ORIJINAL ARAŞTIRMA
Düşük Ayaklı İnmeli Hastalarda Fonksiyonel Elektrik Stimülasyonu ve Denge Ağırlıklı Rehabilitasyon Tedavisinin Etkinliği: Pilot Çalışma
The Efficiency of Functional Electrical Stimulation and Balance-Weighted Rehabilitation Therapy in Stroke Patients with Foot-Drop: A Pilot Study
Received Date : 08 Feb 2021
Accepted Date : 08 Nov 2021
Available Online : 22 Nov 2021
Şükran GÜZELa, Ebru KARACA UMAYb, Erhan Arif ÖZTÜRKb, Aytül ÇAKCIb
aDepartment of Physical Medicine and Rehabilitation, Başkent University Faculty of Medicine, Ankara, TURKEY
bDepartment of Physical Medicine and Rehabilitation, University of Health Science Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, TURKEY
Doi: 10.31609/jpmrs.2021-82149 - Makale Dili: EN
J PMR Sci. 2022;25(1):1-10
ÖZET
Amaç: Düşük ayağı olan inmeli hastalarda, konvansiyonel rehabilitasyon
tedavisine ek olarak fonksiyonel elektrik stimülasyonu
(FES) ve denge ağırlıklı rehabilitasyon uygulanmasının; motor fonksiyon,
ambulasyon, postür, denge, fiziksel yetersizlik, yürüme kalitesi ve
günlük yaşam aktiviteleri üzerine etkilerinin değerlendirilmesi amaçlandı.
Gereç ve Yöntemler: Çalışmaya düşük ayağı olan 35 inmeli hasta alındı.
Hastaların motor fonksiyonları, fonksiyonel dizabiliteleri, ambulasyon
seviyeleri, günlük yaşam aktiviteleri, postürleri, denge ve düşme riskleri
değerlendirildi. Hastaların motor fonksiyonları, Brunnstrom motor evrelemeleri
ile değerlendirildi. Ayrıca fonksiyonel dizabilite Fonksiyonel
Bağımsızlık Ölçeği, yürüyüş performansı Fonksiyonel Ambulasyon Sınıflandırılması,
fonksiyonel denge ve düşme riski Berg Denge Ölçeği ve
Postür Gövde Kontrol Testi ile değerlendirildi. Hastalara 10 m için video
destekli görsel yürüme analizi yapıldı. Salınım ve basma olarak 2 ayrı
fazda inceleme yapıldı. Yürüme hızı (m/sn) ve yürüme ritmi (adım/dk) belirlendi.
Tüm hastalara ortalama 4 hafta süre ile haftada 5 gün olmak üzere
konvansiyonel rehabilitasyon, FES ve denge ağırlıklı rehabilitasyon programı
uygulandı. Tedavinin 2 ve 4. haftasında tekrar değerlendirilme yapıldı
ve bu parametreler karşılaştırıldı. Bulgular: Tekrarlayan ölçümler
arasında; tedavi öncesi ve 4. hafta arasında fonksiyonel dizabilite ile değiştirilmesini,
denge, üst ve alt ekstremite motor fonksiyonları, yürüme
hızı ve ritminde anlamlı olarak iyileşme saptandı. Sonuç: Düşük ayağı
olan inmeli hastalarda konvansiyonel rehabilitasyon programına ek olarak
FES ve denge ağırlıklı rehabilitasyon, fonksiyonel ambulasyonu geliştirerek
günlük yaşam aktivitelerindeki bağımsızlık düzeyini artırdığı
için hemiplejik ayak rehabilitasyonunda etkili bir tedavi yöntemidir.
Anahtar Kelimeler: İnme; düşük ayak; fonksiyonel elektrik stimülasyonu; rehabilitasyon; denge
ABSTRACT
Objective: This study aimed to evaluate the effects of
FES and balance-weighted rehabilitation therapy in addition to conventional
rehabilitation in stroke patients with foot-drop on motor function,
ambulation, posture, balance, physical disability, gait quality and
activities of daily living. Material and Methods: This study included
35 stroke patients with foot-drop. The patients were evaluated in respect
of motor function, activities of daily living posture, balance and
risk of falling. Brunnstrom stages of motor recovery was administered
to assess motor function. The functional disability were assessed by
Functional Independence Measure. Functional Ambulation Category
was used to assess the patients’ gait performance. Berg Balance Scale
was used in functional balance and risk of falling. Posture were assessed
using the Trunk Control Test. Video-assisted visual gait analysis
(VGA) over a distance of 10 m was also applied to patients. The
two gait phases of swing and stance were analysed. Walking speed
(m/sn) and walking rhythm (step/min) were determined. All patients
received conventional rehabilitation, FES and balance-weighted rehabilitation
therapy 5 days a week for 4 weeks. The evaluation parameters
were repeated in weeks 2 and 4 and these parameters were
compared. Results: From the baseline values to the end of week 4, a
significant improvement was determined in respect of functional disability,
balance, upper and lower extremity functions, walking speed
and rhythm. Conclusion: FES and balance-weighted rehabilitation
therapy in addition to conventional rehabilitation is an effective treatment
method for hemiplegic foot rehabilitation as it improves functional
ambulation and increases the level of independence in daily
living activities.
Keywords: Stroke; foot-drop; functional electrical stimulation; rehabilitation; balance
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