Fulya DEMİRHAN, Yıldız Analay AKBABA, Nurettin TAŞTEKİN

COVID-19 Pandemisi Nedeniyle Evlerinde Sosyal İzolasyon Yaşayan ve Daha Önceden Fibromyalji Sendromu Tanısı Almış Bireylere Uygulanan Tele-Rehabilitasyonun Etkinliğinin Araştırılması

Fibromyalji hastalarındaTele-rehabilitasyon uygulamasının hastalığın semptomları üzerine olan etkisinin araştırılması amaçlanmıştır. Olgular kuvvetlendirme (n=20), germe-gevşeme (n=20) ve kontrol (n=20) olmak üzere üç grup olarak randomize edildi. Çalışma 55 kişi ile sonlandırıldı. Tüm olgularda; Fibromyalji Etki Sorgulama Ölçeği (FIQ), Görsel Analog Skala (VAS), Yaşam Kalitesi Ölçeği (SF-36), Beck Depresyon Envanteri (BDE), Pittsburgh Uyku Kalite İndeksi (PUKİ) ve Pozitif-Negatif Duygu Durumu Ölçeği (PANAS), 5 Defa Otur-Kalk Testi (5-DOKT), Zamanlı Kalk ve Yürü Testi (TUG) ve V-Otur-Uzan Testi (VOUT) kullanıldı. Grupların demografik ve klinik özellikleri açısında istatistiksel olarak anlamlı bir fark bulunmadı (p>0,05). Grup içi değerlendirmelerde kuvvetlendirme grubunda FIQ skoru (p=0,01), PUKİ skoru (p=0,01), VAS skoru (p=0,00), PANAS pozitif-negatif (p=0,01), 5-DOKT, TUG, VOUT (p=0,01) skorları ile SF-36 ölçeğinin bütün alt skorlarında anlamlı farklılık bulunmuştur. Germe-gevşeme grubunda PUKİ (p=0,01), SF-36 Fiziksel fonksiyon (p=0,01), SF-36 Rol Kısıtlaması (Fiziksel) (p=0,03), SF-36 Vitalite (Enerji) (p=0,01) ve SF-36 Mental Sağlık (p=0,01) alt skorlarında istatistiksel olarak anlamlı farklılık bulundu. Gruplar arası karşılaştırmada, BDE (p=0,03), VOUT (p=0,006) ile SF-36 Ağrı (p=0,04), Vitalite (Enerji) (p=0,00) ve Mental Sağlık (p=0,01) alt skorlarında istatistiksel olarak anlamlı farklılık bulundu. Fibromyalji hastalarında uygulanan farklı egzersiz içeriklerine sahip Tele-rehabilitasyon uygulamaları, sağlık durumu, ağrı, uyku kalitesi, depresyon, duygu-durum, fiziksel performans ve yaşam kalitesi sonuçlarını olumlu etkilemektedir. Kas kuvvetlendirme egzersizleri verilen grupta diğer gruplara göre yaşam kalitesi ve depresyon yönünden; germe- gevşeme egzersizi verilen grupta ise esneklik yönünden daha fazla iyileşme olduğu gözlenmiştir. Kliniğe ulaşımın zor olduğu durumlarda Tele-rehabilitasyon uygulaması faydalı ve güvenli bir tedavi seçeneği olarak tercih edilebilir.

Anahtar Kelimeler:

Fibromiyalji, Tele-rehabilitasyon, Fiziksel Aktivite, Egzersiz, Kuvvetlendirme, Germe, Gevşeme Egzersizi

Investigation of the Effectiveness of Tele-Rehabilitation in Individuals Experiencing Social Isolation at Home Due to the COVID-19 Pandemic and Previously Diagnosed with Fibromyalgia Syndrome

It was aimed to investigate the effect of Tele-rehabilitation application on the symptoms of the disease in patients with fibromyalgia. The cases were randomized into three groups as strengthening (n=20), stretching-relaxation (n=20) and control (n=20). The study was terminated with 55 people. In all cases; Fibromyalgia Impact Inquiry Scale (FIQ), Visual Analogue Scale (VAS), Quality of Life Scale (SF-36), Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI) and Positive-Negative Affect Scale (PANAS), 5 The Sit-to-Go Test (5-TSBS), Timed Up and Go Test (TUG) and V-Sit-Reach Test (VSR) were used. There was no statistically significant difference in terms of demographic and clinical characteristics of the groups (p>0,05). The intragroup assessment showed that in strengthening group, FIQ score (p=0,01), PSQI score (p=0,01), VAS score (p=0,00), PANAS positive-negative (p=0,01), 5-TSBS, TUG, VSR (p=0,01) scores and all sub-scores of the SF-36 scale were found to be significantly different. In the stretching-relaxation group, PSQI (p=0,01), SF-36 Physical function (p=0,01), SF-36 Role Restriction (p=0,03), SF-36 Vitality (p=0,01) and SF-36 Mental Health (p=0,01) sub-scores were found to be statistically significant. In comparison between groups, BDI (p=0,03), VSR (p=0,006) and SF-36 Pain (p=0,04), Vitality (p=0,00) and Mental Health (p=0,01) sub-scores were found to be statistically significant. Tele-rehabilitation applications with different exercise contents applied in patients with fibromyalgia positively affect the health status, pain, sleep quality, depression, mood, physical performance and quality of life results. In terms of quality of life and depression in the group given muscle strengthening exercises compared to the other groups; In the group that was given stretching-relaxation exercise, more improvement was observed in terms of flexibility. In cases where access to the clinic is difficult, Tele-rehabilitation application can be preferred as a useful and safe treatment option.

Keywords:

Fibromyalgia, Tele-rehabilitation, Physical Activity, Exercise, Strengthening, Stretching, Relaxation Exercise,

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