidotomy are applied. Before planning therapy for a patient, it is important to assess his condition at the very beginning so that the physiotherapist can use the S.O.A.P. model of planning where he takes the patient’s history, performs various tests and measurements and finally analyzes the data and sets up a rehabilitation plan. The main goal is to facilitate the daily life of patients so therapeutic exercises used are stretching, breathing, strengthening and coordination exercises as well as electrotherapy, massage, Bobath, PNF and recreational activities. |
