| Abstract | Parkinsonova bolest jedna je od najčešćih neurodegenerativnih bolesti. Obzirom na progresivni tijek i brojne motoričke i nemotoričke simptome, ova bolest može u znatnoj mjeri utjecati na funkcionalni status, kvalitetu života i invaliditet osobe. U liječenju za oboljele od ove multisustavne bolesti, primarno uz neurologa, sudjeluje više specijalista i stručnjaka, kako medicinskog tako i nemedicinskog profila. Multidisciplinarni tim čine: neurolog, specijalizirana medicinska sestra (eng. PD nurse), fizijatar, fizikalni terapeut, psihijatar, psiholog, logoped, socijalni radnik, somnolog, dijetetičar, gastroenterolog, urolog, dermatolog te druge specijalnosti ovisno o potrebama samog pacijenta. Uz postojanje djelotvorne farmakološke terapije, iznimnu važnost ima sveobuhvatna neurorehabilitacija koja započinje od samog dijagnosticiranja bolesti, s ciljem prevencije i liječenja nastalih komplikacija, usporenja i zaustavljanja progresije simptoma te prilagodbe na novonastalo stanje. Ono što se nastoji potaknuti su kompenzacijski i redundancijski mehanizmi te neuroplasticitet. Neurorehabilitacija se provodi kroz razne programe fizikalne terapije, programe dijetoterapije, programe radne i okupacione terapije usmjerene na rješavanje motoričkog manjka i poremećaja hoda, posturalnog instabiliteta, poremećaja gutanja i funkcije sfinktera. Veliko značenje ima neurorehabilitacija glasa i govora uz primjenu specifičnih metoda govorne terapije, kao što je Lee Silverman Voice Treatment (LSVT). Rehabilitacija se provodi kroz individualni i grupni tretman sa ciljem osposobljavanja pacijenata za svakodnevni život. Od velike je važnosti i psihološka i psihijatrijska pomoć kod rješavanja kognitivnih poremećaja i depresije. Postoje i komplementarne tehnike (joga, Thai Chi, meditacija, akupunktura, terapijski ples, muzikoterapija, etc.) U neurorehabilitaciji važnu ulogu ima edukacija i podrška obitelji i osobe koje njeguju bolesnika, kao i prilagodba doma i radne sredine. |
| Abstract (english) | Parkinson's disease is one of the most common neurodegenerative diseases. Due to its progressive nature, as well as many motor and non-motor symptoms, this disease can significantly influence the functional status, quality of life and patient’s disability. Patients with this multisystem disease are primarily treated by neurologist, as well as many other specialists with both medical and non-medical background. The multidisciplinary team consists of a neurologist, PD nurse, physiatrist, physical therapist, psychiatrist, psychologist, speech and language therapist, social worker, somnologist, dietitian, gastroenterologist, urologist, dermatologist and other specialists depending on the specific needs of each patient. Besides an efficient pharmacological therapy, a comprehensive neurorehabilitation plays an important role in treatment, aiming to prevent and treat incurred complications, to slow and stop the progression of symptoms, and to adapt to a new situation. It is intended to stimulate compensatory and redundancy mechanisms and neuroplasticity. Neurorehabilitation is conducted through a variety of physical therapy programs, dietotherapy programs, work and occupational therapies, intended to treat motor deficiency and problems with walking, postural instability, swallowing disorders and sphincter functions. Voice and speech neurorehabilitation, along with the use of specific speech therapy methods, for instance the Lee Silverman Voice Treatment (LSVT), plays an important role. Rehabilitation is conducted through individual and group treatment with a view to enabling the patient function in his everyday life. Psychological and psychiatric help is of a significant importance in dealing with cognitive disorders and depression. Complementary techniques exist as well (yoga, Thai Chi, meditation, acupuncture, therapeutic dance, musical therapy, etc.). Education and family support or the support of the person taking care of a patient, as well as housing and work environment adaptations, play a significant role in neurorehabilitation. |
