Publication: Myofasiyal gevşetme tekniğinin hemiplejik üst ekstremitede spastisite, ağrı, eklem hareket açıklığı ve günlük yaşam aktivitelerine etkisi
Abstract
Amaç: Çalışmamızın amacı myofasiyal gevşetme tekniğinin spastik inmeli bireylerin üst ekstremitesi üzerinde spastisite, ağrı, eklem hareket açıklığı ve günlük yaşam aktiviteleri üzerine etkisini incelemektir.Gereç ve Yöntem: Çalışmaya dahil edilme kriterlerini karşılayan 30 hasta katıldı. Çalışma kesitsel tipte planlandı. Hastalar randomize olarak 15 kişiden oluşan 2 gruba ayrıldı. Çalışma grubuna myofasiyal gevşetme tekniği ve brunnstrom metodu uygulanırken kontrol grubuna yalnızca brunnstrom metodu uygulandı. Çalışmamızdaki hastaların; spastisite düzeyi, ağrı şiddeti, eklem hareket açıklığı ve günlük yaşam aktivitelerine etkisi sırasıyla modifiye ashworth skalası (MAS), vizüel analog skala(VAS),gonyometre ve Barthell Günlük Yaşam Aktiviteleri İndeksi (Bİ) ile tedavi öncesi ve sonrasında değerlendirildi. Çalışmamıza katılan hastalar İstanbul FTR EAH’de toplam 40 seans tedavi aldı. Bulgular: Çalışma ve kontrol grubunun grup içi tedavi öncesi ve tedavi sonrası MAS dirsek fleksör spastisite düzeyi incelendiğinde istatiksel olarak anlamlı bir fark bulundu (p<0,05),fakat çalışma ve kontrol grubunun grup içi tedavi öncesi ve tedavi sonrası MAS el bileği fleksör spastisite düzeyi incelendiğinde istatiksel olarak anlamlı bir fark bulunmadı (p>0,05). Her iki grubun grup içi tedavi öncesi ve tedavi sonrası VAS ile Bİ değerleri incelendiğinde istatiksel olarak anlamlı bir fark bulundu (p<0,05). Çalışma grubunun tedavi öncesi ve tedavi sonrası dirsek fleksiyon-ekstansiyon açısı, ön kol supinasyon -pronasyon açısı değerleri incelendiğinde istatiksel olarak anlamlı bir fark ortaya çıktı (p<0,05). Tedavi sonucunda gruplar arası karşılaştırılan parametrelerin hiçbirinde istatiksel olarak anlamlı bir fark bulunmadı(p>0,05). Sonuç: Brunnstrom tekniğine ek olarak uygulanan Myofasiyal gevşetme tekniğinin yalnızca Brunnstrom tekniği uygulamasına kıyasla spastisite derecesi, ağrı şiddeti,eklem hareket açıklığı ve günlük yaşam aktivitelerine katılım düzeyi açısından istatiksel olarak anlamlı bir fark yaratmadığı görüldü.
Objective: The aim of our study is to examine the effect of myofascial release technique on spasticity,pain,range of motion and daily living activities on the upper extremity of individuals with spastic stroke.Material and methods: Thirty patients who developed spasticity in the upper extremity after stroke included in the study.The study was planned in a cross-sectional type.The patients were randomly divided into 2 groups of 15 people.While myofascial relaxation technique and brunnstrom method were applied to the study group,only brunnstrom method was applied to the control group.Pain intensity,spasticity level,range of motion and effects on daily living activities were evaluated with VAS,MAS,goniometer and Bİ respectively.All evaluations were made before and after treatment. The patients participating in our study received a total of 40 sessions of treatment in Istanbul FTR EAH.Results: When the MAS elbow flexor spasticity level of the study and control groups was examined before and after the treatment, a statistically significant difference was found (p<0.05). However, when the MAS wrist flexor spasticity level of the study and control groups was examined before and after the treatment,no statistically significant difference was found (p>0.05).When the pre-treatment and post-treatment VAS and BI values of both groups were examined, a statistically significant difference was found (p<0.05).When the elbow flexion-extension angle, forearm supination-pronation angle values of the study group were examined before and after the treatment, a statistically significant difference emerged (p<0.05).At the end of the treatment, no statistically significant difference was found in any of the parameters compared between the groups (p>0.05).Conclusion: It was observed that the Myofascial release technique applied in addition to the Brunnstrom technique did not make a statistically significant difference in terms of pain intensity,range of motion,degree of spasticity and participation in activities of daily living compared to the Brunnstrom technique alone.
Objective: The aim of our study is to examine the effect of myofascial release technique on spasticity,pain,range of motion and daily living activities on the upper extremity of individuals with spastic stroke.Material and methods: Thirty patients who developed spasticity in the upper extremity after stroke included in the study.The study was planned in a cross-sectional type.The patients were randomly divided into 2 groups of 15 people.While myofascial relaxation technique and brunnstrom method were applied to the study group,only brunnstrom method was applied to the control group.Pain intensity,spasticity level,range of motion and effects on daily living activities were evaluated with VAS,MAS,goniometer and Bİ respectively.All evaluations were made before and after treatment. The patients participating in our study received a total of 40 sessions of treatment in Istanbul FTR EAH.Results: When the MAS elbow flexor spasticity level of the study and control groups was examined before and after the treatment, a statistically significant difference was found (p<0.05). However, when the MAS wrist flexor spasticity level of the study and control groups was examined before and after the treatment,no statistically significant difference was found (p>0.05).When the pre-treatment and post-treatment VAS and BI values of both groups were examined, a statistically significant difference was found (p<0.05).When the elbow flexion-extension angle, forearm supination-pronation angle values of the study group were examined before and after the treatment, a statistically significant difference emerged (p<0.05).At the end of the treatment, no statistically significant difference was found in any of the parameters compared between the groups (p>0.05).Conclusion: It was observed that the Myofascial release technique applied in addition to the Brunnstrom technique did not make a statistically significant difference in terms of pain intensity,range of motion,degree of spasticity and participation in activities of daily living compared to the Brunnstrom technique alone.