Physiotherapy methods in the treatment of femoroactebular impingement - literature review

Ovaj rad napravljen je kao sustavni pregled literature unutar kojeg su identificirane i izdvojene dostupne studije o terapijskim, odnosno postoperativnim i rehabilitacijskim metodama koje se primjenjuju kod pacijenata s dijagnozom fermoroacetabularnog sraza. Cilj rada je ustanoviti postoperativne rehabilitacijske protokole i utvrditi stupanj učinkovitosti fizioterapeutskih metoda koje se primjenjuju u postoperativnom razdoblju nakon artroskopije kuka kod pacijenata s femoroacetabularnim srazom. Pretraga dostupnih članaka izvršena je na online platformama PubMed, Web of Science i Google Scholar, a za daljnju analizu odabrana su tri članka koji ukljuljučuju opise standardnih i specifičnih rehabilitacijskih protokola i tri randomizirane kontrolirane studije. Ustanovljeno je kako ne postoji usuglašen standardan rehabilitacijski protokol već on zavisi o brojnim čimbenicima, uključujući pravila ustanove u kojoj se rehabilitacija provodi, vještine, iskustvo i znanja fizioterapeuta i drugih tehničara te o zahtjevima i sposobnostima pacijenata. Učinkovitost specifičnih rehabilitacijskih protokola u kratkoročnom poboljšanju funkcionalnosti zgloba kuka kod pacijenata dokazana je u studijama, no ipak, pojedine studije ukazuju na to kako pacijenti koji su prošli rehabilitacijske vježbe i terapije pod nadzorom terapeuta i oni koji su u postoperativnom razdoblju samostalno provodili vježbe u obliku kućnih treninga, u konačnici imaju slične rezultate. Mjere ishoda za jedne i druge, nakon 24 tjedna od operacije bile su bez značajnijih razlika. No ipak, preporučuje se provodba većeg broja sličnih studija s većim uzorkom pacijenata kako bi potvrdio značaj i učinkovitost postojećih rehabilitacijskih protokola kod pacijenata s femoroacetabularnim srazom nakon artroskopije kuka.This thesis was made as a systematic literature review within which were identified and selected available studies on therapeutic, ie postoperative and rehabilitation methods used in patients diagnosed with fermoroacetabular impingement. The aim of this study is to establish postoperative rehabilitation protocols and determine the degree of effectiveness of physiotherapeutic methods used in the postoperative period after hip arthroscopy within patients with femoroacetabular impingement. A search of available articles was performed on the online platforms PubMed, Web of Science and Google Scholar, and for further analysis, three articles that include descriptions of standard and specific rehabilitation protocols and three randomized controlled studies were selected. It was found that there is no agreed standard rehabilitation protocol. It depends on a number of factors, including the rules of the institution where the rehabilitation is conducted, skills, experience and knowledge of physiotherapists and other technicians and the requirements and abilities of patients. The effectiveness of rehabilitation protocols in short-term improvement of hip joint function in patients has been proven in studies, however, it has been shown that patients who underwent rehabilitation exercises and therapies under the supervision of a therapist and those who performed exercises in the form of home training, finally have almost equal results. Outcome measures for both groups, 24 weeks after surgery, were without significant differences. However, further research with a larger sample of patients is recommended to confirm the importance and effectiveness of existing rehabilitation protocols in patients with femoroacetabular impingement after hip arthroscopy