ORIJINAL ARAŞTIRMA
Akut Mekanik Bel Ağrılı Hastalarda Lomber Korse Kullanımının Klinik Değişkenlikler Üzerinde Etkinliği: Randomize Kontrollü Çalışma
The Efficacy of Lumbar Corset Use on Clinical Variability in Patients with Acute Mechanical Low Back Pain: A Randomized Controlled Study
Received Date : 18 Oct 2019
Accepted Date : 13 Dec 2019
Available Online : 01 May 2020
Ayşe Gülşen DOĞANa, Nebahat SEZERb
aHitit Üniversitesi Erol Olçok Eğitim ve Araştırma Hastanesi, Fiziksel Tıp ve Rehabilitasyon ABD, Çorum, TÜRKİYE
bAnkara Yıldırım Beyazıt Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon ABD, Ankara, TÜRKİYE
Doi: 10.31609/jpmrs.2019-71921 - Makale Dili: TR
J PMR Sci
ÖZET
Amaç: Akut mekanik kökenli bel ağrılı hastalarda lomber korse
tedavisinin hastaların lomber eklem hareket açıklığı, fonsiyonel dizabilite
düzeyi, hasta-hekim memnuniyeti ve ağrı düzeyi üzerindeki etkinliğini
değerlendirmektir. Gereç ve Yöntemler: Çalışmaya yaş
aralığı 18-65 yıl olan, son 4 haftada korse kullanımı, malignite, travma,
enfeksiyon ve spinal cerrahi öyküsü bulunmayan akut mekanik kökenli
bel ağrılı 52’si kadın, 48’i erkek 100 hasta dâhil edildi. Sosyodemografik
özellikler kaydedildi. Hastalar kapalı zarf çekme işlemi uygulanarak
2 gruba randomize edildi. Bir gruba nonsteroid antiinflamatuar
ilaçlar (NSAİİ)+egzersiz, diğer gruba NSAİİ+egzersiz+lomber korse
tedavisi uygulandı. Tedavi öncesi, tedavinin 10. gününde ve 30. gününde
olmak üzere 3 kez lomber eklem hareket açıklığı ölçümü, ağrı
düzeyi ve fonksiyonel değerlendirme yapıldı. İstatistiksel analizler
SPSS versiyon 20 paket yazılımı kullanılarak yapılmıştır. Bulgular:
İstirahat, gece ve hareket vizüel analog skala (VAS) skorlarında, lomber
fleksiyon, ekstansiyon ve lateral fleksiyon hareket açıklıklarında
artma tedavinin 30. gününde korse grubunda, kontrol grubuna göre istatistiksel
olarak anlamlı düzeyde bulundu (istirahat VAS p=0,043 gece
VAS p=0,003 hareket VAS p=0,001 lomber fleksiyon, ekstansiyon ve
lateral fleksiyon p=0,000). Bel ağrısının yol açtığı fonksiyonel dizabiliteyi
değerlendirdiğimiz Modifiye Oswestry skorlarında, tedavinin 30.
gününde korse grubunda, kontrol grubuna göre istatistiksel olarak anlamlı
bir düzelme gözlendi (p=0,026). Sonuç: Çalışma sonuçlarımız,
lomber korse kullanımının akut dönem bel ağrılı hastalarda konservatif
tedavi protokolu içerisinde yer almasının tedavi etkinliğini artırdığını
göstermektedir.
Anahtar Kelimeler: Akut mekanik bel ağrısı; lomber korse
ABSTRACT
Objective: The purpose of this study was to evaluate the
efficacy of lumbar corset treatment on the range of motion of the lumbar
joint, functional disability level, patient-physician satisfaction and pain
level in patients with acute mechanical low back pain. Material and
Methods: Total of 100 patients, 52 female and 48 male, between 18-65
years of age and without any history of malignancy, trauma, infection,
spinal surgery and corset use in the past four weeks were included in the
study. Sociodemographic characteristics of the patients were recorded.
Patients were randomized into 2 groups by using sealed envelope randomization
method. Nonsteroid anti-inflammatory drug (NSAID)+exercise
treatment regiment was applied for one group and
NSAID+exercise+lumbar corset for the other group. Lumbar joint range
of motion measurement, pain level and functional evaluation were performed
before the treatment and on the 10th and 30th day of the treatment.
Statistical analyses were performed by using SPSS version 20 package
software. Results: In at rest, night and movement visual analog scale
(VAS) scores; increased range of motion in lumbar flexion, extension
and lateral flexion on the 30th day of the treatment was found to be statistically
significantly higher in the corset group than the control group (at
reset VAS p=0.043, night VAS p=0.003, movement VAS p=0.001; lumber
flexion, extension and lateral flexion p=0.000). In the Modified Oswestry
scores, which we used to evaluate functional disability caused by
the low back pain, statistically significant improvement was observed in
the corset group on the 30th day of the treatment when compared against
the control group (p=0.026). Conclusion: Our study results indicate that
including lumbar corset use in the conservative treatment protocol for
acute low back pain patients increases the efficacy of treatment.
Keywords: Acute mechanical low back pain; lomber corset
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