The process of physical therapy and rehabilitation of patients with Ankylosing spondilitis

Ankilozantni spondilitis je kronična, upalna i progresivna reumatska bolest vezivnog tkiva, nepoznatog uzroka i autoimunog karaktera. Spada u skupinu bolesti koju nazivamo seronegativne spondiloartropatije. Kod bolesti dolazi do upale zglobova što dovodi do bolova i ukočenosti. Uglavnom su zahvaćeni sakroilijakalni zglobovi i kralježnica. Također, bolest može zahvatiti i druge zglobove kao što su kuk i rame te visceralne organe poput pluća i očiju. Bolest najčešće počinje postupno i polagano te se tegobe razvijaju tijekom nekoliko tjedana ili mjeseci. Kako vrijeme prolazi, zbog upale kralješci međusobno sraštaju, što dovodi do ograničenja pokretljivosti i ukočenja kralježnice, a sve to rezultira pojavom invaliditeta. Kao dugotrajne bolesti bolesnik zauzima tipičan stav, stav skijaša, tijelo je lagano nagnuto prema naprijed, glava lagano zabačena prema natrag, ramena su podignuta dok su koljena i kukovi lagano savijeni. Bolest se javlja u ranoj odrasloj dobi, češća je u muškaraca između 15-te i 29-e godine života. Uzrok bolesti je nepoznat, ali kako se sve češće javlja u obitelji moguće je da postoji genetski utjecaj. Kod u više od 90% bolesnika s ankilozantnim spondilitisom prisutan je antigen tkivne podudaranosti HLA – B27. Bolest se kod svake osobe razlikuje, svaka osoba je jedinka za sebe te se stupanj funkcionalne neosposobljenosti i bolesti razlikuje od bolesnika do bolesnika. Zbog toga je potrebno za svakog bolesnika napraviti kvalitetnu i dobru obradu te je fizioterapijske postupke potrebno prilagoditi i individualizirati.Ankylosing spondilitis is a chronic, inflammatory and progressive rheumatic disease of connective tissue, of unknown cause and autoimmune character. It belongs to a group of diseases called seronegative spondyloarthropaties. The disease causes inflammation of the joints, which leads to pain anf stiffness. The sacroiliac joints and spine are mainly affected. Also, the disease can affect other joints such as hip and shoulder and visceral organs such as lungs and eyes. The disease ussually begins gradually and slowly and the symptoms develop over a period of weeks and months. As time passes, because of inflammation, the vertebrae fuse with each other, which leads to limited mobility and stiffness of the spine, which results with disability. As a long – term illness the patient assumes a tipical posture, the attitude of a skier, the body is slightly tilted forward, the head is slightly tilted back, the shoulders are raised while the knees and hips are slightly bent. The disease occurs in early adulthood, it is more aommon in men between 15 to 29 years of age. The cause of the disease is unknown, but as it occurs more frequently in the family it is possible that there is a genetic influence. HLA . B27 tissue matching antigen is present in more than 90% of patients with ankylosing spondylitis. The disease is different for each person, each person is an individual for itself and the degree of functional disability and illness varies from patient to patient. Therefore, it is necessary to make quality and good treatment for each patient, and physiotherapy procedure need to be adjust and individualized