Rehabilitation Treatment in Patients with Ankylosing Spondylitis

Ankilozantni spondilitis je upalna reumatska bolest koja zahvaća kralježnicu i sakroilijakalne zglobove. Uzrok bolesti je nepoznat, iako postoji povezanost ankilozantnog spondilitisa s prisutnošću antigena HLA-B27 u oboljelih. Bolest se javlja u mlađih osoba, u dobi od 20 do 40 godina, a muškarci oboljevaju tri puta češće nego žene. Bolest prvenstveno zahvaća kralježnicu i sakroilijakalne zglobove, ali mogu biti aficirani i korijenski zglobovi, enteze itd. Bolesnik ima karakteristično fleksijsko držanje tijela koje povezujemo sa stavom skijaša. Iako je ankilozantni spondilitis bolest kralježnice, bol nije ograničena samo na leđa. Bolest je sistemna, pa se događaju i promjene na očima, srcu i drugim visceralnim organima. Dijagnoza se postavlja na temelju anamneze, kliničkog pregleda, RTG nalaza i krvne pretrage. Liječenje je fakmakološko i nefarmakološko. Rehabilitacija sa sastoji od kinezioterapije, hidroterapije, primjene struja i termoprocedura, radne terapije, primjene pomagala, a u slučaju velikih deformacija i operativno liječenje. U rehabilitaciji najbolji učinak ima kinezioterapija. Vježbama povećavamo opseg pokreta, jačamo i istežemo mišiće i provodimo vježbe torakalnog disanja. Cilj rehabilitacije je spriječiti invaliditet i omogućiti što kvalitetniji život bolesnika.Ankylosing spondylitis is an inflammatory rheumatic disease that affects the spine and sacroiliac joints. The cause of the disease is unknown, although there is a correlation between ankylosing spondylitis and the presence of HLA-B27 in the patients. The disease occurs in young adults, aged 20 to 40 years, and men are affected three times more often than women. The disease primarily affects the spine and sacroiliac joints, but also root joints, enthesis etc. can be affected by. The patient has the characteristic flexion posture that we associate with skiers attitude. Although ankylosing spondylitis is a spine disease, the pain is not restricted to the back. The disease is systemic, so changes occur in the eyes, heart and other visceral organs. Diagnosis is based on anamnesis, clinical examination, x-ray findings and blood tests. Treatment is pharmacological and non-pharmacological. Rehabilitation consists kinesitherapy, hydrotherapy, and the application of current and thermal procedures, occupational therapy, the application of ortoprdic supplies, and in the case of large deformation surgical treatment. The rehabilitation is best used kinesis. With exercise we increase range of motion, strengthen and stretch the muscles and we are also conducting exercises of thoracic breathing. The goal of rehabilitation is to prevent disability and provide a better quality of patients life