Lomber disk hernili hastalarda yüksek yoğunluklu lazer ve egzersiz tedavisinin lomber kas gücü, ağrı, fonksiyonel durum, depresyon ve anksiyete üzerine olan etkisi
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Tarih
2022
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
LOMBER DİSK HERNİLİ HASTALARDA YÜKSEK YOĞUNLUKLU LAZER VE EGZERSİZ TEDAVİSİNİN LOMBER KAS GÜCÜ, AĞRI, FONKSİYONEL DURUM, DEPRESYON VE ANKSİYETE ÜZERİNE OLAN ETKİSİ Amaç: Bu çalışmada subakut ve kronik lomber disk hernisi olan hastalarda lazer ve egzersiz tedavisinin lomber kas gücü, ağrı, fonksiyonel durum, depresyon ve anksiyete üzerine olan etkisini değerlendirmek amaçlandı. Gereç ve Yöntem: Ekim 2020- Mart 2021 tarihleri arasında 4 haftadan uzun süreli bel ağrısı şikayeti ile Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi Fiziksel Tıp ve Rehabilitasyon polikliniklerine başvuran anamnez, fizik muayene ve uygun görüntüleme yöntemleriyle lomber disk hernisi tanısı alan 20-60 yaş arasında 30 bayan-30 erkek hasta tedaviye alındı. Çalışma şartlarını oluşturan hastalar randomize edilerek her grupta 10 kadın ve 10 erkek olacak şekilde üç gruba ayrıldı. İlk gruba 4 hafta (haftada 5 gün toplam 20 seans) süre ile hotpack (HP), transkutanöz elektriksel sinir stimülasyonu (TENS), egzersiz ve yüksek yoğunluklu lazer tedavisi (YYLT) (haftada 3 gün toplam 12 seans), ikinci gruba 4 hafta (haftada 5 gün toplam 20 seans) süre ile HP, TENS, egzersiz ve plasebo lazer tedavisi, üçüncü gruba HP, TENS ve YYLT uygulandı. Hastalar belirlenen ölçeklerle tedavi öncesi, tedavi bitimi ve tedaviden 3 ay sonra değerlendirildi. Ağrı için vizüel analog skala (VAS), disabilite için Oswestry Bel Ağrısı Skalası, yaşam kalitesi için Nothingham Sağlık Profili (NSP), anksiyete için Beck Anksiyete Ölçeği, depresyon için Beck Depresyon Ölçeği, lomber izokinetik kas gücü ölçümü için Biodex System 3 izokinetik cihaz kullanıldı. Bulgular: Tedavi sonrası her üç tedavi grubunda da VAS, el parmak zemin (EPZ) mesafesi, Oswestry Skalası, NSP bölüm 1 ve 2 toplam skoru, beck depresyon ve anksiyete ölçeği değerleri açısından düzelme gözlendi. VAS açısından; tedavi sonrası ve tedavi sonrası 3. ayda 1. ve 3. gruplar arasında anlamlı fark varken, 1. ve 2. gruplar arasında anlamlı fark yoktu. Tedavi öncesi, tedavi sonrası ve tedaviden 3 ay sonra EPZ, Beck Depresyon ve Anksiyete değerleri açısından anlamlı fark yoktu. Oswestry değerleri açısından tedavi öncesi 1. ve 3. gruplar arasında fark varken, 1. ve 2. gruplar arasında fark yoktu. Tedavi sonrası ve tedaviden 3 ay sonra 1. ve 3. gruplar arasında istatistiksel olarak anlamlı fark varken, 1. ve 2. gruplar arasında istatistiksel olarak fark bulunmadı. Gruplar birbirleriyle kıyaslandığında, tedavi öncesi, tedavi sonrası ve tedaviden üç ay sonra Peak Tork, Peak Tork/VA ve AVG Peak Tork açısından anlamlı fark bulunmadı. Gruplar kendi içlerinde değerlendirildiğinde, tedavi öncesi ve tedavi sonrası 3. ayda Tepe Tork, Tepe Tork/VA ve AVG Tepe Tork skorları açısından tedavi öncesine göre anlamlı farklılık gözlendi. VAS azalmasıyla peak tork artışı gruplar ve cinsiyetler arasında anlamlı bulundu. Sonuç: Lomber disk hernisi tedavisinde egzersiz primer tedavi olmalıdır. Uzun vadede etki devamını arttırmak ve ağrı azalmasıyla birlikte kas gücündeki artışı artırmak için egzersiz tedavisi yüksek yoğunluklu lazer tedavisi ile kombine edilebilir. Anahtar Sözcükler: Lomber disk hernisi, biofotomodülasyon, lazer, YYLT, TENS, egzersiz, kronik bel ağrısı, depresyon, anksiyete
THE EFFECT OF HIGH-INTENSITY LASER AND EXERCISE THERAPY ON LUMBAR MUSCLE STRENGTH, PAIN, FUNCTIONAL CONDITION, DEPRESSION AND ANXIETY IN PATIENTS WITH LUMBAR DISC HERNIA Introduction: In this study, it was aimed to evaluate the effects of laser and exercise therapy on lumbar muscle strength, pain, functional status, depression and anxiety in patients with subacute and chronic lumbar disc herniation. Material and methods: Between October 2020 and March 2021, 30 female-30 male patients aged 20-60 years, who were diagnosed with lumbar disc herniation by anamnesis, physical examination and appropriate imaging methods who applied to the physical medicine and rehabilitation polyclinics of Necmettin Erbakan University Meram Faculty of Medicine with complaints of low back pain lasting longer than 4 weeks, were treated. The patients who formed the study conditions were randomized and divided into three groups as 10 women and 10 men in each group. Hotpack (HP) and transcutaneous electrical nerve stimulation (TENS) treatments were applied to all three groups for 4 weeks (5 days a week for a total of 20 sessions). In addition; in the first group, exercise was applied 5 days a week for a total of 20 sessions and high-intensity laser therapy (HILT) was applied 3 days a week for a total of 12 sessions for 4 weeks. In the second group, exercise and placebo laser therapy were additionally applied to HP and TENS. And in the third group high-intensity laser therapy was applied additionally to HP and TENS. The patients were evaluated with the determined scales before the treatment, at the end of the treatment and 3 months after the treatment. Visual analog scale (VAS) was used for pain, Oswestry Low Back Pain Scale for disability, Nothingham Health Profile (NSP) for quality of life, Beck Anxiety Scale for anxiety, Beck Depression Scale for depression and Biodex System 3 isokinetic device was used for lumbar isokinetic muscle strength measurement. Results: After the treatment, improvement was observed in all three treatment groups in terms of VAS, finger floor distance, oswestry scale, NHP part 1 and 2 total score, beck depression scale and beck anxiety scale. When visuel analog scale (VAS) considered, while there was a significant difference between the 1st and 3rd groups after the treatment and at the 3rd month after the treatment, there was no significant difference between the 1st and 2nd groups. There was no significant difference in terms of finger floor distance, beck depression and anxiety values before, after and at 3 months. In terms of Oswestry scores, there was a difference between the 1st and 3rd groups before treatment, but there was no difference between the 1st and 2nd groups. While there was a statistically significant difference between the 1st and 3rd groups after the treatment and 3 months after the treatment, no statistical difference was found between the 1st and 2nd groups. When the groups were compared with each other, no significant difference was found in terms of Peak Torque, Peak Torque/VA and AVG Peak tork before, after and three months after treatment. When the groups were evaluated within themselves, a significant difference was observed in terms of Peak Torque, Peak Torque/VA and AVG Peak Torque scores at the 3rd month after treatment and after treatment compared to before treatment. Peak torque increase with decrease in VAS was found significant between groups and genders. Conclusion: Exercise should be the primary treatment in the treatment of lumbar disc herniation. It can be combined with high intensity laser therapy to increase long-term effect and increase muscle strength by decreasing the pain. Key words: Lumbar disc herniation, biophotomodulation, laser, HILT, TENS, exercise, chronic low back pain, depression, anxiety
THE EFFECT OF HIGH-INTENSITY LASER AND EXERCISE THERAPY ON LUMBAR MUSCLE STRENGTH, PAIN, FUNCTIONAL CONDITION, DEPRESSION AND ANXIETY IN PATIENTS WITH LUMBAR DISC HERNIA Introduction: In this study, it was aimed to evaluate the effects of laser and exercise therapy on lumbar muscle strength, pain, functional status, depression and anxiety in patients with subacute and chronic lumbar disc herniation. Material and methods: Between October 2020 and March 2021, 30 female-30 male patients aged 20-60 years, who were diagnosed with lumbar disc herniation by anamnesis, physical examination and appropriate imaging methods who applied to the physical medicine and rehabilitation polyclinics of Necmettin Erbakan University Meram Faculty of Medicine with complaints of low back pain lasting longer than 4 weeks, were treated. The patients who formed the study conditions were randomized and divided into three groups as 10 women and 10 men in each group. Hotpack (HP) and transcutaneous electrical nerve stimulation (TENS) treatments were applied to all three groups for 4 weeks (5 days a week for a total of 20 sessions). In addition; in the first group, exercise was applied 5 days a week for a total of 20 sessions and high-intensity laser therapy (HILT) was applied 3 days a week for a total of 12 sessions for 4 weeks. In the second group, exercise and placebo laser therapy were additionally applied to HP and TENS. And in the third group high-intensity laser therapy was applied additionally to HP and TENS. The patients were evaluated with the determined scales before the treatment, at the end of the treatment and 3 months after the treatment. Visual analog scale (VAS) was used for pain, Oswestry Low Back Pain Scale for disability, Nothingham Health Profile (NSP) for quality of life, Beck Anxiety Scale for anxiety, Beck Depression Scale for depression and Biodex System 3 isokinetic device was used for lumbar isokinetic muscle strength measurement. Results: After the treatment, improvement was observed in all three treatment groups in terms of VAS, finger floor distance, oswestry scale, NHP part 1 and 2 total score, beck depression scale and beck anxiety scale. When visuel analog scale (VAS) considered, while there was a significant difference between the 1st and 3rd groups after the treatment and at the 3rd month after the treatment, there was no significant difference between the 1st and 2nd groups. There was no significant difference in terms of finger floor distance, beck depression and anxiety values before, after and at 3 months. In terms of Oswestry scores, there was a difference between the 1st and 3rd groups before treatment, but there was no difference between the 1st and 2nd groups. While there was a statistically significant difference between the 1st and 3rd groups after the treatment and 3 months after the treatment, no statistical difference was found between the 1st and 2nd groups. When the groups were compared with each other, no significant difference was found in terms of Peak Torque, Peak Torque/VA and AVG Peak tork before, after and three months after treatment. When the groups were evaluated within themselves, a significant difference was observed in terms of Peak Torque, Peak Torque/VA and AVG Peak Torque scores at the 3rd month after treatment and after treatment compared to before treatment. Peak torque increase with decrease in VAS was found significant between groups and genders. Conclusion: Exercise should be the primary treatment in the treatment of lumbar disc herniation. It can be combined with high intensity laser therapy to increase long-term effect and increase muscle strength by decreasing the pain. Key words: Lumbar disc herniation, biophotomodulation, laser, HILT, TENS, exercise, chronic low back pain, depression, anxiety
Açıklama
Anahtar Kelimeler
Lomber disk hernisi, Biofotomodülasyon, Lazer, YYLT, Lumbar disc herniation, Biophotomodulation, Laser, HILT
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Sak, N. İ. (2022). Lomber disk hernili hastalarda yüksek yoğunluklu lazer ve egzersiz tedavisinin lomber kas gücü, ağrı, fonksiyonel durum, depresyon ve anksiyete üzerine olan etkisi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Bölümü Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Konya.
