Show simple item record

Influence of biopsychosocial factors on the outcome of rehabilitation in patients after lumbar microdiscectomy

dc.contributor.advisorVuleković, Petar
dc.contributor.advisorTomašević-Todorović, Snežana
dc.contributor.otherDevečerski, Gordana
dc.contributor.otherCigić, Tomislav
dc.contributor.otherFilipović, Danka
dc.contributor.otherMihalj, Marija
dc.contributor.otherBobić, Branislav
dc.creatorPantelinac, Slobodan
dc.date.accessioned2020-07-03T13:26:29Z
dc.date.available2020-07-03T13:26:29Z
dc.date.issued2014-12-08
dc.identifier.urihttp://nardus.mpn.gov.rs/handle/123456789/4703
dc.identifier.urihttp://www.cris.uns.ac.rs/DownloadFileServlet/Disertacija14092269316156.pdf?controlNumber=(BISIS)89984&fileName=14092269316156.pdf&id=2553&source=NaRDuS&language=srsr
dc.identifier.urihttp://www.cris.uns.ac.rs/record.jsf?recordId=89984&source=NaRDuS&language=srsr
dc.identifier.urihttp://www.cris.uns.ac.rs/DownloadFileServlet/IzvestajKomisije140922693940976.pdf?controlNumber=(BISIS)89984&fileName=140922693940976.pdf&id=2554&source=NaRDuS&language=srsr
dc.description.abstractUvod: Mikrodiskektomija je jedan od savremenih hirurških metoda u lečenju osoba sa lumbalnim sindromom, čiji je uzrok hernijacija intervertebralnog diska. Na postoperativni oporavak, ishod rehabilitacije i funkcionalno stanje, veliki uticaj imaju i biopsihosocijalni faktori. Cilj: Glavni cilj istraživanja je bio procena uticaja biopsihosocijalnih faktora na ishod lečenja i funkcionalni status bolesnika sa lumbalnim sindromom nakon mikrodiskektomije i sprovedenog rehabilitacionog tretmana. Materijal i metode: Sprovedena je prospektivna studija na 200 pacijenata (96 muškaraca i 104 žene), različitih profesija, prosečne životne dobi 50.20 ± 10.26 godina (raspon 29–69 godina). U istraživanje su uključeni pacijenti nakon operativnog lečenja hernijacije diska, putem mikrodiskektomije, premešteni sa Klinike za neurohirurgiju na Kliniku za medicinsku rehabilitaciju, Kliničkog centra Vojvodine u Novom Sadu. Stratifikacija ispitanika je izvršena prema njihovim biološko-demografskim, socio-ekonomskim, psihološkim i funkcionalnim obeležjima, uz korišćenje podataka iz anamneze, kliničkog pregleda, raspoložive medicinske dokumentacije i odgovarajućih upitnika i testova. Korišćeni su sledeći upitnici: za procenu bola-vizuelna analogna skala (VAS), upitnik o bolu (Pain Detect Test), za procenu psiholoških karakteristika Spilbergerovi testovi za trenutnu i opštu anksioznost (Spielberger Anxiety Inventory-State and Trait Test), Bekova skala depresije (BDI), upitnik za procenu prisustva straha od fizičke aktivnosti i posla i njihovog izbegavanja (The Fear-Avoidance Beliefs Questionnaire - Physical activity and Work), a za procenu funkcionalnog statusa Osvestrijev upitnik o onesposobljenosti (ODI) i Kvebek skala onesposobljenosti osoba sa lumbalnim sindromom. Fleksibilnost i indeks pokretljivosti lumbalnog segmenta kičme su procenjivani pomoću Šoberovog i Tomajerovog testa. Navedena ispitivanja su obavljena postoperativno pre početka sprovođenja rehabilitacionog tretmana (0. mesec), potom posle mesec dana i zatim 3 i 6 meseci posle mikrodiskektomije. Rezultati: Na doživljavanje bola i na funkcionalnu sposobnost imali su signifikantnog uticaja sledeći navedeni činioci. Pol: subjektivno doživljavanje bola je bilo jače kod žena nego kod muškaraca, ali je stepen funkcionalne onesposobljenosti (prema ODI i Kvebek skali) bio signifikantno veći (p<0.01) kod muškaraca. Životna dob: Stepen oporavka pacijenata nakon mikrodiskektomije je tokom vremena u pojedinim starosnim grupama bio promenljiv, ali je u celini bio lošiji kod starijih osoba. Navika pušenja: intenzitet bola (VAS) i stepen funkcionalne onesposobljenosti (prema ODI i Kvebek skali ) su bili veći kod pušača nego kod nepušača (p<0.01). Mehaničko opterećenje kičme: manji stepen oporavka su imali ispitanici čije zanimanje je povezano sa većim dinamičkim i statičkim opterećenjem kičmenog stuba. Socijalni faktori: redovno zaposlenje i novčana primanja su povezani sa boljim funkcionalnim oporavkom. Psihološki status i stepen optimizma: anksioznost i strahovi od fizičke aktivnosti i posla, strah od gubitka posla, depresija, negativni stavovi i pesimizam su signifikantno češće prisutni kod ispitanika koji su imali manji stepen funkcionalnog oporavka tokom praćenog perioda. Zaključci: Na doživljavanje bola i na funkcionalnu sposobnost i oporavak pacijenata nakon mikrodiskektomije imali su signifikantnog uticaja sledeći biopsihosocijalni faktori: pol, životna dob, navika pušenja, mehaničko opterećenje kičme, socijalno-ekonomski faktori, psihološki status i stepen optimizma pacijenta. Primenom odgovarajućih upitnika i registrovanjem ovih faktora, može se kreirati model za predviđanje stepena funkcionalnog oporavka i za primenu dopunskih terapijskih postupaka posle načinjene mikrodiskektomije.sr
dc.description.abstractIntroduction: Microdiscectomy is one of the modern surgical methods for the treatment of people with low back pain, caused by a herniated intervertebral disc. On postoperative recovery, rehabilitation outcome and functional status, among others, great influence have also biopsychosocial factors. Goal: The main goal of the research was to assess which biopsychosocial factors have a significant impact on treatment outcome and functional status of patients with low back pain after lumbar microdiscectomy and the subsequent physical therapy. Material and methods: The research was conducted as a prospective study on 200 patients (96 men and 104 women), of various professions and mean age 50.20 ± 26.10 years (range 29-69 years). The study involved patients after surgical treatment of disc herniation by microdiscectomy, who were transferred from the Clinic for neurosurgery to the Clinic for medical rehabilitation, in Clinical center of Vojvodina, Novi Sad, in order to perform physical therapy and rehabilitation. Stratification of patients was performed according to their biological, demographic, socio-economic, psychological and functional characteristics, using data from the health history, clinical examination, the available medical records and appropriate questionnaires and tests. Among the questionnaires were those that are used for assessment of pain, psychological and psychosocial characteristics and functional status of patients with low back pain, including a visual analogue scale, Pain Detect Test, Spielberger Anxiety Inventory-State and Trait, Beck Depression Inventory, The Fear-Avoidance Beliefs Questionnaire (Physical activity and Work), Oswestry Low Back Pain Disability Questionnaire (ODI) and Quebec Back Pain Disability Scale. The flexibility of the lumbar segment of the spine and its movement index were assessed by Schober's and Thomayer's tests. All of these above mentioned assessments were carried out just before the start of the rehabilitation treatment (month 0), at the beginning of physical therapy (month 0), one month later and then 3 and 6 months after microdiscectomy. Results: On the pain and functional ability / disability the significant influences had following listed factors. Gender: subjective perception of pain was stronger among women than among men, but the degree of functional disability (ODI and Quebec Scale) was significant higher in the group of men (p<0.01). Age: The degree of recovery among patients after microdiscectomy over time in different age groups was varying, but in general was worse in the group of older people. Smoking habits: pain intensity and degree of functional disability were higher among smokers than nonsmokers (p<0.01). Mechanical loading of the spine: lower degree of recovery had subjects whose job is associated with a higher dynamic and static loading of the spine. Social factors: regular employment and cash income are associated with better functional recovery. Psychological status and the degree of optimism: anxiety and fear of physical activity and work as well as the possibility of job loss, depression, negative attitudes and pessimism, were significantly more often present in the group of patients who had a lower degree of functional recovery during the studied period. Conclusions: On the experience of pain, on functional ability and recovery of patients after microdisectomy, significant influences have the following biopsychosocial factors: gender, age, smoking habits, the mechanical loading of the spine, socio-economic factors, psychological status and the degree of optimism of the patient. Using the appropriate questionnaires and registering mentioned factors, it is possible to create a model for predicting the degree of functional recovery and for the application of additional therapeutic procedures after microdisectomy.en
dc.languagesr (latin script)
dc.publisherУниверзитет у Новом Саду, Медицински факултетsr
dc.rightsopenAccessen
dc.sourceУниверзитет у Новом Садуsr
dc.subjectLumbalni sindromsr
dc.subjectLow back painen
dc.subjectmicrodiscectomyen
dc.subjectbiopsychosocial factorsen
dc.subjectfunctional recoveryen
dc.subjectmikrodiskektomijasr
dc.subjectbiopsihosocijalni faktorisr
dc.subjectfunkcionalni oporavaksr
dc.titleUticaj biopsihosocijalnih faktora na ishod rehabilitacije pacijenata nakon lumbalne mikrodiskektomijesr
dc.titleInfluence of biopsychosocial factors on the outcome of rehabilitation in patients after lumbar microdiscectomyen
dc.typedoctoralThesisen
dc.rights.licenseBY-NC
dcterms.abstractВулековић Петар; Томашевић-Тодоровић Снежана; Девечерски Гордана; Цигић Томислав; Филиповић Данка; Михаљ Марија; Бобић Бранислав; Пантелинац Слободан; Утицај биопсихосоцијалних фактора на исход рехабилитације пацијената након лумбалне микродискектомије; Утицај биопсихосоцијалних фактора на исход рехабилитације пацијената након лумбалне микродискектомије;
dc.identifier.fulltexthttp://nardus.mpn.gov.rs/bitstream/id/34772/IzvestajKomisije277.pdf
dc.identifier.fulltexthttp://nardus.mpn.gov.rs/bitstream/id/34771/Disertacija277.pdf


Files in this item

Thumbnail
Thumbnail

This item appears in the following Collection(s)

Show simple item record