{"id":7033,"date":"2018-05-10T13:12:43","date_gmt":"2018-05-10T11:12:43","guid":{"rendered":"https:\/\/www.bonumsalutem.sk\/rehabilitacie\/?p=7033"},"modified":"2018-05-10T13:46:33","modified_gmt":"2018-05-10T11:46:33","slug":"ako-bojovat-so-svalovym-zapalom","status":"publish","type":"post","link":"https:\/\/www.bonumsalutem.sk\/rehabilitacie\/ako-bojovat-so-svalovym-zapalom\/","title":{"rendered":"Ako bojova\u0165 so svalov\u00fdm z\u00e1palom?","gt_translate_keys":[{"key":"rendered","format":"text"}]},"content":{"rendered":"

Poh\u013ead na porovnanie nesteroidn\u00fdch protiz\u00e1palov\u00fdch liekov (NSAIDS), \u013eadu a lasera.<\/span><\/strong><\/p>\n

Ka\u017edodenne diskutovanou t\u00e9mou v klinickom prostred\u00ed je z\u00e1pal. Z\u00e1pal je sprievodn\u00fd pr\u00edznak procesu hojenia a m\u00f4\u017ee by\u0165 potrebn\u00fd pre spr\u00e1vne zahojenie ak\u00fatnych poranen\u00ed m\u00e4kk\u00e9ho tkaniva. Pacienti \u010dasto h\u013eadaj\u00fa \u00fa\u013eavu od sprievodnej bolesti a radu, ako zlep\u0161i\u0165 proces hojenia. \u010cas uzdravenia a proces obnovy po\u0161koden\u00e9ho svalov\u00e9ho tkaniva m\u00f4\u017eu ovplyvni\u0165 vedomosti lek\u00e1ra a fyzioterapeuta, ako aj dostupn\u00e9 prostriedky.<\/span><\/p>\n

Ak\u00fatny z\u00e1pal (NSAIDS)<\/span><\/strong><\/p>\n

V pr\u00edpade zvierac\u00edch a \u013eudsk\u00fdch modelov sa objavuje st\u00e1le viac d\u00f4kazov o tom, \u017ee tlmenie ak\u00fatneho z\u00e1palu br\u00e1ni rastu a regener\u00e1cii svalov.\u00a0Z d\u00f4vodu schopnosti t\u00ed\u0161i\u0165 boles\u0165 a\u00a0zmier\u0148ova\u0165\u00a0z\u00e1pal prostredn\u00edctvom ich vplyvu na enz\u00fdmy\u00a0cyklooxygen\u00e1zy-2 (COX-2) lek\u00e1ri \u010dasto odpor\u00fa\u010daj\u00fa na ak\u00fatny z\u00e1pal NSAIDS. Aj ke\u010f NSAIDS dok\u00e1\u017eu zmierni\u0165 opuch , uk\u00e1zalo sa, \u017ee negat\u00edvne ovplyv\u0148uj\u00fa obnovu tkaniva. Sp\u00f4sobuj\u00fa zn\u00ed\u017eenie rozmno\u017eovania , diferencovania a f\u00faziu satelitn\u00fdch buniek \u010do m\u00f4\u017ee vies\u0165 k oslabeniu rastu a obnovy kostrov\u00e9ho svalstva a k zv\u00fd\u0161en\u00e9mu stavu fibr\u00f3zy. Najnov\u0161ie \u0161t\u00fadie tvrdia, \u017ee mnoh\u00fd lek\u00e1ri a terapeuti nemaj\u00fa dostato\u010dn\u00e9 vedomosti o NSAIDS alebo si svoje vedomosti v tejto oblasti nedop\u013a\u0148aj\u00fa o aktu\u00e1lne inform\u00e1cie. T\u00e1to skuto\u010dnos\u0165 sa m\u00f4\u017ee sta\u0165 ve\u013ek\u00fdm probl\u00e9mom v lie\u010dbe poranen\u00ed kostrov\u00e9ho svalstva, v\u010faka \u010domu sa fyzioterapeuti st\u00e1vaj\u00fa vyh\u013ead\u00e1vanej\u0161\u00ed.\u00a0<\/span><\/p>\n

Enz\u00fdmy COX – 2 sa zap\u00e1jaj\u00fa do protiz\u00e1palov\u00fdch ale aj proz\u00e1palov\u00fdch medi\u00e1torov v r\u00f4znych \u0161t\u00e1di\u00e1ch z\u00e1palov\u00e9ho procesu. Elimin\u00e1cia aktivity COX – 2 m\u00f4\u017ee zn\u00ed\u017ei\u0165 proz\u00e1palov\u00fa reakciu, av\u0161ak m\u00f4\u017ee tie\u017e br\u00e1ni\u0165 \u00fapln\u00e9mu priebehu z\u00e1palu \u010do m\u00f4\u017ee negat\u00edvne vpl\u00fdva\u0165 na hojenie svalstva.\u00a0 Existuje mno\u017estvo z\u00e1palov\u00fdch medi\u00e1torov, ktor\u00e9 maj\u00fa d\u00f4le\u017eit\u00fa sprostredkovaciu \u00falohu pri n\u00e1bore neutrofilov a monocytov, nevyhnutn\u00fdch na obnovu tkaniva. \u010eal\u0161\u00edm negat\u00edvnym vplyvom potl\u00e1\u010dania z\u00e1palu je br\u00e1nenie zbierania makrof\u00e1gov na mieste poranenia, \u010do m\u00e1 negat\u00edvny dopad na regener\u00e1ciu tkaniva. D\u00f4sledkom m\u00f4\u017ee by\u0165 zv\u00fd\u0161en\u00e1 akumul\u00e1cia tuku, trvalo odumret\u00e9 svalov\u00e9 vl\u00e1kna, zmen\u0161enie myofibrilov a spomalenie regener\u00e1cie svalstva. V\u0161etky tieto faktory je potrebn\u00e9 zv\u00e1\u017ei\u0165 pred odporu\u010den\u00edm NSAIDS pri ak\u00fatnych poraneniach svalov.<\/span><\/p>\n

Chronick\u00fd z\u00e1pal (NSAIDS)<\/span><\/strong><\/p>\n

Bolo klinicky preuk\u00e1zan\u00e9, \u017ee NSAIDS s\u00fa ne\u00fa\u010dinn\u00e9 pri zmier\u0148ovan\u00ed dif\u00fazneho syst\u00e9mov\u00e9ho z\u00e1palu. Steroidy ako napr\u00edklad predniz\u00f3n s\u00fa lep\u0161ou alternat\u00edvou pri obnovovan\u00ed rovnov\u00e1hy z\u00e1palov\u00e9ho procesu pri chronickom z\u00e1pale, najm\u00e4 pri opakovan\u00fdch „async\u00b4hr\u00f3nnych“ poraneniach svalov\u00e9ho tkaniva, ako napr\u00edklad opakovan\u00e9 svalov\u00e9 nap\u00e4tie toho ist\u00e9ho tkaniva. Chronick\u00fd z\u00e1pal m\u00f4\u017ee zv\u00fd\u0161i\u0165 degrad\u00e1ciu svalstva a oslabi\u0165 synt\u00e9zu kontraktiln\u00fdch prote\u00ednov svalov\u00fdch vl\u00e1kien. Medzi pr\u00edklady chronick\u00e9ho z\u00e1palu rad\u00edme napr. dif\u00faznu osteoartrit\u00eddu, chronick\u00fa ob\u0161truk\u010dn\u00fa chorobu p\u013e\u00fac, ochorenia obli\u010diek a podobne \u010do v\u0161etko s\u00favis\u00ed s \u00fabytkom svalovej hmoty. Medzi skuto\u010dnosti, ktor\u00e9 treba zoh\u013eadni\u0165 patr\u00ed \u010dasov\u00e9 ohrani\u010denie pozit\u00edvnych \u00fa\u010dinkov SAIDS na mesiace a\u017e roky. Pri ich dlhodobom pou\u017e\u00edvan\u00ed m\u00f4\u017ee d\u00f4js\u0165 k degrad\u00e1ci\u00ed prote\u00ednov, \u010do m\u00e1 za n\u00e1sledok svalov\u00fa atrofiu a pokles prolifer\u00e1cie a diferenci\u00e1cie myoblastov. V\u00a0mnoh\u00fdch pr\u00edpadoch m\u00e1 dlhodob\u00fd \u00fabytok svalov v\u00e4\u010d\u0161iu v\u00e1hu ako kr\u00e1tkodob\u00e9 protiz\u00e1palov\u00e9 \u00fa\u010dinky.<\/span><\/p>\n

D\u00f4le\u017eit\u00e9 inform\u00e1cie o protiz\u00e1palov\u00fdch liekoch<\/strong><\/span><\/span><\/span><\/p>\n

Lok\u00e1lny z\u00e1pal zohr\u00e1va d\u00f4le\u017eit\u00fa \u00falohu a\u00a0v procese hojenia je potrebn\u00fd. Analgetick\u00e9 met\u00f3dy ako aj analgetik\u00e1 s\u00fa vhodnej\u0161ou variantou pri ak\u00fatnych poraneniach svalov ne\u017e NSAIDS. Pri lok\u00e1lnych chronick\u00fdch z\u00e1palov\u00fdch podmienkach NSAIDS pom\u00e1haj\u00fa pri t\u00ed\u0161en\u00ed bolesti av\u0161ak nedok\u00e1\u017eu dobre zmier\u0148ova\u0165 chronick\u00fd z\u00e1pal. Pri chronick\u00fdch, lok\u00e1lnych z\u00e1paloch je opodstatnen\u00e9 pou\u017eitie SAIDS, av\u0161ak ich dlhodob\u00e9 pou\u017e\u00edvanie m\u00f4\u017ee vies\u0165 k rozpadu prote\u00ednov a n\u00e1sledn\u00e9mu \u00fabytku svalovej hmoty. Preto by sme ich u\u017e\u00edvanie mali d\u00f4kladne zv\u00e1\u017ei\u0165. <\/span><\/p>\n

\u013dad<\/strong><\/span><\/p>\n

\u013dad sa proti z\u00e1palu pou\u017e\u00edva u\u017e desa\u0165ro\u010dia, tak bude asi dobrou vo\u013ebou. Alebo to nie je tak? Ortopedick\u00fd chirurg Gabe Mirkin\u00a0v roku 1978 vyna\u0161iel zn\u00e1mi akronym „R.I.C.E“ (pokoj, \u013ead, kompresia a zv\u00fd\u0161enie polohy) vyjadruj\u00faci ako lie\u010di\u0165 z\u00e1pal. V lek\u00e1rskej komunite je u\u017e 40 rokov v\u010faka jeho jednoduchosti a v\u0161eobecn\u00e9mu prijatiu zlat\u00fdm \u0161tandardom pri lie\u010dbe z\u00e1palu. Dr. Milkin sa v\u0161ak ned\u00e1vno vyjadril \u017ee odmieta minim\u00e1lne polovicu met\u00f3dy R.I.C.E. Vo svojej publik\u00e1ci\u00ed Iced! <\/em>vysvet\u013euje, \u017ee pokoj a chlad v\u00f4bec neuzn\u00e1va. Dr. Mirkin uv\u00e1dza, \u017ee pre v\u00e4\u010d\u0161inu \u0161portovcov je d\u00f4le\u017eitej\u0161ie dlhodob\u00e9 vylie\u010denie ne\u017e prechodn\u00e1 \u00fa\u013eava od bolesti. \u201eA v\u00fdskum,\u201c p\u00ed\u0161e Dr. Mirkin, \u201eteraz dokazuje, \u017ee \u013ead aj dlhodob\u00fd pokoj v skuto\u010dnosti predl\u017euj\u00fa proces zotavovania.\u201c \u010ealej uv\u00e1dza \u017ee \u013ead sa be\u017ene pou\u017e\u00edva po ak\u00fatnom svalovom nap\u00e4t\u00ed, ale zatia\u013e neexistuj\u00fa \u017eiadne klinick\u00e9 \u0161t\u00fadie, ktor\u00e9 by jeho \u00fa\u010dinnos\u0165 potvrdili. V \u010dasopise Journal of Strength and the Conditioning Research <\/em>uv\u00e1dza, \u017ee \u013ead dokonca m\u00f4\u017ee sp\u00f4sobi\u0165 \u017ee zotavovanie z poranenia trv\u00e1 dlh\u0161ie. Sk\u00f4r ne\u017e by mal \u013ead zmier\u0148ova\u0165 z\u00e1pal p\u00f4sob\u00ed analgeticky. \u0160t\u00fadia v \u010dasopise Journal of Applied Physiology<\/em> z\u00a0roku 2013 preuk\u00e1zala, \u017ee vplyv kryoterapie na proz\u00e1palov\u00e9 ukazovatele pri svale po\u0161kodenom v d\u00f4sledku cvi\u010denia\u00a0je mierny a\u017e nulov\u00fd.\u00a0Zistenia Clevelandskej kliniky poukazuj\u00fa na oddialenie vyl\u00fa\u010denia IGF – 1 horm\u00f3nu, ktor\u00fd sa z\u00fa\u010dast\u0148uje z\u00e1palovej kask\u00e1dy a pom\u00e1ha obnovi\u0165 po\u0161koden\u00e9 tkanivo po aplik\u00e1ci\u00ed kryoterapie.<\/span><\/p>\n

Laser<\/span><\/strong><\/p>\n

\u0160t\u00fadie teda preuk\u00e1zali, \u017ee NSAIDS br\u00e1nia procesu hojenia tkaniva pri ak\u00fatnych zranenia a v pr\u00edpade chronick\u00fdch z\u00e1palov s\u00fa ne\u00fa\u010dinn\u00e9. \u010ealej sa preuk\u00e1zalo \u017ee ani met\u00f3da R.I.C.E ktor\u00e1 sa pou\u017e\u00edva 40 rokov nie je odpove\u010fou. Ak\u00e1 je teda najlep\u0161ia strat\u00e9gia pre lie\u010dbu z\u00e1palu a ur\u00fdchlenie obnovy tkaniva? St\u00e1le viac uzn\u00e1van\u00e1 met\u00f3da je podpora akt\u00edvneho zotavovania. Autor knihy Iced! The Illusionary Treatment Option<\/em>\u00a0a uzn\u00e1van\u00fd \u0161portov\u00fd tr\u00e9ner Gary Reinl ver\u00ed, \u017ee odpove\u010fou je nov\u00fd akronym: A.R.I.T.A,\u00a0teda akt\u00edvne zotavenie. Nehybnos\u0165, ktor\u00e1 prispieva k zn\u00ed\u017eeniu pr\u00fadenia krvi by mala by\u0165 nahraden\u00e1 jej \u010do najv\u010dasnej\u0161\u00edm rozh\u00fdban\u00edm a\u00a0uveden\u00edm do obehu. Sofistikovan\u00e9 rehabilita\u010dn\u00e9 centr\u00e1 preto v s\u00falade s touto koncepciou presadzuj\u00fa laserov\u00fa terapiu. Laser pom\u00e1ha pri tvorbe fotobiomodul\u00e1cie (PBM), \u010do je mechanizmus, pomocou ktor\u00e9ho fot\u00f3ny podnecuj\u00fa fotofyzik\u00e1lne a fotochemick\u00e9 deje v tkanive ved\u00face k fyziologick\u00fdm zmen\u00e1m a terapeutick\u00fdm \u00fa\u010dinkom. Tento proces pom\u00e1ha ur\u00fdchli\u0165 z\u00e1palov\u00fd proces, \u010do vedie k lep\u0161iemu hojeniu tkaniva. Laser metabolicky vpl\u00fdva\u00a0na\u00a0poranen\u00e9 tkanivo na mitochondri\u00e1lnej \u00farovni , \u010d\u00edm ur\u00fdch\u013euje proces hojenia na rozdiel od NSAIDS, ktor\u00e9 blokuj\u00fa z\u00e1palov\u00fa kask\u00e1du na \u00farovni COX-2 a \u013eadu,\u00a0ktor\u00fd od\u010fa\u013euje z\u00e1palov\u00fd proces do\u010dasn\u00fdm obmedzen\u00edm prietoku krvi. Fotobiomodul\u00e1cia nepriamo\u00a0sp\u00f4sobuje modul\u00e1ciu z\u00e1palovej kask\u00e1dy prostredn\u00edctvom enzymatick\u00fdch zmien a m\u00e1 priamy fotochemick\u00fd vplyv na mitochondrie \u00a0\u00a0\u00a0 prostredn\u00edctvom Cytochr\u00f3m C oxid\u00e1zy. Tieto \u00fa\u010dinky skracuj\u00fa\u00a0\u010das potrebn\u00fd na obnovu tkaniva. Pri klinickom testovan\u00ed lasera maj\u00fa jeho \u00fa\u010dinky na\u00a0 prv\u00fd poh\u013ead podobn\u00fd \u00fa\u010dinok ako farmakoterapia. Zasahuj\u00fa z\u00e1palov\u00fa kask\u00e1du na ve\u013emi podobn\u00fdch miestach ako s\u00fa napr\u00edklad zn\u00ed\u017een\u00e9 hladiny COX-2, zn\u00ed\u017eenie hladiny Bradykin\u00ednu, zn\u00ed\u017eenie hladiny IL-1 a zn\u00ed\u017eenie PGE -2. Ve\u013emi d\u00f4le\u017eitou skuto\u010dnos\u0165ou je, \u017ee poklesy hlad\u00edn pri fotobiomodul\u00e1ci\u00ed sa uskuto\u010d\u0148uj\u00fa z vn\u00fatornej, protiz\u00e1palovej signaliz\u00e1cie vyvolanej lep\u0161\u00edm bunkov\u00fdm metabolizmom a zlep\u0161enou mikrocirkul\u00e1ciou. Ned\u00e1vno boli vydan\u00e9 dve \u0161t\u00fadie, ktor\u00e9 porovn\u00e1vaj\u00fa: \u013ead, \u013ead v kombin\u00e1cii s laserom a laserov\u00fa terapiu pou\u017eit\u00fa nez\u00e1visle na lie\u010dbu \u0161tvorhlav\u00e9ho svalu po maxim\u00e1lnych vo\u013en\u00fdch kontrakci\u00e1ch (MVC). Tieto \u0161t\u00fadie pri\u0161li k z\u00e1veru, \u017ee laser mal v\u00fdrazne vy\u0161\u0161ie MVC pri zopakovanom testovan\u00ed a menej oxida\u010dn\u00e9ho stresu v porovnan\u00ed s placebo skupinou. Zistili aj to, \u017ee ke\u010f bola kryoterapia kombinovan\u00e1 s laserom, do\u0161lo k zn\u00ed\u017eeniu \u00fa\u010dinnosti v\u00a0porovnan\u00ed so samostatne aplikovan\u00fdm laserov\u00fdm o\u0161etren\u00edm.Druh\u00e1 \u0161t\u00fadia sk\u00famala podobn\u00e9 kombin\u00e1cie, ale v\u0161\u00edmala si oneskoren\u00fd n\u00e1stup svalovej bolestivosti (DOMS), MVC a oxida\u010dn\u00e9 po\u0161kodenie. Zistilo sa, \u017ee laser pou\u017eit\u00fd ako jedin\u00e1 lie\u010dba (nie aplikovan\u00fd v kombin\u00e1cii s \u013eadom) je najlep\u0161\u00edm postupom pre podporu obnovy po cvi\u010den\u00ed, ktor\u00fd vedie k \u00faplnej obnove na v\u00fdchodiskov\u00fa \u00farove\u0148 od 24 hod\u00edn po vysoko-intenz\u00edvnych excentrick\u00fdch kontrakci\u00e1ch. Tieto skuto\u010dnosti vo v\u0161eobecnosti podporuj\u00fa\u00a0postup akt\u00edvneho zotavenia. Tieto \u0161t\u00fadie v spojen\u00ed s \u010fal\u0161\u00edm v\u00fdskumom spochyb\u0148uj\u00fa pou\u017eitie NSAIDS a kryoterapie ako inde\u00e1lnej vo\u013eby o\u0161etrenia poranen\u00e9ho svalov\u00e9ho tkaniva a podporuj\u00fa vyu\u017eitie fotobiomodul\u00e1cie.<\/span><\/p>\n

\u00a0<\/span><\/p>\n

\u00a0___________________________________________________________________________________________________<\/span><\/p>\n

 <\/p>\n

Pou\u017eit\u00e1 literat\u00fara:
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\n8. Duchesne E, Tremblay MH, C\u00f4t\u00e9 CH. [Mast cell tryptase stimulates myoblast proliferation; a mechanism relying on protease-activated receptor-2 and cyclooxygenase-2.] Mastocytov\u00e1 trypt\u00e1za stimuluje prolifer\u00e1ciu myoblastov; mechanizmus zalo\u017een\u00fd na prote\u00e1zou aktivovanom receptore-2 a cyklooxygen\u00e1ze-2. BMC Musculoskelet Disord . 2011;12:235.
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\n10. Summan M, Warren GL, Mercer RR et al [Macrophages and skeletal muscle regeneration: a clodronate-containing liposome depletion study.] Regener\u00e1cia makrof\u00e1gov a kostrov\u00e9ho svalstva: \u0161t\u00fadia o depl\u00e9cii klodron\u00e1t-obsahuj\u00faceho lipoz\u00f3mu. Am J Physiol Regul Integr Comp Physiol . 2006;290:R1488\u2013R1495.
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\n12. Sin DD, Reid WD. [Is inflammation good, bad or irrelevant for skeletal muscles in COPD?] Je z\u00e1pal dobr\u00fd, zl\u00fd alebo irelevantn\u00fd pre kostrov\u00e9 svaly pri chronickej ob\u0161truk\u010dnej chorobe p\u013e\u00fac? Thorax . 2007;63:95\u201396.
\n13. Dadgar S, Wang Z, Johnston H et al [Asynchronous remodeling is a driver of failed regeneration in Duchenne muscular dystrophy.] Asynchr\u00f3nna remodel\u00e1cia je hnac\u00edm motorom ne\u00faspe\u0161nej regener\u00e1cie pri Duchennovej svalovej dystrofii. J Cell Biol . 2014;207:139\u2013158.
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15. W\u00e5hlin-Larsson B, Carnac G, Kadi F. [The influenceof systemic inflammation on skeletal muscle in physically active elderly women.] Vplyv systematick\u00e9ho z\u00e1palu na kostrov\u00e9 svalstvo v pr\u00edpade fyzicky akt\u00edvnych star\u0161\u00edch \u017eien. Age (Dordr) .2014;36:9718.
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\nresults from the 1999\u20132004 National Health and Nutrition Examination Survey.] Sarkop\u00e9nia,
\nsarkopenick\u00e1 obezita a z\u00e1pal: v\u00fdsledky prieskumu N\u00e1rodn\u00e9ho in\u0161tit\u00fatu zdravia a v\u00fd\u017eivy formou
\nvy\u0161etren\u00ed z rokov 1999 – 2004. Clin Nutr.2016;35:1472\u20131483.
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19. te Pas MF, de Jong PR, Verburg FJ. [Glucocorticoid inhibition of C2C12 proliferation
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\n20. Reinl G. [ICED! The Illusionary Treatment Option.] SCHLADEN\u00dd! Iluz\u00f3rna lie\u010debn\u00e1 met\u00f3da. Okt. 15, 2013: 9-11.
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\nz\u00edskan\u00e9 prostredn\u00edctvom CCR2 produkuj\u00fa inzul\u00ednu podobn\u00fd rastov\u00fd faktor-1 na obnovu ak\u00fatneho zranenia kostrov\u00e9ho svalstva. The FASEB Journal,2010; DOI: 10.1096\/ fj.10-171579
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\nna perif\u00e9rne nervy cicavcov a v\u00fdznam pre analgetick\u00e9 \u00fa\u010dinky. Systematick\u00fd preh\u013ead.
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\n25. Liebert, A.D. et al. (2014) [Protein conformational modulation by photons: a mechanism for laser treatment effects.] Prote\u00edn-konforma\u010dn\u00e1 modul\u00e1cia fot\u00f3nmi: mechanizmus pre \u00fa\u010dinky laserov\u00e9ho o\u0161etrenia. Med Hypothesis. 82(3):275-281.<\/p>\n

26. Prianti, A.C.G. et al. (2014) [Low-level PBMT(LLLT) reduces the COX-2 mRNA expression in
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\nlaserov\u00e1 terapia) zni\u017euje prejav COX-2 mRNA v subplant\u00e1rnych aj \u00fapln\u00fdch mozgov\u00fdch tkaniv\u00e1ch
\nna modeli perif\u00e9rneho z\u00e1palu vyvolan\u00e9ho podan\u00edm karag\u00e9nanu. Lasers Med Sci.29(4):1397-1403.
\n27. Jimbo, K. et al. (1998) [Suppressive effects of low- power laser irradiation on bradykinin evoked action potentials in cultured murine dorsal root ganglion cells.] Tlmiv\u00e9 \u00fa\u010dinky slab\u00e9ho laserov\u00e9 o\u017earovania na bradykin\u00ednom vyvolan\u00fd ak\u010dn\u00fd potenci\u00e1l v kultivovan\u00fdch my\u0161\u00edch dorz\u00e1lnych kore\u0148ov\u00fdch gangliov\u00fdch bunk\u00e1ch. Neurosci Lett. 240(2):93-96.
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\ninflammatory mouse pleurisy induced by carrageenan.] Spont\u00e1nne \u00fa\u010dinky n\u00edzko-hladinovej
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\n29. Mizutani, K. et al. (2004) [A clinical study on s\u00e9rum prostaglandin E2 with low-level PBMT.] Klinick\u00e1 \u0161t\u00fadia prostagland\u00edn s\u00e9ra E2 s n\u00edzko-hladinovou fotobiomodula\u010dnou terapiou. Photomed Laser Surg. 22(6)537-539.
\n30. De Marchi, T. et al. (2017) [Does photobiomodulation therapy is better than
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\nplacebom kontrolovan\u00fd klinick\u00fd pokus. Lasers Med Sci. DOI 10.1007\/s10103-016- 2139-9.
\n31. De Paiva, P. et al. [Photobiomodulation therapy (PBMT) and\/or cryotherapy in skeletal muscle restitution, what is better? A randomized, double- blinded, placebo-controlled clinical trial] Fotobiomodula\u010dn\u00e1 terapia (PBMT) a\/alebo kryoterapia pri obnove kostrov\u00e9ho svalstva, ktor\u00e1 je lep\u0161ia? Randomizovan\u00fd, dvojito zaslepen\u00fd, placebom kontrolovan\u00fd klinick\u00fd pokus. Lasers Med Sci. (2016) 31:1925-1933.<\/p>\n

 <\/p>\n

\u00a0<\/span><\/p>\n

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Poh\u013ead na porovnanie nesteroidn\u00fdch protiz\u00e1palov\u00fdch liekov (NSAIDS), \u013eadu a lasera. Ka\u017edodenne diskutovanou t\u00e9mou v klinickom prostred\u00ed je z\u00e1pal. Z\u00e1pal je sprievodn\u00fd pr\u00edznak procesu hojenia a m\u00f4\u017ee by\u0165 potrebn\u00fd pre spr\u00e1vne zahojenie ak\u00fatnych poranen\u00ed m\u00e4kk\u00e9ho tkaniva. Pacienti \u010dasto h\u013eadaj\u00fa \u00fa\u013eavu od sprievodnej bolesti a radu, ako zlep\u0161i\u0165 proces hojenia. \u010cas uzdravenia a proces obnovy po\u0161koden\u00e9ho svalov\u00e9ho…<\/p>\n","protected":false,"gt_translate_keys":[{"key":"rendered","format":"html"}]},"author":6,"featured_media":7065,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[27],"tags":[],"class_list":["post-7033","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-fyzioterapia"],"acf":[],"yoast_head":"\nAko bojova\u0165 so svalov\u00fdm z\u00e1palom? - BonumSalutem - rehabilit\u00e1cie<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.bonumsalutem.sk\/rehabilitacie\/ako-bojovat-so-svalovym-zapalom\/\" \/>\n<meta property=\"og:locale\" content=\"sk_SK\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Ako bojova\u0165 so svalov\u00fdm z\u00e1palom? - BonumSalutem - rehabilit\u00e1cie\" \/>\n<meta property=\"og:description\" content=\"Poh\u013ead na porovnanie nesteroidn\u00fdch protiz\u00e1palov\u00fdch liekov (NSAIDS), \u013eadu a lasera. 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