Physiotherapy process in osteoarthritis of the knee

Artroza dolazi od grčke riječi „arthr“ što znači zglob i „ose“ što u prijevodu znači bolest. Artoza može zahvatiti bilo koji zglob, ali najčešće zahvaća nosive zglobove, među kojima je i koljeno. Artrozu koljena dijelimo na primarne i sekundarne artroze. Primarnim gonartrozama ne možemo objasniti nastanak poznatim uzročnim čimbenicima, a sekundarnim gonartrozama uvijek prethodi neka druga bolest ili ozljeda koljena te postojanje osovinskog deformiteta. Gonartrozu karakterizira bol nakon velikog napora, duljeg hodanja i hodanja po stepenicama te nakon rada čučeći i klečeći. Osim bolova javlja se oteklina koljena, krepitacije, deformacije, kretnje postaju sve manje, a kvadriceps je u hipotrofiji. Dijagnoza se postavlja na temelju kliničkog i rendgenološkog nalaza, a od dijagnostičkih metoda koriste se još i magnetska rezonaca i artroskopija. Liječenje možemo podijeliti na konzervativno i operativno. Konzervativno liječenje se sastoji od mjera kojima se rasterećuje koljeno, medikamentoznog liječenja te metoda fizioterapije. Operativno liječenje dijeli se na palijativno i kauzalno liječenje, aloartroplastiku te artrodezu. Najvažniji dio liječenja je fizioterapija, no prije same fizioterapijske intervencije potrebno je provesti detaljnu procjenu koja se sastoji od subjektivnog i objektivnog pregleda. U sklopu objektivnog pregleda provode se inspekcija, palpacija, goniometrija, antropometrijska mjerenja, MMT i procjena hoda. U procjeni se koriste i funkcionalni testovi te skale boli. Na temelju dobro provede procjene radimo plan i program za daljnju fizioterapijsku intervenciju. Najvažniji dio fizioterapije je kineziterapija, odnosno liječenje pokretom. Provode se statičke i dinamičke vježbe, vježbe istezanja, vježbe propriocepcije te hidrokineziterapija. Od ostalih metoda fizioterapijskog pristupa provode se metode termoterapije i krioterapije, elektroterapija, magnetoterapija i laseroterapija. Uloga fizioterapeuta je i provođenje edukacije pacijenta o samoj bolesti, korištenju pomagala te o promjeni štetnih životnih navika.Arthrosis comes from the Greek word ‘’arthr’’ which means joint and the word ‘’ose’’ which in translation means disease. Arthrosis can affect any joint, but most commonly affects the supporting joints, including the knee. Knee arthrosis is divided into primary and secondary. Primary gonarthrosis cannot be explained by the known causal factors, and secondary gonarthrosis is always preceded by another disease or injury of the knee and the existence of an axial deformity. Gonarthrosis is characterized by pain after strenuous exertion, prolonged walking and walking up stairs, but also after work which includes squatting and kneeling. In addition to pain, there is swelling of the knee, crepitation, deformity, movements become less and less, and the quadriceps is in hypotrophy. The diagnosis is made on the basis of clinical and radiological findings, and magnetic resonance imaging and arthroscopy are also used as diagnostic methods. Treatment can be divided into conservative and operative. Conservative treatment consists of measures to relieve the knee, medication and physiotherapy methods. Operative treatment is divided into palliative and causal treatment, alloarthroplasty and arthrodesis. The most important part of treatment is physiotherapy, but before the physiotherapy intervention itself, it is necessary to conduct a detailed assessment consisting of a subjective and objective examination. As part of the objective examination, inspection, palpation, goniometry, anthropometric measurements, MMT and gait assessment are performed. Functional tests and pain scales are also used in the assessment. Based on a well-conducted assessment, we are working on a plan and program for further physiotherapy intervention. The most important part of physiotherapy is kinesitherapy, is movement therapy. Static and dynamic exercises, stretching exercises, proprioception exercises and hydrokinesitherapy are performed. Other methods of physiotherapy approach include thermotherapy and cryotherapy, electrotherapy, magnetotherapy and laser therapy. The role of the physiotherapist is to educate patients as well. It is very important to educate patients about the disease itself, the use of aids and the change of harmful life habits