Usporedba učinkovitosti kineziterapije i kombinacije kineziterapije i elektromagnetoterapije na bol i funkcijsku sposobnost bolesnika s osteoartritisom koljena

doctoral thesis

• Title (english): A comparison of effectiveness of kinesiotherapy and combination of kinesiotherapy and pulsed electromagnetic fields on pain and functional ability in patients with knee osteoarthritis
• Author: Tomislav Nemčić
• Mentor: Simeon Grazio (mentor); MBZ: 178772
• Committee member: Dubravka Ciliga (predsjednik povjerenstva)
• Committee member: Valentina Matijević (član povjerenstva); MBZ: 347845
• Committee member: Branka Matković (član povjerenstva)
• Committee member: Lana Ružić (član povjerenstva)
• Committee member: Tomislav Krističević (član povjerenstva)
• Granter: University of Zagreb; Faculty of Kinesiology; Zagreb
• Defense date and country: 2014-10-30, Croatia
• Scientific / art field, discipline and subdiscipline: SOCIAL SCIENCES; Kinesiology; Kinesiotherapy and Adapted Physical Activity
• Universal decimal classification (UDC): 615 - Pharmacology. Therapeutics. Toxicology ; 796/799 - Sport

Abstract

Osteoartritis (OA) je najčešća bolest zglobova u razvijenim zemljama i vodeći je uzrok
kronične onesposobljenosti, napose ukoliko je bolešću zahvaćeno koljeno ili kuk. Kako uzrok
OA nije poznat, liječenje je prvenstveno usmjereno na uklanjanje simptoma i sprječavanje
funkcijske nesposobnosti. Od nefarmakoloških terapijskih postupaka čvrsti dokazi o
djelotvornosti postoje samo za kineziterapiju, no još uvijek nije utvrđena optimalna "doza"
(frekvencija, intenzitet i trajanje) vježbanja kao niti najučinkovitija vrsta vježbi. U kliničkoj
praksi se često primjenjuje i elektromagnetoterapija (EMT), o čijoj učinkovitosti u literaturi
postoje kontradiktorni podatci.
Cilj ovog istraživanja bio je usporediti učinkovitost osmišljenog kineziterapijskog programa i
njegove kombinacije s EMT na bol i funkcijsku sposobnost bolesnika s OA koljena.
U istraživanju su sudjelovala 92 ispitanika, metodom slučajnog izbora podijeljena u dvije
skupine: jednu, koja je provodila kineziterapijski program i drugu, u kojoj je uz
kineziterapijski program bila primijenjena i EMT.
Rezultati su pokazali da je u obim skupinama nastupilo statistički značajno smanjenje
intenziteta boli i osjećaja zakočenosti, poboljšanje bolesti mjereno globalnom ocjenom
liječnika i poboljšanje funkcijske sposobnosti, mjereno "Timed up and go" (TUG) testom i
WOMAC (od engl. Western Ontario and McMaster Universities Index of Osteoarthritis)
upitnikom. Ispitanici koji su samo provodili vježbe naveli su i značajno poboljšanje bolesti
prema vlastitoj globalnoj ocjeni, dok se u ispitanika koji su uz vježbe primali i EMT značajno
povećao opseg fleksije bolnog koljena.
Usporedbom skupina ispitanika pokazano je da nema statistički značajno većeg terapijskog
učinka u ispitanika koji su dodatno primali EMT u odnosu na one koji su samo provodili
kineziterapijski program, a poboljšanja u većini mjerenih varijabli bila su i izraženija u
skupini ispitanika bez dodatne primjene EMT.
Zaključno, u ovom je istraživanju dokazan pozitivan terapijski učinak osmišljenog
kineziterapijskog programa na bol i funkcijsku sposobnost bolesnika s OA koljena, ali ne i
hipoteza prema kojoj će kombinacija kineziterapije i EMT imati bolji učinak na iste parametre
u odnosu na primjenu samo kineziterapije.
Rezultati istraživanja mogu značajno utjecati na svakodnevni klinički rad i općenito na
liječenje i rehabilitaciju bolesnika s OA koljena.

Abstract (english)

Osteoarthritis (OA) is the most common joint disease and a leading cause of chronic
disability, in large part due to knee or hip involvement. Etiology is unknown, so the treatment
is focused on symptoms elimination and functional disability prevention. Among
nonpharmacologic modalities, only the kinesiotherapy effectiveness was confirmed while
neither the optimal exercise „dosage“ (frequency, intensity and duration) nor the most
effective type of exercise have been defined. Pulsed electromagnetic fields (PEMF) are
frequently used in the treatment, although the literature provides contradictory data related to
its effectiveness.
The aim of this research was to compare the effect of designed kinesiotherapy program and its
combination with PEMF on pain and functional ability in patients with knee OA.
Ninety-two patients were randomly divided into two groups: in the first one the patients
underwent kinesiotherapy program and in the second, besides that program, patients were
treated with PEMF.
In both groups results showed statistically significant reduction of pain intensity and stiffness,
disease improvement measured by physician’s global assessment and improvement of
functional ability measured by "Timed up and go" (TUG) test and WOMAC (Western Ontario
and McMaster Universities Index of Osteoarthritis) questionnaire. Additionally, the patients
that performed exercises only, declared statistically significant disease improvement
according to their global assessment, while the patients that received PEMF therapy after the
identical exercise program had statistically significant improvement of painful knee flexion.
Comparison of the patient’s groups didn’t show any statistically significant improvements in
therapeutic effect in group that combined exercises and PEMF therapy. On the contrary,
increase in most measured variables was even emphasized in group without additional PEMF
therapy.
In conclusion, this research proved the positive therapeutic effect of clearly designed
kinesiotherapy program on pain and function ability in patients with knee OA, while the
hypothesis about better parameters indicators in group who underwent combined therapy
(kinesiotherapy and PEMF) was not substantiated.
The results of the research may be important for daily clinical practice in treatment and
rehabilitation of patients with knee OA.

• Keywords: osteoartritis koljena; kineziterapija; elektromagnetoterapija
• Keywords (english): knee osteoarthritis; kinesiotherapy; pulsed electromagnetic fields
• Language: croatian
• URN:NBN: urn:nbn:hr:117:450784
• Study programme: Title: postgraduate doctoral study of kinesiology; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje društvenih znanosti, polje kineziologija (doktor/doktorica znanosti, područje društvenih znanosti, polje kineziologija)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2016-03-24 11:24:14