Onemocn\u011bn\u00ed kost\u00ed a kloub\u016f se lidem \u010dasto plete. Kloubn\u00edmi prepar\u00e1ty se lid\u00e9 myln\u011b sna\u017e\u00ed „l\u00e9\u010dit“ i choroby, na kter\u00e9 nezab\u00edraj\u00ed, na n\u011b\u017e m\u00e1 podstatn\u011bj\u0161\u00ed vliv pravideln\u00e9 cvi\u010den\u00ed a fyzioterapie. D\u016fle\u017eit\u00e1 je aktivn\u00ed role pacienta a jeho motivace, \u0159\u00edk\u00e1 v rozhovoru profesor Ladislav \u0160enolt, vedouc\u00ed Odd\u011blen\u00ed experiment\u00e1ln\u00ed revmatologie Revmatologick\u00e9ho \u00fastavu v Praze.
Onemocn\u011bn\u00edm kost\u00ed a kloub\u016f trp\u00ed statis\u00edce \u010cech\u016f. Jak\u00e9 jsou prvotn\u00ed p\u0159\u00edznaky, kter\u00e9 by n\u00e1s m\u011bly varovat?<\/p>\n\n\n\n
Na za\u010d\u00e1tku je t\u0159eba odli\u0161it onemocn\u011bn\u00ed kost\u00ed a kloub\u016f. Lid\u00e9 si t\u0159eba \u010dasto pletou osteopor\u00f3zu, osteoartr\u00f3zu (artr\u00f3zu) a artritidu. Zn\u00ed to skoro stejn\u011b, ale pr\u016fb\u011bh je jin\u00fd. Osteopor\u00f3za je metabolick\u00e9 onemocn\u011bn\u00ed skeletu prov\u00e1zen\u00e9 \u00fabytkem kostn\u00ed hmoty se zv\u00fd\u0161en\u00fdm rizikem zlomeniny (typicky nap\u0159. ob\u00e1van\u00e1 zlomenina kr\u010dku). Osteoartr\u00f3za je degenerativn\u00ed kloubn\u00ed onemocn\u011bn\u00ed vedouc\u00ed k postupn\u00e9mu \u00fabytku chrupavky a ke zm\u011bn\u00e1m p\u0159ilehl\u00e9 kosti. Ta se projevuje bolest\u00ed, ztuhlost\u00ed a sn\u00ed\u017eenou pohyblivost\u00ed posti\u017een\u00fdch kloub\u016f. Rozvoj p\u0159\u00edznak\u016f je u osteoartr\u00f3zy pl\u00ed\u017eiv\u00fd a dlouhodob\u00fd, n\u011bkdy trv\u00e1 i roky. Mnohem vz\u00e1cn\u011bj\u0161\u00ed je pak revmatoidn\u00ed artritida, autoimunitn\u00ed onemocn\u011bn\u00ed, kter\u00e9 postihuje \u010dast\u011bji \u017eeny ne\u017e mu\u017ee, obvykle za\u010d\u00edn\u00e1 kolem 35. a\u017e 55. roku a v\u011bt\u0161inou se vyv\u00edj\u00ed postupn\u011b v pr\u016fb\u011bhu n\u011bkolika m\u00e1lo t\u00fddn\u016f a\u017e m\u011bs\u00edc\u016f.
Maj\u00ed nap\u0159\u00edklad ob\u00e9zn\u00ed lid\u00e9 vy\u0161\u0161\u00ed pravd\u011bpodobnost, \u017ee se budou pot\u00fdkat s onemocn\u011bn\u00edm pohybov\u00e9ho apar\u00e1tu? A jak je to u jin\u00fdch p\u0159idru\u017een\u00fdch chorob?<\/p>\n\n\n\n
Nadv\u00e1ha samoz\u0159ejm\u011b p\u0159edstavuje d\u016fle\u017eit\u00fd rizikov\u00fd faktor osteoartr\u00f3zy, jednodu\u0161e se jedn\u00e1 o mechanick\u00e9 p\u0159et\u00ed\u017een\u00ed velk\u00fdch kloub\u016f. Ob\u00e9zn\u00ed pacienti maj\u00ed v\u011bt\u0161\u00ed riziko kardiovaskul\u00e1rn\u00edch a n\u00e1dorov\u00fdch onemocn\u011bn\u00ed, zd\u00e1 se tak\u00e9, \u017ee mohou i o n\u011bco \u010dast\u011bji trp\u011bt revmatoidn\u00ed artritidou, ale v tomto ohledu neexistuje mezi odborn\u00edky jednozna\u010dn\u00e1 shoda. V p\u0159\u00edpad\u011b revmatoidn\u00ed artritidy nejde o prost\u00e9 mechanick\u00e9 p\u0159et\u00ed\u017een\u00ed, ale sp\u00ed\u0161e o zv\u00fd\u0161en\u00e9 uvol\u0148ov\u00e1n\u00ed n\u011bkter\u00fdch z\u00e1n\u011btliv\u00fdch l\u00e1tek z tukov\u00e9 tk\u00e1n\u011b. Pacienti s revmatoidn\u00ed artritidou, jej\u00ed\u017e aktivita nen\u00ed dostate\u010dn\u011b korigov\u00e1na l\u00e9\u010dbou, maj\u00ed asi dvakr\u00e1t v\u011bt\u0161\u00ed riziko kardiovaskul\u00e1rn\u00edch a plicn\u00edch onemocn\u011bn\u00ed, \u010dast\u011bji trp\u00ed \u00fanavou, mohou b\u00fdt depresivn\u00ed a maj\u00ed \u010dast\u011bji infek\u010dn\u00ed komplikace.<\/p>\n\n\n\n
V obchodech \u010di v televizi se na n\u00e1s val\u00ed nejr\u016fzn\u011bj\u0161\u00ed kloubn\u00ed prepar\u00e1ty. Jsou tyto p\u0159\u00edpravky opravdu tak z\u00e1zra\u010dn\u00e9?<\/p>\n\n\n\n
Samoz\u0159ejm\u011b \u017ee ne, z\u00e1zra\u010dn\u011b \u00fa\u010dinn\u00e9 p\u0159\u00edpravky nepot\u0159ebuj\u00ed reklamu. Voln\u011b prodejn\u00e9 „dopl\u0148ky stravy“ zn\u00e1m\u00e9 jako „kloubn\u00ed v\u00fd\u017eiva“, stejn\u011b jako obdobn\u00e9 p\u0159\u00edpravky v\u00e1zan\u00e9 na recept, jsou prim\u00e1rn\u011b ur\u010deny pro zlep\u0161en\u00ed osteoartr\u00f3zy. Nemaj\u00ed \u017e\u00e1dn\u00e9 doklady o \u00fa\u010dinnosti proti autoimunitn\u00edm onemocn\u011bn\u00edm typu revmatoidn\u00ed artritidy, nav\u00edc maj\u00ed pouze mal\u00e9 \u00fa\u010dinky na zm\u00edn\u011bnou osteoartr\u00f3zu. Nelze proto v\u011b\u0159it n\u011bkter\u00fdm tenden\u010dn\u00edm reklam\u00e1m a zejm\u00e9na nepravd\u00e1m koluj\u00edc\u00edm na internetu o vyl\u00e9\u010den\u00ed z artr\u00f3zy po p\u0159\u00edpravku, kter\u00fd je zrovna n\u00e1hodou ur\u010den „pr\u00e1v\u011b pro v\u00e1s a s ohromnou slevou“. Osteoartr\u00f3za je bohu\u017eel st\u00e1le onemocn\u011bn\u00ed nevyl\u00e9\u010diteln\u00e9, nav\u00edc velmi obt\u00ed\u017en\u011b l\u00e9\u010diteln\u00e9. Na druh\u00e9 stran\u011b je ale t\u0159eba, aby se p\u0159i artr\u00f3ze n\u011bco za\u010dalo d\u011blat.
\u010c\u00edm bychom m\u011bli za\u010d\u00edt?<\/p>\n\n\n\n
Mus\u00edme si uv\u011bdomit, \u017ee l\u00e9\u010dba osteoartr\u00f3zy je komplexn\u00ed a „kloubn\u00ed v\u00fd\u017eiva“ pouze dopl\u0148kem. Podstatnou roli maj\u00ed ostatn\u00ed opat\u0159en\u00ed, hlavn\u011b pravideln\u00e9 cvi\u010den\u00ed, fyzioterapie, redukce v\u00e1hy u ob\u00e9zn\u00edch pacient\u016f, \u00falevu v\u011bt\u0161inou p\u0159in\u00e1\u0161\u00ed aplikace tepla, elektrol\u00e9\u010dba, magnetoterapie, p\u0159i bolestech se vyu\u017e\u00edvaj\u00ed lok\u00e1ln\u00ed nebo syst\u00e9mov\u00e1 analgetika nebo lok\u00e1ln\u00ed obst\u0159ik kloub\u016f. Fin\u00e1ln\u00ed \u0159e\u0161en\u00ed u trvale bolestiv\u00fdch stav\u016f ale p\u0159in\u00e1\u0161\u00ed \u010dasto a\u017e chirurgick\u00e1 intervence.<\/p>\n\n\n\n
Jak m\u016f\u017eeme spr\u00e1vnou \u017eivotospr\u00e1vou p\u0159isp\u011bt k lep\u0161\u00edmu zdrav\u00ed na\u0161ich kloub\u016f?<\/p>\n\n\n\n
Spr\u00e1vn\u00e1 \u017eivotospr\u00e1va rozhodn\u011b pom\u00e1h\u00e1, sni\u017euje riziko \u00famrt\u00ed na kardiovaskul\u00e1rn\u00ed a n\u00e1dorov\u00e1 onemocn\u011bn\u00ed. Existuje jedin\u00e9 revmatick\u00e9 onemocn\u011bn\u00ed, u kter\u00e9ho m\u00e1 dietn\u00ed opat\u0159en\u00ed opravdu kl\u00ed\u010dov\u00fd v\u00fdznam, a t\u00edm je dna, p\u0159i kter\u00e9 je t\u0159eba omezit p\u0159\u00edjem purin\u016f. Ze stravy by se m\u011blo vylou\u010dit \u010derven\u00e9 maso, vnit\u0159nosti, trvanliv\u00e9 sal\u00e1my, uzen\u00e9 maso, mo\u0159sk\u00e9 ryby, alkohol atp. U ob\u00e9zn\u00edch jedinc\u016f m\u016f\u017ee reduk\u010dn\u00ed dieta sn\u00ed\u017eit v\u011bt\u0161\u00ed zat\u00ed\u017een\u00ed pohybov\u00e9ho apar\u00e1tu a p\u0159isp\u011bt k men\u0161\u00ed bolesti kloub\u016f zasa\u017een\u00fdch osteoartr\u00f3zou. U revmatoidn\u00ed artritidy a ostatn\u00edch imunitn\u011b podm\u00edn\u011bn\u00fdch nemoc\u00ed je vztah onemocn\u011bn\u00ed a \u017eivotospr\u00e1vy m\u00e9n\u011b jasn\u00fd, existuj\u00ed ale ur\u010dit\u00e9 doklady nap\u0159. o pozitivn\u00edm vlivu st\u0159edomo\u0159sk\u00e9 stravy, tj. stravy bohat\u00e9 na ovoce, zeleninu, o\u0159echy, lu\u0161t\u011bniny, r\u016fzn\u00e1 sem\u00ednka a ryby.<\/p>\n\n\n\n
Existuj\u00ed jednoduch\u00e9 cviky na prevenci onemocn\u011bn\u00ed souvisej\u00edc\u00edch s pohybov\u00fdm apar\u00e1tem?<\/p>\n\n\n\n
Jednoduch\u00e9 cviky existuj\u00ed, ale nezabra\u0148uj\u00ed vzniku revmatick\u00e9ho onemocn\u011bn\u00ed. P\u0159isp\u00edvaj\u00ed v\u0161ak k lep\u0161\u00ed kondici, mohou zm\u00edrnit bolest, zkr\u00e1tit ztuhlost a zlep\u0161it rozsah pohybu. Preventivn\u011b mohou zabra\u0148ovat vzniku nevhodn\u00e9ho postaven\u00ed v kloubech, rozvoji kontraktur a deformit. D\u016fle\u017eit\u00e9 je protahov\u00e1n\u00ed sval\u016f, zejm\u00e9na t\u011bch, kter\u00e9 maj\u00ed sklon ke zkracov\u00e1n\u00ed, a posilov\u00e1n\u00ed ochabl\u00fdch svalov\u00fdch skupin. Pacient s revmatick\u00fdm onemocn\u011bn\u00edm by m\u011bl b\u00fdt vy\u0161et\u0159en fyzioterapeutem, kter\u00fd by s n\u00edm provedl vhodn\u00fd n\u00e1cvik spr\u00e1vn\u00e9 techniky. D\u016fle\u017eit\u00e1 je aktivn\u00ed role pacienta, jeho motivace a pravidelnost. Vhodn\u00e9 je nap\u0159. aerobn\u00ed cvi\u010den\u00ed, ch\u016fze, j\u00edzda na kole nebo rotopedu a plav\u00e1n\u00ed.
Daj\u00ed se kloubn\u00ed nemoci zcela vyl\u00e9\u010dit, nebo jde u\u017e jen v\u00edcem\u00e9n\u011b o udr\u017eov\u00e1n\u00ed do\u010dasn\u00e9ho stavu, jen aby se stav nezhor\u0161il?<\/p>\n\n\n\n
Revmatick\u00e1 onemocn\u011bn\u00ed nelze ve v\u011bt\u0161in\u011b p\u0159\u00edpad\u016f vyl\u00e9\u010dit, pouze u z\u00e1n\u011btliv\u00fdch revmatick\u00fdch chorob to ji\u017e pom\u011brn\u011b dob\u0159e dok\u00e1\u017eeme. Na druh\u00e9 stran\u011b degenerativn\u00ed stavy typu osteoartr\u00f3zy je v\u00edcem\u00e9n\u011b t\u0159eba udr\u017eovat, postupn\u00e9mu zhor\u0161ov\u00e1n\u00ed v\u0161ak nelze \u010dasto zamezit. Jej\u00ed pr\u016fb\u011bh je variabiln\u00ed, \u010dasto postupuje pomalu, st\u0159\u00eddaj\u00ed se r\u016fzn\u011b dlouh\u00e1 obdob\u00ed bez p\u0159\u00edznak\u016f s m\u00edrn\u00fdmi p\u0159\u00edznaky nebo zhor\u0161en\u00edm kloubn\u00edch bolest\u00ed, kdy se mohou pod\u00e1vat analgetika, \u00fa\u010dinn\u00e1 je tak\u00e9 ambulantn\u00ed rehabilita\u010dn\u00ed l\u00e9\u010dba. V n\u011bkter\u00fdch p\u0159\u00edpadech, zpravidla p\u0159i trval\u00e9 bolesti a vymizen\u00ed kloubn\u00ed \u0161t\u011brbiny, je nutn\u00e9 konzultovat ortopeda k napl\u00e1nov\u00e1n\u00ed chirurgick\u00e9 intervence, t\u00edm se nej\u010dast\u011bji mysl\u00ed um\u011bl\u00e1 n\u00e1hrada kloubu.<\/p>\n\n\n\n
Prof. MUDr. Ladislav \u0160enolt, Ph.D. (44)<\/p>\n\n\n\n
Je profesorem Univerzity Karlovy, internistou a revmatologem. Je vedouc\u00edm Odd\u011blen\u00ed experiment\u00e1ln\u00ed revmatologie Revmatologick\u00e9ho \u00fastavu v Praze a zam\u011b\u0159uje se na osteoartr\u00f3zu a revmatoidn\u00ed artritidu.<\/p>\n\n\n\n
Alena Ben\u00ed\u0161kov\u00e1<\/p>\n\n\n\n
Svitavsk\u00fd den\u00edk<\/p>\n\n\n\n
https:\/\/svitavsky.denik.cz\/<\/a><\/p>\n","protected":false},"excerpt":{"rendered":" Onemocn\u011bn\u00ed kost\u00ed a kloub\u016f se lidem \u010dasto plete. Kloubn\u00edmi prepar\u00e1ty se lid\u00e9 myln\u011b sna\u017e\u00ed „l\u00e9\u010dit“ i choroby, na kter\u00e9 nezab\u00edraj\u00ed, na n\u011b\u017e m\u00e1 podstatn\u011bj\u0161\u00ed vliv […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":29620,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"class_list":["post-35465","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\/35465","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=35465"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/35465\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/29620"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=35465"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=35465"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=35465"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}