PHYSIOTHERAPY PROCEDURES IN PATIENTS WITH CHARCOT MARIE TOOTH NEUROPATHY

Uvod: Charcot Marie Tooth neuropatija je najčešća nasljedna neurološka bolest. Spada u skupinu hereditarnih senzomotoričkih neuropatija. Uzrok bolesti je mutacija gena koja uzrokuje demijelinizaciju perifernih živaca , degeneraciju aksona ili oboje, pa se prema tome i dijeli na nekoliko genetskih različitih tipova, sličnih simptoma. Bolest se manifestira u prvim desteljećima života, a glavni simptomi su: mišićna slabost i hipotrofija distalnih mišića udova, poremećaj osjeta, nedostatak miotatskih refleksa, pes cavus. Ova bolest se liječi lijekovima za bol, pacijenti su doživotno uključeni u proces rehabilitacije i po potrebi se vrše kirurški zahvati deformiranih zglobova. Cilj rada: Istražiti dostupnu literaturu i prikazati sve fizioterapijske postupke koji se koriste u rehabilitacijskom tretmanu pacijenata oboljelih od Charcot Marite Tooth neuropatije. Rezultat: Fizioterapijski postupci koji se provode u rehabilitaciji pacijenata oboljelih od Charcot Marie Tooth neuropatije su: fizioterapijska procjena, postavljanje ciljeva fizioterapije, elektroprocedure, kineziterapija, hidroterapija, radna terapija, primjena ortopedskih pomagala i ostali. U elektroterapiji provodi se galvanizacija i elektrostimulacija. Kineziterapija je najvažnija grana fizioterapije u ovoj rehabilitaciji i cilj joj je održavanje funkcije lokomotornog sustava koristeći se aktivnim i pasivnim vježbama za snaženje mišića i povećanje opsega pokreta, vježbama propriocepcije i metodom biofeedback treninga. Hidroterapija je podrška kineziterapiji. Radna terapija provodi se u svrhu integracije pacijenta u okolinu. Važan aspekt ortopedskog liječenja za ove pacijente, u kojem sudjeluju fizioterapeuti, je primjena ortoza. Ostale procedure koje se koriste su: magnetoterapija, dijadinamske struje i termoterapija. Zaključak: Literatura je vrlo siromašna informacijama o ovoj bolesti, osobito o procesu rehabilitacije. Fizikalna terapija je najvažniji dio liječenja Charcot Marie Tooth bolesti, najvrijedniji njezin dio je kineziterapija za koju imamo i znanstvene dokaze o učinkovitosti.Introduction: Charcot Marie Tooth neuropathy is the most common inherited neurological disease. It belongs to a group of hereditary sensor-motor neuropathies. The cause of the disease is a mutation in the gene that causes demyelination of peripheral nerves, axonal degeneration, or both, and is therefore divided into a number of different genetic types with similar symptoms. The disease manifests itself in the first decades of life, and the main symptoms are: muscle weakness and muscle weakness and weakness of the distal muscles of the limbs, disturbance of sensation, lack of myotatic reflexes, pes cavus. This disease is treated with medication for pain, patients have a lifetime involved in the rehabilitation process and, if necessary, to carry out surgical procedures for deformed joints. Objective: To explore the available literature and display all physiotherapy procedures used in rehabilitation treatment of patients with Charcot Marite Tooth neuropathy. Result: The physiotherapy procedures to be applied in the rehabilitation of patients with Charcot Marie Tooth neuropathy are: physiotherapeutic assessment, goal setting physiotherapy, electroprocedures, kinesiotherapy, hydrotherapy, occupational therapy, the use of orthopedic devices and others. In electrotherapy galvanization and electro-stimulation. Kinesiotherapy is the most important branch of physiotherapy in the rehabilitation and aims to maintain the function of the musculoskeletal system using active and passive exercises to strengthen muscles and increase range of motion, proprioceptive exercises and biofeedback training method. Hydrotherapy support kinesitherapy. Occupational therapy is carried out to integrate the patient into the environment. An important aspect of orthopedic treatment for these patients, involving physiotherapists, the application of orthotics. Other procedures used are: magnetic therapy, diadynamic current and thermotherapy. Conclusion: The literature provides very poor information about the disease, especially the process of rehabilitation. Physical therapy is the most important part of the treatment of Charcot Marie Tooth disease, the most valuable part of it is kinesiotherapy for which we have scientific evidence of effectiveness