Merenje parametara proprioceptivnog osećaja nakon dislokacije patele kod adolescentkinja / Measurement of parameters of proprioception after dislocation of patella in adolescent women

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<p>I&scaron;ča&scaron;enje, luksacija ili dislokacija ča&scaron;ice (patele), predstavlja povredu kolena prilikom koje dolazi do pomeranja patele iz patelofemoralnog dela zgloba kolena. Pri ovoj povredi dolazi do o&scaron;tećenja medijalnih mekotkivnih struktura kolena koje su zadužene za pravilno pomeranje ča&scaron;ice unutar patelofemoralnog zgloba. Nakon prve povrede kod velikog borja pacijenata razvije se hronična nestabilnost patelofemoralnog zgloba sa posledičnim recidivantnim luksacijama patele. Mehanizam nastanka hronične nestabilnosti nije u potpunosti razja&scaron;njen i smatra se multifaktorijalnim, a za jedan od faktora smatra se naru&scaron;avanje neurolo&scaron;ke regulacije pokreta kolena. Propriocepcija je složen neurolo&scaron;ki mehanizam koji nam omogućava mentalno mapiranje delova tela, sprečavajući prekomerne i nepravilne pokrete koji mogu dovesti do povređivanja. Za njegovu procenu u zglobu kolena najče&scaron;će se procenjuje osećaj pozicije zgloba (JPS &ndash; eng. &bdquo;Joint Position Sense&ldquo;) kao jedne od komponenti propriocepcije. Nerazja&scaron;njeno je koji je najbolji način za njegovu procenu u pogledu izbora različitih uglova fleksije kolena i pozicija ispitanika, ali i kakav je uticaj povreda struktura kolena na njega. U istraživanju su učestvovale isključivo osobe ženskog pola (15-17 godina), svrstane u tri kategorije od po 30 ispitanika. Prvu, kontrolnu grupu, činile su zdrave ne sportistkinje; drugu, grupu sportistkinja, činile su ispitanice koje su se takmičarski bavile ko&scaron;arkom; treću, grupu pacijentkinja, činile su osobe sa luksacijom ča&scaron;ice kolena. Za merenje JPS kori&scaron;ten je VICON optički sistem (&copy;Vicon Motion Systems Ltd. UK registered no. 1801446) za analizu pokreta. Za svaku grupu meren je JPS metodom pasivnog pozicioniranja-aktivne reprodukcije sa kolenom u različitim nivoima fleksije (30&deg;, 45&deg; i 60&deg;), u uspravnom, ležećem i sedećem položaju, nakon čega su rezultati bili poređeni između grupa. Na&scaron;i rezultati su pokazali da odabir pozicije ispitanika i ugla merenja ne utiče na JPS u zdravim populacijama, kontrolnoj grupi i grupi sportiskinja, niti postoji statistički značajna razlika odgovarajućih pozicija i uglova između ovih grupa. Za grupu pacijentkinja dobili smo da postoji deficit propriocepcije, i da je sedeći stav najosetljivijim za procenu deficita osećaja pozicija zgloba kolena. U odnosu na odgovarajuće uglove kontrolne grupe i grupe sportistkinja, kod pacijentkinja postoji statistički značajno veća gre&scaron;ka traženih uglova u sedećem stavu, zbog čega je ovaj stav karakterističan za ovu grupu. Takođe smo uočili da je najveća razlika pri uglu od 45&deg;, čineći ga kritičnim uglom za grupu pacijentkinja. Ono &scaron;to je ključni zaključak je da nakon povrede kolena po tipu luksacije ča&scaron;ice postoji neurolo&scaron;ki deficit kontrole pokreta kolena, koji potencijalno može dovesti do daljeg povređivanja. Obzirom da je JPS metod kumulativne procene proprioceptivnog sistema, dalja istraživanja bi trebala da budu usmerena na određivanje mesta o&scaron;tećenja istog, čime bi se postiglo bolje razumevanje funkcionisanja sistema regulacije pokreta kao i mogućnost sprovođenja efikasnijeg lečenja nakon povrede kolena.</p> / <p><!--[if gte mso 9]><xml> <o:DocumentProperties> <o:Author>Vukadin Milankov</o:Author> <o:Version>16.00</o:Version> </o:DocumentProperties> <o:OfficeDocumentSettings> <o:AllowPNG/> </o:OfficeDocumentSettings></xml><![endif]--><!--[if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:TrackMoves/> <w:TrackFormatting/> <w:PunctuationKerning/> <w:ValidateAgainstSchemas/> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:DoNotPromoteQF/> <w:LidThemeOther>EN-US</w:LidThemeOther> <w:LidThemeAsian>X-NONE</w:LidThemeAsian> 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3"/> <w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 3"/> <w:LsdException Locked="false" Priority="70" Name="Dark List Accent 3"/> <w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 3"/> <w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 3"/> <w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 3"/> <w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 4"/> <w:LsdException Locked="false" Priority="61" Name="Light List Accent 4"/> <w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 4"/> <w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 4"/> <w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 4"/> <w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 4"/> <w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 4&q

Links & Downloads

1. https://www.cris.uns.ac.rs/DownloadFileServlet/Disertacija154599904668755.pdf?controlNumber=(BISIS)110060&fileName=154599904668755.pdf&id=12496&source=NDLTD&language=en
2. https://www.cris.uns.ac.rs/record.jsf?recordId=110060&source=NDLTD&language=en

Tags

Additional Fields

Identifer	oai:union.ndltd.org:uns.ac.rs/oai:CRISUNS:(BISIS)110060
Date	11 April 2019
Creators	Milankov Vukadin
Contributors	Marić Dušan, Marić Dušica, Harhaji Vladimir, Ninković Srđan, Raković Mirko, Matijević Radmila
Publisher	Univerzitet u Novom Sadu, Medicinski fakultet u Novom Sadu, University of Novi Sad, Faculty of Medicine at Novi Sad
Source Sets	University of Novi Sad
Language	Serbian
Detected Language	French
Type	PhD thesis