Mekanik boyun ağrılı bireylerde mulligan doğal apofizyal tersine kaydırma uygulamasının ağrı ve hareket kısıtlılığı üzerine etkisinin incelemesi
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2021
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Bu çalışmanın amacı; Mekanik boyun ağrılı bireylerde Mulligan doğal apofizyal tersine kaydırma uygulamasının ağrı ve hareket kısıtlılığı üzerine etkilerini araştırmaktır. Çalışmamıza mekanik boyun ağrısı teşhisi konmuş, 20-60 yaşları arasında olan 69 birey dahil edildi. Katılımcılar, Mulligan grubu (MG) 23 kişi, Sham (mobilizasyonun yönü ve amplitüdü farklı) grubu (SG) 23 kişi ve Fizyoterapi gurubu (FG) 23 kişi olmak üzere üç gruba ayrıldı. Grupların belirlenmesinde çevrimiçi randomizasyon aracı olan 'Graph Pad' kullanıldı. Bireyler 11 seans (ilk hafta her gün, sonraki iki hafta gün aşırı) tedaviye alındı. Her üç grubun boyun bölgesine de aynı fizyoterapi uygulamaları yapıldı. MG' de fizyoterapi uygulamalarına ek olarak üst torakal segmentlere Mulligan doğal apofizyal tersine kaydırma tekniği uygulandı. SG' ye itme yönü ve itme kuvvetinin farklı olduğu sham mobilizasyon uygulandı. Hareket açıklığı ölçümleri güvenilirlik çalışması yapılmış olan DrGonyometer(ios) uygulaması, ağrı şiddeti değerlendirmesi Görsel Analog Skalası (GAS) ve boyun ağrısının fonksiyonel yetersizliğinin değerlendirmesi Boyun Özürlülük İndeksi (BÖİ) kullanılarak tedavi öncesi ve tedavi sonrası değerlendirildi. Tedavi sonrası eklem hareket açıklığı, ağrı şiddeti ve fonksiyonellik açısından üç grupta da anlamlı iyileşmeler olduğu görüldü (p<0,05). Özellikle MG' nin ağrı şiddeti, fleksiyon dışındaki eklem hareket açıklığı ve fonksiyonellik açısından en etkili yöntem olduğu görüldü (p<0,05). FG' nin eklem hareket açıklığı ve fonksiyonellikte SG ile benzer etkiye sahip olduğu görüldü (p>0,05). Ağrıyı azaltmada SG' nin FG'den daha etkili olduğu görüldü (p< 0,05). Bu çalışma ile, mekanik boyun ağrılı bireylerde torakal bölgeye uygulanılan Mulligan doğal apofizyal tersine kaydırma tekniğinin ağrıyı azaltmada, eklem hareket açıklığı ve fonksiyonelliği artırmada etkili olduğu görüldü. Anahtar kelimeler: Mekanik Boyun Ağrısı, Torakal Mobilizasyon, Mulligan, Hareket Açıklığı
The aim of this study; To investigate the effects of Mulligan natural apophyseal reversal shift on pain and limitation of motion in individuals with mechanical neck pain. Our study included 69 individuals aged 20-60 years who were diagnosed with mechanical neck pain. The participants were divided into three groups: 23 people in the Mulligan group (MG), 23 people in the Sham (different in the direction and amplitude of mobilization) group (SG) and 23 people in the Physiotherapy group (FG). 'Graph Pad', an online randomization tool, was used to determine the groups. Individuals were treated for 11 sessions (daily for the first week, every other day for the next two weeks). The same physiotherapy treatments were applied to the neck region of all three groups. In addition to physiotherapy applications in MG, Mulligan natural apophyseal reversal technique was applied to the upper thoracic segments. Sham mobilization was applied to the SG in which the thrust direction and thrust force were different. Range of motion measurements were evaluated using the DrGonyometer(ios) application for which reliability studies were performed, the Visual Analogue Scale (VAS) for pain severity assessment, and the Neck Disability Index (BDI) for functional disability of neck pain before and after treatment. Significant improvements were observed in all three groups in terms of joint range of motion, pain intensity and functionality after treatment (p<0.05). In particular, MG was found to be the most effective method in terms of pain intensity, range of motion except flexion, and functionality (p<0.05). It was observed that FG had a similar effect with SG on joint range of motion and functionality (p>0.05). SG was found to be more effective than FG in reducing pain (p< 0.05). In this study, Mulligan's natural apophyseal reversal technique applied to the thoracic region in individuals with mechanical neck pain was found to be effective in reducing pain and increasing joint range of motion and functionality. Keywords: Mechanic Neck Pain, Thoracal Mobilization, Mulligan, Range of Motion
The aim of this study; To investigate the effects of Mulligan natural apophyseal reversal shift on pain and limitation of motion in individuals with mechanical neck pain. Our study included 69 individuals aged 20-60 years who were diagnosed with mechanical neck pain. The participants were divided into three groups: 23 people in the Mulligan group (MG), 23 people in the Sham (different in the direction and amplitude of mobilization) group (SG) and 23 people in the Physiotherapy group (FG). 'Graph Pad', an online randomization tool, was used to determine the groups. Individuals were treated for 11 sessions (daily for the first week, every other day for the next two weeks). The same physiotherapy treatments were applied to the neck region of all three groups. In addition to physiotherapy applications in MG, Mulligan natural apophyseal reversal technique was applied to the upper thoracic segments. Sham mobilization was applied to the SG in which the thrust direction and thrust force were different. Range of motion measurements were evaluated using the DrGonyometer(ios) application for which reliability studies were performed, the Visual Analogue Scale (VAS) for pain severity assessment, and the Neck Disability Index (BDI) for functional disability of neck pain before and after treatment. Significant improvements were observed in all three groups in terms of joint range of motion, pain intensity and functionality after treatment (p<0.05). In particular, MG was found to be the most effective method in terms of pain intensity, range of motion except flexion, and functionality (p<0.05). It was observed that FG had a similar effect with SG on joint range of motion and functionality (p>0.05). SG was found to be more effective than FG in reducing pain (p< 0.05). In this study, Mulligan's natural apophyseal reversal technique applied to the thoracic region in individuals with mechanical neck pain was found to be effective in reducing pain and increasing joint range of motion and functionality. Keywords: Mechanic Neck Pain, Thoracal Mobilization, Mulligan, Range of Motion
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Fizyoterapi ve Rehabilitasyon, Ağrı, Boyun, Boyun ağrısı, Physiotherapy and Rehabilitation, Pain, Eklem hareket açıklığı, Neck, Neck pain, Mulligan tekniği, Range of motion-articular, Omurga, Mulligan technique, Spine, Servikal vertebra, Cervical vertebrae