ORIJINAL ARAŞTIRMA
İnmeli Hastalarda İş-uğraşı Terapisinin Üst Ekstremite Fonksiyonu ve Günlük Yaşam Aktiviteleri Üzerine Etkisi
The Effect of Occupational Therapy on Upper Extremity Function and Daily Life Activities in Stroke Patients
Received Date : 24 Mar 2021
Accepted Date : 08 Aug 2021
Available Online : 18 Jun 2021
Merve AYDİLEKa, Mustafa Fatih YAŞARb, Elif YAKŞİb
aClinic of Physical Therapy and Rehabilitation, Karasu State Hospital, Sakarya, TURKEY
bDepartment of Physical Therapy and Rehabilitation, Bolu Abant İzzet Baysal University Faculty of Medicine, Bolu, TURKEY
Doi: 10.31609/jpmrs.2021-83304 - Makale Dili: EN
J PMR Sci. 2022;25(1):27-33
ÖZET
Amaç: Bu çalışmanın amacı, hemiplejik hastalarda standart rehabilitasyon
tedavilerine eklenen iş-uğraşı tedavisinin günlük yaşam aktiviteleri
ve üst ekstremite fonksiyonları üzerine etkinliğini araştırmaktır. Gereç
ve Yöntemler: Bu çalışma, Bolu Abant İzzet Baysal Üniversitesi Fizik Tedavi
ve Rehabilitasyon Hastanesine başvuran ve serebrovasküler olay nedeniyle
hemipleji gelişen, 20-80 yaşları arasındaki hastalar üzerinde
gerçekleştirildi. Çalışma prospektif, randomize ve kontrollü bir klinik çalışma
olarak planlandı. Çalışmaya inme sonrası hemipleji tanısı olan 50
hasta dâhil edildi. Hastalar 2 gruba ayrıldı. Birinci gruptaki hastalara standart
rehabilitasyon (6 hafta süresince haftada 5 gün) ve ayrıca iş-uğraşı tedavisi
(6 hafta süresince haftada 3 gün, günde 45 dk) uygulandı. İkinci
grupta olan hastalara yalnızca standart rehabilitasyon uygulandı. Tüm hastalar
tedavi öncesi ve tedavi sonrası olmak üzere değerlendirildi. Tedavi etkinliğini
değerlendirmek için Barthel İndeksi (Bİ), Fugl-Meyer Motor
Değerlendirme (FMD) Ölçeği ve Action Research Arm Test (ARAT) kullanıldı.
Bulgular: Hem tedavi hem de kontrol grubunda bulunan hastaların
tedavi öncesine göre Bİ, FMD Ölçeği ve ARAT skorlarında istatistiksel olarak
anlamlı artış olduğu görüldü. FMD Ölçeği ve ARAT skorlarının tedavi
öncesi ve sonrası gruplar arası karşılaştırmasında istatistiksel olarak anlamlı
farklılık saptandı. Bİ skorları ise gruplar arasında anlamlı farklılık göstermedi.
Sonuç: Standart rehabilitasyon uygulamalarına eklenen iş uğraşı tedavilerinin
üst ekstremite motor fonksiyonlarının gelişmesine katkısı
olduğunu saptadık.
Anahtar Kelimeler: Günlük yaşam aktiviteleri; inme rehabilitasyonu; iş-uğraşı tedavisi
ABSTRACT
Objective: This study aims to assess the effectiveness of occupational
therapy (OT) added to standard rehabilitation treatments on hemiplegic
stroke patients' daily life activities and upper extremity functions.
Material and Methods: This prospective, randomized, controlled clinical
study included 50 patients aged between 20 and 80 who had suffered a
stroke and developed hemiplegia due to cerebrovascular accident and applied
to Bolu Abant İzzet Baysal University Physical Therapy and Rehabilitation
Hospital. The study patients were divided into two groups: an OT
[treatment] group receiving standard rehabilitation (five days a week for six
weeks) and OT (three days a week for six weeks, 45 minutes per day) and
a standard treatment (ST) [control] group receiving standard rehabilitation
only. All patients were evaluated before (at initial) and after the treatment
(at the end of the 6-week treatment). The Barthel Index (BI), Fugl-Meyer
Assessment of Motor Recovery (FMA) Scale, and Action Research Arm
Test (ARAT) were used to investigate treatment effectiveness. Results:
There was a significant increase in the post-treatment (at the end of the 6-
week treatment) BI, FMA Scale, and ARAT scores in both OT and ST
groups compared to the pre-treatment (at initial) scores. The FMA scale and
ARAT scores significantly differed between groups 6 weeks after the treatment;
the post-treatment ARAT and FMA scale scores were statistically significantly
higher in the OT group than in the ST group. No significant
difference was found between the groups in pre-treatment and post-treatment
BI scores. Conclusion: The present study revealed that occupational
therapies added to the standard rehabilitation practices contribute to developing
motor functions of the upper extremity in hemiplegic stroke patients.
Keywords: Activities of daily living; stroke rehabilitation; occupational therapy
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