Adeziv Kapsülit Tedavisinde Fizik Tedavi Programı Öncesi Uygulanan Glenohumeral Eklem Enjeksiyonunun Tedavi Sonuçları Üzerine Etkisi

Amaç:Bu çalışmanın amacı, omuzda adeziv kapsüliti (AK) olan hastalarda fizik tedavi ve egzersiz programı (FTEP) öncesinde uygulanan ultrason eşliğinde intraartiküler (İA) glenohumeral eklem enjeksiyonunun tedavi sonuçları üzerine katkı sağlayıp sağlamadığını değerlendirmektir. Gereç ve Yöntem: 1 Ekim 2019 - 1 Mart 2020 tarihleri arasında, üç hafta boyunca haftada beş seans aynı fizik tedavi modaliteleri (yüzeyel ısıtma (infrared), transkutanöz elektriksel sinir stimülasyonu ve terapötik ultrasondan oluşan) ve egzersiz tedavisi uygulanan AK tanılı 93 hastanın tıbbi kayıtları retrospektif olarak değerlendirildi. Dahil etme ve dışlama kriterlerini karşılayan toplam 41 hasta enjeksiyon uygulaması açısından iki gruba ayrıldı. FTEP’den önce ultrason eşliğinde İA glenohumeral enjeksiyon uygulanan hastalar “enjeksiyon yapılan hastalar” (n=19), diğer hastalar “enjeksiyon yapılmayan hastalar” (n=22) olarak kabul edildi. Hastaların başlangıçta (0. gün) ve FTEP’nin sonunda (21. gün), etkilenen omuzdaki aktif ve pasif eklem hareket açıklığı (EHA), ağrı şiddeti, ağrı ve sakatlık dereceleri değerlendirildi. Bulgular: AK tedavisinde kullanılan fizik tedavi modaliteleri ve egzersiz tedavisi, üç haftanın sonunda ağrı skorları, EHA ve özürlülük skorları üzerinde olumlu bir etkiye sahipti. Bu tedaviden önce ultrason eşliğinde uygulanan İA enjeksiyonun, gündüz ve gece ağrı şiddetleri üzerinde olumlu etkisinin olduğu, ancak ROM veya sakatlık üzerine ek katkı sağlamadığı belirlendi. Sonuç: FTEP’den önce ultrason eşliğinde uygulanan glenohumeral İA enjeksiyon tedavisi, ağrı semptomlarının baskın olduğu AK hastalarında faydalı olabilir.

Anahtar Kelimeler:

Donuk Omuz, Omuz Ağrısı, Ultrasonografi, Kortikostreoid, Fizyoterapi

The Effect of Glenohumeral Joint Injection Prior to Physical Therapy on Treatment Outcomes in Adhesive Capsulitis

Objective: The objective of this study was to evaluate whether ultrasound-guided intraarticular (IA) glenohumeral injection applied before physical therapy and exercise therapy program (PTETP) contributes to the treatment outcomes in patients with adhesive capsulitis of the shoulder (ACS). Methods: The medical records of 93 patients diagnosed with ACS who underwent the same physical therapy modalities five sessions per week for three weeks (consisted of superficial heating (infrared), transcutaneous electrical nerve stimulation, and therapeutic ultrasound) and exercise therapy program between October 1, 2019–March 1, 2020 were retrospectively evaluated. A total of 41 patients who met inclusion and exclusion criteria were divided into two groups in terms of injection application. Patients who were applied ultrasound guided IA glenohumeral injections before PTETP were considered “injection patients” (n=19), while other patients were considered “non-injection patients” (n=22). The active and passive range of motion (ROM), severity of pain, and degrees of pain and disability of the affected shoulders were assessed at baseline (day 0) and end of PTETP (day 21). Results: Physical therapy modalities and exercise therapy used in ACS treatment had a positive effect on pain scores, ROM, and disability scores at the end of three weeks. It was determined that ultrasound-guided IA injection prior to this treatment the positive effect on daytime and nighttime pain but did not provide additional benefit on ROM or disability. Conclusion:Ultrasound-guided glenohumeral IA injection therapy before PTETP may be beneficial in ACS patients with predominant symptoms of pain.

Keywords:

Frozen Shoulder, Shoulder Pain, Ultrasonography, Corticostreoid, Physiotherapy,

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