Publication: El osteoartriti ve disabilite
Abstract
Çalışmamıza, Marmara Üniversitesi Fiziksel Tıp ve Rehabilitasyon Tedavi Ünitesinde, el osteoartriti (OA) tanısı konmuş 30 hasta ve üst ekstremitesinden hiçbir şikayeti olmayan 30 sağlıklı kadın olgu alınmıştır. Olgular eklem hareket genişliği, kas gücü, kavrama ve çimdikleme kuvveti, AUSCAN el OA indeksi (The Australian/ Canadian hand OA index) testlerindeki fonksiyonel yetenekleri açısından değerlendirilmişlerdir. Osteoartritli olgulara ek olarak whirpool, su içi ultrason ve TENS'den oluşan fizik tedavi aktif, aktif yardımlı egzersizlerden oluşan rehabilitasyon seans uygulanmıştır. Tedavi sonunda OA'lı hasta grubu uygulanan tedavinin etkinliğini görmek amacı ile yeniden değerlendirilmiştir. Çalışmamızda OA'lı olgular ile sağlıklı olgular arasında, OA'lı olguların tedavi öncesi ve sonrası değerleri arasında, eklem hareket genişligi, kas gücü, kavrama ve çimdikleme kuvveti, AUSCAN skorları açısından istatistiksel olarak anlamlı farklılıklar bulunmuştur (p<0.05). Osteoartritli olguların tedavi sonrası kuvvet ölçümleri ve AUSCAN indeksindeki yetenekleri artmış olmasına rağmen sağlıklı olgular ile karşılaştırıldığında istatistiksel olarak anlamlı yetersizlikler tespit edilmiştir (p<0.05). Sonuç olarak, OA'lı olguların fizik tedavi rehabilitasyon programlarının yanı sıra, iş ve uğraşı tedavisi ünitelerinden de yararlanmaları sağlanmalıdır. Uygun zamanda ve hastaya özel olarak planlanmış rehabilitatif yaklaşımlar, eklemleri koruyucu ve günlük yaşam aktivitelerini kolaylaştırıcı ergonomik düzenlemeler, hastanın ağrısını, başkalarına bağımlılığını ve toplumsal ekonomik kayıpları önemli oranda azaltacaktır. Hastalığın tedavisi ile uğraşan ekibin bu konuda bilgi sahibi olması, muhtemel disabiliteyi önleyecektir. HAND OSTEOARTHRITIS AND DISABILITY
We included 30 female patients with hand osteoarthritis and 30 healthy women who have no upper extremity problems in The Physical Therapy Unit of Physical Medicine and Rehabilitation Department at Marmara University School of Medicine. The two groups were evaluated with range of motion, muscle strength, Pinch and grip strength, and functional ability scores in AUSCAN (The Australian/ Canadian) OA hand Index. Patients with hand osteoarthritis received whirlpool, ultrasound in water, transcutaneous electrical nerve stimulation (TENS), active and active assisted exercises program for 15 sessions. This group was evaluated at the end of the treatment to see the efficacy of treatment program. In the beginning and at the end of the study we found statistically significant differences between the two groups and within the first group for range of motion, muscle strength, grip and pinch strength and success of AUSCAN Index parameters (p<0.05). At the end of the study, muscle strength and ability test in AUSCAN Index was increased in the first group with hand osteoarthritis; but when we compare the first group with the second group, which has no upper extremity problems we found statistically significant differences for disabilities (p<0.05). In conclusion, we believe that addition of occupational therapy to physical therapy is necessary in patients with hand osteoarthritis. Special rehabilitation programs designed for individual patients and at the correct time, ergonomic designs for joint protection and daily life activities are necessary to decrease pain, dependence and preventing economical losses; also increasing the knowledge of the treatment team on this subject could prevent possible disability.
We included 30 female patients with hand osteoarthritis and 30 healthy women who have no upper extremity problems in The Physical Therapy Unit of Physical Medicine and Rehabilitation Department at Marmara University School of Medicine. The two groups were evaluated with range of motion, muscle strength, Pinch and grip strength, and functional ability scores in AUSCAN (The Australian/ Canadian) OA hand Index. Patients with hand osteoarthritis received whirlpool, ultrasound in water, transcutaneous electrical nerve stimulation (TENS), active and active assisted exercises program for 15 sessions. This group was evaluated at the end of the treatment to see the efficacy of treatment program. In the beginning and at the end of the study we found statistically significant differences between the two groups and within the first group for range of motion, muscle strength, grip and pinch strength and success of AUSCAN Index parameters (p<0.05). At the end of the study, muscle strength and ability test in AUSCAN Index was increased in the first group with hand osteoarthritis; but when we compare the first group with the second group, which has no upper extremity problems we found statistically significant differences for disabilities (p<0.05). In conclusion, we believe that addition of occupational therapy to physical therapy is necessary in patients with hand osteoarthritis. Special rehabilitation programs designed for individual patients and at the correct time, ergonomic designs for joint protection and daily life activities are necessary to decrease pain, dependence and preventing economical losses; also increasing the knowledge of the treatment team on this subject could prevent possible disability.