Subakromial sıkışma sendromu tedavisinde PRP enjeksiyonu, kortikosteroid enjeksiyonu ve fizik tedavinin etkinliğinin karşılaştırılması
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Dosyalar
Tarih
2017
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Düzce Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
ÖZET Çalışmamızın amacı subakromiyal sıkışma sendromu (SSS) tanılı hastaların tedavisinde PRP enjeksiyonu, kortikosteroid enjeksiyonu ve fizik tedavinin ağrı, omuz fonksiyonları ve yaşam kalitesine etkinliğini incelemek ve bu etkinlikleri birbirleriyle karşılaştırmaktır. Çalışmaya SSS evre 2 tanısı konan 90 hasta alındı. Hastalar randomize edilerek üç gruba ayrıldı. Birinci grubta etkilenen omuzun subakromial aralığına PRP enjeksiyonu, ikinci grupta subakromial aralığa kortikosteroid enjeksiyonu, üçüncü gruba haftada 5 kez 10 seans fizik tedavi (TENS+ultrason+sıcak paket) uygulandı. Tüm gruplara toplam 8 haftalık eklem hareket açıklığı, sarkaç (codman), germe ve izotonik güçlendirme egzersizleri uygulandı. Hastaların istirahat ve hareketle oluşan omuz ağrısı visüel analog skala (VAS) ile, fonksiyonel durum değerlendirmek için; Omuz Özürlülük Sorgulaması (OÖS), Quick Disabilities of the Arm, Shoulder and Hand Score (Kısa DASH), The University of California and Los Angeles Rating Score (UCLA) testleri kullanıldı. Genel yaşam kalitesi, jenerik bir ölçek olan Short form 36 (SF-36) ile yapıldı. Çalışmamızın sonunda üç gruptaki hastaların hepsinde tedavi öncesine göre tüm skorlarda iyileşme sağlandı. Grupların kendi aralarındaki karşılaştırmalarında 8. hafta Kısa DASH, UCLA, hareket VAS, SF-36 ağrı alt grup skorunda PRP enjeksiyon tedavisi kortikosteroid enjeksiyonu ve fizik tedaviye göre daha üstündü. Sonuç olarak subakromiyal PRP enjeksiyonu, subakromiyal steroid enjeksiyonu ve fizik tedavi modalitelerinin her üçünün de SSS tedavisinde etkili olduğu ve tedavi sonrası iyilik halinin 3. ve 8. hafta da devam ettiği görüldü. Buna karşılık ucuz, noninvaziv, yan etkisi olmayan fizik tedavi ve egzersizin SSS tedavisinde öncelikli tercih edilebilmesi gerektiğini düşünüyoruz. ANAHTAR KELİMELER, Subakromial sıkışma sendromu, plateletten zengin plazma enjeksiyonu, kortikosteroid enjeksiyonu, fizik tedavi, egzersiz
The aim of our study is investigated by the efficacy of PRP injection, corticosteroid injection and physical therapy at pain, shoulder functions and quality of life in the treatment of patients with subacromial impingement syndrome (SIS) and compare these activities to each other. The study was included 90 patients who were diagnosed with stage 2 of SIS. The patients were randomized and divided into three groups. That first group into the subacromial space of the affected shoulder have PRP injection, the second group of subacromial space have corticosteroid injection, the third group have 10 sessions of physical therapy 5 times a week (TENS + ultrasound + hot pack) were administered at the same intervals. However, a total of 8 week exercises of joint range of motion, codman, stretching and isotonic strengthening exercises were applied to all groups. The visual analogue scale (VAS) tests were used to determinate patients' shoulder pain with resting and moving session; Shoulder Disability Questionnaire (SDQ), Quick Disabilities of the Arm, Shoulder and Hand Score (Quick DASH), The University of California and Los Angeles Rating Score (UCLA) tests were evaluated to assess the functional status of patients. The overall quality of life were analyzed by a generic scale named Short form 36 (SF-36). At the end of our study, all three groups of patients improved on all scores compared to before treatment. In comparison between the groups, PRP injection therapy were higher than corticosteroid injection and physical therapy on the 8th week Brief DASH, UCLA, VAS, motion VAS, SF-36 pain subgroup scores. In conclusion, subacromial PRP injection, subacromial steroid injection and physical therapy modalities were found to be effective in the treatment of SIS, and good postoperative course was observed at 3th and 8th weeks. On the other hand, we think that physical therapy and exercise should be preferred in the treatment of SIS due to non-side effect, cheap and noninvasive properties. KEYWORDS, Subacromial impingement syndrome, platelet rich plasma injection, corticosteroid injection, physical therapy, exercise
The aim of our study is investigated by the efficacy of PRP injection, corticosteroid injection and physical therapy at pain, shoulder functions and quality of life in the treatment of patients with subacromial impingement syndrome (SIS) and compare these activities to each other. The study was included 90 patients who were diagnosed with stage 2 of SIS. The patients were randomized and divided into three groups. That first group into the subacromial space of the affected shoulder have PRP injection, the second group of subacromial space have corticosteroid injection, the third group have 10 sessions of physical therapy 5 times a week (TENS + ultrasound + hot pack) were administered at the same intervals. However, a total of 8 week exercises of joint range of motion, codman, stretching and isotonic strengthening exercises were applied to all groups. The visual analogue scale (VAS) tests were used to determinate patients' shoulder pain with resting and moving session; Shoulder Disability Questionnaire (SDQ), Quick Disabilities of the Arm, Shoulder and Hand Score (Quick DASH), The University of California and Los Angeles Rating Score (UCLA) tests were evaluated to assess the functional status of patients. The overall quality of life were analyzed by a generic scale named Short form 36 (SF-36). At the end of our study, all three groups of patients improved on all scores compared to before treatment. In comparison between the groups, PRP injection therapy were higher than corticosteroid injection and physical therapy on the 8th week Brief DASH, UCLA, VAS, motion VAS, SF-36 pain subgroup scores. In conclusion, subacromial PRP injection, subacromial steroid injection and physical therapy modalities were found to be effective in the treatment of SIS, and good postoperative course was observed at 3th and 8th weeks. On the other hand, we think that physical therapy and exercise should be preferred in the treatment of SIS due to non-side effect, cheap and noninvasive properties. KEYWORDS, Subacromial impingement syndrome, platelet rich plasma injection, corticosteroid injection, physical therapy, exercise
Açıklama
YÖK Tez No: 471452
Anahtar Kelimeler
Fiziksel Tıp ve Rehabilitasyon, Physical Medicine and Rehabilitation, Adrenal korteks hormonları, Adrenal cortex hormones, Egzersiz tedavisi, Exercise therapy, Enjeksiyonlar, Injections, Fizik tedavi, Physical therapy, Omuz, Shoulder, Omuz ağrısı, Shoulder pain, Omuz eklemi, Shoulder joint, Omuz sıkışma sendromu, Shoulder impingement syndrome, Trombositten zengin plazma, Platelet rich plasma
