Diz osteoartritli hastalarda radial şok dalga (RSWT) tedavisinin iki farklı enerji yoğunluğunun kombine fizik tedavi uygulamaları ile karşılaştırılması
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2015
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İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
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Amaç: Bu çalışmanın amacı diz osteoartrit (OA)'li hastalarda RSWT tedavisinin iki farklı enerji yoğunluğunun etkinliğini kombine fizik tedavi modaliteleri ve plasebo ile karşılaştırmaktır. Gereç ve yöntem: Çalışmaya, İnönü Üniversitesi Tıp Fakültesi Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı polikliniklerine başvuran, American College of Rheumatology (ACR) kriterlerine göre 'Primer Diz Osteoartriti' tanısı konan, son 3 aydır diz ağrısı olan, Kellgreen-Lawrence skalasına göre radyolojik olarak evre 2-3 olan ve 45 yaş üstü toplam 60 hasta dâhil edildi. Çalışma prospektif, randomize, çift kör, plasebo kontrollü tasarlandı (Kör araştırmacı: Dr. Bilengül Aslan Vural). Hastalar kapalı zarf metodu ile randomize edilerek 15'şer kişilik 4 gruba ayrıldı. BTL marka, 6000 SWT Topline model RSWT cihazı ve ekipmanları ile grup 1-3'e haftada bir olacak şekilde 4 hafta süre ile farklı enerji düzeyinde RSWT tedavisi uygulandı. Grup 1'e; 0.11 mJ/mm2 RSWT (1.5 bar basınç ve 5-10 Hz frekansta, 3000 şok dalgası/hf), grup 2'ye ise 0.25 mJ/mm2 RSWT (3.5 bar basınç ve 5-10 Hz frekansta, 3000 şok dalgası/hf), grup3'e haftada beş gün olacak şekilde üç hafta süreli toplam on beş seans kombine fizik tedavi (hotpack + transkütanöz elektriksel sinir uyarısı (TENS) + ultrason (US) + güçlendirme egzersizleri), grup 4'e sham (sahte) RSWT uygulandı. Tüm fiziksel tıp modalitelerinin uygulamaları aynı kişi (Sağlık Teknisyeni: Aytekin Öztürk) tarafından yapıldı. Hastalar tedavi öncesi ve tedaviden 1, 4 ve 8 hafta sonra WOMAC skoru, Lequesne indeksi ve VAS skorları (hareketle, istirahatte ve gece) kullanılarak değerlendirildi. Bulgular: Tedavi öncesi gruplar arası demografik değerlendirmede istatistiksel olarak anlamlı bir fark saptanmadı. Başlangıç değerleri ile karşılaştırıldığında, tedaviden 1, 4 ve 8 hafta sonrasında WOMAC, Lequesne ve VAS skorlarında grup 1, 2 ve 3'de klinik ve istatiksel olarak anlamlı azalma gözlendi (p<0.05). Grup 4'te istatistiksel olarak anlamlı düzeyde iyileşme olmadı. Tüm parametrelerde sekizinci hafta sonunda yapılan değerlendirmede grup 1 ile karşılaştırıldığında grup 2'deki düzelme daha fazla olmasına rağmen istatistiksel analizlerde gruplar arasında anlamlı farklılık saptanmadı. Sonuç: Bu bulgulardan yola çıkılarak RSWT tedavisinin diz OA'de ağrının azaltılmasında ve fonksiyonel düzelmede kombine fizik tedavi uygulamaları kadar etkili ve kullanılabilir bir yöntem olduğu, gelecekte mevcut yöntemlere ilave bir destekleyici tedavi yöntemi olabileceği sonucuna varıldı. Anahtar kelimeler: Diz, Osteoartrit, RSWT, Şok dalgası, WOMAC, Lequesne İndeksi
ABSTRACT Objective: The aim of this study was to comparwith e the effectiveness of RSWT treatment in two different energy densities with combined physical therapy modalities and also with placebo in the patients with knee osteoarthritis. Materials and methods: 60 patients over 45 years of age who admitted to Inonu University Faculty of Medicine, Department of Physical Therapy and Rehabilitation outpatient clinics with the knee pain lasting 3 months, radiological grade of 2-3 according to Kellgren-Lawrens scale and diagnosed as 'Primary Knee Osteoarthritis' according to the American College of Rheumatology (ACR) criterias were included in the study. The study was designed as a prospective, randomized, double-blind, placebo-controlled trial. Patients were randomly divided into 4 groups of 15 people by using the closed envelope method. RSWT treatment was administered with BTL brand, 6000 SWT Topline model RSWT apparatus and equipment to the groups 1-3 once in a week for 4 weeks with different energy levels. For group 1; 0.11 mJ/mm2 RSWT (1.5 bar pressure and at 5-10 Hz, 3000 shock wave per week), group 2; 0.25 mJ/mm2 RSWT (3.5 bar pressure and at 5-10 Hz, 3000 shock wave per week), group 3; a total of fifteen sessions of combined physical therapy modalities for three weeks (hot pack + transcutaneous electrical nerve stimulation + ultrasound + strengthening exercises) and group 4; sham (fake) RSWT was applied. Patients were assessed using WOMAC score, Lequesne index and VAS scores at movement, at rest and at night before and 1, 4 and 8 weeks after therapy. Results: There was no statistically significant difference between groups in demographic assessment before treatment. A statistically significant reduction was observed in WOMAC, Lequesne and VAS scores of groups 1, 2 and 3 compared with baseline at 1st, 4th and 8th weeks (p <0.05). There was no statistically significant difference in group 4. Although more improvement was observed in group 2 compared to group 1, there was no statistically significant difference between the groups at the assessment made at the end of the 8th week. Conclusion: It's concluded that, RSWT treatment is an effective and usable as combined physical therapy for pain reduction and functional improvement in knee osteoarthritis and it can be added to the existing treatment in the future. Key words: Knee Osteoarthritis, RSWT, shock waves, WOMAC, Lequesne Index
ABSTRACT Objective: The aim of this study was to comparwith e the effectiveness of RSWT treatment in two different energy densities with combined physical therapy modalities and also with placebo in the patients with knee osteoarthritis. Materials and methods: 60 patients over 45 years of age who admitted to Inonu University Faculty of Medicine, Department of Physical Therapy and Rehabilitation outpatient clinics with the knee pain lasting 3 months, radiological grade of 2-3 according to Kellgren-Lawrens scale and diagnosed as 'Primary Knee Osteoarthritis' according to the American College of Rheumatology (ACR) criterias were included in the study. The study was designed as a prospective, randomized, double-blind, placebo-controlled trial. Patients were randomly divided into 4 groups of 15 people by using the closed envelope method. RSWT treatment was administered with BTL brand, 6000 SWT Topline model RSWT apparatus and equipment to the groups 1-3 once in a week for 4 weeks with different energy levels. For group 1; 0.11 mJ/mm2 RSWT (1.5 bar pressure and at 5-10 Hz, 3000 shock wave per week), group 2; 0.25 mJ/mm2 RSWT (3.5 bar pressure and at 5-10 Hz, 3000 shock wave per week), group 3; a total of fifteen sessions of combined physical therapy modalities for three weeks (hot pack + transcutaneous electrical nerve stimulation + ultrasound + strengthening exercises) and group 4; sham (fake) RSWT was applied. Patients were assessed using WOMAC score, Lequesne index and VAS scores at movement, at rest and at night before and 1, 4 and 8 weeks after therapy. Results: There was no statistically significant difference between groups in demographic assessment before treatment. A statistically significant reduction was observed in WOMAC, Lequesne and VAS scores of groups 1, 2 and 3 compared with baseline at 1st, 4th and 8th weeks (p <0.05). There was no statistically significant difference in group 4. Although more improvement was observed in group 2 compared to group 1, there was no statistically significant difference between the groups at the assessment made at the end of the 8th week. Conclusion: It's concluded that, RSWT treatment is an effective and usable as combined physical therapy for pain reduction and functional improvement in knee osteoarthritis and it can be added to the existing treatment in the future. Key words: Knee Osteoarthritis, RSWT, shock waves, WOMAC, Lequesne Index
Açıklama
Anahtar Kelimeler
Fiziksel Tıp ve Rehabilitasyon, Physical Medicine and Rehabilitation
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WoS Q Değeri
Scopus Q Değeri
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Künye
Aslan Vural, B. (2015). Diz osteoartritli hastalarda radial şok dalga (RSWT) tedavisinin iki farklı enerji yoğunluğunun kombine fizik tedavi uygulamaları ile karşılaştırılması. Yayımlanmış Uzmanlık Tezi, İnönü Üniversitesi, Malatya.
