Duygu KORKEM, Hamide Elif ÖZTÜRK, Nurgül DÜRÜSTKAN ELBAŞI

LOMBER DİSK HERNİSİ CERRAHİSİ SONRASI KİNEZYOFOBİ, UYKU KALİTESİ VE YAŞAM KALİTESİNDEKİ DEĞİŞİMİN ARAŞTIRILMASI

Amaç: Lomber disk hernisi (LDH) tanısı koyulan ve mikrodiskektomi cerrahisi geçiren bireylerde kinezyofobi, günlük yaşam aktiviteleri ve uyku kalitesinin değişimini araştırmaktır. Materyal&Method: LDH cerrahisi endikasyonu olup, cerrahi olan 30 hasta çalışmaya dahil edildi. Hastalar ameliyattan önce, ameliyat sonrası birinci, üçüncü ve altıncı aylarda değerlendirildi. Hastaların değerlendirilmesinde kısa form Mcgill ağrı anketi, görsel ağrı skalası (VAS), Oswestry disabilite indeksi (ODİ), Tampa kinezyofobi ölçeği (TKÖ), SF-36 yaşam kalitesi ölçeği ve Pittsburg Uyku Kalitesi İndeksi (PUKİ) kullanıldı. Ayrıca hastaların lomber fleksiyon-ekstansiyon ve lateral fleksiyon normal eklem hareket açıları (NEH) kaydedildi. Hastalara ameliyat sonrası önerilerde bulunuldu. Ev egzersiz programı verildi. Bulgular: Değerlendirmeler sonucunda SF-36’nın bütün alt parametrelerinde, TKÖ, PUKİ ve NEH’lerinin zaman içindeki değişimi anlamlı bulundu (p<0.05). Ameliyat öncesi lomber bölge fleksiyon hareketi ile TKÖ, ODİ Toplam Skoru arasında; VAS skoru ile PUKİ toplam skoru ve SF-36 Emosyonel iyilik hali alt bileşeni arasında; VAS değeri ile PUKİ toplam skoru ve SF-36 Emosyonel iyilik hali alt bileşeni arasında; Mc-Gill duyusal (sensory) alt parametresi ile SF-36 Vücut ağrısı alt bileşeni arasında; Mc-Gill algısal alt parametresi ile TKÖ, Mc-Gill toplam Skoru ile SF-36 Fiziksel problemler nedeniyle olan kısıtlanma alt bileşeni arasında anlamlı ilişki bulundu (p<0,05). 6. ayda PUKİ skoru ile SF-36 Fiziksel problemler nedeniyle olan kısıtlanma ve SF-36 Genel Sağlık Algısı alt bileşeni arasında; SF-36 Emosyonel iyilik hali ve SF-36 Genel Sağlık Algısı alt bileşeni arasında istatistiksel olarak anlamlı ilişki bulundu (p<0,05). Sonuç: LDH cerrahisi ve sonrasında erken dönemden itibaren verilen, aşamalı olarak arttırılan ev egzersiz programı bireylerin subjektif ve objektif bulgularında önemli düzeyde iyileşmeler sağladı.

Anahtar Kelimeler:

Lomber disk hernisi, mikrodiskektomi, ev egzersiz programı, yaşam kalitesi

INVESTIGATION OF CHANGES IN KINESOPHOBIA, SLEEP QUALITY AND LIFE QUALITY AFTER LUMBAR DISC HERNIA SURGERY

Aim: This study aims to investigate the changes in kinesiophobia, daily living activities and sleep quality in patients diagnosed with lumbar disc herniation (LDH) and undergone microdiscectomy surgery. Materials & Methods: The patients with indication for surgery of LDH were included in this study. The patients were evaluated preoperatively and postoperatively at the 1st, 3rd, and 6th months. Short form Mcgill pain questionnaire, visual analogue scale (VAS), Oswestry disability index (ODI), Tampa kinesiophobia scale (TKS), SF-36, and Pittsburg Sleep Quality Index (PSQI) were employed as assessment scales. Goniometric lumbar flexion-extension and lateral flexion angles (ROM) were recorded for each patient. In addition, postoperative recommendations and home exercise program were given to the patients. Results: The changes in scores of TKS, PSQI over time was significant in all scores of SF-36. There was a significant increase of ROM postoperatively compared to preoperative evaluations. Statistically significant relationship was detected between the preoperative lumbar flexion movement and the TKS total score; between preoperative VAS score and PSQI total score; between VAS scores and PSQI total score, SF-36 emotional well-being subscale; (p <0.05). Mc-Gill sensorial sub-parameter as well as SF-36 sub-component due to total body pain were significantly correlated (p <0.05). At the 6th month, a statistically significant correlation was between PUKI score with SF-36 subcomponent due to physical problems restrictions and SF-36 Health Perception subcomponent; (p<0.05). Conclusion: Home exercise programs started early after LDH surgery and increased gradually during the postoperative period provided significant improvements in subjective and objective findings of the patients.

Keywords:

Lumbar disc hernia, lumbar disc surgery, home exercise program, quality of life,

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