N\u011bjak\u00e1 obecn\u00e1 preventivn\u00ed a pro v\u0161echny pou\u017eiteln\u00e1 oby\u010dejn\u00e1 preventivn\u00ed opat\u0159en\u00ed vlastn\u011b neexistuj\u00ed, uvedl Ond\u0159ej Hor\u00e1\u010dek, prim\u00e1\u0159 rehabilita\u010dn\u00edho centra berounsk\u00e9 nemocnice. „To se mus\u00ed \u0159e\u0161it individu\u00e1ln\u011b s konkr\u00e9tn\u00edm pacientem. Zde z\u00e1le\u017e\u00ed, jak\u00e9 m\u00e1 pacient pohybov\u00e9 pracovn\u00ed stereotypy, jak\u00e9 m\u00e1 pracovn\u00ed podm\u00ednky,“ vysv\u011btlil.
Rehabilitace pat\u0159\u00ed mezi pom\u011brn\u011b \u0161irok\u00fd obor, kter\u00fd souvis\u00ed s \u0159adou dal\u0161\u00edch oblast\u00ed a proto se r\u016fzn\u00ed specialist\u00e9 v oboru dopl\u0148uj\u00ed. A jak l\u00e9ka\u0159 vysv\u011btluje, po\u010det lid\u00ed, kte\u0159\u00ed si st\u011b\u017euj\u00ed na bolesti pohybov\u00e9ho apar\u00e1t\u016f, v posledn\u00ed dob\u011b rozhodn\u011b p\u0159ib\u00fdv\u00e1.<\/p>\n\n\n\n
\u010casto se d\u00e1 zaslechnout, \u017ee modern\u00ed sedav\u00fd zp\u016fsob \u017eivota si vyb\u00edr\u00e1 da\u0148 v podob\u011b bolestiv\u00fdch zad. M\u016f\u017eete to potvrdit z va\u0161\u00ed praxe? Nar\u016fst\u00e1 po\u010det takov\u00fdch probl\u00e9m\u016f u pacient\u016f, nebo se dr\u017e\u00ed posledn\u00ed roky zhruba na stejn\u00e9 \u00farovni?<\/p>\n\n\n\n
Ze sv\u00e9 praxe mohu potvrdit, \u017ee u \u010d\u00e1sti pacient\u016f je sedav\u00fd zp\u016fsob \u017eivota ur\u010dit\u011b jedn\u00edm z faktor\u016f, kter\u00fd k bolestem zad p\u0159isp\u00edv\u00e1. V\u011bt\u0161inou to nen\u00ed d\u016fvod jedin\u00fd, p\u0159i rozvoji bolest\u00ed zad se \u010dasto kombinuje v\u00edce faktor\u016f. Sedav\u00fd zp\u016fsob \u017eivota v\u0161ak p\u0159isp\u00edv\u00e1 je\u0161t\u011b k jin\u00fdm a z\u00e1va\u017en\u011bj\u0161\u00edm zdravotn\u00edm obt\u00ed\u017e\u00edm. Nedostatek pohybu zji\u0161\u0165ujeme nap\u0159\u00edklad u pacient\u016f s hypertenz\u00ed nebo cukrovkou. Jinak bolest\u00ed zad v \u017e\u00e1dn\u00e9m p\u0159\u00edpad\u011b neub\u00fdv\u00e1, sp\u00ed\u0161e pozorujeme opa\u010dn\u00fd trend. I p\u0159es to, \u017ee ve\u0159ejnost je ji\u017e docela dob\u0159e informov\u00e1na o nutnosti spr\u00e1vn\u00e9 \u017eivotospr\u00e1vy, vhodn\u00e9m pohybov\u00e9m re\u017eimu a v\u00fdznamu preventivn\u00edho cvi\u010den\u00ed. Otev\u0159eli jsme v na\u0161\u00ed nemocnici Nutri\u010dn\u00ed poradnu. Nutri\u010dn\u00ed poradna zaji\u0161\u0165uje odborn\u00e9 konzultace v oblasti l\u00e9\u010debn\u00e9 v\u00fd\u017eivy, v\u010detn\u011b vyhodnocen\u00ed stravovac\u00edch zvyklost\u00ed pacienta. Poradna je ur\u010den\u00e1 v\u0161em, kte\u0159\u00ed cht\u011bj\u00ed sami se sebou n\u011bco ud\u011blat. M\u00e1 za c\u00edl zlep\u0161it, udr\u017eet nebo podporovat zdrav\u00ed klienta a z\u00e1rove\u0148 poskytuje sv\u00fdm klient\u016fm individu\u00e1ln\u00ed, profesion\u00e1ln\u00ed a hlavn\u011b lidsk\u00fd p\u0159\u00edstup.<\/p>\n\n\n\n
S \u010d\u00edm za v\u00e1mi lid\u00e9 nej\u010dast\u011bji chod\u00ed, na jak\u00e9 bolesti si st\u011b\u017euj\u00ed?<\/p>\n\n\n\n
V r\u00e1mci na\u0161eho oboru \u010dasto \u0159e\u0161\u00edme pacienty zejm\u00e9na po ortopedick\u00fdch operac\u00edch, po \u00farazech hybn\u00e9 soustavy ale i pacienty s neurologick\u00fdmi poruchami. Nejv\u00edce v\u0161ak m\u00e1me pacient\u016f s bolest\u00ed pohybov\u00e9ho apar\u00e1tu, p\u0159edev\u0161\u00edm s bolestmi p\u00e1te\u0159e r\u016fzn\u00e9ho charakteru. Pacienti s bolestmi p\u00e1te\u0159e p\u0159itom p\u0159edstavuj\u00ed velmi pestrou skupinu \u2013 \u0159e\u0161\u00edme bolesti p\u00e1te\u0159e akutn\u00ed i chronick\u00e9, n\u011bkte\u0159\u00ed pacienti maj\u00ed bolesti n\u00e1sledkem „ban\u00e1ln\u00ed“ blok\u00e1dy p\u00e1te\u0159e, ani\u017e by m\u011bli n\u011bjak\u00e9 posti\u017een\u00ed p\u00e1te\u0159n\u00edch kloub\u016f nebo plot\u00e9nek. \u010c\u00e1st pacient\u016f m\u00e1 bolesti n\u00e1sledkem v\u00fdh\u0159ez\u016f meziobratlov\u00fdch plot\u00e9nek, kter\u00e9 n\u011bkdy stla\u010d\u00ed nervov\u00fd ko\u0159en a vznik\u00e1 takzvan\u00fd ischias (odborn\u011b radikul\u00e1rn\u00ed syndrom). M\u00e1me tak\u00e9 hodn\u011b pacient\u016f s bolestmi velk\u00fdch kloub\u016f \u2013 tedy ramen, kolen a ky\u010dl\u00ed.<\/p>\n\n\n\n
Lid\u00e9 si \u010dasto mysl\u00ed, \u017ee sta\u010d\u00ed zaj\u00edt jednou za \u010das na mas\u00e1\u017e a probl\u00e9m zmiz\u00ed. Jsou ale ochotni z va\u0161\u00ed zku\u0161enosti zm\u011bnit \u017eivotn\u00ed styl, chodit cvi\u010dit\u2026?<\/p>\n\n\n\n
Je pravda, \u017ee n\u011bkdy p\u0159ich\u00e1z\u00ed pacient s ur\u010ditou p\u0159edstavou o procedur\u00e1ch, kter\u00e9 by m\u011bl absolvovat. Jsou opravdu i takov\u00ed, kte\u0159\u00ed si mysl\u00ed \u017ee v\u0161e vy\u0159e\u0161\u00ed mas\u00e1\u017e a proto ji po\u017eaduj\u00ed. Mas\u00e1\u017e m\u00e1 n\u011bkdy v\u00fdznam a je to u \u010d\u00e1sti pacient\u016f vhodn\u00e1 dopl\u0148kov\u00e1 metoda k uvoln\u011bn\u00ed svalov\u00e9ho nap\u011bt\u00ed a lep\u0161\u00edmu prokrven\u00ed sval\u016f, ale t\u011b\u017eko m\u016f\u017eeme n\u011bkoho vyl\u00e9\u010dit jen mas\u00e1\u017e\u00ed. Nav\u00edc u n\u011bkter\u00fdch pacient\u016f mas\u00e1\u017ee vhodn\u00e9 nejsou a mohou pacientovi i p\u0159it\u00ed\u017eit. P\u0159izn\u00e1v\u00e1m, \u017ee nejsem \u00fapln\u011b nad\u0161en\u00fd, kdy\u017e prvn\u00ed, co mi pacient ozn\u00e1m\u00ed, je, \u017ee pot\u0159ebuje mas\u00e1\u017ee.
Pro\u010d z toho nejste nad\u0161en\u00fd?<\/p>\n\n\n\n
Sv\u011bd\u010d\u00ed to o tom, \u017ee pacient preferuje pasivn\u00ed p\u0159\u00edstup p\u0159i \u0159e\u0161en\u00ed sv\u00fdch bolest\u00ed, ale i o tom, \u017ee m\u00e1 zkreslenou p\u0159edstavu o p\u016fvodu sv\u00fdch obt\u00ed\u017e\u00ed. Daleko l\u00e9pe se mi pracuje a velmi mne pot\u011b\u0161\u00ed, kdy\u017e pacient chce b\u00fdt p\u0159i terapii aktivn\u00ed a p\u0159ich\u00e1z\u00ed s \u017e\u00e1dost\u00ed, abychom ho nau\u010dili spr\u00e1vn\u011b cvi\u010dit. To doslova „zaj\u00e1s\u00e1m“, proto\u017ee to je ten spr\u00e1vn\u00fd p\u0159\u00edstup. Jinak m\u011bnit \u017eivotn\u00ed styl nen\u00ed jednoduch\u00e9, obvykle to lze jen do ur\u010dit\u00e9 m\u00edry. Nejt\u011b\u017e\u0161\u00ed je b\u00fdt d\u016fsledn\u00fd a vydr\u017eet, nap\u0159. pokud jde o pravideln\u00e9 cvi\u010den\u00ed. A to dok\u00e1\u017e\u00ed jen n\u011bkte\u0159\u00ed disciplinovan\u00ed jedinci.<\/p>\n\n\n\n
Jak\u00e1 jsou „oby\u010dejn\u00e1“ preventivn\u00ed \u0159e\u0161en\u00ed, kter\u00e9 by mohl \u010dlov\u011bk do sv\u00e9ho \u017eivota zakomponovat, aby nem\u011bl probl\u00e9my se z\u00e1dy a obecn\u011b s pohybov\u00fdm apar\u00e1tem?<\/p>\n\n\n\n
Na to nen\u00ed jednoduch\u00e1 odpov\u011b\u010f. N\u011bjak\u00e1 obecn\u00e1 preventivn\u00ed a pro v\u0161echny pou\u017eiteln\u00e1 oby\u010dejn\u00e1 preventivn\u00ed opat\u0159en\u00ed vlastn\u011b neexistuj\u00ed. To se mus\u00ed \u0159e\u0161it individu\u00e1ln\u011b s konkr\u00e9tn\u00edm pacientem. Zde z\u00e1le\u017e\u00ed, jak\u00e9 m\u00e1 pacient pohybov\u00e9 pracovn\u00ed stereotypy, jak\u00e9 m\u00e1 pracovn\u00ed podm\u00ednky, t\u0159eba, zda m\u00e1 vyhovuj\u00edc\u00ed pracovn\u00ed \u017eidli, zda se v\u011bnuje n\u011bjak\u00fdm sport\u016fm a jak\u00fdm, zda posiluje a jak to prov\u00e1d\u00ed. P\u0159ihl\u00ed\u017e\u00ed se k individu\u00e1ln\u00ed pohyblivosti p\u00e1te\u0159e. Co je vhodn\u00e9 pro pacienta s vrozen\u011b m\u00e9n\u011b pohyblivou p\u00e1te\u0159\u00ed, nen\u00ed vhodn\u00e9 u pacienta s nadm\u011brnou pohyblivost\u00ed p\u00e1te\u0159e. Obecn\u011b plat\u00ed p\u00e1te\u0159 nep\u0159et\u011b\u017eovat, ale to u ka\u017ed\u00e9ho znamen\u00e1 n\u011bco jin\u00e9ho. U n\u011bkoho to znamen\u00e1 nesed\u011bt 12 hod u PC, u jin\u00e9ho pacienta nepracovat 2 hodiny s rukama nad hlavou, u dal\u0161\u00edho pacienta t\u0159eba ned\u011blat 60 sklapova\u010dek po r\u00e1nu. Je to opravdu vysoce individu\u00e1ln\u00ed. Velmi obecn\u011b lze \u0159\u00edci, \u017ee p\u00e1te\u0159i ned\u011blaj\u00ed dob\u0159e ot\u0159esy – skoky, dopady z v\u00fd\u0161ky, zved\u00e1n\u00ed t\u011b\u017ek\u00fdch b\u0159emen ve vynucen\u00fdch poloh\u00e1ch, dlouhodob\u00e1 pr\u00e1ce v p\u0159edklonu, dlouh\u00e9 cesty autem, nebo prochlazen\u00ed.<\/p>\n\n\n\n
Pohyb je bezpochyby d\u016fle\u017eitou sou\u010d\u00e1st\u00ed \u017eivota. Chod\u00ed k v\u00e1m ale lid\u00e9 z opa\u010dn\u00e9ho konce spektra \u2013 kdy sportuj\u00ed tak intenzivn\u011b, \u017ee jim to p\u0159in\u00e1\u0161\u00ed jin\u00e9 probl\u00e9my? Jak\u00e9 to t\u0159eba jsou, co \u0159e\u0161\u00ed?<\/p>\n\n\n\n
Ano, tito pacienti k n\u00e1m chod\u00ed a nen\u00ed jich m\u00e1lo. Je dost \u010dast\u00e9, \u017ee pacientovi obt\u00ed\u017ee za\u010dnou v n\u00e1vaznosti na n\u011bjakou sportovn\u00ed aktivitu, kter\u00e1 pro n\u011bj nen\u00ed vhodn\u00e1, proto\u017ee doch\u00e1z\u00ed k p\u0159et\u011b\u017eov\u00e1n\u00ed hybn\u00e9 soustavy. N\u011bkdy to nen\u00ed hned z\u0159ejm\u00e9. V posledn\u00edm roce jsem m\u011bl dv\u011b pacientky, \u017eeny ve st\u0159edn\u00edm v\u011bku, kter\u00e9 si st\u011b\u017eovaly na bolesti v k\u0159\u00ed\u017ei. \u017d\u00e1dn\u00e1 z nich d\u0159\u00edve bolestmi p\u00e1te\u0159e netrp\u011bla. Nejd\u0159\u00edve nebylo jasn\u00e9, co za t\u00edm je, pozd\u011bji jsme si ujasnili, \u017ee je jist\u00e1 souvislost mezi rozvojem bolesti a novou sportovn\u00ed aktivitou, kterou za\u010daly provozovat. V jednom p\u0159\u00edpad\u011b to byla j\u00f3ga, ve druh\u00e9m p\u0159\u00edpad\u011b se jednalo o posilovac\u00ed rytmick\u00e9 cvi\u010den\u00ed ve vynucen\u00fdch poloh\u00e1ch. Vy\u0161et\u0159oval jsem v\u00edce pacient\u016f provozuj\u00edc\u00edch golf, hodn\u011b volejbalist\u016f a tenist\u016f. V n\u011bkter\u00fdch p\u0159\u00edpadech se jednalo o obt\u00ed\u017ee v d\u016fsledku jednor\u00e1zov\u00e9ho p\u0159et\u00ed\u017een\u00ed, ale p\u0159i recidiv\u00e1ch obt\u00ed\u017e\u00ed je n\u011bkdy jedinou rozumnou cestou se sportem skon\u010dit. Toto se zejm\u00e9na bedliv\u011b mus\u00ed sledovat u d\u011bt\u00ed. Jde o to, aby d\u00edt\u011b provozovalo sport p\u0159im\u011b\u0159en\u00fd jeho t\u011blesn\u00fdm dispozic\u00edm, proto\u017ee v opa\u010dn\u00e9m p\u0159\u00edpad\u011b m\u016f\u017ee doj\u00edt i k trval\u00e9mu po\u0161kozen\u00ed d\u011btsk\u00e9ho organismu.
Jak\u00e1 byla va\u0161e cesta k oboru?<\/p>\n\n\n\n
J\u00e1 jsem za\u010dal jako neurolog, m\u00e1m prvn\u00ed i druhou atestaci v oborou neurologie. M\u00fdm prvn\u00edm u\u010ditelem, na kter\u00e9ho r\u00e1d vzpom\u00edn\u00e1m, byl profesor Martin Bojar. V\u017edy mne ale zaj\u00edmala problematika pohybov\u00e9ho apar\u00e1tu, proto mne st\u00e1le v\u00edce p\u0159itahoval obor rehabilitace, kter\u00fd se pohybov\u00fdm apar\u00e1tem hodn\u011b zab\u00fdv\u00e1. T\u0159et\u00ed atestaci m\u00e1m pr\u00e1v\u011b v oboru rehabilitace. K rozvoji rehabilitace v \u010cR p\u0159isp\u011bli p\u0159edev\u0161\u00edm dv\u011b slavn\u00e9 osobnosti sv\u011btov\u00e9ho form\u00e1tu: profesor Karel Lewit a profesor Vladim\u00edr Janda. Tyto osobnosti mne tak\u00e9 hodn\u011b ovlivnily a pova\u017euji je za sv\u00e9 u\u010ditele. Pro m\u016fj profesn\u00ed v\u00fdvoj byl tak\u00e9 d\u016fle\u017eit\u00fd profesor Pavel Kol\u00e1\u0159, se kter\u00fdm jsem m\u011bl mo\u017enost spolupracovat a kter\u00fd pat\u0159\u00ed mezi p\u0159edn\u00ed osobnosti sou\u010dasn\u00e9 \u010desk\u00e9 ale i evropsk\u00e9 rehabilitace.<\/p>\n\n\n\n
M\u00e1 obor neust\u00e1le nov\u00e9 trendy, kter\u00e9 je nutn\u00e9 sledovat a vzd\u011bl\u00e1vat se, nebo ji\u017e v\u0161echno bylo objeveno?<\/p>\n\n\n\n
V\u0161echno objeveno ur\u010dit\u011b nebylo. Novinky jsou hlavn\u011b v l\u00e9\u010debn\u00fdch postupech a technice, ale to hlavn\u00ed je, \u017ee do oboru pronikaj\u00ed nov\u00e9 technologie. Za velk\u00fd pokrok lze pova\u017eovat v\u00fdvoj robotick\u00fdch p\u0159\u00edstroj\u016f, kter\u00e9 se v posledn\u00edch letech za\u010d\u00ednaj\u00ed v na\u0161em oboru pou\u017e\u00edvat. Jsou to p\u0159\u00edstroje, kter\u00e9 nap\u0159. umo\u017e\u0148uj\u00ed pacientovi s nepohybliv\u00fdmi kon\u010detinami nacvi\u010dovat ch\u016fzi, nebo u pacienta s nepohyblivou rukou umo\u017e\u0148uje takzvan\u00e1 „robotick\u00e1 rukavice“ pohyb prsty, p\u0159i\u010dem\u017e se vyu\u017e\u00edv\u00e1 vizu\u00e1ln\u00ed zp\u011btn\u00e9 vazby. I tento p\u0159\u00edstroj m\u00e1me v na\u0161em Rehabilita\u010dn\u00edm centru.<\/p>\n\n\n\n
Co je pro v\u00e1s na tomto oboru nejzaj\u00edmav\u011bj\u0161\u00ed?<\/p>\n\n\n\n
Na rehabilitaci se mi p\u0159edev\u0161\u00edm l\u00edb\u00ed, \u017ee pacientovi obt\u00ed\u017ee poj\u00edm\u00e1 komplexn\u011b. N\u00e1\u0161 obor nem\u00e1 ostr\u00e9 hranice, prol\u00edn\u00e1 se s ortopedi\u00ed, traumatologi\u00ed, neurologi\u00ed. Je pot\u0159eba m\u00edt dostate\u010dn\u00e9 znalosti i z t\u011bchto obor\u016f. U \u0159ady pacient\u016f se na obt\u00ed\u017e\u00edch toti\u017e pod\u00edl\u00ed sou\u010dasn\u011b porucha neurologick\u00e1, d\u00e1le porucha kloubn\u00ed nebo po\u00farazov\u00e9 pohybov\u00e9 omezen\u00ed a to v\u0161e je t\u0159eba u dan\u00e9ho pacienta \u0159e\u0161it. S takov\u00fdm slo\u017eit\u00fdm pacientem pracuje v\u017edy cel\u00fd t\u00fdm pracovn\u00edk\u016f jeho\u017e sou\u010d\u00e1st\u00ed je rehabilita\u010dn\u00ed l\u00e9ka\u0159, d\u00e1le fyzioterapeut, ergoterapeut, eventueln\u011b logoped, a protetik a ka\u017ed\u00fd p\u0159isp\u011bje sv\u00fdm d\u00edlem.<\/p>\n\n\n\n
Jakub \u0160\u0165\u00e1stk<\/p>\n\n\n\n
Pra\u017esk\u00fd den\u00edk<\/p>\n\n\n\n
https:\/\/prazsky.denik.cz\/<\/a> N\u011bjak\u00e1 obecn\u00e1 preventivn\u00ed a pro v\u0161echny pou\u017eiteln\u00e1 oby\u010dejn\u00e1 preventivn\u00ed opat\u0159en\u00ed vlastn\u011b neexistuj\u00ed, uvedl Ond\u0159ej Hor\u00e1\u010dek, prim\u00e1\u0159 rehabilita\u010dn\u00edho centra berounsk\u00e9 nemocnice. „To se mus\u00ed \u0159e\u0161it individu\u00e1ln\u011b […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":14065,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"class_list":["post-33424","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zpravy"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/33424","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=33424"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/33424\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/14065"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=33424"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=33424"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=33424"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
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