İlkay KARABAY, Fatma Gülçin URAL NAZLIKUL, Hüseyin NAZLIKUL, Gökhan Tuna ÖZTÜRK, Dilek DİZDAR

KRONİK BEL AĞRISI OLAN HASTALARDA KAYROPRAKSİK MANUEL TEDAVİNİN ETKİNLİĞİNİN DEĞERLENDİRİLMESİ

Amaç: Bel ağrısı sık görülen, kostaların alt sınırıyla aşağı gluteal kıvrımlar arasında lokalize olabilen ve bacaklara da yansıyabilen sakatlığın önemli nedenlerinden biridir. Kayropraksi bel ağrısında kullanılan non invaziv ve ucuz bir tedavi metodudur. Çalışmamızın amacı bel ağrısında kayropraksi ve izometrik egzersizin ağrı ve fonksiyonellik üzerine etkisini değerlendirmektir. Materyal ve Metot: Poliklinikte bel ağrısı tanısı almış hastalar çalışmaya alındı. 30 kadın ve 30 erkekten oluşan 60 hasta randomize olarak iki gruba ayrıldı. Birinci gruba bel bölgesine kayropraksi uygulaması ve bel izometrik egzersiz, ikinci gruba bel izometrik egzersiz programı oluşturuldu. Egzersiz programı her iki gruba da 4 hafta boyunca haftada 5 gün fizyoterapist tarafından yaptırıldı. Kayropraksi tedavisi 4 hafta boyunca haftada 2 gün aynı doktor tarafından uygulandı. Uygulama sırasında kayroprakside yüksek hızlı düşük amplitüdlü manipülasyon tekniği kullanıldı. Tedavi öncesi ve sonrası ağrıyı değerlendirmek için VAS (Vizüel Ağrı Skalası), fonksiyonel durumu değerlendirmek için de Oswestry özürlülük indeksi uygulandı. Eklem hareket açıklığı gonyometre ölçümü ile değerlendirildi. Bulgular: Tedavi öncesi ve tedavi sonrası VAS ve Oswestry değerleri her iki grupta tedavi ile istatistiksel olarak anlamlı şekilde azalırken beldeki eklem hareket açıklığı değerleri belirgin şekilde artmıştı. Egzersiz ve kayropraksi alan hastalarda sadece egzersiz alan hastalara göre VAS istirahat, VAS hareket ve Oswestry değerlerinin istatistiksel olarak anlamlı derecede daha düşük düzeylerde ve eklem hareket açıklığındaki artışın ise daha yüksek düzeylerde olduğu saptandı. Tedavi sırasında herhangi bir yan etkiye rastlanmadı. Sonuç: Kayropraksi ve egzersizin bel ağrısında ağrı ve fonksiyonellik üzerine etkili olduğunu ve birlikte uygulandığında daha etkili olduğunu düşünmekteyiz.

EVALUATION OF THE EFFECTIVENESS OF CHIROPRACTIC MANUAL TREATMENT IN PATIENTS WITH CHRONIC LOW BACK PAIN

Objectives: Low back pain that is localized between the inferior costal margin and inferior gluteal folds and that can reflect legs is a common health problem and a leading cause of disability. Chiropractic is a non-invasive and inexpensive treatment method used for low back pain. The aim of our study was to evaluate the effects of chiropractic and isometric exercises on pain and functionality related to low back pain. Materials and Methods: Patients diagnosed with low back pain in the policlinic examination were taken in the study. Sixty patients consisting of 30 females and 30 males were randomly divided into two groups. Chiropractic application and lumbar isometric exercise were created for the first group, and a lumbar isometric exercise program was created for the second group. The exercise program was applied to both groups five days a week for four weeks by a physiotherapist. Chiropractic treatment was applied by the same doctor two days a week for four weeks. During the application, a high-speed, low amplitude manipulation technique was used in chiropractic. Visual Analog Scale (VAS) was used to score pain, and Oswestry Disability Index (ODI) was used to evaluate functionality before and after treatment. The range of motion was evaluated by goniometer measurement. Results: VAS and ODI scores decreased statistically significantly with treatment in both groups, while the range of motion in the lumbar spine increased significantly before and after treatment. VAS rest, VAS motion, and ODI scores were statistically significantly lower, and the increase in range of motion was higher in patients who received exercise and chiropractic compared to patients who only received exercise. Any adverse effect did not appear in both groups during the treatment. Conclusion: We think that chiropractic and exercise are effective on pain and functionality in low back pain, and they are more effective when applied together.

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