Title Fizioterapijski pristup trudnicama s križoboljom
Title (english) Physiotherapy approach to pregnant women with low back pain
Author Monika Sever
Mentor Nikolina Zaplatić Degač (mentor)
Committee member Manuela Filipec (predsjednik povjerenstva)
Committee member Nikolina Zaplatić Degač (član povjerenstva)
Committee member Ivana Živoder (član povjerenstva)
Granter University North (University centre Varaždin) (Department of Physiotherapy) Koprivnica
Defense date and country 2024-07-15, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Physical Medicine and Rehabilitation
Abstract Trudnoća je razdoblje mnogih hormonalnih, anatomskih i fizioloških promjena kako bi se tijelo prilagodilo sve većim fizičkim i metaboličkim zahtjevima, a posebno rastu i razvoju djeteta te pripremi za porod. Promjene u posturi tijela trudnice posljedica su mišićno-koštanih prilagodbi. Važna promjena u lokomotornom sustavu povezana s trudnoćom jest povećan ligamentarni laksitet, odnosno slabost ligamenata uslijed povećane razine hormona relaksina, estrogena i progesterona. Povećanjem tjelesne težine trudnice i konstantnog rasta maternice dolazi do važnih promjena na mišićima, zglobovima i držanju trudnice. Širenje maternice anteriorno u trbušnu šupljinu rezultira promjenom centra gravitacije zbog čega se kod trudnice uočava lumbalna lordoza i rotacija zdjelice u odnosu na bedrenu kost. Bitne prilagodbe radi očuvanja percepcije okoline i prostorne orijentacije te radi kompenzacije lumbalne lordoze su još povećanje fleksije cervikalne kralježnice, unutarnje rotacije i adukcije ramenog obruča te hiperekstenzije koljena i oslonca na pete. Zbog ovih promjena kod trudnica javljaju se bolovi u donjem dijelu leđa. Fizioterapijska procjena križobolje u trudnoći prema SOAP modelu sastoji se od subjektivne i objektivne procjene te provedbe kliničkih funkcijskih testova. Klinički funkcijski testovi koji se izvode za detekciju križobolje u trudnoći su znak stražnjice, Bragardov test, Sicardov test i test trakcije femoralnog živca. Fizioterapijska intervencija se bazira na rasterećenju boli, jačanju muskulature abdominalne stijenke, leđne muskulature i muskulature zdjelice i zdjeličnog dna, edukaciji trudnice o pravilnom izvođenju aktivnosti svakodnevnog života i zaštitnim položajima te na prevenciji nastanka križobolje. Vrlo važnu ulogu kod fizioterapijskog pristupa križobolji ima vježbanje. Stabilizacijski trening za kralježnicu djeluje na smanjenje opterećenja na spinalne strukture tijekom izvođenja svakodnevnih aktivnosti i pomaže održavati optimalnu neuromišićnu kontrolu i koordinaciju.
Abstract (english) Pregnancy is a period of many hormonal, anatomical and physiological changes in order for the body to adapt to increasing physical and metabolic demands, especially to the growth and development of the child and preparation for childbirth. Changes in the body posture of a pregnant woman are the result of musculoskeletal adjustments. An important change in the locomotor system associated with pregnancy is increased ligament laxity, weakness of the ligaments due to increased levels of the hormones relaxin, estrogen and progesterone. The increase in the body weight of the pregnant woman and the constant growth of the uterus lead to important changes in the muscles, joints and posture. The expansion of the uterus anteriorly into the abdominal cavity results in a change in the center of gravity, due to which a pregnant woman observes lumbar lordosis and rotation of the pelvis in relation to the femur. Important adaptations to preserve the perception of the environment and spatial orientation and to compensate for lumbar lordosis are an increase in flexion of the cervical spine, internal rotation and adduction of the shoulder girdle, and hyperextension of the knees and support on the heels. Because of these changes, pregnant women experience lower back pain. Physiotherapy assessment of low back pain in pregnancy according to the SOAP model consists of subjective and objective assessment and implementation of clinical function tests. Clinical functional tests performed to detect low back pain in pregnancy are the Straight leg raise test, Bragard test, Sicard test, and Femoral nerve tension test. Physiotherapy intervention is based on relieving pain, strengthening the musculature of the abdominal wall, back musculature and the musculature of the pelvis and pelvic floor, educating the pregnant woman on the proper performance of activities of daily life and protective positions, and on the prevention of low back pain. Exercise plays a very important role in the physiotherapy approach to low back pain. Stabilization training for the spine works to reduce the load on spinal structures during daily activities and helps maintain optimal neuromuscular control and coordination.
Keywords
trudnoća
križobolja
fizioterapijski pristup
vježbanje
Keywords (english)
pregnancy
low back pain
physiotherapy approach
exercise
Language croatian
URN:NBN urn:nbn:hr:122:611653
Study programme Title: Physiotherapy Study programme type: professional Study level: undergraduate Academic / professional title: prvostupnik/prvostupnica (baccalaureus/baccalaurea) fizioterapije (prvostupnik/prvostupnica (baccalaureus/baccalaurea) fizioterapije)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2024-08-28 09:24:02