Pediatrik suprakondiler humerus kırığı olan hastalarda video temelli oyun tedavisinin üst ekstremite fonksiyonel sonuçlarına etkisi: Karşılaştırmalı prospektif çalışma
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Tarih
2021
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Hatay Mustafa Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Suprakondiler humerus kırıkları pediatrik vakalarda en sık görülen dirsek kırıklarıdır. Dirsek kırıkları sonrasında hastalar normal fonksiyonuna dönebilmek için genellikle fizik tedaviye ihtiyaç duyarlar. Teknolojinin ilerlemesi ile birlikte rehabilitasyon uygulamaları kapsamında aktif video temelli oyun sistemi kullanılmaya başlanmıştır. Çalışmamızda, pediatrik suprakondiler humerus kırığı olan hastalara klasik fizik tedavi yöntemleri ile birlikte aktif video temelli oyun tedavisi uygulanmıştır ve üst ekstremite fonksiyonel sonuçlarına etkisinin karşılaştırılması amaçlanmıştır. Çalışmamıza 3-15 yaş aralığında 18 erkek, 12 kız toplam 30 pediatrik hasta katılmıştır. Hastalar randomize bir şekilde her grupta 15 kişi olacak şekilde gruplara dahil edilmiştir. Kontrol grubunda bulunan hastalara klasik rehabilitasyon yöntemleri, çalışma grubunda bulunan hastalara klasik rehabilitasyon yöntemleri ile birlikte aktif video temelli oyun tedavisi uygulanmıştır. Her iki grupta bulunan hastalar tedavinin 3, 6, 9 ve 12. haftalarında Vizüel Analog Skala (VAS), gonyometrik ölçümler, digital dinamometre, JAMAR digital dinamometre, pinç metre, Flynn kriterleri ve MAYO Dirsek Performans Skoru anketi kullanılarak değerlendirilmiştir. Verilerin analizinde Ki-kare, Wilcoxon, Friedmann, Mann-Whitney-U testleri ve All Pairwise yöntemi kullanılmıştır. Yaş ortalaması kontrol grubunda 6,13±3,04, çalışma grubunda 6,33±2,19 yıldır. Kontrol grubunda 3. haftada istirahat, gece ve aktivite ağrı düzeylerinin çalışma grubuna göre daha yüksek düzeylerde olduğu saptanmıştır (p=0,01). Her iki grupta da 6, 9 ve 12.hafta değerlendirmelerinde ağrı bulgusunun olmadığı saptanmıştır (p>0,05). Dirsek fleksör-ekstansör grup kas kuvveti, gross kavrama kuvveti, pinç kavrama kuvveti ve fleksiyon ekstansiyon EHA değerlerinde her iki grupta da iyileşme olduğu ve iyileşmenin istatistiksel olarak farklılık göstermediği saptanmıştır (p>0,05). MAYO dirsek performans skoru tedavi öncesi ve sonrası puan değişiminin her iki grupta da istatistiksel olarak anlamlı olduğu saptanmıştır (p=0,01). Çalışma grubunda kas kuvveti değerleri, EHA değerleri ve MAYO dirsek performans skoru puanlarının kontrol grubuna göre daha yüksek olduğu görülmüştür. Sonuç olarak pediatrik suprakondiler humerus kırığı olan hastalarda klasik fizyoterapi yöntemleri ile birlikte uygulanan aktif video temelli oyun sisteminin hastaların iyileşmesinde katkısının olduğu görülmüştür. Anahtar Sözcükler: Aktif Video Temelli Oyun, Fizyoterapi, Fonsiyonel Sonuç Ölçütleri, Pediatrik Suprakondiler Humerus Kırığı
Supracondylar humeral fracture is the most common elbow fractures observed in pediatric cases. After the elbow fractures, patients generally need physiotherapy to regain their normal functions. Video game based system has begun to be used within the scope of rehabilitation practices by means of the advancements in technology. Active video game based treatment were administered in addition to conventional physiotherapy methods to the patients with pediatric supracondylar humeral fracture and it is aimed to compare effect of upper extremity functional results in our study. 18 men and 12 women, in total 30 pediatric patients ranging from 3 to 15 years old participated in the study. Patients were randomly involved in groups where each would consist of 15 patients. Conventional rehabilitation methods were administered to the patients in control group and active video game based treatment were administered in addition to conventional rehabilitation methods to the patients in study group. The patients in both groups were evaluated via Visual Analogue Scale (VAS), goniometric measurements, digital dynamometer, JAMAR digital dynamometer, pinch meter, Flynn criteria and MAYO Elbow Performance Score survey at the 3rd, 6th, 9th and 12th weeks. Kikare, Wilcoxon, Friedmann, Mann-Whitney-U tests and All Pairwise methods were applied in the analysis of data. The average age of the patients were 6,13±3,04 in control group and 6,33±2,19 in study group. That the level of rest, night, and activity pain in control group was higher compared to the study group was observed (p=0,01). On 6th, 9th and 12th week evaluations, that pain symptoms were relieved was ascertained (p>0,05). In both groups, elbow flexor – extensor group muscular strength, gross grip strength, pinch grip strength and flexion extension EHA values were observed to improve; however, no difference was identified statistically (p>0,05). As the pre treatment and post-treatment points of MAYO elbow performance score was analyzed, the change of points in both groups were determined to be significant statistically. In the study group muscular strength values, that EHA values and MAYO elbow performance score points are higher compared to control group was determined (p=0,01). Consequently, active video game system administered to the patients with pediatric supracondylar humeral fracture along with conventional physiotherapy methods was observed to have an effect in recovery process.
Supracondylar humeral fracture is the most common elbow fractures observed in pediatric cases. After the elbow fractures, patients generally need physiotherapy to regain their normal functions. Video game based system has begun to be used within the scope of rehabilitation practices by means of the advancements in technology. Active video game based treatment were administered in addition to conventional physiotherapy methods to the patients with pediatric supracondylar humeral fracture and it is aimed to compare effect of upper extremity functional results in our study. 18 men and 12 women, in total 30 pediatric patients ranging from 3 to 15 years old participated in the study. Patients were randomly involved in groups where each would consist of 15 patients. Conventional rehabilitation methods were administered to the patients in control group and active video game based treatment were administered in addition to conventional rehabilitation methods to the patients in study group. The patients in both groups were evaluated via Visual Analogue Scale (VAS), goniometric measurements, digital dynamometer, JAMAR digital dynamometer, pinch meter, Flynn criteria and MAYO Elbow Performance Score survey at the 3rd, 6th, 9th and 12th weeks. Kikare, Wilcoxon, Friedmann, Mann-Whitney-U tests and All Pairwise methods were applied in the analysis of data. The average age of the patients were 6,13±3,04 in control group and 6,33±2,19 in study group. That the level of rest, night, and activity pain in control group was higher compared to the study group was observed (p=0,01). On 6th, 9th and 12th week evaluations, that pain symptoms were relieved was ascertained (p>0,05). In both groups, elbow flexor – extensor group muscular strength, gross grip strength, pinch grip strength and flexion extension EHA values were observed to improve; however, no difference was identified statistically (p>0,05). As the pre treatment and post-treatment points of MAYO elbow performance score was analyzed, the change of points in both groups were determined to be significant statistically. In the study group muscular strength values, that EHA values and MAYO elbow performance score points are higher compared to control group was determined (p=0,01). Consequently, active video game system administered to the patients with pediatric supracondylar humeral fracture along with conventional physiotherapy methods was observed to have an effect in recovery process.
Açıklama
Anahtar Kelimeler
Fizyoterapi ve Rehabilitasyon, Physiotherapy and Rehabilitation, Active Video Game, Functional Outcome Measures, Pediatric Supracondylar Humeral Fracture, Physiotherapy
