Physiotherapy of eating disorders

Poremećaji prehrane su stanja kod kojih se javlja iskrivljena percepcija o vlastitom tijelu i poremećen odnos prema hrani što rezultira oštećenjem mentalnog i fizičkog zdravlja te promjenom u socijalnom funkcioniranju. U navedene poremećaje spadaju anoreksija i bulimija kao glavni predstavnici te specifični i nespecifični poremećaji prehrane. Iako ne postoji konsenzus o točnoj etiologiji, smatra se kako su uzroci multifaktorske prirode. Biološki čimbenici kao što su dob, spol i genetika, psihološki čimbenici poput samopoštovanja, perfekcionizma i depresije te socijalni čimbenici poput medija i utjecaja vršnjaka imaju utjecaj na razvoj navedenih poremećaja. Mali broj pacijenata priznaje da ima problem i većina na početku odbija liječenje stoga je dijagnostika nerijetko vrlo težak proces. Važno je što ranije detektirati poremećaj te prevenirati kronicitet i relapse. Prije liječenja svakako treba napraviti detaljan plan i procijeniti početno psihičko i fizičko stanje pacijenta uz pomoć raznih objektivnih alata i anamneze/heteroanamneze. S obzirom da navedene poremećaje gotovo uvijek prati još neki psihijatrijski komorbiditet važno je liječenje farmakoterapijom. Od neizostavne važnosti je i psihoterapija, a nezaobilazna stavka u liječenju svakako je i nutricionistička rehabilitacija. Sve veću važnost ima i fizioterapija. Od fizioterapije najčešće se koriste masaža, autogeni trening, balneoterapija, hidroterapija i najvažnije od svega - kineziterapija. Glavni cilj ovog rada je odrediti učinkovitost fizioterapije u liječenju anoreksije i bulimije. Specifičan cilj je utvrditi učinak pojedinih vrsta fizioterapije (kineziterapija, masaža, autogeni trening, hidroterapija, baleneoterapija) na glavne predstavnike poremećaja prehrane (anoreksija, bulimija). Za pisanje rada koristila se literatura pronađena na izvorima poput Hrčka, PubMed i Google Scholar baza podataka. Također su se koristile stručne knjige i drugi završni/diplomski radovi. Mnoga istraživanja prikazana u radu potvrđuju pozitivne učinke fizioterapije u liječenju poremećaja prehrane. Fizioterapija poboljšava opće fizičko stanje, smanjuje simptome depresije, anksioznosti i stresa te potiče samopoštovanje i bolju percepciju o vlastitom tijelu.Eating disorders are conditions in which distorted perception of one's body and a disturbed attitude towards food result in impaired mental and physical health, as well as changes in social functioning. These disorders include anorexia and bulimia as the main representatives and specific and non-specific eating disorders. Although there is no consensus on the exact etiology, the causes are considered to be multifactorial in nature. Biological factors such as age, gender and genetics, psychological factors such as self-esteem, perfectionism and depression, and social factors such as the media and the influence of peers have an impact on the development of these disorders. A small number of patients admit that they have a problem but most refuse treatment at the beginning, so diagnosis is often a very difficult process. It is important to detect the disorder as early as possible and prevent chronicity and relapses. Before treatment, a detailed plan should be made and the initial mental and physical condition of the patient should be assessed with the help of various objective tools and anamnesis / heteroanamnesis. Since these disorders are almost always accompanied by another psychiatric comorbidity, pharmacotherapy is important. Psychotherapy is also indispensable, and nutritional rehabilitation is certainly an unavoidable part of treatment. Physiotherapy is also becoming increasingly important. When it comes to physiotherapy the methods that are used the most are: massage, autogenic training, balneotherapy, hydrotherapy and most importantly - kinesiotherapy. The main goal of this paper is to determine the effectiveness of physiotherapy in the treatment of anorexia and bulimia. The specific goal is to determine the effect of certain types of physiotherapy (kinesitherapy, massage, autogenic training, hydrotherapy, baleneotherapy) on the main representatives of eating disorders (anorexia, bulimia). Literature used in writing of this thesis was found on sources such as Hrčak, PubMed and Google Scholar. Other sources include professional books, as well as other graduate thesis. Many studies presented in this paper confirm the positive effects of physiotherapy in the treatment of eating disorders. Physiotherapy improves general physical condition, reduces symptoms of depression, anxiety and stress, and promotes self-esteem and better perception of one's own body