Publication: Adölesan idiyopatik skolyozda cerrahi sonrası telerehabilitasyonun etkinliği
Abstract
Amaç: Bu tez çalışmasında Adölesan İdiyopatik Skolyoz (AİS) tanılı bireylerin cerrahi sonrası iyileşme süreçleri ve ihtiyaçları doğrultusunda dizayn edilen ve uzaktan senkron olarak yürütülen rehabilitasyon programının, cerrahi sonrası gövde kas enduransı, gövde esnekliği, fonksiyonel kapasite, ağrı şiddeti, beden görünüm algısı ve yaşam kalitesi üzerine etkisinin araştırılması amaçlandı. Gereç ve Yöntem: Emsey Hospital ve Prof. Dr. Süleyman Yalçın Şehir Hastanesi’ ne rutin kontrole gelen ve cerrahi sonrası altı ay ila iki yıl geçmiş olan 32 olgu randomize olarak iki gruba ayrıldı. Deney grubu sekiz hafta boyunca, hafta iki gün egzersiz eğitimi içeren ve senkron yürütülen telerehabilitasyon programına dahil edildi. Kontrol grubuna rutinde olduğu gibi herhangi bir egzersiz uygulanmadı. Olguların skolyoz açıları Cobb yöntemi ile, gövde enduransları McGill dayanıklılık testleri ile, gövde esneklikleri öne ve yana eğilme testleri ile, fonksiyonel kapasiteleri Altı Dakika Yürüme testi ile, algılanan ağrı şiddeti Sayısal Derecelendirme Ölçeği ile, beden görünüm algıları Skolyoz Dış Görünüş Anketi ile ve yaşam kaliteleri Skolyoz Research Society- 30 formu ile eğitim öncesi ve sekiz haftalık eğitim sonrası değerlendirildi. Verilerin analizinde SPSS-24 istatistik kullanıldı. Bulgular: Telerehabilitasyon grubunda tüm parametrelerde anlamlı iyileşme olduğu ve kontrol grubuna göre daha fazla iyileşme elde edildiği belirlendi (p<0,05). Tedavi sonrası telerehabilitasyon grubunun gövde kas enduransı, gövde esnekliği, ağrı şiddeti ve yaşam kalitesi değerleri kontrol grubundan anlamlı düzeyde üstündü (p<0,05). Fonksiyonel kapasite ve beden görünüm algısı tedavi sonrası gruplar arasında benzerlik gösterdi (p>0,05). Sonuç: Bu çalışmada AİS’ li bireylerde cerrahi sonrası altıncı aydan itibaren uygulanan ve çevrim içi yürütülen rehabilitasyon programının, hastaların gövde kas enduransı, gövde esnekliği, fonksiyonel kapasite, ağrı şiddeti, görünüm algısı ve yaşam kalitesini iyileştirmede etkili olduğu bulundu. Bu çalışmanın sonuçları, skolyoz cerrahisi sonrası fizyoterapist gözetiminde yürütülen egzersiz programının tasarlanması, yaygınlaşması ve rehabilitasyon bilincinin arttırılması açısından önemlidir.
Objective: In this thesis, it was aimed to investigate the effect of the rehabilitation program, designed in accordance with the post-surgical recovery processes and needs of individuals with Adolescent Idiopathic Scoliosis (AIS) and carried out remotely synchronously, on post-surgical trunk muscle endurance, trunk flexibility, functional capacity, pain severity, perception of appearance and quality of life. Materials and Methods: Thirty-two patients who came to Emsey Hospital and Prof. Dr. Süleyman Yalçın City Hospital for routine control and six months to two years after surgery were randomly divided into two groups. The experimental group was included in the synchronous telerehabilitation program that included exercise training two days a week for eight weeks. As in the routine, no exercise program was applied to the control group. Scoliosis angles of the cases were evaluated with the Cobb method, trunk endurance with McGill endurance tests, trunk flexibility with forward and side bending tests, functional capacities with the Six-Minute Walk test, pain intensity with the Numeric Rating Scale, perception of appearance with the Scoliosis Appearance Questionnaire, and quality of life with the Scoliosis Research Society-30 form before and after eight weeks of training. Results: It was determined that there was a significant improvement in all parameters in the telerehabilitation group and a greater improvement was achieved compared to the control group (p <0.05). After the treatment, the trunk muscle endurance, trunk flexibility and quality of life results of the telerehabilitation group were significantly superior to the control group, and the pain intensity was lower (p<0.05). Functional capacity and perception of appearance were similar between groups after treatment (p>0.05). Conclusion: In this study, it was found that the rehabilitation program applied to individuals with AIS starting from the sixth month after surgery was effective in improving the patients' trunk muscle endurance, trunk flexibility, functional capacity, pain intensity, appearance perception and quality of life. The results of this study are important in terms of designing and disseminating exercise practices carried out under the supervision of a physiotherapist and increasing awareness of rehabilitation after scoliosis surgery.
Objective: In this thesis, it was aimed to investigate the effect of the rehabilitation program, designed in accordance with the post-surgical recovery processes and needs of individuals with Adolescent Idiopathic Scoliosis (AIS) and carried out remotely synchronously, on post-surgical trunk muscle endurance, trunk flexibility, functional capacity, pain severity, perception of appearance and quality of life. Materials and Methods: Thirty-two patients who came to Emsey Hospital and Prof. Dr. Süleyman Yalçın City Hospital for routine control and six months to two years after surgery were randomly divided into two groups. The experimental group was included in the synchronous telerehabilitation program that included exercise training two days a week for eight weeks. As in the routine, no exercise program was applied to the control group. Scoliosis angles of the cases were evaluated with the Cobb method, trunk endurance with McGill endurance tests, trunk flexibility with forward and side bending tests, functional capacities with the Six-Minute Walk test, pain intensity with the Numeric Rating Scale, perception of appearance with the Scoliosis Appearance Questionnaire, and quality of life with the Scoliosis Research Society-30 form before and after eight weeks of training. Results: It was determined that there was a significant improvement in all parameters in the telerehabilitation group and a greater improvement was achieved compared to the control group (p <0.05). After the treatment, the trunk muscle endurance, trunk flexibility and quality of life results of the telerehabilitation group were significantly superior to the control group, and the pain intensity was lower (p<0.05). Functional capacity and perception of appearance were similar between groups after treatment (p>0.05). Conclusion: In this study, it was found that the rehabilitation program applied to individuals with AIS starting from the sixth month after surgery was effective in improving the patients' trunk muscle endurance, trunk flexibility, functional capacity, pain intensity, appearance perception and quality of life. The results of this study are important in terms of designing and disseminating exercise practices carried out under the supervision of a physiotherapist and increasing awareness of rehabilitation after scoliosis surgery.