Ngokuqala kweempawu ze- rheumatoid arthritis okanye ngexesha lokutshatyalaliswa kweempawu, abantu banqwenela ukukhwela etaweni baze bahlale apho. Oku kuqondakalayo kwaye kuyaqondakala. Yiloo nto esiyenzayo xa singaziva kakuhle, kunene? Kodwa, i-rheumatoid arthritis isifo esingapheliyo. Akukho nonyango . Isifo kufuneka siphethwe ngexesha. Ukuphumla kombhede kufanelana nesicwangciso sexesha elide lokulawula i-rheumatoid arthritis?
Iyintoni umphumo wokuphumla kombhede kwimisebenzi yesifo?
Iingcebiso ezivela kwi-Long Ago
UHippocrates wathi, "Kulo lonke uhambo lomzimba, naluphi na umntu eqala ukunyamezela intlungu, kuya kukhululeka ngokuphumla." Yiloo ndlela ekude kufuneka sihambe ngayo ukuze sifumane imvelaphi yokucinga ukuba ukuphumla kombhede kuyona nto ibuhlungu ngayo. Okuthakazelisayo, oogqirha babambelele kuloo nto kwaye bacebisa ukuphumla kokulala kwiimeko ezahlukeneyo zeeons. Kodwa, njengoko abaphandi baphumelele ekuhlolisiseni izifundo ezaziqwalasela umphumo wokuphuluka kwephulo lokulala, iziphumo ezibalulekileyo zazinzima ukuza-kwaye kubaluleke nakakhulu, ezinye iziphumo zibhekiselele kwimiphumo emibi ngokuphumla kombhede.
Ngowe-1978, i-Clinical Mayo yathi isifo sokuphumla kwi-rheumatoid arthritis "yayingqubuzana". Ububungqina ngexesha eliphakanyisiweyo lokuba umsebenzi ukhulisa ukuvutha kunye nokutshatyalaliswa, ngelixa ukuphumla kunciphisa ukuvutha. Yacetyiswa ukuba ukulaliswa esibhedlele kunokuphucula ukuvuvukala.
Kwakhona kwacetyiswa ukuba ukhathala kufuneka kusetyenziswe njengesikhokelo ekuphatheni i-rheumatoid arthritis. I-Clinical Mayo yagqiba ukuba ukuphumla ngokwaneleyo ukukhusela ukukhathala ngokudibanisa neyeza elifanelekileyo lonyango yinkqubo engcono yokonyango.
Iziphumo zokuhlalutya
Ngo-1999, u-Allen C. et al. (I-Lancet ngo-Oktobha 8, 1999; 354: 1229-33) yenze i-meta-analysis ngokuphanda i-MEDLINE kunye ne-Cochrane Library ukwenzela ukuba uphononongo lwefuthe lokuphumula lokulala.
Baqaphela izilingo ezingama-39 ezilawulwe ngokulandelelana, ezibandakanya izigulane ezingama-5,700 eziphathwe izifo nezimo ezi-15. Kwi-15 yezilingo, ukuphumla kombhede kwafundwa njengonyango oluphambili lweemeko ezibandakanya intlungu ephantsi, umsebenzi wezandla, ukungabikho komzimba we-myocardial infarction, i-hepatitis ephezulu kunye ne-rheumatoid arthritis. Ababhali baphetha ukuba ubungqina obuncinane bunokufumaneka ukuxhasa ukusetyenziswa kokulala kwebhedlele. Kukho uluhlu lweziphumo zokuphumla kwebhedi-ukusuka ekungabikho inxaxheba ekwenzeni inobungozi. Ababhali bacaphuna iingcebiso ekuqaleni banikezela amashumi eminyaka ngaphambili, bathi ukuphumla komntu ubhedu "luhlobo olunobungozi obunobungozi obunobungozi, ukuba luyalelwe imiqondiso ethile kwaye luyeke ngokukhawuleza."
Ixesha elifutshane elibhekiselele ekuphumleni kwexesha elide
Abaphengululi baye bathetha ukuba ukuphumla kunokuba luncedo kwiindawo ezithintekayo kwaye zibuhlungu kwixesha elifutshane. Ukuphumla kunokunciphisa intlungu kunye nokuvuvukala kwamalungu athintekayo. Kodwa, kwixesha elide, kukho iziphumo ezimbi ezibangelwa ukungasebenzi, ngoJohn Hopkins. Iziphumo ezichaphazelayo zibandakanya uluhlu oluncinane lokunyakaza , ukunciphisa amandla, ukuphendula okutshintshelwe ukulayishwa ngokubambisana , kunye nokunciphisa amandla aerobic. Ngokusekelwe kwiziphumo zophando ezivela kuMueller et al.
(I-Archives of Medicine and Rehabilitation, 1970), izigulane zokuphumla kwebhedlele eziqinileyo zingalahlekelwa ipesenti ezili-1.5 ukuya kuma-1.5 ekhulwini lamandla ngosuku ngemini yeeveki ezimbini. Umgqirha wenyama wandixelele ukuba kuthatha iiveki nje ukuba zilahleke, ngokwemandla emisipha, zithatha iinyanga ezininzi ukuzuza kwakhona.
Nangona ukuphumla kwexesha lesigxina okanye elifutshane kunokuncedisa ukunciphisa intlungu nokunciphisa inani lamathenda amathenda okanye amanxeba atshabalalayo, ukuphumla kwexesha lokulala ixesha elide elibhekiselele kakhulu. Ukuphumla kwexesha lokulala, kunye ne- atrophy ye-muscle , kunokubangela izilonda ze-decubitus, ukunciphisa i-tendon, kunye nezivumelwano. Inokuthi idibaniswe nesifo se-thromboembolic (ukwakheka kwegazi kunye ne-insulin).
Ekubeni kunomngcipheko wokwenza umonakalo ongaphezu kokulungileyo kunye nokuphumla kwexesha lokulala, ezinye iindlela kufuneka ziqwalaselwe. Kwamalungu athile athile, ukuchithwa kwempahla kunokuba nako okwethutyana ngokusebenzisa ubuqaqawuli okanye ngokugqoka inkxaso ekunciphiseni ukunyakaza kweqela elichaphazelekayo. Ngokufanelekileyo, kufuneka kubekho umlinganiselo phakathi kokuphumla kunye nomsebenzi. Awukwazi ukuyeka ukuzivocavoca kunye nokusebenza ngokwenyama ngenxa yokuphumla ixesha elide. Ukuzivocavoca kuyimfuneko ukukhusela i-atrophy, i-weakness, kunye nokungazinzi. Ukucinga kwangoku kukhombisa ukuba ekusebenzeni ixesha elide, umzimba uyanciphisa intlungu kunye nokukhathala kunokunyusa. Ukuba ulala embhedeni ucinga ukuba awukwazi ukusebenziseka ngokwaneleyo kwanokuba uyintoni na, cinga kwakhona.
> Imithombo:
> Isiphequluli, uRoy G. Iziphumo zeNtlawulo yokulala. Yunivesithi yaseJohn Hopkins. Ishicilelwe kwiMicrotherapy Care Critical Care. I-Vol.37 Ungezelelo 10. Oktobha 2009.
> Cush, Weinblatt, kunye neKavanaugh. Ukuphumla nokuzivocavoca. Page 92. I-Arthritis ye-Rheumatoid: Ukuxilongwa kwangaphambili kunye noTyango. UQhagamshelwano loLwazi, Inc. Inkcazelo yesithathu.
> Krabak, uBrian MD kunye noMinkoff, uEvan DO. Johns Hopkins Isikhungo seArthritis. Ulawulo lokubuyiswa kweeRumatoid Arthritis Patients. Uphumlo Olwalamano. Ukuhlaziywa ngoJulayi 31, 2012.
> Smith RD kunye nePolley HF. Uphulo lokuphumla kwi-Rheumatoid Arthritis. IMayo Clinic Proceedings. Ngo-1978 Matshi; 53 (3): 141-5.
> Ukudonga, u-Anne D. MD. Qaphela Ukuphakamisa Ukuphumla Kwebhedlele Kwizifo ezininzi. WaseMerika ugqirha. 2000 Feb 15; 61 (4): 1164.