Abstract | Parkinsonova bolest je druga najčešća progresivna neurodegenerativna bolest odmah iza Alzheimerove bolesti te obuhvaća višestruke neurotransmiterske moždane puteve, posebno dopaminski nigrostrijatalni put. Etiologija idiopatske Parkinsonove bolesti nije poznata sve do danas. U većini slučajeva pojavljuje se kao sporadična bolest. Pretpostavlja se da nastaje složenom interakcijom između genske sklonosti i utjecaja okolišnih čimbenika. Kod većine pacijenata bolest započinje podmuklo. Osnovni simptomi Parkinsonove bolesti su rigidnost, bradikinezija, tremor te posturalna nestabilnost. Motoričke smetnje stvaraju progresivni invaliditet sa smanjenjem mogućnosti izvođenja svakodnevnih aktivnosti , te automatski smanjuju kvalitetu života oboljele osobe.Prognoza bolesti ovisi o samom tipu bolesti. Postoje tri glavne skupine na koje se može podijeliti PB, a to su tip A (tremor dominantni tip), tip B (akinetičko rigidni tip) i tip C (mješoviti tip).Procjena pacijenta započinje anamnezom i fizičkim pregledom usmjerenim na otkrivanje tipičnih znakova.. Kod postavljanja dijagnoze koriste se kliničke ljestvice ocjene, in vitro testovi i magnetska rezonanca. Za farmakološko liječenje obično se koristi levodopa u kombinaciji s karbidopom, koja poboljšava bioraspoloživost SŽS te smanjuje nuspojave. Fizioterapijska procjena pacijenta temelji se na S.O.A.P. modelu, testovima i mjerenjima. U procjeni se koriste skala Hoehn i Yahr, jedinstvena ocjenska skala za procjenu PB (UPDRS),Bergovo ispitivanje ravnoteže i Tinettijev test hoda i ravnoteže. Od fizioterapijskih vježbi od velike su važnosti aerobne vježbe, vježbe jačanja, vježbe s otporom, vježbe disanja, vježbe koordinacije, vježbe istezanja te vježbe relaksacije. Također, potvrđeno je da hidroterapija, tai chi i terapija glazbom uvelike koriste poboljšanju PB. Cilj svih ovih vježbi i postupaka je smanjiti simptome i olakšati pacijentovu svakodnevicu. |
Abstract (english) | Parkinson's disease is the second most common progressive neurodegenerative disease after Alzheimer's disease and involves multiple neurotransmitter brain pathways, especially the dopamine nigrostriatal pathway. The etiology of idiopathic Parkinson's disease is not known to date. In most cases, it appears as a sporadic disease. It is assumed that it arises from a complex interaction between genetic predisposition and the influence of environmental factors. In most patients, the disease begins insidiously. The main symptoms of Parkinson's disease are rigidity, bradykinesia, tremor and postural instability. Motor disorders create progressive disability with a decrease in the ability to perform daily activities, and automatically reduce the quality of life of the affected person. The prognosis of the disease depends on the type of disease itself. There are three main groups into which PB can be divided, which are type A (tremor dominant type), type B (akinetic rigid type), and type C (mixed type). The evaluation of the patient begins with a medical history and a physical examination aimed at detecting typical signs. Movement disorder clinics have the ability to use a unique PD rating scale to quantify the patient's behavior, mentality, mood, tremors, daily activities, motor examinations, and therapy complications. When making a diagnosis, clinical rating scales, in vitro tests and magnetic resonance imaging are used. For pharmacological treatment, levodopa is usually used in combination with carbidop, which improves the bioavailability of the CNS and reduces side effects. Physiotherapy assessment of the patient is based on the S.O.A.P. model, tests and measurements. The Hoehn and Yahr scale, the Unified Rating Scale for Assessing PB (UPDRS), the Berg balance test and the Tinetti gait and balance test are used in the assessment.Of the physiotherapy exercises, aerobic exercises, strengthening exercises, resistance exercises, breathing exercises, coordination exercises, stretching exercises and relaxation exercises are of great importance. Also, hydrotherapy, tai chi and music therapy have been confirmed to greatly benefit the improvement of PD. The goal of all these exercises and procedures is to reduce symptoms and make the patient's everyday life easier. |