Title Komparacija uspjeha rehabilitacije u stacionarnim ustanovama nakon ugradnje endoproteze kuka
Title (english) COMPARISON OF REHABILITATION SUCCESS IN STATIONARY INSTITUTIONS AFTER HIP ARTHROPLASTY
Author Mia Dunkić
Mentor Dinko Pivalica (mentor)
Committee member Frane Mihanović (predsjednik povjerenstva)
Committee member Fabijan Čukelj (član povjerenstva)
Committee member Dinko Pivalica (član povjerenstva)
Granter University of Split (University Department of Health Studies) Split
Defense date and country 2020-09-25, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences
Abstract Cilj istraživanja: Cilj ovog rada je usporediti uspješnost i razliku uspješnosti rehabilitacije između „Zavoda za fizikalnu medicinu i rehabilitaciju s reumatologijom KBC-a Split“ i Specijalnih bolnica za medicinsku rehabilitaciju „Biokovka“ i „Kalos“.
Ispitanici i metode: Istraživanje je provedeno u KBC-u Split na „Zavodu za fizikalnu medicinu i rehabilitaciju s reumatologijom“ i u Specijalnim bolnicama za medicinsku rehabilitaciju „Biokovka“ u Makarskoj i „Kalos“ u Vela Luci u razdoblju od 1.6.2019. do 1.5.2020. U istraživanje je uključeno 66 ispitanika. Ulazni parametri korišteni za ovo istraživanje su degenerativne promjene zgloba kuka i stacionarno liječeni pacijenti, a isključeni su pacijenti s traumama zgloba kuka i ambulantno liječeni pacijenti. Za evaluaciju pacijenata korišteni su: podaci iz medicinske dokumentacije, goniometrija, manualni mišićni test (MMT), VAS skala boli i funkcionalni upitnik Harris hip score (HHS).
Rezultati: U istraživanje je bilo uključeno 65% žena, te 35% muškaraca. Što se tiče goniometrije uočavamo porast vrijednosti svih praćenih parametara, s tim da statistički značajnu razliku između skupina uočavamo kod aktivne fleksije natkoljenice s flek. potkoljenicom, aktivne fleksije natkoljenice s eks. potkoljenicom i aktivne abdukcije natkoljenice. Utvrđen je statistički značajan rast srednje vrijednosti ukupnog Harris hip scora nakon provedene rehabilitacije u obje skupine, s tim da je HHS nakon završetka terapije za 14 bodova manji u skupini 1 u odnosu na skupinu 2, te je razlika između skupina statistički značajna (p˂0,001). Također možemo zaključiti da najveći utjecaj na promjeru vrijednosti HHS ima čestica „pain“, a najmanji utjecaj ima čestica „enter public transport“. VAS skala boli je nakon završetka terapije statistički značajno i negativno povezana s aktivnom i pasivnom fleksijom natkoljenice s ekstendiranom potkoljenicom, abdukcijom, dok je povezanost kod manualnog mišićnog testa utvrđena kod fleksije i abdukcije, a povezanost s ekstenzijom nije statistički značajna (rho=-0,18; p=0,159). Srednja vrijednost svih promatranih varijabli manualnog mišićnog testa na početku terapije je za 1 bod veća kod „skupine 2“ u odnosu na „skupinu 1”. Nakon završetka terapije došlo je do povećanja snage svih testiranih mišića, osim abdukcije natkoljenice kod skupine 1, a postojanje statistički značajne razlike između skupina utvrđeno je kod fleksije i abdukcije natkoljenice (p˂0,001).
Zaključci: Ugradnja endoproteze kuka se pokazala kao najbolje rješenje za osobe oboljele od artroze kuka kojima je kvaliteta života toliko smanjena da konzervativne metode liječenja više ne pomažu u smanjenju bolova i poboljšanju svakodnevnih aktivnosti. Iz provedenog istraživanja zaključujemo da su ispitanici koji su kasnije započeli sa stacionarnim liječenjem pri inicijalnom mjerenju imali bolje rezultate manualnog mišićnog testa (MMT) i Harris hip scora (HHS), što je očekivano s obzirom na vremenski razmak od operativnog zahvata. Također, uočavamo da ukupno povećanje funkcionalnosti mjereno Harris hip scorom pokazuje veći pomak kod prve skupine ispitanika. Na temelju dobivenih rezultata potvrđena je zadana hipoteza, akutni bolnički odjel ima jednako kvalitetnu rehabilitaciju kao i specijalna bolnica.
Abstract (english) Research aim: The aim of this research is to compare the success and the difference of rehabilitation success between ”Institute for Physical Medicine and Rehabilitation with Rheumatology of KBC Split and Specials Hospitals for Medical Rehabilitation “Biokovka” and “Kalos”.
Subjects and methods: The research was conducted in KBC Split at the “Institute for Physical Medicine and Rehabilitation with Rheumatology” and in the Special Hospitals for Medical Rehabilitation “Biokovka” in Makarska and “Kalos” in Vela Luka in the period from 1.6.2019. to 1.5.2020.
The study included 66 subjects. Input parameters used for this study were degenerative hip joint changes and inpatients, patients with hip joint trauma and outpatient patients were excluded. For the evaluation of patients were used: data from medical records, goniometry, manual muscle test (MMT), VAS pain scale and functional questionnaire Haris hip score (HHS).
Results: 65% of women and 35% of men were included in the research. Regarding goniometry, we notice an increase in the values of all monitored parameters, with a statistically significant difference observed in active thigh flexion with flexed lower leg, active thigh flexion with extended lower leg and active thigh abduction. There was a statistically significant change of mean value in the total Haris hip score after rehabilitation in both groups, provided that HHS after the end of the therapy by 14 points lower in “Group 1” compared to “Group 2”, with difference between the groups being statistically significant (p<0.001). We can conclude that the greatest influence on the change of the HHS value has the particle “pain” and the smallest influence has the particle “enter public transport”. Upon completion of therapy VAS pain scale was statistically significantly and negatively associated with active and passive thigh flexion with extended lower leg, abduction, while the association with manual muscle test was determined with flexion and abduction, and the association with extension was not statistically significant (rho= -0,18; p=0.159). The mean value of all observed variables of the manual muscle test at the beginning of the therapy is 1 point higher in “Group 2” compared to “Group 1”. Upon therapy completion there was an increase in the strength of all tested muscles, except thigh abduction in “Group 1”, with the test finding the statistically significant difference between the groups in flexion and abduction of the thigh (p<0.001).
Conclusions: The implantation of a hip endoprosthesis has proven to be the best solution for people with hip osteoarthritis whose quality of life is so reduced that conservative treatment methods no longer help to reduce pain and improve daily activities. From the conducted research we conclude that the subjects who later began inpatient treatment at initial measurement had better manual muscle test results (MMT) and Harris hip score (HHS), which is expected given the time interval from surgery. We also notice that the overall increase in functionality measured by the Harris hip score shows a greater shift in the first group of subjects. Based on obtained results, the given hypothesis was confirmed, the acute hospital has the same quality rehabilitation as the special hospital.
Keywords
komparacija rehabilitacije
stacionarne ustanove
endoproteza kuka
Keywords (english)
comparison of rehabilitation
stationary institutions
hip arthroplasty
Language croatian
URN:NBN urn:nbn:hr:176:123992
Study programme Title: Physiotherapy (university/graduate) Study programme type: university Study level: graduate Academic / professional title: magistar/magistra fizioterapije (magistar/magistra fizioterapije)
Type of resource Text
File origin Born digital
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Created on 2021-02-04 08:36:22