DIJAGNOSTIČKI MODALITETI I FIZIKALNA TERAPIJA KOD PACIJENATA SA KARPAL TUNEL SINDROMOM

  • Darko Bulatović Institut za Rehabilitaciju, Beograd, Srbija
  • Dejan Nikolić Medicinski fakultet, Univerziteta u Beogradu, Beograd, Srbija i Univerzitetska Dečja klinika, Beograd, Srbija
Ključne reči: Karpal tunel sindrom, simptomi, znaci, dijagnostika, fizikalna terapija

Sažetak


Karpal tunel sindrom (CTS) predstavlja jednu od najčešćih kompresivnih perifernih neuropatija na gornjim ekstremitetima, i karakteriše se kompresijom medijalnog nerva na putu njegovog prolaska kroz predeo karpalnog tunela. Prve promene koje iskuse pacijenti sa CTS-om su senzorne i javljaju se pretežno noću, a ako se na vreme ne prepoznaju i ne leče, progrediraju i postaju kontinuirano prisutne. Prolongirana kompresija medijalnog nerva u regiji karpalnog tunela može dovesti do trajnog oštećenja ovog nerva što za posledicu može da ima da pacijent izgubi i mogućnost razlikovanja toplog od hladnog kao i atrofije mišića tenara i otežane palmarna abdukcija palca. Dijagnostika CTS-a se uopšteno postavlja na osnovu simptoma koje pacijent ima, kliničke istorije i anamneze kao i elektrodijagnostičkih ispitivanja. Pored ovih metoda, u evaluaciji CTS-a se koriste provokativni testovi, nuklearna magnetna rezonanca (NMR) kao i ultrazvučna ispitivanja. Kod pacijenata sa CTS-om u kliničkoj praksi koristi se veliki broj metoda, kako hirurških tako i nehirurških u lečenju. Pokazano je da miofascijalna masaža, ultrazvuk, interferentne struje, kontinualna kratkotalasna dijatermija, ekstrakorporalna Shock wave terapija (ESWT) mogu biti od koristi u smanjenju bola i simptoma ili poboljšanja funkcije kod pacijenata sa CTS-om kratkoročno i srednjoročno. Takođe je istaknuto da ne postoje čvrsti zaključci o optimalnim dozama i terapijskim parametrima. Bolje razumevanje etiologije i patofizioloških mehanizama CTS-a kao i efekata određenih terapijskih modaliteta u terapiji ovog stanja doprineće daljem razumevanju nastanka i progresije CTS-a kao i mogućnostima prevencija i lečenja ovih pacijenata u cilju poboljšanja kvaliteta njihovog života i funkcionalnosti zahvaćenog ekstremiteta.

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Objavljeno
2022/10/19
Broj časopisa
Vol. 73 Br. 3 (2022): Medicinski podmladak
Rubrika
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