Rehabilitacija vrtoglavega bolnika – izziv za biopsihologe / Vertigo rehabilitation – challenge for biopsychology - v pripravi

  • Anton Grad

Abstract

An upright posture and gait demand an evolutional adaptation not only of the locomotor but also of the sensory system with the functional integration of the brain. The vestibular system has an important role in maintaining balance control, spatial orientation, and visual image stabilisation. Unilateral vestibular function loss causes the illusion of  movement experienced by the patient as  vertigo. Vestibular nuclei project to the multimodal sensory areas of the brain cortex. In this way, vertigo causes imbalance, oculomotor disturbances (nystagmus), and an autonomic nervous response with nausea, vomiting, and sweating. Consequently, an emotional response (anxiety) is triggered that immobilizes the patient, leading to passive habituation which is always an incomplete form of  vestibular rehabilitation. Complete rehabilitation is only possible in the form of adaptation, which demands the patient's active participation. This means that the patient has to overcome unpleasant feelings and conquer his/her own anxiety. At this point, biopsychologists, with knowledge of the neurobiological basis of  vertigo  and the psychological responses of the individual, having competences in managing vestibular rehabilitation, can make good  use of the methods of cognitive behaviour therapy and relaxation techniques.


Izvleček


Za pokončno držo in hojo je potrebna evolucijska prilagoditev ne samo gibalnega, temveč tudi čutnega sistema z integracijsko vlogo možganov. Pri vzdrževanju ravnotežja, zaznavanju telesa v prostoru in fiksaciji pogleda s stabilno vidno sliko med gibanjem ima pomembno vlogo vestibularni sistem. Enostranska okvara vestibularnega organa povzroči iluzijo gibanja, kar bolnik občuti kot vrtoglavico. Projekcije iz vestibularnih jeder končajo v multimodalnih senzornih predelih možganov, zato vrtoglavica sproži motnje ravnotežja, nehoteno gibanje zrkelj (nistagmus) in odziv avtonomnega živčevja (slabost, bruhanje, znojenje). Posledično se sproži čustven odziv (anksioznost), ki bolnika imobilizira. To vodi v pasivno habituacijo, zato je taka oblika rehabilitacije vedno nepopolna. Popolna rehabilitacija je možna le v obliki prilagoditve na podlagi nevroplastičnosti, kar pa zahteva bolnikovo aktivno sodelovanje. To pomeni, da se mora bolnik soočiti s svojimi neprijetnimi občutki in premagati anksioznost. Tu pa lahko pomaga biopsiholog, saj je zaradi poznavanja nevrobioloških podlag vrtoglavice in psiholoških odzivov posameznika usposobljen za vodenje rehabilitacije vrtoglavega bolnika z metodami kognitivne vedenjske terapije in metodami sproščanja.

Published
2018-11-19
How to Cite
GRAD, Anton. Rehabilitacija vrtoglavega bolnika – izziv za biopsihologe / Vertigo rehabilitation – challenge for biopsychology - v pripravi. Bilten: ekonomika, organizacija, informatika v zdravstvu <br/> (BULLETIN economics, organisation and informatics in healthcare) <br/> ISSN 2630-2543, [S.l.], v. 29, n. 1, p. 1 -- 8, nov. 2018. ISSN 2630-2543. Available at: <https://journals.famnit.upr.si/index.php/bilten/article/view/44>. Date accessed: 17 feb. 2020.