Journal of Traditional Medical Complementary Therapies

.: ORIGINAL RESEARCH
Spesifik Olmayan Kronik Bel Ağrısında Ev Egzersizi, Enstrüman Destekli Yumuşak Doku Mobilizasyonu ve Enstrüman Destekli Spinal Manipülasyon Tedavi Yöntemlerinin Etkinliğinin Araştırılması: Randomize Klinik Çalışma
Investigation of the Efficacy of Home Exercise, Instrument Assisted Soft Tissue Mobilization and Instrument Assisted Spinal Manipulation Treatment Methods in Non-Specific Chronic Low Back Pain: Randomized Clinical Trial
Nur NAMALIRa, Hasan Kerem ALPTEKİNb, Sefa Haktan HATIKc, Vildan BİNAY SAFERd, Başar ÖZTÜRKe
aBahçeşehir Üniversitesi Lisanüstü Eğitim Enstitüsü, Fizyoterapi ve Rehabilitasyon Programı, İstanbul, TÜRKİYE
bBahçeşehir Üniversitesi Sağlık Bilimleri Fakültesi, Fizyoterapi ve Rehabilitasyon Bölümü, İstanbul, TÜRKİYE
cSinop Üniversitesi Türkeli Meslek Yüksekokulu, Sağlık Bakım Hizmetleri Bölümü, Sinop, TÜRKİYE
dŞehit Prof. Dr. İlhan Varank Eğitim ve Araştırma Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, İstanbul, TÜRKİYE
eBiruni Üniversitesi Sağlık Bilimleri Fakültesi, Ergoterapi Bölümü, İstanbul, TÜRKİYE
J Tradit Complem Med. 2021;4(3):318-25
doi: 10.5336/jtracom.2021-81833
Article Language: TR
Full Text
ÖZET
 Amaç: Spesifik olmayan kronik bel ağrılarında, enstrüman destekli yumuşak doku mobilizasyonu (EDYDM) ve enstrümantal spinal manipülasyon (ESM) tedavilerinin etkinliği incelenmektir. Gereç ve Yöntemler: Tanısı konmuş, 18-65 yaş aralığındaki 93 gönüllü çalışmaya dâhil edildi. Randomize olarak ESM grubu (n=31, 26 kadın, 5 erkek), EDYDM grubu (n=31, 24 kadın, 7 erkek) ve kontrol grubu (KG) (n=31, 25 kadın, 6 erkek) olmak üzere 3'e ayrıldı. Tedavi öncesinde ve tedavi sonrasında 2 kez olmak üzere demografik bilgiler anketi, McGill Ağrı Ölçeği-Kısa Formu (MAÖ-KF), Oswestry Bel Ağrısı Engellilik Anketi (OBAEA), Numerik ağrı skalası (NAS), Pittsburgh Uyku Kalitesi İndeksi (PUKİ) ve Eklem Hareket Açıklığı (EHA) ölçümleri ile değerlendirildi. Bütün gruplara ev egzersiz programı verildi. ESM ve EDYDM grubuna ise egzersize ek olarak 4 hafta boyunca haftada 2 kez tedavi uygulandı. Bulgular: Grup içi tüm parametrelerde ve gruplar arasında yapılan analizde ise PUKİ dışındaki tüm parametrelerde anlamlı bir farklılıklar bulundu (p<0,05). İkili karşılaştırmalarda, ESM grubunun KG'ye göre PUKİ dışındaki tüm ölçüm parametrelerinde olumlu sonuçlar ortaya koyduğu görüldü. EDYDM'nin KG'ye göre NAS 4. hafta ölçümü ve PUKİ dışındaki tüm ölçüm parametrelerinde olumlu sonuçlara ulaşıldı. ESM ve EDYDM grupları arasında ise PUKİ ve MAÖ-KF dışındaki parametrelerde, EHA fleksiyon, OBAEA parametrelerinin sadece 8. hafta ölçümü ile diğer tüm ölçüm parametrelerinin 4. hafta ve 8. hafta ölçümünde ESM grubu lehine olumlu sonuçlar elde edildi (p<0,05). Sonuç: Egzersizlere ilave olarak uygulanan, ESM ve EDYDM grubunun yalnızca egzersiz uygulamalarına oranla daha etkili olduğu görüldü.

Anahtar Kelimeler: Kayropraktik; mobilizasyon; ev egzersizi; kronik bel ağrısı
ABSTRACT
 Objective: To examine the effectiveness of Instrument-Assisted Soft Tissue Mobilization (IASTM) and Instrument-Assisted Spinal Manipulation in non-specific chronic low back pain. Material and Methods: 93 diagnosed volunteers, aged 18-65, were included in the study. Randomized instrumental spinal manipulation group (n=31, 26 females, 5 males), IASTM group (n=31, 24 females, 7 males) and control group (n=31, 25 females, 6 males demographic information questionnaire before and after treatment, a short form of the McGill Pain Questionnaire (MPQ), Oswestry Disability Index (ODI), Numeric pain scale, Pittsburgh Sleep Quality Index (PSQI) and range of motion measurements. Home exercise program was given to all groups. In addition to exercise, treatment was applied twice a week for 4 weeks to the instrumental spinal manipulation and IASTM group groups. Results: Significant differences were found in all parameters within the group and in all parameters except PSQI in the analysis between groups (p>0.05). In paired comparisons, it was seen that instrumental spinal manipulation showed positive results in all measurement parameters except PSQI compared to control group. Positive results were obtained in all measurement parameters except numeric pain scale 4th week measurement and PSQI according to control group of IASTM group. Between instrumental spinal manipulation and IASTM group, positive results were obtained in favor of instrumental spinal manipulation in parameters other than PSQI and a short form of the MPQ, measuring range of motion flexion, IASTM parameters only at the 8th week and measuring all other measurement parameters at the 4th week and 8th week (p<0.05). Conclusion: It was seen that instrumental spinal manipulation and IASTM group applied in addition to exercises were more effective than exercise applications alone.

Keywords: Chiropractic; mobilization; home exercise; chronic; low back pain
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