Title Fizioterapija kod djece sa spina bifidom
Title (english) Physiotherapy support for children with spina bifida
Author Margareta Šarić
Mentor Jasminka Potočnjak (mentor)
Committee member Helena Munivrana Škvorc (predsjednik povjerenstva)
Committee member Jasminka Potočnjak (član povjerenstva)
Committee member Pavao Vlahek (član povjerenstva)
Granter University North (University centre Varaždin) (Department of Physiotherapy) Koprivnica
Defense date and country 2021-09-21, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Physical Medicine and Rehabilitation
Abstract Spina bifida je urođena mana gdje dolazi do nepotpunog spajanje ili izostanka spajanja lukova
kralježnice te može, ali ne mora biti udružen s rascjepom kralježnične moždine. Ono nastaje
zbog izostanka srašćivanja postraničnih dijelova lukova kralježnice. Zaostaje dorzalni rascjep
kralježnice, obično na prelascima pojedinih odsječaka kralježnice. Može nastati u okcipitalnocervikalnom,
cervikalno- torakalnom te najčešće u lumbo-sakralnom dijelu. Također postoje više
malformacija tj. više stupnjeva spina bifide. Spina bifida occulta je rascjep lukova kralježnične
moždine prekriven kožom koji obično ne zahvaća kralježničnu moždinu. Spina bifida cystica
teža je malformacija neuralne cijevi kod koje se kroz rascijepljene lukove kralježaka i otvor na
koži izbočuje živčano tkivo i/ili moždane ovojnice u obliku ciste (vreće). Ona se dijeli na tri
vrste. Spina bifida s meningokelom, kod koje se kroz rascjepa kralježnice izbočuju samo
ovojnice ispunjene cerebrospinalnom tekućinom. Kod spine bifide s meningomijelokelom u cisti
se nalazi i živčano tkivo koje se nije uspjelo zatvoriti tijekom embrijskog razvoja. Do spina
bifide s mijeloshizom ili rabishizom dolazi kad izostane zatvaranje neuralne cijevi, lukovi
kralježaka manjkaju, a spljoštena masa živčanog tkiva otvara se prema van nešto ispod razine
kože. Izloženo živčano tkivo degenerira se u maternici, što rezultira neurološkim deficitom koji
variva ovisno o vrsti lezije. Iako je uzrok spina bifide ne poznati, neki ne genetski faktori su
smanjeni unos folata, dijabetes melitus, pretilost, visoka temperatura, valproična kiselina,
hipervitaminoza i brojni drugi teratogeni čimbenici. Prenatalna dijagnoza postavlja se
ultrazvukom. Lezije se do rođenja kirurški zatvaraju u maternici. Važno je započeti s
fizioterapijom od rane dobi kako bi se poboljšala kvaliteta života što dijete stari. Optimizacijom i
održavanjem pokretljivosti, što na kraju može pomoći djeci da postanu neovisnija kako stare.
Fizioterapeut će provesti početnu procjenu mišićne snage i raspona pokreta dojenčadi u
određenim zglobovima. To će fizioterapeutu omogućiti da utvrdi koji mišići rade ispravno, a koji
mišići su slabiji. Pasivne vježbe pomoći će u održavanju fleksibilnosti i izbjegavanju razvoja
kontraktura. Promijenjeni mišićni tonus čest je kod SB, stoga fizioterapeut koristi vježbe otpora
kako bi ojačali oslabljene mišiće.
Abstract (english) Spina bifida is a congenital defect wher there is an incomplete fusion or no fusion oft he
spinal arches and may or may not be associate with a spinal cort cleft. It occurs due to the lack of
fusion of the lateral part of the arches oft he spine. The dorsal cleft oft he spine is left behind,
usually at the junction of individual sections oft he spine. It can occur int he occipital-cervical,
cervical-thoracic and most often int he lumbo-sacral part. There are also more malformations i.e.
multiple degrees of spina bifida. Spina bifida occulta is a clef of the spinal cord arches covered
with skin that does not usually involve the spinal cord. Spina bifida cystica is a more severe
malformation oft he neural tube in which nerve tissue and/or meninges int he form of a cyst (sac)
protude through split vertebral arches anda n opening int he skin. It is divided into three types.
Spina bifida with meningocele, in which only envelopes filled with cerebrospinal fluid protrude
through the cleft spine. In spina bifida with meningomyelocele, the cyst also contains nerve
tissue that failed to close during embryonic development. Spina bifida with myeloshis or rabiesis
occurs when neural tube closure is absent, vertebral arches are missing and a flattened mass of
nerve tissue opens outward just below skin level. Exposed nerve tissue degenerates int he uterus,
resulting in a neurological deficit that varies depending on the type of lession. Although the
cause of spina bifida is not know, some non-genetic factors include decreased folate intake,
diabetes mellitus, obesity, high fever, valproic acid, hypervitaminosis and a number of other
teratogenic factors. Prenatal diagnosis is made by ultrasound. The lesions are surgically closed
int he uterus until birth. It is important to start physiotherapy from an early age in order to
improve the quality of life as the child ages. By optimizing and maintaining mobility, withh can
ultimately help children become more independet as they age. The physiotherapist will conduct
an initial assessment oft he muscle strenght and range of motion oft he infants in specific joints.
This will allow the physiotherapist to determine which muscles are working properly and which
muscles are weaker. Passive exercises will help maintain flexibility and avoid the development
of contractures. Alterd muscle tone is common in SB, so the physiotherapist uses resistance
exercises to strenghten weakened muscles.
Keywords
Spina bifida
dijagnoza
fizioterapija
ortopedska pomagala
Keywords (english)
Spina bifida
diagnosis
physiotherapy
ortopedic aids
Language croatian
URN:NBN urn:nbn:hr:122:393172
Study programme Title: physiotherapy Study programme type: professional Study level: undergraduate Academic / professional title: stručni/a prvostupnik/ prvostupnica (baccalaureus/ baccalaurea) fizioterapije (stručni/a prvostupnik/ prvostupnica (baccalaureus/ baccalaurea) fizioterapije)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2022-03-17 17:24:02