Publication: Talus osteokondral lezyon cerrahisi sonrası uygulanan kısmi ağırlık aktarma protokolünün anlık geri bildirim ile takibinin erken dönem ağrı, kinezyofobi ve fonksiyon üzerine etkisi
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Date
2022-09-01
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Abstract
Amaç: Talus Osteokondral Lezyona (TOL) yönelik cerrahi sonrası reçete edilen kısmi ağırlık aktarmalı (KAA) yürüyüş sırasında uzaktan erişimle
sağlanan anlık geri-bildirimin cerrahi sonrası erken dönemde KAA limitlerine uyum, ağrı şiddeti, kinezyofobi ve fonksiyonel düzey üzerindeki
etkisini araştırmaktır.
Gereç ve Yöntem: Araştırma, mikrokırık cerrahisi sonrası KAA protokolü reçete edilen ve taburculuk sonrası 6-hafta boyunca protokol limitlerine
uyumları uzaktan erişimle takip edilen hastalarla (n=10) gerçekleştirildi. Hastalar geri-bildirimli (GB) ve geri-bildirimsiz (GBZ) gruplar olmak üzere
rastgele iki ayrı gruba ayrıldı. Hastaların Vizüel Analog Skala (VAS) ile ağrı şiddeti, TAMPA Kinezyofobi Ölçeği (TKÖ) ile kinezyofobi ve Avrupa Ayak
ve Ayak Bileği Cemiyeti Ölçütü (EFAS) ile ayak, ayak bileği fonksiyonel düzeyleri değerlendirildi. Değerlendirmeler cerrahi öncesi, 3 ve 6 hafta
sonrası olmak üzere 3 ayrı zaman diliminde gerçekleştirildi.
Bulgular: Cerrahi sonrası KAA protokol limitlerine uyum açısından 0-3 hafta arasında gruplar arası fark yokken, 3-6 hafta arası dönemde GBZ
grubu aleyhine istatistiksel anlamlı fark belirlendi. GB grubunda 3. ve 6. haftalarda ortalama ağrı şiddetinde anlamlı bir azalma gözlenirken (p=
0,005 ve p= 0.002) GBZ grubunda 3. hafta ortalama ağrı şiddetinde anlamlı artış tespit edildi (p=0,012). GB grubunun kinezyofobi düzeylerinde
3. ve 6. Haftalarda (p=0,033; p=0,049), EFAS skorlarında ise sadece 6. Haftada (p= 0,004) anlamlı iyileşme tespit edildi. Cerrahi sonrası 3. haftada
GB grubunun ağrı şiddetinde GBZ grubuna göre anlamlı azalma kaydedildi (p=0,003). GB grubunun kinezyofobi (p=0,045) ve EFAS skorları
(p=0,002) GBZ grubuna göre 6. haftada istatistiksel olarak anlamlı iyileşme gösterdi.
Sonuç: TOL cerrahisi sonrası hastalara KAA yürümenin reçete edildiği ilk 6-haftalık dönemde, ağırlık aktarım miktarlarının uzaktan takibini
mümkün kılan ve hastalara anlık geri bildirimde bulunabilen sistemler ile sürecin yönetilmesi, bu hasta grubunda erken dönem iyileşmeyi
destekleyen bir yaklaşımdır
Aim: The aim of the study is to investigate the effect of instant feedback provided by remote-access during partial weight bearing (PWB) walking, which is prescribed as post-surgical treatment for Osteochondral Lesion of the Talus (OLT), on compliance with PWB limits, pain intensity, kinesiophobia, and functional level in the early postoperative period. Methods: The study was conducted with patients (n=10) who were prescribed PWB protocol after microfracture surgery and whose compliance with the protocol limits was followed remotely for 6 weeks after discharge. The patients were randomly divided into two groups as the feedback group (FB) and the non-feedback (NFB) group. Pain intensity was evaluated with the Visual Analogue Scale (VAS), kinesiophobia with the TAMPA Kinesiophobia Scale (TKS), and foot and ankle functional levels were assessed with the European Foot and Ankle Society Scale (EFAS). Assessments were carried out in 3 different time periods: pre-operative, 3rd & 6th-weeks after surgery. Results: While there was no difference between groups in terms of compliance with PWB protocol limits between 0-3 weeks postoperatively, a statistically significant difference was determined against NFB group in between 3–6-week period. There was a significant decrease in mean pain intensity at 3 & 6 weeks in the FB group (p= 000.5 and p= 0.002), while a significant increase was observed in mean pain intensity at 3rd week in NFB group (p=0.012). A significant improvement was found in kinesiophobia levels of FB group at 3-and-6 weeks (p=0.033 and p=0.049), and in EFAS scores at only 6 weeks (p= 0.004). There was no significant difference in kinesiophobia and EFAS scores’ changes of NFB group at all measurement times. In comparison between groups, a significant decrease was observed in pain intensity of FB group compared to NFB group at 3rd-week (p=0.003). Kinesiophobia (p=0.045) and EFAS scores of FB group (p=0.02) showed statistically significant improvement at 6th-week compared to NFB group. Conclusion: Management of the patients with OLT surgery who were prescribed PWB at the first post-operative 6 weeks can be supported by using the systems that enable remote monitoring of weight-bearing and provide instant feedback to patients to improve early clinical recovery.
Aim: The aim of the study is to investigate the effect of instant feedback provided by remote-access during partial weight bearing (PWB) walking, which is prescribed as post-surgical treatment for Osteochondral Lesion of the Talus (OLT), on compliance with PWB limits, pain intensity, kinesiophobia, and functional level in the early postoperative period. Methods: The study was conducted with patients (n=10) who were prescribed PWB protocol after microfracture surgery and whose compliance with the protocol limits was followed remotely for 6 weeks after discharge. The patients were randomly divided into two groups as the feedback group (FB) and the non-feedback (NFB) group. Pain intensity was evaluated with the Visual Analogue Scale (VAS), kinesiophobia with the TAMPA Kinesiophobia Scale (TKS), and foot and ankle functional levels were assessed with the European Foot and Ankle Society Scale (EFAS). Assessments were carried out in 3 different time periods: pre-operative, 3rd & 6th-weeks after surgery. Results: While there was no difference between groups in terms of compliance with PWB protocol limits between 0-3 weeks postoperatively, a statistically significant difference was determined against NFB group in between 3–6-week period. There was a significant decrease in mean pain intensity at 3 & 6 weeks in the FB group (p= 000.5 and p= 0.002), while a significant increase was observed in mean pain intensity at 3rd week in NFB group (p=0.012). A significant improvement was found in kinesiophobia levels of FB group at 3-and-6 weeks (p=0.033 and p=0.049), and in EFAS scores at only 6 weeks (p= 0.004). There was no significant difference in kinesiophobia and EFAS scores’ changes of NFB group at all measurement times. In comparison between groups, a significant decrease was observed in pain intensity of FB group compared to NFB group at 3rd-week (p=0.003). Kinesiophobia (p=0.045) and EFAS scores of FB group (p=0.02) showed statistically significant improvement at 6th-week compared to NFB group. Conclusion: Management of the patients with OLT surgery who were prescribed PWB at the first post-operative 6 weeks can be supported by using the systems that enable remote monitoring of weight-bearing and provide instant feedback to patients to improve early clinical recovery.
Description
Keywords
Talus Osteokondral Lezyon, kinezyofobi, ağrı, fonskiyon, geribildirim, Talus Osteocondral Lesions, kinesiophobia, pain, function, feedback
Citation
AVCI E. E. , AKGÜN G., TİMURTAŞ E., UYGUR M. E. , POLAT M. G. , DEMİRBÜKEN İ., "Talus Osteokondral Lezyon Cerrahisi Sonrası Uygulanan Kısmi Ağırlık Aktarma Protokolünün Anlık Geri Bildirim ile Takibinin Erken Dönem Ağrı, Kinezyofobi ve Fonksiyon Üzerine Etkisi", Journal of Health Sciences and Management, cilt.2, sa.3, ss.60-67, 2022