Conservative treatment of patient with femoroacetabular impingement

Uvod: Mišično-kostne poškodbe povezane z bolečinami v kolku predstavljajo velik delež vzrokov za nezmožnost in invalidnosti v družbi. Ena izmed njih je tudi femoroacetabularni utesnitveni sindrom, ki je posledica nepravilne oblike kolčnega sklepa oziroma omejene sklepne razdalje med glavo stegnenice in robom acetabuluma, kjer prihaja do utesnitve. Večinoma se pojavi pri mladih, aktivnih posameznikih starimi med 20 in 45 let. Bolečina je prisotna v kolčnem sklepu in dimljah, ki lahko seva po sprednji strani stegna vse do kolena. Bolečina se lahko tudi širi v ledveni del hrbta ali zadnjico. Pojavi se predvsem pri ponavljajočih gibih v končnih obsegih gibov fleksije, addukcije in notranje rotacije kolčnega sklepa. Navadno se poslabša pri pospeševalnih športih, počepih, vzpenjanju po stopnicah in dolgotrajnem sedenju. Pacienti lahko poročajo tudi o omejeni sklepni gibljivosti, napetosti, škrtanju, zatikanju ali blokiranju. Namen: Na podlagi pregleda literature predstaviti učinke konservativnega zdravljenja pri pacientih s femoroacetabularnim utestnitvenim sindromom. Metode dela: Literaturo objavljeno med leti 2011 in 2021 smo iskali v podatkovnih zbirkah. Rezultati: V analizo smo vključili 6 člankov, ki so bili prosto dostopni v polnem besedilu. Rezultati o učinkovitosti konservativnega zdravljenja femoroacetabularnega utesnitvenega sindroma na bolečino so si med seboj različni. Konservativno zdravljenje učinkovito poveča obseg fleksije kolka ter mišično jakost kolčnih mišic. Za povečanje je pomembna aktivacija globoke prečne trebušne mišice in krepitev pelviotrohanternih mišic in mišic kolka. Pomembna razlika je bila opažena v funkcijski zmogljivosti spodnjega uda in kakovosti življenja pri preiskovancih, ki so se konservativno zdravili v primerjavi s skupino brez intervencije. Razprava in zaključek: V analiziranih raziskavah so avtorji poročali o učinkovitosti konservativnega zdravljenja na zmanjšanje bolečine, povečanju obsega gibljivosti fleksije v kolku, povečanju mišične jakosti kolčnih mišic, večji funkcionalni zmogljivosti spodnjega uda in kakovosit življenja. Potrebne bi bile nadaljnje raziskave z večjim številom preiskovancev in daljšim opazovanjem po intervenciji, da bi lahko ugotovili dolgoročne učinke konservativnega zdravljenja.Introduction: Musculoskeletal injuries, such as hip-related pain, are leading causes of pain and disability in the community. One of those is femoroacetabular impingement. Femoroacetabular impingement is a consequence of an irregular shape of the hip joint or limited joint distance between femoral head and acetabular rim, where the compression occurs. Ussualy, it appears with young and active individuals, aged between 20–45 years. The pain is present in the hip joint and groin, that can spread of the thigh\u27s front side all the way down to the knee. The pain can also spread to the lumbar spine or the buttocks. Mostly it occurs with repeatable moves in the final range of motion of the flexion, adduction and internal rotation of the hip joint. However, pain from femoroacetabular impingement is commonly held to be aggravated with acceleration sports as well as squatting, climbing stairs and prolonged sitting. Additional symptoms such as stiffness, restricted range of motion, clicking, catching, locking or giving way may be reported. Purpose: The purpose of the diploma work was to present the effects of conservative treatment in patients with femoroacetabular impingement, based on the literature review. Methods: English literature published between 2011 and 2021 was searched in the PubMed and PEDro databases. Results: We included 6 studies in the analysis which where freely available in full text. The results on the efficacy of conservative treatment femoroacetabular impingement on pain varied. Conservative treatment effectively increases range of motion of hip flexion and muscle strength of the hip muscles. For increasing that is very important to activate the deep transverse abdominal muscle and to strenghten the pelviotrochanteric and hip muscles. A significant difference was observed in function of lower limb and quality of life in participants where they were treated conservatively compared to the non-interventional group. Discussion and conclusion: In the analyzed studies, the authors reported the effectiveness of conservative treatment on reducing pain, increasing range of motion of hip flexion, increasing muscle strength of the hip muscles, increased function of the lower limb and quality of life. Further research with more participants and longer post-intervention follow-up is needed to determine the long-term effects of conservative treatment