Adheziv kapsülitli hastalarda oral prednizon veya ultrasonografi eşliğinde glenohumeral eklem içine uygulanan kortikosteroid tedavisinin etkinliği ve aksiller (inferior) poş kalınlıkları bakımından değerlendirilmesi
Küçük Resim Yok
Tarih
2022
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Adheziv kapsülit (AK)'li hastalarda oral prednizon veya ultrasonografi eşliğinde glenohumeral eklem içine uygulanan kortikosteroid tedavisinin etkinliği ve aksiller(inferior)poş kalınlıkları bakımından değerlendirilmesi. Gereç ve Yöntem: Çalışmamıza 18-65 yaş aralığında omuz eklem hareket kısıtlığı ve ağrılı klinik ön tanısı AK olan 48 hasta dâhil edildi. Bireyler randomize olarak enjeksiyonve oral grupolmak üzere ikiye ayrıldı. Tüm bireylerin demografik bilgileri alındıktan sonra randomizasyon şeması ile belirlenen birinci grubaUSG eşliğinde glenohumeral enjeksiyon ile 3 ml %2 prilokain ve 1 ml 20 mg triamsonolon hekzasetenoid karışımı, diğer grubaoral prednizon0.5 mg/kg dozdan başlanıp 5'er gün 4 mg'lık dozlarda azaltıldı. Her iki gruba da aynı zamanda fizik tedavi başlandı. 3 haftalık egzersizuygulaması sonrası hastalar ev egzersizleri ile devam etti. Çalışmaya başlandığı gün ve 6.haftada SPADI anketi, gonyometrik aktif ve pasif EHA ölçümleri ve ultrasongrafik değerlendirme ile aksillerpoş kalınlık ölçümleri (AR)yapıldı. Bulgular: Çalışmanın steroid enjeksiyonu grubuna yaş ortalaması 55.16±6.39 yılolan 24 hasta ile oral prednizon grubuna ise yaş ortalaması 55.37±8.1yıl olan 24 hasta dâhil edilmiştir.Çalışmamıza katılan her iki grup hastada tedavi öncesi ve sonrası pasif-aktifolarak belirlenen fleksiyon, abdüksiyon, ekstansiyon, internal ve eksternal rotasyon ortalama değerleri arasında istatistiksel olarak anlamlı fark tespit edildi (p<0.05) Steroid enjeksiyonu yapılan hastalarda tedavi sonrası aktif ve pasif fleksiyon, abdüksiyon, ekstansiyon, internal ve eksternal rotasyon değerlerinin oral steroid alan hastalara göre pozitif yönde daha anlamlı bir artış olduğu saptanmıştır (p<0.05). Enjeksiyon grubunda USG ile ölçülen inferior poş ortalama değeri tedavi öncesi (3.91±0.47) iken tedavi sonrası (2.50±0.39) olarak hesaplandı.Oral tedavi grubunda USG ile inferior poş ölçüm ortalama değeri tedavi öncesi 3.65 (3.65±0.65) iken tedavi sonrası 2.6 (2.76±0.69) olarak hesaplandı. Steroid enjeksiyonu ile oral tedavi alan hastalar arasında tedavi sonrası USG ile bakılan poş kalınlık ölçümleri bakımından istatistiksel olarak anlamlı fark bulunmadı (p>0.05). Sonuç: Bu verilere dayanarak, AK hastalarında steroid enjeksiyonu+FTR grubunda daha belirgin olmak üzere her iki grupta omuz ağrı anketinde azalma ve pasif-aktif eklem hareket açıklığında fleksiyon ve abduksiyonda bariz olarak artış olmuştur. Tedavi sonrası her iki grupta da USG ile aksiler poş kalınlığı değerleri azalmasına rağmen birbirine kıyaslandığında farklılık yoktu. Adheziv Kapsülit tanı ve tedavisinde ultrasonografinin bir kriter olacağı umuduyla daha büyük gruplarla yeni çalışmalara ihtiyaç vardır.
Objective: The aim of this study was to evaluate the efficacy of oral prednisone or corticosteroid therapy administered into the glenohumeral joint with ultrasonography in patients with adhesive capsulitis and its evaluation in terms of axillary (inferior) pouch thicknesses. Methods:Our study included 48 patients aged 18-65 years with shoulder joint range of motion and painful clinical prediagnosis of AK. Individuals were randomly divided into injection and oral groups.After obtaining the demographic information of all individuals, the first group determined by the randomization scheme was administered glenohumeral injection with 3 ml of 2% prilocaine and 1 ml of 20 mg triamsonolone hexacetenoid mixture under the guidance of USG, and oral prednisone 0.5 mg/kg was administered to the other group in doses of 4 mg for 5 days. reduced. Physical therapy was started in both groups at the same time. After 3 weeks of exercise, the patients continued with home exercises. SPADI questionnaire, goniometric active and passive ROM measurements, ultrasonographic evaluation and axillary pouch thickness measurements (AR) were performed on the day of the study and at the 6th week. Results: The study included 24 patients with a mean age of 55.16±6.39 years in the steroid injection group and 24 patients with a mean age of 55.37±8.1 years in the oral prednisone group. A statistically significant difference was found between the mean values of flexion, abduction, extension, internal and external rotation determined as passive-active before and after the treatment in both groups of patients who participated in our study (p<0.05). It was determined that the values of active and passive flexion, abduction, extension, internal and external rotation after the treatment in patients who received steroid injection were more positive than the patients who received oral steroids (p<0.05). In the injection group, the mean value of the inferior pouch measured by USG was before treatment (3.91±0.47) and after treatment (2.50±0.39). In the oral treatment group, the mean value of the inferior pouch measurement by USG was 3.65 (3.65±0.65) before the treatment and 2.6 (2.76±0.69) after the treatment. There was no statistically significant difference between the patients who received steroid injection and oral treatment in terms of pouch thickness measurements obtained by USG after treatment (p>0.05). Conclusion:Based on these data, there was a decrease in shoulder pain questionnaire and a significant increase in passive-active range of motion, flexion and abduction in both groups, more significantly in the steroid injection+FTR group in AK patients. Although the axillary pouch thickness values decreased in both groups after the treatment, there was no difference when compared to each other. There is a need for new studies with larger groups in the hope that ultrasonography will be a criterion in the diagnosis and treatment of Adhesive Capsulitis.
Objective: The aim of this study was to evaluate the efficacy of oral prednisone or corticosteroid therapy administered into the glenohumeral joint with ultrasonography in patients with adhesive capsulitis and its evaluation in terms of axillary (inferior) pouch thicknesses. Methods:Our study included 48 patients aged 18-65 years with shoulder joint range of motion and painful clinical prediagnosis of AK. Individuals were randomly divided into injection and oral groups.After obtaining the demographic information of all individuals, the first group determined by the randomization scheme was administered glenohumeral injection with 3 ml of 2% prilocaine and 1 ml of 20 mg triamsonolone hexacetenoid mixture under the guidance of USG, and oral prednisone 0.5 mg/kg was administered to the other group in doses of 4 mg for 5 days. reduced. Physical therapy was started in both groups at the same time. After 3 weeks of exercise, the patients continued with home exercises. SPADI questionnaire, goniometric active and passive ROM measurements, ultrasonographic evaluation and axillary pouch thickness measurements (AR) were performed on the day of the study and at the 6th week. Results: The study included 24 patients with a mean age of 55.16±6.39 years in the steroid injection group and 24 patients with a mean age of 55.37±8.1 years in the oral prednisone group. A statistically significant difference was found between the mean values of flexion, abduction, extension, internal and external rotation determined as passive-active before and after the treatment in both groups of patients who participated in our study (p<0.05). It was determined that the values of active and passive flexion, abduction, extension, internal and external rotation after the treatment in patients who received steroid injection were more positive than the patients who received oral steroids (p<0.05). In the injection group, the mean value of the inferior pouch measured by USG was before treatment (3.91±0.47) and after treatment (2.50±0.39). In the oral treatment group, the mean value of the inferior pouch measurement by USG was 3.65 (3.65±0.65) before the treatment and 2.6 (2.76±0.69) after the treatment. There was no statistically significant difference between the patients who received steroid injection and oral treatment in terms of pouch thickness measurements obtained by USG after treatment (p>0.05). Conclusion:Based on these data, there was a decrease in shoulder pain questionnaire and a significant increase in passive-active range of motion, flexion and abduction in both groups, more significantly in the steroid injection+FTR group in AK patients. Although the axillary pouch thickness values decreased in both groups after the treatment, there was no difference when compared to each other. There is a need for new studies with larger groups in the hope that ultrasonography will be a criterion in the diagnosis and treatment of Adhesive Capsulitis.
Açıklama
Anahtar Kelimeler
Fiziksel Tıp ve Rehabilitasyon, Physical Medicine and Rehabilitation
