Kronik bel ağrısı olan kadınlarda farklı egzersiz programlarının etkinliğinin araştırılması

Amaç: Bu çalışma kronik bel ağrılı kadınlarda geleneksel egzersiz yaklaşımları ile segmental stabilizasyon egzersizlerinin etkilerini karşılaştırmak amacıyla yapıldı. Yöntem: Çalışmaya bel ağrısı tanılı 18-60 yaş arası 66 gönüllü kadın alındı. Olgular segmental stabilizasyon egzersiz grubu (1), Williams fleksiyon egzersiz grubu (2) ve ev egzersiz programıyla takip edilen kontrol grubu (3) olmak üzere üç gruba ayrıldı. Olgular tedavi öncesi ve sekiz haftalık tedavi sonrası olmak üzere 2 kez; ağrı, postür analizi, esneklik, fonksiyonel düzey, ruhsal durum, lumbosakral bölgenin radyolojik görünümü ve sağlıkla ilgili yaşam kalitesi yönünden değerlendirildi. Sonuçlar: Her 3 grupta da ağrı, fonksiyonel düzey, ruhsal durum, esneklik ve sağlıkla ilgili yaşam kalitesi puanlarında düzelme bulundu (p0,05). Gruplar arası karşılaştırma bulgularında, ağrı, esneklik, fonksiyonel düzey, ruhsal durum, ve sağlıkla ilgili yaşam kalitesi açısından fark bulunmadı (p>0,05). Fiziksel performans açısından grup 1 ve grup 2 arasında, gövde kas kuvveti açısından grup1 ile grup 3 ve grup 2 ile grup 3 arasında, lumbosakral açı bakımından grup 1 ve grup 2 arasında anlamlı fark bulundu (p

Investigation of the effectiveness of different exercise applications in women with chronic low back pain

Keywords:

-,

___

  • Atlas SJ, Nardin RA. Evaluation and treatment of low back pain: an evidence based approach to clinical care. Muscle Nerve. 2003;27:265-284.
  • van Tulder MW, Koes BW, Bouter LM. Conservative treatment of acute and chronic nonspecific low back pain. Spine (Phila Pa 1976). 1997;22:2128-2156.
  • van Tulder M, Koes B, Bombardier C. Low back pain. Best Pract Res Clin Rheumatol. 2002;16:761- 775.
  • Baxter GD, Gracey JH. Exercise and chronic low back pain: what works? Pain. 2004;107, 176-190.
  • Bongers PM, de Winter CR, Kompier MAJ. Psychosocial factors at work and musculoskeletal disease. Scand J Work Environ Health. 1993;19:297- 312.
  • Coşkun G, Can F. Kronik bel ağrısında dinamik ve statik stabilizasyon egzersizlerinin ağrı ve fonksiyonel düzeye etkileri. Fizyoter Rehabil. 2012;23(2):65-72.
  • O'Sullivan PB, Phyty GD, Twomey LT. Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis. Spine (Phila Pa 1976). 1997;22:2959-2967.
  • Panjabi MM. The stabilising system of the spine. Part 1. Function, dysfunction, adaption, and enhancement. J Spinal Disord. 1992;5:383-389.
  • Cresswell AG, Grundstrom H, Thorstensson A. Observations on ıntra-abdominal pressure and patterns of abdominal ıntra-muscular activity ın man. Acta Physiol Scand. 1992;144:409-418.
  • Cresswell AG, Oddsson L, Thorstensson A. The ınfluence of sudden perturbations on trunk muscle activity and ıntra-abdominal pressure while standing. Exp Brain Res. 1994;98:336-341.
  • van der Windt DA, van der Heijden GJ, van den Berg SG, et al. Ultrasound therapy for musculoskeletal disorders: a systematic review. Pain. 1999;81:257-271.
  • Jemmett R. Spinal Stabilization: The new science of back pain effective solutions for people with low back pain. 2003; 2nd Ed. Canada: Novont Health Publishing.
  • Richardson C, Jull G, Hodges P, et al. Therapeutic Exercises for Spinal Segmental Stabilization in Low Back Pain: Scientific Basis and Clinical Approach. Edinburgh: Churchill Livingstone. 1999;105-107.
  • Hicks GE, Fritz JM, Dellito A, et al. Prelininary development of a clinical prediction rule for determining which patients with low back pain will respond to a stabilization exercise program. Arch Phys Med Rehabil. 2005;86:1753-1762.
  • Otman AS. Egzersiz Tedavisinde Temel Prensipler ve Yöntemler. Ankara: Meteksan. 2006.
  • Yakut Y, Yakut E, Bayar K, et al. Reliability and validity of the Turkish version short-form McGill pain questionnaire in patients with rheumatoid arthritis. Clin Rheumatol. 2007;26:1083-1087.
  • Zachezewski JE. Improving flexibility. In: Scully RM, Barnes MR, eds. Physical Therapy. Philadelphia, PA: JB Lippincott; 1989. pp. 698–738.
  • Yakut E, Düger T, Öksüz C, et al. Validation of the Turkish version of the Oswestry Disability Index for patients with low back pain. Spine (Phila Pa 1976). 2004;29:581-585.
  • Hisli N. Beck Depresyon Envanteri'nin geçerliği üzerine bir çalışma. Psikoloji Dergisi. 1988;6:118-122.
  • Simmonds MJ, Olson SL, Jones S, et al. Psychometric characteristics and clinical usefulness of physical performance tests in patients with low back pain. Spine (Phila Pa 1976). 1998;23:2412-2421.
  • Bayramoğlu M, Akman MN, Kilinc S¸ et al. Isokinetic measurement of trunk muscle strength in women with chronic low-back pain. Am J Phys Med Rehabil. 2001;80:650-655.
  • Stokes IA. Axis for dynamic measurement of flexion and extension torques about the lumbar spine. Practice. 1987;67:1230-1233.
  • Ito T, Shirado O, Suzuki H, et al. Lumbar trunk muscle endurance testing: an inexpensive alternative to a machine for evaluation. Arch Phys Med Rehabil. 1996;77:75-79.
  • Lundberg G, Gerdle B. The relationships between spinal sagittal configuration, joint mobility, general low back mobility and segmental mobility in female homecare personnel. Scand J Rehab Med. 1999;31:197-206.
  • Vialle R, Levassor N, Rillardon L, et al. Radiographic analysis of the sagittal alignment and balance of the spine in asymptomatic subjects. J Bone Joint Surg Am. 2005;87:260-267.
  • Okçu G, Yercan H, Yorulmaz İ, et al. Lomber omurganın sagittal planda radyolojik analizi. Journal of Arthroplasty Arthroscopic Surgery. 2000;11:146- 150.
  • Küçükdeveci AA, McKenna SP, Kutlay S, et al. The development and psychometric assessment of the turkish version of the Nottingham Health Profile. Int J Rehabil Res. 2000;23:31-33.
  • Alpar R. Spor Bilimlerinde Uygulamalı İstatistik (2. Baskı). Ankara: Nobel Yayıncılık. 2001
  • Arokoski JP, Valta T, Kankaanpää M, et al. Activation of lumbar paraspinal and abdominal muscles during therapeutic exercises in chronic low back pain patients. Arch Phys Med Rehabil. 2004;85:823-832.
  • Mori A. Electromyographic activity of selected trunk muscles during stabilization exercises using a gym ball. Electromyogr Clin Neurophysio. 2004;44:57-64.
  • Souza GM, Baker LL ve Powers CM. Electromyographic activity of selected trunk muscles during dynamic spine stabilization exercises. Arch Phys Med Rehabil. 2001;82:1551-1557.
  • Richardson CA, Hodges PW, Hides JA. Therapeutic Exercise for Lumbopelvic Stabilization: A Motor Control Approach for the Treatment and Prevention of Low Back Pain. 2nd ed. London: Churchill Livingstone. 2004.
  • Kumar S, Sharma VP, Negi MP. Efiicacy of dynamic muscular stabilization techniques (DMST) over conventional techniques in rehabilitation of chronic low back pain. J Strength Cond Res.2009;23:2651- 2659.
  • Costa LO, Maher CG, Latimer J et al. Motor control exercise for chronic low back pain: a randomized placebo-controlled trial. Phys Ther. 2009;89:1275- 1286.
  • Cairns MC, Foster NE, Wright C. Randomized controlled trial of specific spinal stabilization exercises and conventional physiotherapy for recurrent low back pain. Spine (Phila Pa 1976). 2006;31:670-681.
  • Unsgaard-Tİndel M, Fladmark AM, Salvesen O, et al. Motor control exercises, sling exercises, and general exercises for patients with chronic low back pain: a randomized controlled trial with 1-year 40. Sokunbi O, Cross V, Watt P, et al. Experiences of follow-up. Phys Ther. 2001;90:1426-1440.
  • George SZ, Wittmer VT, Fillingim RB, et al. Comparison of graded exercise and graded exposure clinical outcomes for patients with chronic low back pain. J Orthop Sports Phys Ther. 2010;40:694-704.
  • Eker L, Tüzün EH, Daşkapan A, et al. The relationship between EQ-5D and SF-36 instruments in patients with low back pain. Fizyoter Rehabil. 2007;18:3-10.
  • Goldby LJ, Moore AP, Doust J, et al. A randomized controlled trial investigating the efficiency of musculoskeletal physiotherapy on chronic low back disorder. (Phila Pa 1976). 2006;31:1083-1093. individuals with chronic low back pain during and after their participation in a spinal stabilisation exercise programme - a pilot qualitative study. Man Ther. 2010;15:179-184.
  • Marin R, Cyhan T, Miklos W. Sleep disturbance in patients with chronic low back pain. Am J Phys Med Rehabil. 2006;85:430-435.