Proloterapi uygulanan diz osteoartritli hastalarda derin ısıtıcının(kısa dalga diatermi) ağrı, fonksiyonellik ve yaşam kalitesi üzerine etkisi: Prospektif, randomize, plasebo kontrollü, çift kör çalışma
Küçük Resim Yok
Tarih
2018
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Diz osteoartritinde Proloterapi uygulamasına ek olarak Kısa Dalga Diatermi tedavisinin ağrı, fiziksel fonksiyon ve yaşam kalitesi üzerine etkilerinin gözlenmesi Gereç ve yöntem: Çalışma 2018-2019 tarihleri arasında Ege Üniversitesi Tıp Fakültesi Fizik Tedavi ve Rehabilitasyon Anabilim Dalı polikliniğine diz ağrısı ile başvuran hastalara Amerika Romatoloji Birlig?i (ACR) klinik/radyolojik tanı kriterlerine göre diz osteoartriti tanısı kondu ve Kellgren-Lawrence (K-L) evresi 2 ve 3 olan 37 hasta çalışmaya alındı, hastalar Proloterapi +Kısa Dalga Diatermi tedavi grubu(n:18) ve Proloterapi + sham Kısa Dalga Diatermi (KDD)(n:19) olmak üzere iki gruba randomize edildi. Her iki gruba ek olarak Kuadriseps izometrik güçlendirme egzersizleri (günde 3 set 10 tekrar olmak üzere hergün, toplamda 6 hafta) verildi. Hastalara 3'er hafta arayla 0, 3, ve 6.haftada 3 defa Proloterapi enjeksiyonu ve her enjeksiyon sonrası 20 dk (gerçek veya sham) KDD verildi. Hastalar tedavi öncesi ve tedavi sonrası (3.enjeksiyon sonrası) VAS, WOMAC ve SF-36 sonuç ölçümleri ile değerlendirildi. Bulgular: Her iki grupta da VAS ve WOMAC alt gruplarında anlamlı düzeyde düzelme gözlendi (p<0,05). Her iki grupta da tedavi öncesine göre SF 36 ölçeğinin alt gruplarınndan fiziksel fonksiyon, emosyonel rol, genel sağlık, vücut ağrısı, sosyal fonksiyon parametrelerinde anlamlı düzelme gözlendi (P<0,05). Gruplar arası karşılaştırmalarda ise değerlendirilen ölçeklerin hiçbirisinde anlamlı farklılık tespit edilmedi (P>0,05). Sonuç: Bu çalışmada, her iki grupta, ağrı, fonksiyonellik ve hayat kalitesi açısından anlamlı düzelme saptanmakla birlikte, gruplar arasında fark saptanmadı. KDD nin proloterapi tedavisine ek katkı sağlayıp sağlamadığı konusunda kesin bir karara varmak güçtür. Bu nedenle, örneklem sayısının büyük olduğu , proloterapi ile diğer tedavi seçeneklerini karşılaştıran , iyi dizayn edilmiş, yeni yüksek kalite çalışmalara ihtiyaç vardır
Objective: In this double-blind randomized controlled trial we aimed to investigate the effectiveness of short-wave diathermy(SWD) implementation following injections of dextrose prolotherapy on pain, functionality and quality of life in patients with knee osteoarthritis. Material and Method: 37 , Kellgren-Lawrence(K-L) grade 2-3, patients with knee osteoarthritis in our hospital were included. Patients were randomized into two groups; Group 1: Prolotherapy + SWD (intervention group)(n:18), Group 2 : Prolotherapy + sham SWD (control)(n:19). Intra-articular(% 15 dextrose) and peri-articular(% 25 dextrose) injections were performed at 0. 3. and 6. weeks. SWD were applied to the patients after each injection. Additionally, all participants received quadriceps strengthening exercises. Outcome measures were VAS(Visual Analog Scale), WOMAC(Western Ontario and McMaster Universities Osteoarthritis Index) and SF-36(Short Form). Patients were assessed pre and post-intervention. Findings: Both groups showed significant improvement at VAS and WOMAC scores over time. The items of the SF-36 quality of life questionnaire showed statistically significant improvement in the aspects physical functioning , pain , emotional role, general health and social functioning compared with baseline status(P<0,05). There was no statistically significant change in the scores of vitality, mental health and physical role(P>0,05). There wasn't any significant differences between groups in any outcome measures(P>0,05). Conclusion: In this study, both groups had significant improvement at pain, functionality and quality of life but there wasn't any significant differences between groups. It is difficult to draw definitive conclusions about the positive contribution of SWD. Therefore, future research is needed larger sample size, comparing dextrose prolotherapy with other treatment options for knee OA and high-quality RCTs.
Objective: In this double-blind randomized controlled trial we aimed to investigate the effectiveness of short-wave diathermy(SWD) implementation following injections of dextrose prolotherapy on pain, functionality and quality of life in patients with knee osteoarthritis. Material and Method: 37 , Kellgren-Lawrence(K-L) grade 2-3, patients with knee osteoarthritis in our hospital were included. Patients were randomized into two groups; Group 1: Prolotherapy + SWD (intervention group)(n:18), Group 2 : Prolotherapy + sham SWD (control)(n:19). Intra-articular(% 15 dextrose) and peri-articular(% 25 dextrose) injections were performed at 0. 3. and 6. weeks. SWD were applied to the patients after each injection. Additionally, all participants received quadriceps strengthening exercises. Outcome measures were VAS(Visual Analog Scale), WOMAC(Western Ontario and McMaster Universities Osteoarthritis Index) and SF-36(Short Form). Patients were assessed pre and post-intervention. Findings: Both groups showed significant improvement at VAS and WOMAC scores over time. The items of the SF-36 quality of life questionnaire showed statistically significant improvement in the aspects physical functioning , pain , emotional role, general health and social functioning compared with baseline status(P<0,05). There was no statistically significant change in the scores of vitality, mental health and physical role(P>0,05). There wasn't any significant differences between groups in any outcome measures(P>0,05). Conclusion: In this study, both groups had significant improvement at pain, functionality and quality of life but there wasn't any significant differences between groups. It is difficult to draw definitive conclusions about the positive contribution of SWD. Therefore, future research is needed larger sample size, comparing dextrose prolotherapy with other treatment options for knee OA and high-quality RCTs.
Açıklama
Anahtar Kelimeler
Fiziksel Tıp ve Rehabilitasyon, Physical Medicine and Rehabilitation, Ağrı, Pain, Diyatermi, Diathermy, Fizik tedavi, Physical therapy, Fizik tedavi yöntemleri, Physical therapy modalities, Osteoartrit, Osteoarthritis, Osteoartrit-diz, Osteoarthritis-knee, Proloterapi, Prolotherapy, Yaşam kalitesi, Quality of life
