Nespecifična Križobolja - Seminarski Rad

8/21/2019 Nespecifična Križobolja - Seminarski Rad

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S A D R Ž A J

1. UVOD..................................................................................................................................................2

2. FIZIOTERAPIJSKA PROCJENA:DIFERENCIJALNA DIJAGNOSTIKA, FIZIOTERAPIJSKIPREGLED I PROCES DONOŠENJA FIZIOTERAPIJSKE

DIJAGNOZE…………………………………………………………………………………….62.1. Nači

!"#a$%a..............................................................................................................................6

2.2. Aa&'(a...................................................................................................................................6

2.). Fi(i"*'+a'-*$%i+'#'!............................................................................................................./

2.0. Aa#i(a i !""'' 3(i"*'+ai$%'!ia"('…………………………………………………………………………4

). PLANIRANJE I PROGRA5IRANJEFIZIOTERAPIJA…………………………………………………………………………..).1. Fi(i"*'+a'-*$%'

i*'+7'8i'....................................................................................................

).1.1. 5i+"7a'.............................................................................................................................

).1.2. Za!+9a7a' a%*i7" ačia9i7"*a…………………………………………………………………………….…..1

).1.). T'+ai$%"

7'9;a'………………………………………………………………………………………………..………1

).1.0. . T+a%8ia……………………………………………………………………………………………………………………………12

).1.6.


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).2.1. Fi(i"*'+ai$%i +i$*- %"! a8i'a*a $a "+&a#i *i'%"&;"#'$*i……………………………..……1)

).2.1.1. I?"+&i+a' i$a7'*"7a'………………………………………………………………………….……………..10

).2.1.2. P"*i8a' a8i'*"7'

$-+a!'……………………………………………………………………………..……10

).2.2. Fi(i"*'+a'-*$%i +i$*- %"! a8iaa*a $a a;"+&a#i& *i'%"&;"#'$*i………………………10

).2.2.1.

).2.2.0. T'+ai$%"7'9;a'……………………………………………………………………………..……………………16

).2.2.>. T+aa'3(i"*'+ai'………………………………………………………………………………..………………..1/

0. EVALUACIJA...........................................................................................................

...........................1/>. ZAVRŠETAK RE@A


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3(i"*'+ai' %"! "$";a $ ;"#i - #-&;a#"& !i'#- %+a#'i8'. O7' $&'+i8'"!"$' $' a '$'8i3č- ;"# !"' !i'#a %+a#'i8' %"! %"' '&a $'8i3č"-(+"%a, %a" *" $- %"&+'$ia %"+i'a $ia#" 9i78a B+a!i%-#a+i $i!+"&,*+a-&a, i?'%8ia i#i &a#ia ;"#'$*. N'$'8i3ča ;"# !"' !i'#a %+a#'i8'";-=7aa $7i= $#-ča'7a ;"#i - !"'& !i'#- %+a#'i8'. U "7i&$&'+i8a&a ' +a(&a*+a- $' "$*-8i &a-a#' 3(i"*'+ai'. G#a7i 8i# "7i=

$&'+i8a ' "i$a*i +i&'+'i +"8'$ 3(i"*'+ai' (a a8i'*' $ '$'8i3č"&;"#i - !"'& !i'#- #'a, a *'&'#' $' a a"7ii& (a$*7'i& i $*+-či&$"(aa&a. R'(-#*a* 3(i"*'+ai$%" +"8'$a *+';a" ;i ;i*i "*-i ""+a7a%a8i'*a i "7+a*a% "*i&a#" +a(ii ?-%8i"i+aa i $-!'#"7aa - !+-*7-.S'%-!a+i 8i# ' +'7'8ia %+"iči= +";#'&a i "a7#aa ;"#i - !"'& !i'#-#'a. N'%a "! i*aa a %"a "7' $&'+i8' "%-a7a- "!"7"+i*i $-:

• 5"9' #i $' !'3i+a*i '$'8i3ča %+i9";"#a

• K"#i%" 7'#i%"& +";#'&- $' +a!i

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Bol donjeg dijela leđa

>. "!i' 9i7"*a.


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Epidemiologija

U $7"& $-$*a7"& +'#'!- #i*'+a*-+' F+&"'+ B144. i("$i "!a*a% !a6H -%-' "-#a8i' ;a+'& '!"& - 9i7"*- !"9i7#a7a 'i("!- ;"#"7a -!"'& !i'#- #'a, a "!ia i8i!'8ia i("$i >. G"!ia i8i!'8ia i+'7a#'8ia '$'8i3č' ;"#i - !"'& !i'#- #'!a - +" H $'č" "+!ia8ii

+i&a+' (!+a7$*7'' (a*i*' i("$i ), "!"$" )> 'i("!a a 1 a8i'a*aB7a Ra7'$;-+, 1>. 2/ $7i= a8i'a*a %"i !"#a(' 3(i"*'+a'-*- --'"

' (;" ;"#i - !"'& !i'#- #'a B7a Ra7'$;-+ i $-+., 1>.. K+i9";"#a i'$a&" 7'#i%i &'!i8i$%i +";#'&, 7' i (ačaa '%""&$%i +";#'&. U @+7a*$%"'&a&" !"$*-i= "!a*a%a #'!' i$#ai7aa a%a!' (a ;"#"7a' (;"%+i9";"#', a#i +i&'+i8', 11. "!i' ' +"8i'' !+-*7'i *+"a% -Ni("('&$%" (;" %+i9";"#' i i("$i" ' 1,/ ;+-*" a8i"a#" !"="*%a B7a

T-#!'+ i $-+., 1>.. G#a7i -!i" - *+"%"7i&a Bča% ) +'!$*a7#a#i $-i!i+'%*' *+"%"7' %"i $- "$#'!i8a %+i9";"#', %a" *" ' i$#ai7a' a%a!'(a ;"#"7a'. U!i" !i+'%*i= &'!i8i$%i= *+"%"7a %"i ";-=7aa- *+"%"7'

#i'č'a i("$i" ' $a&" / -%-' $-&'.

Prognoza i tijek bolesti

K"! "%" 6 a8i'a*a $ ;"#i - !"'& !i'#- #'a, %+i9";"#a a$*-aa#", *i'%"& a%*i7"$*i %"' -%#-č-- $aia' i#i "!i(a' *'+'*a. K"! "$*a#i=0 a8i'a*a $i&*"&i (a"či- "$*''" Ba!!'##, 14.. O;ič" *"ča-(+"% $i&*"&a "$*a' '"(a* BNa8='&$", 12.. K"! a8i'a*a $' '"$*a7#a $'8i3ča &'!i8i$%a !ia"(a. U";iča' *i'% ;"#'$*i "7i$i " +a(ii+";#'&a a8i'*a. U "" "-#a8ii +""(a ' -#a7"& "7"#a.P+"8'-' $' !a %"! />H a8i'a*a ;"# $"*a" '$*a' --*a+ 0H6 *'!aa

Ba!!'##, 14.. '$*" $' a7#a- "a7#a-' 'i("!' %+i9";"#'. />a8i'a*a %"i (a*+a9' "&" "! #i'či%a +i&a+' (!+a7$*7'' (a*i*' i&aa&a' '!- ""7#'- 'i("!- aa!aa --*a+ "!i' !aa B7a !'@""' i $-+., 14.. S*-a "'$"$";#'a ' a7a9ii +'!i%*"+ i$="!a %"!a8i'a*a $ %+i9";"#"& B7" K"++? i Sa-!'+$, 16.. Ti'% ;"#'$*i &"9' $'"!i'#i*i a normalan i#i abnormalan. K"! "+&a#" *i'%a ;"#'$*i a8i'*"7a+a(ia a%*i7"$*i i "'$"$";#'a "$*-" $' "7'a7a !" "*i&a#' +a(i'%"a ' "$*"a#a +i' a$*-a %+i9";"#'. T" ' (ači -9" !a ' !"#" !""*-' "!$-*"$*i ;"#i, 7' !a (;" ' 7i' i' "+aič'" $-!'#"7a' -a%*i7"$*i&a i ?-%8i"i+a- - !+-*7-. V'ia a8i'a*a i&a "+&a#a *i'%

;"#'$*i. A;"+&a#i *i'% ;"#'$*i (ači !a ' !"#a(i !" $&a'a, 7' "7'aa+a(i' "'$"$";#'"$*i. K"! 7'i' a8i'a*a "7' *'%"' +a'' $- *+ai&$i&*"&i&a i#i $' "i ""+a7a-. A;"+&a#i *i'% ;"#'$*i &"- ' i %"! a%-*'

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i %"! %+"ič' %+i9";"#'. Ti'% ;"#'$*i $&a*+a $' a;"+&a#i& -%"#i%" --*a+ *+i*'!a a8i'* ' "7'a +a(i- $7"' a%*i7"$*i. K"! a;"+&a#" *i'%a ;"#'$*i:

• $i&*"&i $' ' "7#ač' i#i $' ""+a7a-,

• *i'%"& 7+'&'a a8i'* $7' 7i' "$*a' 'a%*i7a,

• -"*+';a aa#'*i%a "$*a' i$*a i#i $' "7'a7a,

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' !"#a(i !" "7+a*%a - "+&a#' a%*i7"$*i $7a%"!'7" 9i7"*a,• a8i'* i(+iči*" *+a9i i?"+&a8i' " $7"" !ia"(i i a#*'+a*i7'

&"-"$*i #i'č'a.

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P+'*"$*a7#a $' !a $i="$"8ia#i či&;'i8i i&a- 7a9- -#"- (a$i&*"&a*"#"i- %+i9";"#'. A;"+&a#i *i'% ;"#'$*i +'(-#*a* ' ;i"$i="$"8ia#i=či&;'i%a. Oi -%#-č--:

• biološke čimbenike: $&a'- &";i#"$*, a%"$* &iia i#i %""+!ia8i-

• psihološke čimbenike: $*+a= "! %+'*aa i "+'" (a%#-či7a' "

"(;i#"$*i "+'&'aa• socijalne čimbenike: +";#'&' - +a!"& "%+-9'- i '+i%#a!- $"8ia#-

"*"+- a+*'+a i#i +ia*'#a.

Prognostički čimbenici koji utječu na simptome

Li*" B2. ' +"7'" $-$*a7i +'#'! #i*'+a*-+' " "7'(a"$*i$i="#"%i= či&;'i%a i ;"#"7a - %+a#'i8i. P+'#'! ' -%#-či" )6 +"$'%*i7i=$*-!ia, a a-*"+ (a%#-č-' !a "$*"' $i="#"%i či&;'i8i %"i $- a%" "7'(ai $a$*-'& "'$"$";#'a i $ a+'!"7a'& a%-*' ;"#i - %+"ič-. D"!a*",$i="$"8ia#i či&;'i8i i&a- 7'i -*'8a a "'$"$";#'' "! ;i"&'!i8i$%i= i

;i"&'=aič%i= či&;'i%a. V+#" $- 7a9i a8i'*"7i $*a7"7i i '&"8i"a#" $*a'.Pa$i7' $*+a*'i' $-"ča7aa $ +";#'&"&, %a*a$*+"3ča '+8'8ia ;"#i i $*aa"-* !'+'$i' i $*+a=a +i#ič" $- "7'(aa $ "7'a'& ;"#"7a i

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"'$"$";#'a. P"$*"' -&'+'i !" a%i !"%a(i !a "7i $i="$"8ia#i či&;'i8i!-"+"č" +'!7ia- +a(i- ;"#i i "'$"$";#'a.

a!!'## i a!!'## B2. +"7'#i $- $-$*a7i +'#'! #i*'+a*-+' " -*'8a-$"8ia#i= či&;'i%a a ;"#"7' %+a#'i8'. Za%#-či#i $- !a, ia%" "$*"' &"ii!i%a*"+i !a $' $"8ia#i či&;'i8i &"- "7'(a*i $ ;"#"7i&a - %+a#'i8i, '&a

!'3i*i7' "*7+!' (;" &'*"!"#"%i &a%a7" +"7'!'i= i$*+a9i7aa. Sa&" $'i9i $"8ia#i $*a*-$ i $i="$"8ia#i a$'%*i +a!" &'$*a, %a" *" ''(a!"7"#$*7" "$#"&, &"- "7'(a*i $a %+i9";"#"&. O7i či&;'i8i '+i!""$' +a(7"- "+'&'aa, a#i &"- -*'8a*i a +a(i- ;"#i i ači $-"ča7aa$a $i&*"&i&a. P$i="$"8ia#i či&;'i8i &"- i&a*i i "(i*i7a -*'8a a$i&*"&'. Pa8i'*"7 a+'!a% ;i* ' ;+9i -%"#i%" ' " $"$";a $-"či*i $' $"+'&'a'& a "!"7a+a-i ači *' a%" "$*"i !";+a $"8ia#a "*"+a'"7' "%"#i' %"a a "*ič' a "7'a' +a(i' a%*i7"$*i.

Način suočavanja s križoboljom

Nači $-"ča7aa $ ;"#"7i&a &"9' ;i*i +i&'+' i#i '+i&'+'.

S-"ča7a' $' !'3i+a %a" %"i*i7i i ;i='7i"+a#i a"+ %"' "'!ia8 čii !a;i %"*+"#i+a", $&ai" i *"#'+i+a" --*a+' i 7a$%' (a=*'7' %"i $- "$#'!i8a'%" $*+'$"+a BF"#%&a, La(a+-$, 14.. S-"ča7a' &"9' ;i*i a%*i7" i#ia$i7". K"! a%*i7" $-"ča7aa "'!ia8 $a&"$*a#" "!-(i&a "!+''a!'#"7aa !a ;i %"*+"#i+a" ;"#. P+i&'+i8', *" &"9' ;i*i "!7#ač'' a9' a!+-' $*7a+i i#i %+'*a'. P"'!ia8 %"i $' a$i7" $-"ča7a $ ;"#"7i&a i&aa$i7a $*a7, " &i+-' i *+"i #i'%"7'. 5"9' "$*a*i "7i$a " !+-i&a i $&a-'$7"' a%*i7"$*i - a!i !a ' *i&' "$*ii $&a'' ;"#"7a BJ'$' i T-+'+,11.. A%*i7" $-"ča7a' "7'(-' $' $ ;"#"& ?-%8i"&, !"% $' a$i7"$-"ča7a' &"9' "7'(a*i $ #"ii& ?-%8i"i+a'& BJ'$' i T-+'+, 11..

Nači a %"i $' "'!ia8 $-"ča7a $a $7"i& $i&*"&i&a "7i$i " '"7i&%a+a%*'+i$*i%a&a i i*'+a%8ia&a $ "%"#i"&.

Zača %"i a8i'* +i!a' $7"& $*a-, *' "$'a %"*+"#' a! $*a'& $-!7i' +a(#iči*' %a+a%*'+i$*i%' 7a9' (a +""(-. Zača %"i $' +i!a'$i&*"&i&a *'&'#i $' a $-;'%*i7" '+8'8ii i i*'++'*a8ii i ' &"+a"!"7a+a*i ";'%*i7" +'a#"$*i. 5"-' $- #"ič%' +'%' "! %"i= 'a-";iča'ia %a*a$*+"3ča "#'! a ;"#'$*, "!"$" "i&a' ;"#i i $i*-a8i'"(;i#"& +i'*"&, %a*a$*+"?"&. O$'a %"*+"#' a! $i&*"&i&a *a%"'+ '7a9a. Pa8i'* &"9' i&a*i "$'a !a i&a %"*+"#- a! $7"i& (!+a7#'&B--*a+i #"%-$ %"*+"#' i#i !a '"7' $i&*"&' -#a7"& %"*+"#i+a- !+-'"$";' i#i "%"#"$*i B7a$%i #"%-$ %"*+"#'. N'%i #-!i $%#"i $- +';aH 8i7a*i a!+-' "$";' %"*+"#- a! $7"i& (!+a7$*7'i& $*a'& B@Q+%QQQ i $-+., 16..U-*a+i #"%-$ %"*+"#' č'$*" ' "7'(a $ a%*i7i& $-"ča7a'& i "$#'!ič";"#i& ači"& %"*+"#' ;"#i BJ'$' i T-+'+, 11..

I (ača %"i a8i'* +i!a' ;"#"7i&a i '+8'8ia %"*+"#' a! $*a'&&"- -*'8a*i a '"7" "aa' i $*a7 +'&a %+'*a-. P+i&'+i8', -%"#i%" $';"# $=7a*i %a" (a% &"-' "(#'!', "$*"i 7'i +i(i% "! +a(7"a $*+a=a "!%+'*aa. Pa8i'*a ' $*+a= !a ' %+'*a' -(+"%"7a*i "7- ;"# i#i "(#'!-, a *"!a#' 7"!i - $7' 7'' i(;'a7a' %+'*aa BV#a'' i $-+., 1>.. D"!a*",

-%"#i%" a *'&'#- +'*="!i= i$%-$*a7a a8i'* "č'%-' "7'a' ;"#"7a "!"!+''' a%*i7"$*i, 7'#i%' $- a$' !a ' - i(;'a7a*i.

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2. FIZIOTERAPIJSKA PROCJENA: DIFERENCIJALNA DIJAGNOSTIKA,FIZIOTERAPIJSKI PREGLED I PROCES DONOŠENJA FIZIOTERAPIJSKE

DIJAGNOZE

G#a7i 8i# 3(i"*'+ai$%' +"8'' ' "!+'i7a' *'9i' i *i'%a ;"#'$*i.O$i& *"a, "*+';" ' +"8i'i*i !" %"' $*-a ' &"-' ";"#a*i

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2.1. Način !"a#$a

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i $-!'#"7aa - !+-*7-, *' $7' i?"+&a8i' " !"$a!ai& !ia"$*ič%i&+"8'!-+a&a i +""(i. Ta%"!'+, ;i#'9' $' $7i "!a8i " +"i$a" ?a+&a%"#"%"*'+aii, %"&"+;i!i*'*i&a i +'#'7a*i& $i="$"8ia#i& či&;'i8i&a.

2.2. Ana%n&'a

S7+=a -(i&aa aa&'(' ' +a(a$i*i $#i%- " (!+a7$*7'"& $*a- a8i'*a.P"*+';" ' "!"7"+i*i a $#'!'a i*aa:

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8/29

Pa8i'*"7 ači $-"ča7aa $a $i&*"&i&a 7+#" ' 7a9a i?"+&a8ia.P"$#'!ič", 3(i"*'+a'-* ;i *+';a" i$*+a9i*i %a%a7 (ača a8i'* +i!a' $7"&$*a-. P"*+';" ' "!"7"+i*i a $#'!'a i*aa:

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N'%a "! %#-či= i*aa +i#i%"& -(i&aa aa&'(' a8i'*a $%+i9";"#"& a7'!'a $- - *a;#i8i 1. O7i i !"!a*i "!a8i " a8i'*"7"& ači-!"#a$%a 3(i"*'+a'-*- "&a9- i!'*i38i+a*i či&;'i%' %"i &"- i&a*i 'a*i7a-*'8a a *i'% ;"#"7a - !"'& !i'#- #'a *' a i(;"+ i*'+7'8ia. K"!a8i'a*a $ "a7#a-i& 'i("!a&a %+i9";"#' "*+';" ' "*+a9i*i &"-'-(+"%' "a7#aa ;"#"7a B+i&'+i8', +"&'' +a!" "*'+''a i#i a%*i7"$*i*' -*7+!i*i -%-" *+aa' $i&*"&a i 7+i'&' i(&'- !7i' 'i("!' ;"#"7a.

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R"#a!H5"++i$"7 -i*i% BR"#a!, 5"++i$, 14). %"i $' %"+i$*i (a +"8'-?-%8i"a#" $*a*-$a a8i'*a. Pa8i'* "(ača7a $7' *7+!' B"! "-'i= 20%"' +i&'+'" "i$-- '"7" *+'-*" $*a'. R"#a!H 5"++i$"7 -i*i% $a!+9a

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4


9/29

• i&;'i8i "7'(ai $ +a!i& &'$*"&.Izvor: KNGFguidelin.es orph!sical "herap! in pa"ien"s #i"h lo# backpain$ Bekkering i sur.$

%&&'.

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ukupni broj označ enihbodova

54 1.

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2.(. Fi'i!)&*a+i#$i +*&-"&

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10/29

*' i?"+&a8i' " "$'- "'$"$";#'a i '&"-"$*i $-!'#"7aa - a%H*i7"$*i&a. D"!a*", 3(i"*'+a'-* *+';a $*'i -7i! - ači' a %"' a8i'*%"*+"#i+a $7"' $i&*"+', 3(ič%" ?-%8i"H i+a' i %7a#i*'*- "%+'*#i7"$*i.Pa8i'* %"i $' ;"i %+'*aa i(;'a7a* ' i %+'*a' i +"i$a' *'+ai$%' 7'9;'.

U%"#i%" $' *i'%"& +'#'!a "$-&a a %"&+'$i- %"+i'a $ia#"

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1


11/29

-či%"7i*"$*i 3(i"*'+ai$%i= i*'+7'8ia (a ;"#"7' - !"'& !i'#- #'a. D"!a*" ' +"a'" i '* $-$*a7i= +'#'!a #i*'+a*-+' " -či%- '#'%*+"*'+ai$%i="$*-a%a %"! a8i'a*a $ &ii"H%"*ai& "+'&'ai&a. Va T-#!'+ i$-+a!i8i B1. a7"!' č'*i+i +a(i' %7a#i*'*' (a$*7'i= !"%a(a %"' $'*'&'#' a ;+"- +"7'!'i= +a!"&i(i+ai= %"*+"#i+ai= i$*+a9i7aa i i="7"&'*"!"#"%" %7a#i*'*i B*a;#i8a 2.

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Nespecifična Križobolja - Seminarski Rad

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