| Abstract | Ankilozantni spondilitis je reumatska bolest kronične upalne i progresivne prirode. Zahvaća kralježnične i sakroilijakalne zglobove, kukove, ramena i ostale zglobove na rukama i nogama. Upala se kod AS-s razvija na hvatištima sveza i tetiva te na sinhondrozama. Mogu se razviti upala oka i srca, a rijetko i pluća. Prevalencija bolesti ovisi o dobi, spolu, rasi i geografskom položaju. Veliku ulogu u nastanku bolesti ima genetska predispozicija, a prevalencija gena HLA-B27 obilježava bolest. Bolest se najčešće javlja u dobi od 15. do 29. godine života, nešto češće u muškaraca nego u žena. Osnovno obilježje bolesti je upalni proces na mjestu hvatišta zglobne čahure, tetiva i ligamenata za kost. Bolest započinje upalnim procesima na sakroilijakalnim zglobovima koji su najčešće simetrični, potom se širi na lumbalnu kralježnicu. Javljaju se križobolja i jutarnja zakočenost u križima. Kod većine bolesnika bol je najjača rano ujutro, pred zoru ili nakon dužeg mirovanja tijekom dana. Mišići uz kralježnicu postaju kruti i povišenog tonusa. Kada se bolest proširi na prsni dio kralježnice, širenje prsnog koša je smanjeno ili postaje potpuno nepomičan pri disanju. U toku bolesti zglobni prostor postaje sve uži, javljaju se znaci nepotpune ankiloze, da bi na kraju došlo do potpune ankiloze sakroilijakalnih zglobova. U sklopu fizioterapijske procjene kod AS-a primjenjuje se mjerenje indeksa sagitalne gibljivosti cervikalne, torakalne i lumbalne kraježnice, indeks disanja, promatra se prisutnost fenomena „gumene lopte“, „cervikalnog flesha“ i znak tetive na luku te se koristimo specifičnim testovima poput: BASDAI, BASFI i BASMI testom. Pacijentima s ankilozantnim spondilitisom važno je svakodnevno vježbanje kako bi se mogle izvoditi aktivnosti svakodnevnog i profesionalnog života. Fizioterapijska intervencija usmjerena je na suzbijanje boli, smanjenje ukočenosti i zamora, jačanje muskulature, poboljšanje pokreta i funkcije te održavanje pravilne posture. U rehabilitaciji ankilozantnog spondilitisa provode se: vježbe disanja, vježbe za poboljšavanje i održavanje mobilnosti, vježbe istezanja, vježbe jačanja i vježbe aerobnog kapaciteta. |
| Abstract (english) | Ankylosing spondylitis is a rheumatic disease of chronic inflammatory and progressive nature. It affects the spinal and sacroiliac joints, hips, shoulders, and other joints in the arms and legs. Inflammation in AS-s develops on the grips of ligaments and tendons and on synchondrosis. Inflammation of the eyes and heart may develop, and rarely of the lungs. The prevalence of the disease depends on age, sex, race, and geographical location. Genetic predisposition plays a major role in the development of the disease, and the prevalence of the HLA-B27 gene characterizes the disease. The disease most commonly occurs between the ages of 15 and 29, somewhat more common in men than in women. The main feature of the disease is an inflammatory process at the site of the grip of the joint capsule, tendons, and ligaments for the bone. The disease begins with inflammatory processes on the sacroiliac joints that are most often symmetrical, then spreads to the lumbar spine. Low back pain and morning stiffness in the lower back occur. In most patients, the pain is strongest early in the morning, before dawn, or after prolonged rest during the day. The muscles along the spine become stiff and of increased tone. When the disease spreads to the thoracic spine, the expansion of the chest is reduced or becomes completely immobile when breathing. During the disease, the joint space becomes narrower, there are signs of incomplete ankylosis, and in the end there is complete ankylosis of the sacroiliac joints. As part of physiotherapy assessment in AS, measurement of the sagittal mobility index of the cervical, thoracic and lumbar spine, respiratory index, the presence of the phenomenon of "rubber ball", "cervical flush" and the sign of the tendon on the arch, BASFI and BASMI test. For patients with ankylosing spondylitis, daily exercise is important so that activities of daily and professional life can be performed. Physiotherapy intervention is aimed at suppressing pain, reducing stiffness and fatigue, strengthening muscles, improving movement and function, and maintaining proper posture. In the rehabilitation of ankylosing spondylitis, the following are performed: breathing exercises, exercises to improve and maintain mobility, stretching exercises, strengthening exercises and aerobic capacity exercises. |
