Publication: Anterior akromioplasti sonrası rehabilitasyonda sürekli pasif hareket cihazının etkinliği
Abstract
Bu çalışma akromiyoplasti operasyonu sonrası rehabilitasyonda sürekli pasif hareket (SPH) cihazının erken ve geç dönem etkilerini izleme amacıyla Ekim 1999 - Temmuz 2001 tarihleri arasında Marmara Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji ndan Fiziksel Tıp ve Rehabilitasyon refere edilmiş 30 hasta üzerinde gerçekleştirildi. Tesadüfi yöntemle 15'er kişilik 2 gruba ayrılan hastaların birinci grubuna Fiziksel Tıp ve Rehabilitasyon nda rutin olarak uygulanan ve ameliyat sonrası 2. günde başlanan konvansiyonel rehabilitasyon uygulandı. Bu programın eklem hareket açıklığına yönelik tedavi bölümünde, ilk hafta terapist tarafından uygulanan pasif, 2. haftadan itibaren aktif, aktif-asistif egzersizler yaptırıldı. İkinci gruba ise konvansiyonel programın standart eklem hareket açıklığı egzersizleri dışındaki bütün komponentleri verildi; ancak pasif germe egzersizi yerine ikinci günden itibaren SPH cihazı ile üç planda elevasyon ve rotasyon hareketleri yaptırıldı. Her hasta toplam 3 aylık tedaviye alındı. Tüm hastalara rehabilitasyon öncesi, 1, 2, 4, 6, 8 ve 12. haftalarda goniometrik eklem hareket açıklığı ölçümleri ( pasif ve aktif), ağrı ( vizüel analog skala, yüz skalası), hasta memnuniyeti, hekim-terapist memnuniyeti, Constant Skorlaması ile analjezik kullanımı sorgulanarak değerlendirme yapıldı. Sonuç olarak, SPH cihazının akromiyoplasti operasyonu geçiren hastalarda, konvansiyonel eklem hareket açıklığı egzersizlerine bir üstünlüğü olmadığı, her iki tedavi metodunun da eşit derecede etkin oldukları kanaatine varıldı.
This study was conducted at Marmara University School of Medicine, Department of Physical Medicine and Rehabilitation, between October 1999-July 2001. 30 patients who underwent an anterior acromioplasty (AA) operation in the Department of Orthopedic Surgery and referred for rehabilitation were enrolled in the study. Patients were randomly divided into two groups consisting each 15 patients. The control group was started at the second day of operation a conventional rehabilitation program. The components of this program performed to increase shouder range of motion (ROM) ,consisted of passive exercises applied by the physical therapist at the first week and active, active-assisted exercises starting from the second week of treatment. The second group were given all components of the conventional program exept range of motion exercises. In this group, shoulder elevation and rotation exercises in three planes were performed by means of a continous passive motion (CPM) device instead of passive streching. The duration of treatment for both groups was three months. All patients were evaluated at baseline, first, second, 4th,6th,8th and 12th weeks of treatment with goniometric active and passive ROM measurements, visual analogue scale for pain, Constant Score, patient's global assessment, physician/ therapist global assessment and the amount of analgesic medication used. As a result, both conventional exercises and CPM were found effective in the rehabilitation following the anterior acromioplasty operation, whereas no statistical difference was found between these two treatment methods .
This study was conducted at Marmara University School of Medicine, Department of Physical Medicine and Rehabilitation, between October 1999-July 2001. 30 patients who underwent an anterior acromioplasty (AA) operation in the Department of Orthopedic Surgery and referred for rehabilitation were enrolled in the study. Patients were randomly divided into two groups consisting each 15 patients. The control group was started at the second day of operation a conventional rehabilitation program. The components of this program performed to increase shouder range of motion (ROM) ,consisted of passive exercises applied by the physical therapist at the first week and active, active-assisted exercises starting from the second week of treatment. The second group were given all components of the conventional program exept range of motion exercises. In this group, shoulder elevation and rotation exercises in three planes were performed by means of a continous passive motion (CPM) device instead of passive streching. The duration of treatment for both groups was three months. All patients were evaluated at baseline, first, second, 4th,6th,8th and 12th weeks of treatment with goniometric active and passive ROM measurements, visual analogue scale for pain, Constant Score, patient's global assessment, physician/ therapist global assessment and the amount of analgesic medication used. As a result, both conventional exercises and CPM were found effective in the rehabilitation following the anterior acromioplasty operation, whereas no statistical difference was found between these two treatment methods .