Author/Editor		Kovačič, Franjo
Title		Rehabilitacijski postopki pri osebah z okvaro zgornjega motoričnega nevrona, ki jih izvaja fizioterapevt
Translated title		Rehabilitation procedures in persons with the lesion of upper motor neuron, performed by physiotherapist
Type		članek
Source		Zdrav Vars
Vol. and No.		Letnik 39, št. 7-8
Publication year		2000
Volume		str. 165-7
Language		slo
Abstract		Abnormal coordination of movement patterns is the consequence of upper motor neuron lesions, which manifests itself as the abnormality of muscular tonus and reciprocal innervation. The most frequent disease of the central nervous system is the stroke. It is the third most common cause of death and the first most common cause for disability. After stroke the patients are suddenly bedridden, with paralysed limbs, unable to move independently and to perform daily activities, their undestanding is impaired or non-exsistent, they experience visual disturbances, loss of temporal and spatial orientation and have problems on the domain of attention, memory, perception, tkinking, feeling and behaviour. Clinical picture is manifold, as well as the consequences and the degree of recovery. An individually adjusted team approach is needed for the rehabilitation programme, and specificity and complexity of problematics demand an additional and properly directed knowledge from the members of the team. Neurotherapeutic treatment is based on the facilitation of normal movement pattern and the inhibition of the abnormal one. Sensory reeducation is performed which renders possible sensory integration, followed by a greater activity and independence. The work of the members of the team is constantly complemented and transdisciplinary intertwined. Key points of neurophysiotherapeutic procedures are the following: testing, assessment and evaluation of the patient's health state; reducing of the spasticity with the suppression of spastic patterns; inhibition of the entire movement patterns and facilitation of the functional, selective patterns; variability of movement; treatment in the normal milieu; involvement of the relatives with patient's rehabilitation abd resocialization process. The approach is a holistic and specific one and the quality of the function realization is stressed.
Summary		Posledica okvare zgornjega motoričnega nevrona je abnormalna koordinacija gibalnih vzorcev, kar se kaže kot abnormalnost vzorcev drže in gibanja ter abnormalnost mišičnega tonusa in recipročne intervacije. Najpogostejša bolezen osrednjega živčnega sistema je možganska kap. Po vzrokih smrti je na tretjem mestu, po številu invalidnih oseb pa na prvem. Po možganski kapi se bolnik nenadoma znajde v postelji z ohromelostjo okončin, nezmožen samostojnega gibanja in izvajanja dnevnih dejavnosti, sporazumevanje je poslabšano ali onemogočeno, nastopijo motnje vida, prizadeta je časovna in prostorska orientacija, pojavijo se težave na področju pozornosti, spomina, dojemanja, mišljenja, čustvovanja in vedenja. Klinična slika je zelo raznolika. prav tako posledice in stopnje okrevanja. Vse to zahteva skupinski pristop k rehabilitacijskemu programu, ki mora biti prilagojen posameznemu bolniku. Posebnost in zahtevnost problematike pa zahteva od članov skupine dodatno in pravilno usmerjeno znanje. Nevroterapevtska obravnava temelji na facilitaciji normalnega gibalnega vzorca in inhibiciji patološkega. Izvaja se senzorna reedukacija, ki omogoča senzorno integracijo. Rezultat je večja aktivnost in večja samostojnost. Delo članov skupine se nenehno dopolnjuje in trandisciplinarno prepleta. Ključne točke nevrofizioterapevtskih postopkov so: testiranje, ocenjevanje in vrednotenje bolnikovega stanja; zmanjševanje spastičnosti z odpravljanjem spastičnih vzorcev; inhibicija celostnih gibalnih vzorcev in facilitacija funkcionalnih, selektivnih vzorcev; variabilnost gibanja; obravnava v normalnem okolju; vključevanje svojcev v proces rehabilitacije in resocializacija bolnika. Pristop je holističen in specifičen, pri čemer je poudarek na kakovosti izvedbe funkcije.
Descriptors		CEREBROVASCULAR DISORDERS MOTOR NEURON DISEASE PHYSICAL THERAPY MUSCLE SPASTICITY MUSCLE HYPOTONIA