PELVİK TABAN DİSFONKSİYONUNDA EMG-BIOFEEDBACK ETKİNLİĞİ

Pelvik taban terimi, kemikli pelvik çıkışı (pelvik outlet) kapatan bileşik yapı ile ilgilidir. Pelvik kaslar terimi pelvik tabanın kas tabakasını ifade eder. Pelvik taban farklı katmanlardan oluşur. Pelvik taban orta katmanları ağırlıklı olarak kas dokusundan oluşur. Bunların dışında, bu tabakada endo pelvik fasya gibi fibromüsküler ve fibröz elementler bulunur. Pelvis içindeki pozisyonu bir trambolin gibi düşünülen bu yapı, pelvik açıklıklara (üretra, vajina ve anüs) yapısal destek verir. Ayrıca işeme, dışkılama, seksüel fonksiyon ve pelvik organların desteklenmesinden de sorumludur. Pelvik taban kaslarının ön, orta veya arka kompartmanlarının herhangi birinde meydana gelen bir patoloji; alt üriner sistem semptomları, bağırsak semptomları, prolapsus, seksüel fonksiyon ve ağrı ile ilişkili olan pelvik taban disfonksiyonuna neden olmaktadır. Tüm cinsiyetleri ve her yaş grubundan bireyi etkilemektedir. Pelvik taban disfonksiyonu tedavi seçenekleri arasında cerrahi, medikal ve fizyoterapi ve rehabilitasyon yaklaşımları yer almaktadır. Fizyoterapi ve rehabilitasyonun amacı semptomları azaltmak, progresyonu önlemek, cerrahiyi önlemek ya da geciktirmek ve yaşam kalitesini arttırmaktır. Bu amaçlara ulaşmak için pelvik taban disfonksiyonu tedavisinde uygulanan fizyoterapi ve rehabilitasyon yaklaşımları pelvik taban kas eğitimini içermektedir. Pelvik taban kas eğitimi; manuel terapi teknikleri, davranış ve yaşam şekli değişiklikleri, fonksiyonel egzersiz eğitimi ile kombine bir eğitim programıdır. Pelvik taban kas egzersizleri; vajinal kon, biofeedback, üç boyutlu realtime ultrasound ve sanal gerçeklik eğitimi ile birlikte uygulanabilir. Bu derleme EMG- Biofeedback’ in pelvik taban kas eğitiminde uygulanabilirliğini ve avantajlarını vurgulamaktadır.

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