Sažetak
Polineuropatija predstavlja ozbiljan zdravstveni problem koji značajno narušava kvalitetu života. Predstavlja složenu skupinu bolesti perifernog živčanog sustava s različitim uzrocima i kliničkim slikama. Patološke promjene započinju u distalnim dijelovima ekstremiteta, s progresijom bolesti postupno se širi prema proksimalnim dijelovima. Najčešći oblici polineuropatije uključuju dijabetičku, alkoholnu, kemoterapijom induciranu polineuropatiju, Guillain- Barreov sindrom, kronična inflamatorna demijelinizacijska poliradikuloneuropatija (CIDP), nasljedne polineuropatije, nedostatak vitamina B12, pri čemu se klinička slika često očituje kombinacijom motoričkih, osjetnih i vegetativnih vlakna. Dugotrajan i progresivan tijek bolesti dovodi do funkcionalnih ograničenja, smanjene samostalnosti i povećanog rizika od padova što smanjuje kvalitetu života. Mogućnosti liječenja polineuropatije ovisi o uzroku, koji je potrebno precizno dijagnosticirati primjenom odgovarajućih postupaka. Dijagnostički postupak temelji se na kliničkoj slici, laboratorijskim nalazima i elektrodijagnostici. Fizioterapijska procjena obuhvaća subjektivni i objektivni pregled te standardizirane ljestvice i testove. Pomoću procjene stvaramo plan intervencije s ciljevima. Fizioterapijska intervencija sastoji se od elektroterapije (TENS, PENS, galvanska struja, magnetoterapija) i različitih oblika terapijskih vježbi te koncepta i tehnika (PNF, Vojta i Bobath), za poboljšanje stabilnosti pri stajanju i hodanju, te ravnotežu, koordinaciju i propriocepciju.
Ključne riječi: polineuropatija, periferni živčani sustav, fizioterapija
Abstract
Polyneuropathy represents a serious health problem that significantly impairs quality of life. It is a complex group of disorders of the peripheral nervous system with diverse causes and clinical presentations. Pathological changes typically begin in the distal parts of the extremities and, as the disease progresses, gradually spread toward the proximal regions. The most common forms of polyneuropathy include diabetic, alcoholic, and chemotherapyinduced polyneuropathy, Guillain–Barré syndrome, chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), hereditary polyneuropathies, and polyneuropathy caused by vitamin B12 deficiency. The clinical presentation often involves a combination of motor, sensory, and autonomic nerve fiber involvement. The long-term and progressive course of the disease leads to functional limitations, reduced independence, and an increased risk of falls, thereby significantly reducing quality of life. Medical treatment for polyneuropathy depend on the underlying cause, which must be precisely diagnosed using appropriate diagnostic procedures. The diagnostic process is based on clinical presentation, laboratory findings, and electrodiagnostic testing. Physiotherapy assessment includes both subjective and objective examination, as well as the use of standardized scales and tests. Based on the assessment, an intervention plan with defined goals is developed. Physiotherapy intervention consists of electrotherapy (TENS, PENS, galvanic current, magnetotherapy), various forms of therapeutic exercises, neurorehabilitation concepts and techniques (PNF, Vojta, and Bobath) aimed at improving stability during standing and walking, as well as balance, coordination and proprioception
Keywords: polyneuropathy, peripheral nervous system, physical therapy