Artroskopik rotator tamiri sonrası yavaş ve hızlı rehabilitasyon protokollerinin karşılaştırılması:Ağrı ve fonksiyonel aktivite

Amaç: Bu çalışma, rotator kılıf tamiri sonrası uygulanan hızlandırılmış ve yavaş protokolün ağrı ve fonksiyonel aktivite düzeyi üzerine etkisini karşılaştırmak amacıyla planlanmıştır. Çalışma planı: Çalışmaya evre 2 ve 3 rotator kılıf yırtığı tanısı ile artroskopik cerrahi uygulanan 26 kadın 3 erkek toplam 29 hasta alınmıştır. Çalışmaya alınan hastalar rastgele hızlandırılmış protokolle (n=13) ve yavaş protokolle (n=16) takip edilmek üzere iki gruba ayrılmıştır. Hızlandırılmış protokolle takip edilen hastalar cerrahi öncesinde ortalama 4-6 hafta süreyle rehabilitasyon programına alınmıştır. Değerlendirmeler cerrahi öncesi ve sonrası 24 hafta boyunca yapılmıştır. Ağrı değerlendirmesinde görsel analog skalası ve fonksiyonel aktivite düzeyinin belirlenmesinde "The Disabilities of The Arm Shoulder and Harıd" (DASH) anketi kullanılmıştır. Hızlandırılmış protokolde cerrahi sonrası 3. hafta başlanan aktif eklem hareketine yavaş protokolde 6. haftada başlanmıştır. Rehabilitasyon programı hızlandırılmış protokolde 8. haftada, yavaş protokolde 22. haftada tamamlanmıştır. Bulgular: Hızlandırılmış protokol ile yavaş protokol karşılaştırıldığında hastaların istirahat ağrısında istatistiksel olarak fark bulunmazken (p>0.05), aktivite ağrısının 5. ve 16. haftada, gece ağrısının ise 5. haftada hızlandırılmış protokolde istatistiksel olarak daha az olduğu görülmüştür (p

Anahtar Kelimeler:

Artroskopi, Motor aktivite, Anketler, Tek kör metot, Tedavi sonucu, Yırtık, Rotator manşet, Fonksiyon iyileşmesi, Egzersiz tedavisi, İzleme çalışmaları, El yaralanmaları, Özürlülük değerlendirmesi, Ağrı ölçümü, Ağrı, ameliyat sonrası

Comparison of slow and accelerated rehabilitation protocol after arthroscopic rotator cuff repair: Pain and functional activity

Objectives: In this study, we sought to compare the effects of the slow and accelerated protocols on pain and functional activity level after arthroscopic rotator cuff repair. Methods: The study included 29 patients (3 men, 26 women) who underwent arthroscopic repair of stage 2 and 3 rotator cuff tears. Patients were randomized in two groups: the accelerated pro tocol group (n=13) and slow protocol group (n=16). Patients in the accelerated protocol group participated in a preoperative rehabilitation program for 4-6 weeks. Patients were evaluated pre operatively and for 24 weeks postoperatively. Pain was assessed by visual analog scale, and functional activity level was assessed by The Disabilities of The Arm Shoulder and Hand (DASH) questionnaire. The active range of motion was initiated at week 3 after surgery for the accelerated rehabilitation protocol and at week 6 for the slow protocol. The rehabilitation pro gram was completed by the 8th week with the accelerated protocol and by the 22nd week with the slow protocol. Results: There was no significant difference between the slow and accelerated protocols with regard to pain at rest (p>0.05). However, the accelerated protocol was associated with less pain during activity at weeks 5 and 16, and with less pain at night during week 5 (p<0.05). The accel erated protocol was superior to the slow protocol in terms of functional activity level, as deter mined by DASH at weeks 8, 12, and 16 after surgery (p<0.05). Conclusion: The accelerated protocol is recommended to physical therapists during rehabilita tion after arthroscopic rotator cuff repair to prevent the negative effects of immobilization and to support rapid reintegration to daily living activities.

Keywords:

Arthroscopy, Motor Activity, Questionnaires, Single-Blind Method, Treatment Outcome, Rupture, Rotator Cuff, Recovery of Function, Exercise Therapy, Follow-Up Studies, Hand Injuries, Disability Evaluation, Pain Measurement, Pain, Postoperative,

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