.: ORİJİNAL ARAŞTIRMA
Kronik Miyofasiyal Boyun Ağrısı Olan Hastalarda Enstrüman Destekli Yumuşak Doku Mobilizasyonu ve/veya Egzersizin Ağrı, Postüral Denge, Uyku ve Yaşam Kalitesi Üzerine Etkileri: Randomize Kontrollü Bir Çalışma
The Effects of Instrument-Supported Soft Tissue Mobilization and/or Exercise on Pain, Postural Balance, Sleep and Quality of Life in Patients with Chronic Myofacial Neck Pain: A Randomized Controlled Study
J Tradit Complem Med. 2022;5(2):87-95
doi: 10.5336/jtracom.2021-87069
Makale Dili: TR
Tam Metin
ÖZET
Amaç: Bu çalışmanın amacı; kronik miyofasiyal boyun ağrısı (KMBA) olan hastalarda, enstrüman destekli yumuşak doku mobilizasyonu (EDYDM) ve/veya egzersizin ağrı, postüral denge, uyku ve yaşam kalitesi üzerine olan etkilerini araştırmaktı. Gereç ve Yöntemler: Çalışmaya 30-50 yaş arası KMBA olan 36'sı kadın, 36'sı erkek toplam 72 hasta dâhil edildi. Hastalar randomize EDYDM grubu, egzersiz grubu ve plasebo grubu olacak şekilde 3 gruba ayrıldı. Bireylerin demografik ve fiziksel özellikleri olgu rapor formu ile kaydedildi. EDYDM grubuna sadece EDYDM, egzersiz grubuna ev egzersiz programı, kontrol grubuna ise plasebo EDYDM uygulandı. Ağrı şiddeti, Görsel Analog Skalası [Visual Analogue Scale (VAS)] ile, denge Dört Adım Kare Testi (DAKT) ve Tek Ayak Üzerinde Durma Testi (TAÜDT) ile, uyku kalitesi Pittsburg Uyku Kalitesi İndeksi (PUKİ) ile, yaşam kalitesi SF-36 Yaşam Kalitesi Ölçeği ile değerlendirildi. Ölçümler tedavi öncesi ve sonrasında tekrarlandı. Bulgular: Çalışmada, EDYDM grubu ve egzersiz grubunda tedavi öncesi ve sonrası VAS, DAKT, TAÜDT, PUKİ ve SF-36 yaşam kalitesi ölçeklerinin alt parametrelerinde anlamlı fark vardı (p0,05). Sonuç: Çalışma sonucunda EDYDM ve egzersiz grubunda VAS, DAKT, TAÜDT, PUKİ ve SF-36 yaşam kalitesi ölçeklerinin alt parametrelerinde anlamlı gelişmeler görülürken, plasebo grubunda anlamlı bir fark yoktu.
Anahtar Kelimeler: Boyun ağrısı; egzersiz; kas-iskelet manipülasyonları; uyku
Amaç: Bu çalışmanın amacı; kronik miyofasiyal boyun ağrısı (KMBA) olan hastalarda, enstrüman destekli yumuşak doku mobilizasyonu (EDYDM) ve/veya egzersizin ağrı, postüral denge, uyku ve yaşam kalitesi üzerine olan etkilerini araştırmaktı. Gereç ve Yöntemler: Çalışmaya 30-50 yaş arası KMBA olan 36'sı kadın, 36'sı erkek toplam 72 hasta dâhil edildi. Hastalar randomize EDYDM grubu, egzersiz grubu ve plasebo grubu olacak şekilde 3 gruba ayrıldı. Bireylerin demografik ve fiziksel özellikleri olgu rapor formu ile kaydedildi. EDYDM grubuna sadece EDYDM, egzersiz grubuna ev egzersiz programı, kontrol grubuna ise plasebo EDYDM uygulandı. Ağrı şiddeti, Görsel Analog Skalası [Visual Analogue Scale (VAS)] ile, denge Dört Adım Kare Testi (DAKT) ve Tek Ayak Üzerinde Durma Testi (TAÜDT) ile, uyku kalitesi Pittsburg Uyku Kalitesi İndeksi (PUKİ) ile, yaşam kalitesi SF-36 Yaşam Kalitesi Ölçeği ile değerlendirildi. Ölçümler tedavi öncesi ve sonrasında tekrarlandı. Bulgular: Çalışmada, EDYDM grubu ve egzersiz grubunda tedavi öncesi ve sonrası VAS, DAKT, TAÜDT, PUKİ ve SF-36 yaşam kalitesi ölçeklerinin alt parametrelerinde anlamlı fark vardı (p0,05). Sonuç: Çalışma sonucunda EDYDM ve egzersiz grubunda VAS, DAKT, TAÜDT, PUKİ ve SF-36 yaşam kalitesi ölçeklerinin alt parametrelerinde anlamlı gelişmeler görülürken, plasebo grubunda anlamlı bir fark yoktu.
Anahtar Kelimeler: Boyun ağrısı; egzersiz; kas-iskelet manipülasyonları; uyku
ABSTRACT
Objective: The aim of this study is; to investigate the effects of instrument-assisted soft tissue mobilization (IASTM) and/or exercise on pain, postural balance, sleep and quality of life in patients with chronic myofascial neck pain (CMNP). Material and Methods: A total of 72 patients, 36 females and 36 males, with CMNP between the ages of 30 and 50 years were included in the study. The patients were divided into 3 groups as randomized IASTM group, exercise group and placebo group. Demographic and physical characteristics of the individuals were recorded with the case report form. Only IASTM was applied to the IASTM group, home exercise program to the exercise group, and placebo IASTM to the control group. Pain severity was assessed using Visual Analogue Scale (VAS), balance was assessed using Four Step Square Test (FSST) and the One-Leg Stand Test (OLST), sleep quality was assessed using Pittsburg Sleep Quality Index (PSQI), while assessment of quality of life was done using SF-36 Quality of Life Scale. The measurements were repeated before and after the study. Results: In the study, there was a significant difference in the sub-parameters of VAS, FSST, OLST, PSQI and SF-36 quality of life scales before and after treatment in the IASTM group and exercise group (p0.05). Conclusion: As a result of the study, significant improvements were observed in the sub-parameters of the VAS, FSST, OLST, PSQI and SF-36 quality of life scales in the IASTM and exercise group, but no significant results were obtained in the placebo group.
Keywords: Neck pain; exercise; musculoskeletal manipulations; sleep
Objective: The aim of this study is; to investigate the effects of instrument-assisted soft tissue mobilization (IASTM) and/or exercise on pain, postural balance, sleep and quality of life in patients with chronic myofascial neck pain (CMNP). Material and Methods: A total of 72 patients, 36 females and 36 males, with CMNP between the ages of 30 and 50 years were included in the study. The patients were divided into 3 groups as randomized IASTM group, exercise group and placebo group. Demographic and physical characteristics of the individuals were recorded with the case report form. Only IASTM was applied to the IASTM group, home exercise program to the exercise group, and placebo IASTM to the control group. Pain severity was assessed using Visual Analogue Scale (VAS), balance was assessed using Four Step Square Test (FSST) and the One-Leg Stand Test (OLST), sleep quality was assessed using Pittsburg Sleep Quality Index (PSQI), while assessment of quality of life was done using SF-36 Quality of Life Scale. The measurements were repeated before and after the study. Results: In the study, there was a significant difference in the sub-parameters of VAS, FSST, OLST, PSQI and SF-36 quality of life scales before and after treatment in the IASTM group and exercise group (p0.05). Conclusion: As a result of the study, significant improvements were observed in the sub-parameters of the VAS, FSST, OLST, PSQI and SF-36 quality of life scales in the IASTM and exercise group, but no significant results were obtained in the placebo group.
Keywords: Neck pain; exercise; musculoskeletal manipulations; sleep
REFERANSLAR:
- Carroll LJ, Hogg-Johnson S, van der Velde G, Haldeman S, Holm LW, Carragee EJ, et al; Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Course and prognostic factors for neck pain in the general population: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Spine (Phila Pa 1976). 2008;33(4 Suppl):S75-82. [Crossref] [PubMed]
- Harris GR, Susman JL. Managing musculoskeletal complaints with rehabilitation therapy: summary of the Philadelphia Panel evidence-based clinical practice guidelines on musculoskeletal rehabilitation interventions. J Fam Pract. 2002;51(12):1042-6. [PubMed]
- Laudner K, Compton BD, McLoda TA, Walters CM. Acute effects of instrument assisted soft tissue mobilization for improving posterior shoulder range of motion in collegiate baseball players. Int J Sports Phys Ther. 2014;9(1):1-7. [PubMed] [PMC]
- Loghmani MT, Warden SJ. Instrument-assisted cross fiber massage increases tissue perfusion and alters microvascular morphology in the vicinity of healing knee ligaments. BMC Complement Altern Med. 2013;13:240. [Crossref] [PubMed] [PMC]
- Highland TR, Dreisinger TE, Vie LL, Russell GS. Changes in isometric strength and range of motion of the isolated cervical spine after eight weeks of clinical rehabilitation. Spine (Phila Pa 1976). 1992;17(6 Suppl):S77-82. [Crossref] [PubMed]
- Kaźmierczak H, Pawlak-Osińska K, Kasprzak H. Wpływ zaburzeń propriocepcji szyjnej na odruchy posturalne--badania doświadczalne i kliniczne [The influence of the cervical proprioception on the postural reflexes--experimental and clinical study]. Otolaryngol Pol. 2004;58(4):839-42. Polish. [PubMed]
- Sarig-Bahat H. Evidence for exercise therapy in mechanical neck disorders. Man Ther. 2003;8(1):10-20. [Crossref] [PubMed]
- Griffiths C, Dziedzic K, Waterfield J, Sim J. Effectiveness of specificneck stabilization exercises or a general neck exercise program for chronic neck disorders: a randomized controlled trial. J Rheumatol. 2009;36(2):390-7. [Crossref] [PubMed]
- Gulick DT. Instrument-assisted soft tissue mobilization increases myofascial trigger point pain threshold. J Bodyw Mov Ther. 2018;22(2):341-5. [Crossref] [PubMed]
- Lin IH, Chang KH, Liou TH, Tsou CM, Huang YC. Progressive shoulder-neck exercise on cervical muscle functions in middle-aged and senior patients with chronic neck pain. Eur J Phys Rehabil Med. 2018;54(1):13-21. [Crossref] [PubMed]
- Fathollahnejad K, Letafatkar A, Hadadnezhad M. The effect of manual therapy and stabilizing exercises on forward head and rounded shoulder postures: a six-week intervention with a one-month follow-up study. BMC Musculoskelet Disord. 2019;20(1):86. [Crossref] [PubMed] [PMC]
- Tunwattanapong P, Kongkasuwan R, Kuptniratsaikul V. The effectiveness of a neck and shoulder stretching exercise program among office workers with neck pain: a randomized controlled trial. Clin Rehabil. 2016;30(1):64-72. [Crossref] [PubMed]
- Durmus B. Servikal bölge sorunlarında egzersiz reçeteleme [Prescribing exercise for neck problems]. Türkiye Fiziksel Tip ve Rehabilitasyon Dergisi. 2014;60(Özel Sayı 2):15-24. [Crossref]
- Quek J, Brauer SG, Clark R, Treleaven J. New insights into neck-pain-related postural control using measures of signal frequency and complexity in older adults. Gait Posture. 2014;39(4):1069-73. [Crossref] [PubMed]
- Humphreys BK. Cervical outcome measures: testing for postural stability and balance. J Manipulative Physiol Ther. 2008;31(7):540-6. [Crossref] [PubMed]
- Omori S, Isose S, Otsuru N, Nishihara M, Kuwabara S, Inui K, et al. Somatotopic representation of pain in the primary somatosensory cortex (S1) in humans. Clin Neurophysiol. 2013;124(7):1422-30. [Crossref] [PubMed]
- Field S, Treleaven J, Jull G. Standing balance: a comparison between idiopathic and whiplash-induced neck pain. Man Ther. 2008;13(3):183-91. [Crossref] [PubMed]
- Toprak ÇŞ, Mete O, Korkut Z, Özalp M, Ünüvar BS, Sevim M. Kronik boyun ağrılı bireylerde derin boyun fleksör kas performansının denge ve yürüme parametreleri ile ilişkisi [Relationship between deep neck flexor muscle performance, balance and gait parameters in individuals with chronic neck pain]. Turk J Physiother Rehabil. 2020;31(1):52-7. [Link]
- Acet N. Nonspesifik boyun ağrılı hastalarda servikal bölgeye yapılan mobilizasyonun denge ve propriosepsiyona etkisi [Doktora tezi]. Ankara: Gazi Üniversitesi; 2020. [Erişim tarihi: 10 Ekim 2021]. Erişim linki: [Link]
- Kim JE, Ha S, Kim WM. The effects of 8-week spinal stabilization exercise program on NDI, postural balance and body shape change in patients with chronic neck pain. J Korea Acad Industr Coop Soc. 2020;21(12):43-51. [Link]
- Lee JH, Lee DK, Oh JS. The effect of Graston technique on the pain and range of motion in patients with chronic low back pain. J Phys Ther Sci. 2016;28(6):1852-5. [Crossref] [PubMed] [PMC]
- Bostan A. Kronik boyun ağrısı olan hastalarda aletli yumuşak doku mobilizasyon uygulamasının etkinliği: Randomize kontrollü çalışma [Yüksek lisans tezi]. İstanbul: İstanbul Medipol Üniversitesi; 2021. [Erişim tarihi: 13 Ekim 2021]. Erişim linki: [Link]
- Salo PK, Häkkinen AH, Kautiainen H, Ylinen JJ. Effect of neck strength training on health-related quality of life in females with chronic neck pain: a randomized controlled 1-year follow-up study. Health Qual Life Outcomes. 2010;8:48. [Crossref] [PubMed] [PMC]
- Häkkinen A, Salo P, Tarvainen U, Wirén K, Ylinen J. Effect of manual therapy and stretching on neck muscle strength and mobility in chronic neck pain. J Rehabil Med. 2007;39(7):575-9. [Crossref] [PubMed]
- Kelson DM, Mathiassen SE, Srinivasan D. Trapezius muscle activity variation during computer work performed by individuals with and without neck-shoulder pain. Appl Ergon. 2019;81:102908. [Crossref] [PubMed]
- Hacıömeroğlu Ç. Kronik boyun ağrısı olan olgularda eklem pozisyon hissinin değerlendirilmesi [Yüksek lisans tezi]. İstanbul: İstanbul Medipol Üniversitesi; 2020. [Erişim tarihi: 12 Ekim 2021]. Erişim linki: [Link]
- Bostan A. Kronik boyun ağrısı olan hastalarda aletli yumuşak doku mobilizasyon uygulamasının etkinliği: Randomize kontrollü çalışma [Yüksek lisans tezi]. İstanbul: İstanbul Medipol Üniversitesi; 2021. [Erişim tarihi: 12 Ekim 2021]. Erişim linki: [Link]
- Falla D, Lindstrøm R, Rechter L, Boudreau S, Petzke F. Effectiveness of an 8-week exercise programme on pain and specificity of neck muscle activity in patients with chronic neck pain: a randomized controlled study. Eur J Pain. 2013;17(10):1517-28. [Crossref] [PubMed]
- Björnsdóttir SV, Jónsson SH, Valdimarsdóttir UA. Functional limitations and physical symptoms of individuals with chronic pain. Scand J Rheumatol. 2013;42(1):59-70. [Crossref] [PubMed]
- Gutiérrez-Rojas C, González I, Navarrete E, Olivares E, Rojas J, Tordecilla D. The effect of combining myofascial release with ıce application on a latent trigger point in the forearm of young adults: a randomized clinical trial. MYOPAIN. 2015;23(3):201-8. [Crossref]
- Çağlar A. Miyofasiyal ağrı sendromlu bireylerde egzersiz programına ek olarak uygulanan manuel tedavi yöntemlerinin etkisi [Doktora tezi]. Ankara: Hacettepe Üniversitesi; 2019. [Erişim tarihi: 15 Ekim 2021]. Erişim linki: [Link]
.: İşlem Listesi