15 KB197 KB14 KB200820252011Akyuz, Gulserenletnik:10številka:supl. 1COBISSID:1106793ISSN:1580-9315URN:URN:NBN:SI:doc-CHRZ1QL3enUniverzitetni rehabilitacijski inštitut Slovenije - SočaRehabilitacija (Ljubljana)dejavniki tveganjakolenoosteoartozapriporočilarehabilitacijavocational rehabilitationEvidence based rehabilitation in knee arthrosis| Z dokazi podprta rehabilitacija pri artrozi kolena|Osteoarthritis (OA) of the knee is one of the five leading causes of disability among elderly men and women. The risk for disability from OA of the knee is as great as that from cardiovascular disease. It usually occurs in knees that have experienced trauma, infection, or injury. The incidence of knee OA is high throughout the world. At . 25 years of age, there were about 21 million cases of OA in 1995 and 27 million in 2008. The incidence of symptomatic knee OA is 1% per year, with a radiographic incidence of 2% per year. The exact causes of OA are unknown, but there are a number of known risk factors, such as aging, heredity, weight, repetitive overuse, and crystal deposits. Knee OA is common in individuals who play intense physical sports, such as football. Previous injury to the knee is a strong indicator for development of OA in the future. There are many treatment algorythms in OA; the most commonly used one is OARSI guideline. The goals of 2008 OARSI treatment guideline are: reducing joint pain and stiffness, maintaining and improving joint mobility, reducing physical disability and handicap, improving health-related quality of life, limiting the progression of joint damage, and educating patients about the nature of the disorder and its management. The general recommendation is that optimal treatment is provided by combining non-pharmacological and pharmacological treatment. The most recent guideline was reported by ACR in 2010. It includes pharmacological and nonpharmacological recommendations, which are similar to the OARSI recommendations. Treatment of knee OA should be planned according to treatment guidelines, but it should not be forgotten to individualize the treatment for the patient. For evidence based rehabilitation, more studies about physical agents are necessaryOsteoartroza (OA) kolena je eden od petih najpogostejših vzrokov omejitev pri dejavnostih starejših moških in žensk. Tveganje za omejitve pri osebah zaradi OA kolena je tako veliko kot za omejitve zaradi srčno-žilnih bolezni. OA se pogosto razvije po poškodbi ali vnetju kolenskega sklepa. Incidenca je povsod po svetu visoka. Pri osebah starih 25 ali več let je bilo leta 1995 21 milijonov, leta 2008 pa 27 milijonov novih primerov OA. Incidenca simptomatske OA kolena je 1 %, rentgensko potrjene pa 2%. Natančen razlog OA ni znan, obstajajo pa številni dejavniki tveganja, kot so staranje, dednost, telesna teža, ponavljajoče se preobremenitve in odlaganje kristalov v sklep. OA kolena je pogosta pri posameznikih, ki se ukvarjajo z intenzivnimi športi, kot npr. z nogometom. Predhodna poškodba kolena je močan napovedni dejavnik za razvoj OA v prihodnosti. Obstajajo številni algoritmi zdravljenja OA. Najpogosteje se uporabljajo smernice OARSI iz leta 2008, ki vključujejo: zmanjšanje bolečine in okorelosti, vzdrževanje in izboljšanje gibljivosti sklepa, zmanjšanje omejitev pri dejavnostih in sodelovanju, izboljšanje z zdravjem povezane kakovosti življenja, omejitev napredovanja okvare sklepa in izobraževanje pacientov o naravi bolezni in njenem obvladovanju. Splošno priporočilo je, da optimalno zdravljenje zagotavlja kombinacija nefarmakoloških in farmakoloških ukrepov. Zadnje smernice je objavilo ACR v letu 2010. Vključujejo farmakološka in nefarmakološka priporočila, ki so podobna priporočilom OARSI. Zdravljenje OA kolena je potrebno načrtovati skladno s smernicami, vendar mora biti individualno prilagojeno posameznemu pacientu. Potrebne so nadaljnje raziskave o učinkovitosti posameznih fizikalnih agensovTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaUniverzitetni rehabilitacijski inštitut RS – Soča