Hamstring tendon otogrefti ile ön çapraz bağ rekonstrüksiyonu sonrası aynı fizyoterapi protokolünün farklı metotlarla uygulanması
Yükleniyor...
Dosyalar
Tarih
2022
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Hatay Mustafa Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Ön Çapraz Bağ (ÖÇB) yaralanmaları genellikle spor aktiviteleri ve zorlayıcı egzersizler sırasında ortaya çıkar, sadece Amerika Birleşik Devletleri'nde yılda ortalama 250.000 kişi ÖÇB rüptürüne maruz kalır. ÖÇB rüptürü tedavisi için klinik uygulamalar dünya çapında farklılık gösterir. ÖÇB rüptürü olan sporcular çoğunlukla cerrahi Ön çapraz Bağ rekonstrüksiyonunu (ÖÇBR) tercih ederler. Çalışmamızda Hatay Mustafa Kemal Üniversitesi Hastanesi (HMKÜ) Ortopedi ve Travmatoloji polikliniğine başvuran ve diz ÖÇB cerrahisi için uygun görülen hastalar postoperatif tedaviye alınmıştır. Yaşları 18-55 arasında olan 25 erkek, 5 kadın toplam 30 hasta çalışmaya dahil edilmiştir. Hastalar, Grup 1 (Fizyoterapist gözetiminde rehabilitasyon ) ve Grup 2 (Ev temelli rehabilitasyon) olmak üzere, hasta sayısı her iki grupta eşit olacak şekilde rastgele iki gruba ayrılmıştır. Her iki gruba da aynı tedavi, farklı metotlarla uygulanmıştır. Grup 1'de bulunan hastalar ameliyattan sonra ilk haftadan itibaren 12 hafta boyunca haftada 2 kez fizyoterapist gözetiminde tedaviye alınmıştır. Grup 2'deki hastalar ameliyattan hemen sonra ortopedi servisinde ziyaret edilerek ilk hafta için tanımlanan protokole göre yapmaları gereken egzersizler öğretilmiş ayrıca hastalara postoperatif erken dönemde uymaları gereken tavsiyeler önemle anlatılmıştır. Postoperatif 1, 3, 6 ve 12. hafta değerlendirmeleri için belirlenen kontrol randevularında egzersizler ve öneriler güncellenerek rehabilitasyon programı ilerletilmiştir. Her iki grupta bulunan hastalarda Vizüel Analog Skala (VAS) ile ağrı değerlendirmesi ve gonyometrik ölçümler tedavinin 1, 3, 6 ve 12. haftalarında yapılmıştır. Ayrıca, dijital dinamometre ile kas kuvveti, diz stabilitesi ve diz fonskiyonu (Lysholm, Tegner, KOOS, IKDC skorlamaları kullanılarak) değerlendirmeleri postoperatif 12. haftada yapılmıştır. Analizler SPSS 25.0 paket programı ile yapılmıştır, verilerin analizinde Ki-kare, Wilcoxon, Friedmann, Mann-Whitney-U testleri kullanılmıştır. Grup 1'de bulunan hastaların yaş ortalaması 27,2±8,63 yıl, Grup 2'de bulunan hastaların yaş ortalaması ise 30,8±11,26 yıl olarak bulunmuştur. Çalışma sonucunda 3, 6 ve 12. hafta VAS ağrı skorunda ve postop 3. ayda Lysholm skorunda Grup 1 lehine anlamlı fark bulunurken; EHA, izometrik kas kuvveti, Tegner aktivite skoru, IKDC skoru, KOOS skoru ve diz stabilitesi değerlendirmelerinde iki grup arasında istatistiksel olarak anlamlı bir fark bulunamamıştır. Sonuç olarak ÖÇB rekonstrüksiyon cerrahisi sonrası postoperatif erken dönemde Fizyoterapist Gözetiminde Tedavinin, Ev temelli Rehabilitasyona kıyasla daha iyi klinik sonuçlar verdiği bulunmuştur. Anahtar Sözcükler: Ön Çapraz Bağ, Diz Yaralanmaları, Fizyoterapi, Ön Çapraz Bağ Rekonstrüksiyonu, Diz Rehabilitasyonu
Anterior Cruciate Ligament (ACL) injuries usually occur during sports activities and strenuous exercise. In United States alone, approximately 250,000 people suffering from ACL rupture annually. Clinical treatment modalities for the treatment of ACL rupture vary around the world. Athletes with ACL rupture mostly prefer surgical ACL reconstruction. In our study, patients who applied to Hatay Mustafa Kemal University Hospital (HMKU) Orthopedics and Traumatology outpatient clinic and were deemed suitable for knee ACL surgery were included in postoperative treatment. Totally 30 patients, 25 male and 5 female, aged between 18-55 were included in the study. The patients were randomly divided into two groups as Group 1 (rehabilitation under the supervision of a physiotherapist) and Group 2 (Home-based rehabilitation). The same rehabilitation protocol was applied to both groups with different methods. The patients in Group 1 were treated under the supervision of a physiotherapist twice a week for 12 weeks from the first week after the operation. The patients in Group 2 were visited on the first day after surgery, and the exercises they should do according to the protocol defined for the first week were taught, and the recommendations that should be followed in the early postoperative period were explained to the patients. The rehabilitation program was advanced by updating the exercises and recommendations at the control appointments determined for the postoperative 1st, 3rd, 6th and 12th week evaluations. Pain assessment with Visual Analogue Scale (VAS) and goniometric measurements were evaluated in patients in both groups at 12 weeks postoperatively. Muscle strength with digital dynamometer, knee stability and knee function (using Lysholm, Tegner, KOOS, IKDC scores) were evaluated in patients in both groups at 1, 3, 6 and 12 weeks postoperatively. Analyzes were made with SPSS 25.0 package program, Chi-squared, Wilcoxon, Friedmann, Mann-Whitney-U tests were used in the analysis of the data. The mean age of the patients in Group 1 was 27.2±8.63 years, and the mean age of the patients in Group 2 was 30.8±11.26 years. As a result of the study, there was a significant difference in favor of Group 1 in the VAS pain score at the 3rd, 6th and 12th weeks, and in the Lysholm score at the postoperative 3rd month; No statistically significant difference was found between the two groups in ROM, isometric muscle strength, Tegner activity score, IKDC score, KOOS score and knee stability evaluations. As a result, better clinical results were found in Physiotherapist Supervised Treatment in the early postoperative period after ACL reconstruction surgery compared to Home-based Rehabilitation.
Anterior Cruciate Ligament (ACL) injuries usually occur during sports activities and strenuous exercise. In United States alone, approximately 250,000 people suffering from ACL rupture annually. Clinical treatment modalities for the treatment of ACL rupture vary around the world. Athletes with ACL rupture mostly prefer surgical ACL reconstruction. In our study, patients who applied to Hatay Mustafa Kemal University Hospital (HMKU) Orthopedics and Traumatology outpatient clinic and were deemed suitable for knee ACL surgery were included in postoperative treatment. Totally 30 patients, 25 male and 5 female, aged between 18-55 were included in the study. The patients were randomly divided into two groups as Group 1 (rehabilitation under the supervision of a physiotherapist) and Group 2 (Home-based rehabilitation). The same rehabilitation protocol was applied to both groups with different methods. The patients in Group 1 were treated under the supervision of a physiotherapist twice a week for 12 weeks from the first week after the operation. The patients in Group 2 were visited on the first day after surgery, and the exercises they should do according to the protocol defined for the first week were taught, and the recommendations that should be followed in the early postoperative period were explained to the patients. The rehabilitation program was advanced by updating the exercises and recommendations at the control appointments determined for the postoperative 1st, 3rd, 6th and 12th week evaluations. Pain assessment with Visual Analogue Scale (VAS) and goniometric measurements were evaluated in patients in both groups at 12 weeks postoperatively. Muscle strength with digital dynamometer, knee stability and knee function (using Lysholm, Tegner, KOOS, IKDC scores) were evaluated in patients in both groups at 1, 3, 6 and 12 weeks postoperatively. Analyzes were made with SPSS 25.0 package program, Chi-squared, Wilcoxon, Friedmann, Mann-Whitney-U tests were used in the analysis of the data. The mean age of the patients in Group 1 was 27.2±8.63 years, and the mean age of the patients in Group 2 was 30.8±11.26 years. As a result of the study, there was a significant difference in favor of Group 1 in the VAS pain score at the 3rd, 6th and 12th weeks, and in the Lysholm score at the postoperative 3rd month; No statistically significant difference was found between the two groups in ROM, isometric muscle strength, Tegner activity score, IKDC score, KOOS score and knee stability evaluations. As a result, better clinical results were found in Physiotherapist Supervised Treatment in the early postoperative period after ACL reconstruction surgery compared to Home-based Rehabilitation.
Açıklama
Anahtar Kelimeler
Fizyoterapi ve Rehabilitasyon, Physiotherapy and Rehabilitation, Anterior Cruciate Ligament, Knee Injuries, Physiotherapy, Anterior Cruciate Ligament Reconstruction, Knee Rehabilitation
