Mustafa Aziz YILDIRIM, Ata Bora AYNA, Kadriye ÖNEŞ

Hemiplejik hastalarda iş uğraşı tedavisi etkinliği

Amaç: Geleneksel tedaviye kombine edilen tekrarlı amaca özgü egzersizi içeren iş uğraşı tedavisinin üst ekstremite motor ve fonksiyonel gelişimi üzerine ek bir fayda sağlayıp sağlamadığını araştırmaktır.Gereç ve yöntem: Çalışma prospektif, randomize, tek kör kontrollü bir klinik çalışma olarak planlandı. Çalışmaya hemiparezi gelişmiş olan 51 hasta dahil edildi. Hastalar iki gruba ayrılarak, 1. gruba geleneksel rehabilitasyon (dört hafta boyunca haftada beş gün) ve iş uğraşı tedavisi (dört hafta haftada beş gün, günde bir saat) , 2. gruba yalnızca geleneksel rehabilitasyon uygulandı. Tüm hastalar tedavi öncesi ve bitiminde değerlendirildi. Tedavi etkinliğini değerlendirmek için Vizüel Anolog Skalası (VAS), Brunnstrom evrelemesi, Modifiye Ashworth Skalası, Nine Hole Peg Testi (NHPT), Barthel İndeksi, Fugl Meyer Motor Fonksiyon Skalası üst ekstremite bölümü ve Nottingham Sağlık Profili (NHP) kaydedildi. Bulgular: Her iki grup arasında sonuç parametrelerinde istatistiksel anlamlı bir fark yok idi. Ancak grup 1’de Brunnstrom üst ekstremite evrelemesinde ve NHP duygusal reaksiyonlar alt bölümünde elde edilen istatistiksel anlamlı gelişmeler grup 2’de görülmemiştir. Sonuç: Sonuçlarımız kombinasyon tedavisinin belirgin lehine olmamakla birlikte, literatür ve çeşitli tedavi kılavuzları göstermektedir ki tekrarlı amaca özgü egzersizleri içeren iş uğraşı tedavisi üst ekstremite inme rehabilitasyonunda tamamlayıcı bir yöntem olarak yer almalıdır. Bu konuda hala yanıtlanması gereken sorular olduğundan ileri çalışmalara ihtiyaç olduğu kanısındayız.

Anahtar Kelimeler:

İnme, üst ekstremite

Effectiveness of occupational therapy in hemiplegic patients.

Introdoction: This study aimed to investigate whether combine application of conventional therapy with occupational therapy in the content of repetitive task specific training provided additional benefits to motor and functional outcome of upper extremity in patients with stroke. Material and Method: The study was designed as prospective, randomized, controlled, single blind clinical trial.51 inpatient who have had hemiparesis related cerebrovascular accident involved to study. Patients were assigned into two groups, conventional therapy (five days in a week, for four weeks) and occupational therapy in the content of repetitive task specific training (an hour once in a day, five days in a week, for four weeks) were performed for group 1, only conventional therapy was performed for group 2. All patients were evaluated before and after the treatment. To assess efficiency of treatment Visual Analog Scale (VAS), Brunnstrom grades, Modified Ashworth Scale, Nine Hole Peg Test (NHPT), Barthel Index, Fugl Meyer Motor Assessment upper extremity component and Nottingham Health Profile (NHP) were performed. Results: There was not a significant statistical difference between two group’s outcome parameters. But improvements statistical significant at Brunnstrom grade upper extemity and NHP emotional reactions in group 1 there was not seen in group 2. Despite our results are not supporting combined therapy clearly. Conclusion: According to literature and treatment guidelines occupational therapy including repetitive task specific training is suggested in upper extremity stroke rehabilitation as a complemantary procedure. Because of still there are questions that have to be answered, we think further studies are required on this issue.

Keywords:

stroke upper limb, occupational therapy,

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