Kronik bel ağrılı hastalarda enstrüman destekli yumuşak doku mobilizasyonu ve kinezyolojik bantlamanın konnektif doku kalınlığı üzerine etkisi
Abstract
Bu çalışmanın amacı; kronik non-spesifik bel ağrısı (KNBA) olan hastalarda, lomber bölge ve hamstringlerde konservatif tedaviye ek olarak uygulanan enstrüman destekli yumuşak doku mobilizasyonu (EDYDM) ve kinezyolojik bantlama (KB) uygulamalarının ağrı, fonksiyonellik ve konnektif doku kalınlığı üzerine etkilerini araştırmaktır. Randomize kontrollü olarak planlanan çalışmamıza 30 - 50 yaş arası KNBA olan 30 hasta dahil edildi. Hastalar 2 gruba randomize edildi. Bireylerin demografik ve fiziksel özellikleri kaydedildi. Her iki gruba hotpack, Transkutanöz Elektriksel Sinir Stimulasyonu (TENS) ve terapötik ultrasondan oluşan konservatif tedavi uygulandı. İlk gruba konservatif tedaviye ek olarak EDYDM uygulandı. İkinci gruba ise KB uygulandı. Ağrı Vizüel Analog Skalası (VAS) ile, fonksiyonel yetersizlik Roland Morris Engellilik Anketi (RMDQ) ile, depresyon Beck Depresyon Ölçeği ile, hamstring kısalığı düz bacak kaldırma testi ile, esneklik Otur ve Uzan Testi ve lomber ekstansorlerin kısalığı değerlendirmesi ile, spinal mobilite Modifiye Schober Testi ve el parmak ucu-zemin arasındaki mesafe ölçülerek, konnektif doku kalınlığı ise ultrasonografi (USG) ile değerlendirildi. Ölçümler tedavi öncesi, ilk seans sonrası ve tedavi sonrası olarak yapıldı. Çalışmanın sonucunda; uyguladığımız iki yöntemin ağrı, fonksiyonellik, depresyon, hamstring kısalığı, spinal mobilite, lomber perimuskuler zon kalınlığı, hamstringler perimuskuler ve subkutanöz zon kalınlığı gibi parametrelerde birbirine karşı üstünlüğü olmadığı görüldü (p>0,05). Tedavi öncesi ve sonrası kalınlık farkına göre bakıldığında ise EDYDM uygulamasının lomber subkutanöz zon kalınlığı üzerinde daha iyi bir iyileşme sağladığı görüldü (p<0,05). Sonuç olarak; EDYDM ile KB uygulamaları KNBA olan hastalarda ağrı, fonksiyonellik ve konnektif doku kalınlığı üzerinde iyileştirici bir etkiye sahiptir. Anahtar Kelimeler: Bel ağrısı, Mobilizasyon, Kinezyolojik bantlama, Perimuskuler zon, Subkutanöz zon.
The aim of the study is to investigate the effects of instrument assisted soft tissue mobilization (IASTM) and kinesio taping (KT) that are additional treatment to the conservative treatment for the lumbar region and hamstrings, on pain, fuctionality and connective tissue tickness in patients with chronic non-specific low back pain (NSLBP). 30 patients with NSLBP at age between 30 – 50 range were included into the randomized controlled triad designed study. Patients were randomized into two groups. Demographical and physical data of the patients were recorded. A conservative treatment that composed of hotpack, Transcutaneous Electrical Nerve Stimulation (TENS) and ultrasound was applied for both two groups. For the first group, in addition to the conservative treatment, IASTM was applied. KT was applied for second group. Pain with Visual Analog Scale (VAS), functional impairment with Roland Morris Disability Questionnaire (RMDQ), depression with Beck Depression Inventory, hamstring shortness with straight leg raise, flexibility with sit and reach test, lumbar extensor shortness assessment, spinal mobility Modified Schober Test and finger-ground distance measurement and connective tissue thickness was assessed with Ultrasonography (USG). Measuremets were carried out at the beginning of the treatment, after the first session of the treatment period and at the end of the treatment. According to the results; it was concluded that the applied two methods did not have superiority over each other in parameters like pain, functionality, depression, hamstring shortness, spinal mobility, lumbar perimuscular zone thickness, hamstrings perimuscular and subcutaneous zone thickness (p>0,05). According to the thickness difference before and after treatment, it has been observed that, IASTM provides a better improvement on the subcutaneous zone thickness in the lumbar (p<0,05). As a result; IASTM and KT have healing effects on pain, fuctionality and connective tissue tickness in patients with NSLBP. Keywords: Low back pain, Mobilization, Kinesio taping, Perimuscular zone, Subcutaneous zone.
The aim of the study is to investigate the effects of instrument assisted soft tissue mobilization (IASTM) and kinesio taping (KT) that are additional treatment to the conservative treatment for the lumbar region and hamstrings, on pain, fuctionality and connective tissue tickness in patients with chronic non-specific low back pain (NSLBP). 30 patients with NSLBP at age between 30 – 50 range were included into the randomized controlled triad designed study. Patients were randomized into two groups. Demographical and physical data of the patients were recorded. A conservative treatment that composed of hotpack, Transcutaneous Electrical Nerve Stimulation (TENS) and ultrasound was applied for both two groups. For the first group, in addition to the conservative treatment, IASTM was applied. KT was applied for second group. Pain with Visual Analog Scale (VAS), functional impairment with Roland Morris Disability Questionnaire (RMDQ), depression with Beck Depression Inventory, hamstring shortness with straight leg raise, flexibility with sit and reach test, lumbar extensor shortness assessment, spinal mobility Modified Schober Test and finger-ground distance measurement and connective tissue thickness was assessed with Ultrasonography (USG). Measuremets were carried out at the beginning of the treatment, after the first session of the treatment period and at the end of the treatment. According to the results; it was concluded that the applied two methods did not have superiority over each other in parameters like pain, functionality, depression, hamstring shortness, spinal mobility, lumbar perimuscular zone thickness, hamstrings perimuscular and subcutaneous zone thickness (p>0,05). According to the thickness difference before and after treatment, it has been observed that, IASTM provides a better improvement on the subcutaneous zone thickness in the lumbar (p<0,05). As a result; IASTM and KT have healing effects on pain, fuctionality and connective tissue tickness in patients with NSLBP. Keywords: Low back pain, Mobilization, Kinesio taping, Perimuscular zone, Subcutaneous zone.
Description
Keywords
Fizyoterapi ve Rehabilitasyon, Ağrı, Bel ağrısı, Physiotherapy and Rehabilitation, Fizik tedavi, Pain, Back pain, Fizik tedavi yöntemleri, Physical therapy, Kinezyo bantlama, Physical therapy modalities, Kinesio taping, Yumuşak doku, Soft tissue