Diz osteoartritli hastalarda nöromüsküler elektrik stimülasyonu (NMES) ve izokinetik egzersizin yürüme analizine etkisinin karşılaştırılması
Küçük Resim Yok
Tarih
2019
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Osteoartrit yaşam kalitesini etkileyen en önemli kas iskelet sistemi patolojisinden biridir. Diz osteoartriti ağrı, tutukluk, kas güçsüzlüğü ile karakterizedir. Bu durum fiziksel dizabiliteye ve hastalığın ilerlemesine neden olur. Tedavisinde amaç ağrının azaltılması ve fonksiyonun iyileştirilmesidir. Bunun için farmakolojik ve farmakolojik olmayan tedavi yöntemleri uygulanır. Çalışmamızda diz osteoartrit hastalarına uygulanan farmakolojik olmayan tedavi seçeneklerinden nöromüsküler elektrik stimülasyonu ve izokinetik egzersizin ağrı, fonksiyon, kuadriceps kas gücü ve yürüme parametrelerine etkisini karşılaştırmayı amaçladık. Çalışmaya bilateral diz osteoartritli yetmiş altı hasta dahil edildi. Her hastaya ev egzersiz programı verildi. Hastalar nöromüsküler elektrik stimülasyon grubu, izokinetik egzersiz grubu, nöromüsküler elektrik stimülasyonu ve izokinetik egzersiz grubu, kontrol grubu olarak 4 gruba randomize edildi. Başlangıçta ve 6 haftalık tedavi sonrasında hastalar vizüel analog skala, eklem hareket açıklığı, tek ayak üzerinde durma testi ve zamanlı kalk yürü testi ile değerlendirildi. Western Ontario and McMasters Universities Osteoarthritis Index, Short Form 36 skorları, diz ekstansör ve fleksör kas gruplarının maksimum kas güçleri belirlendi. Hastalar yürüme analizi ile değerlendirildi. Tüm gruplar ağrı, fonksiyonel durum, kas gücü, eklem hareket açıklığı ve yaşam kalitesi açısından düzelme gösterdi. Kas gücü izokinetik uygulaması içeren gruplarda daha belirgin arttı. Grupların yürüme parametrelerinden adım uzunluğu, hız ve kadans skorlarında iyileşme gözlendi. Salınım fazı ve basma fazında değişiklikler saptandı. Yüklenme değerlerinde anlamlı değişiklik gözlenmedi. Diz kaslarını güçlendirmeye yönelik tedavi seçenekleri klinik düzelme sağlar. Hastaların klinik özelliklerine göre tedavi alternatiflerinin araştırıldığı daha büyük populasyonlarda yapılan çalışmalara ihtiyaç vardır. Anahtar kelimeler: Diz osteoartriti, izokinetik egzersiz, nöromusküler elektrik stimülasyonu, yürüme analizi
Osteoarthritis is one of the most important musculoskeletal pathology affecting quality of life. Knee osteoarthritis is characterized by pain, stiffness, muscle weakness. This causes physical disability and disease progression. The aim of treatment is to reduce pain and improve function. For this, pharmacological and non-pharmacological treatment methods are applied. In this study, we aimed to compare the effect of neuromuscular electrical stimulation and isokinetic exercise on pain, function, quadriceps muscle strength and gait parameters. Seventy-six patients with bilateral knee osteoarthritis were included in the study. Each patient was given a home exercise program. The patients were randomized into 4 groups as neuromuscular electrical stimulation group, isokinetic exercise group, neuromuscular electrical stimulation and isokinetic exercise group and control group. At baseline and after 6 weeks of treatment, the patients were evaluated by visual analog scale, range of motion, single leg standing test and timed up to go test. Western Ontario and McMasters Universities Osteoarthritis Index, Short Form 36 scores, maximal strength of knee extensor and flexor muscle groups were determined. The patients were evaluated by gait analysis. All groups showed improvement in pain, functional status, muscle strength, range of motion and quality of life. Muscle strength increased significantly in the groups containing isokinetic administration. Improvement in stride length, velocity and cadence scores was observed. Changes in swing phase and stance phase were detected. No significant changes were observed in the loading values. Treatment options for strengthening the knee muscles provide clinical improvement.Further studies are needed in larger populations in which treatment alternatives are investigated according to the clinical characteristics of patients. Key words: Knee osteoarthritis, isokinetic exercise, neuromuscular electric stimulation, gait analysis
Osteoarthritis is one of the most important musculoskeletal pathology affecting quality of life. Knee osteoarthritis is characterized by pain, stiffness, muscle weakness. This causes physical disability and disease progression. The aim of treatment is to reduce pain and improve function. For this, pharmacological and non-pharmacological treatment methods are applied. In this study, we aimed to compare the effect of neuromuscular electrical stimulation and isokinetic exercise on pain, function, quadriceps muscle strength and gait parameters. Seventy-six patients with bilateral knee osteoarthritis were included in the study. Each patient was given a home exercise program. The patients were randomized into 4 groups as neuromuscular electrical stimulation group, isokinetic exercise group, neuromuscular electrical stimulation and isokinetic exercise group and control group. At baseline and after 6 weeks of treatment, the patients were evaluated by visual analog scale, range of motion, single leg standing test and timed up to go test. Western Ontario and McMasters Universities Osteoarthritis Index, Short Form 36 scores, maximal strength of knee extensor and flexor muscle groups were determined. The patients were evaluated by gait analysis. All groups showed improvement in pain, functional status, muscle strength, range of motion and quality of life. Muscle strength increased significantly in the groups containing isokinetic administration. Improvement in stride length, velocity and cadence scores was observed. Changes in swing phase and stance phase were detected. No significant changes were observed in the loading values. Treatment options for strengthening the knee muscles provide clinical improvement.Further studies are needed in larger populations in which treatment alternatives are investigated according to the clinical characteristics of patients. Key words: Knee osteoarthritis, isokinetic exercise, neuromuscular electric stimulation, gait analysis
Açıklama
Tıpta Uzmanlık
Anahtar Kelimeler
Fiziksel Tıp ve Rehabilitasyon, Physical Medicine and Rehabilitation
