ORIJINAL ARAŞTIRMA
Kompleks Bölgesel Ağrı Sendromlu Hastaların Demografik ve Klinik Özellikleri: Üçüncü Basamak Tecrübesi
The Demographic and Clinical Characteristics of the Patients with Complex Regional Pain Syndrome: A Tertiary Clinic Experience
Received Date : 07 Nov 2019
Accepted Date : 18 Feb 2020
Available Online : 20 Feb 2020
Nurdan YILMAZa, Osman DEMİRb
aDepartment of Physical Therapy and Rehabilitation, Tokat Gaziosmanpasa University Faculty of Medicine, Tokat, TURKEY
bDepartment of Biostatistics, Tokat Gaziosmanpasa University Faculty of Medicine, Tokat, TURKEY
Doi: 10.31609/jpmrs.2019-72270 - Makale Dili: EN
J PMR Sci. 2020;23(3):152-7
ÖZET
Amaç: Bu çalışmanın amacı, kompleks bölgesel ağrı sendromlu
(KBAS) hastaların demografik ve klinik özelliklerini belirleyerek
KBAS’ın epidemiyolojik özelliklerini açığa çıkarmaktır. Gereç ve
Yöntemler: Çalışmaya, Ocak 2010 ve Aralık 2018 tarihleri arasında
kliniğimizce takip edilen KBAS tanılı 88 hasta dahil edildi. Hastalar
retrospektif olarak demografik özellikler, semptom karakteristikleri
(duyusal, vazomotor, sudomotor/ödem ve motor/trofik), tutulan ekstremite
ve etkilenen taraf, etyolojik faktörler (ortopedik cerrahi öyküsü,
yumuşak doku travması, inme, immobilizasyon, alçı kullanımı), olası
risk faktörleri (sigara kullanımı, menopoz, migren, osteoporoz, astım ve
anksiyete bozukluğu) ve kullanılan tedavi yöntemleri açısından değerlendirildi.
Bulgular: Yaş ortalaması 51,14±15,25 yıl (min: 18, maks:
82) idi. Hastaların %60,2 (n: 53)’sinde üst ekstremite tutulumu vardı
ancak etkilenen taraf açısından istatistiksel olarak anlamlı bir fark yoktu
(p: 0,754). Yumuşak doku travmaları her iki cinsiyette de etyolojideki
en sık faktördü. Hastalar en fazla duyusal semptomlar ile başvurmuşlardı.
Kadınlarda belirlenen en sık risk faktörü menopoz iken erkeklerde
ise sigara kullanımı idi. Hastaların %56,8 (n: 50)’inde alçıda
kalma öyküsü varken ortalama alçıda kalma süresi 41,60±11,33 gün
(min: 20 gün; maks: 70 gün) idi. Hastaların %63.6 (n: 56)’sı fizik tedavi
programına alınırken; ortalama seans sayısı 33,42±10,70 (min: 20
seans; maks: 60 seans) idi. Alçıda kalma süresi ile fizik tedavi seans
sayısı arasında istatistiksel olarak anlamlı pozitif bir korelasyon var idi
(r: 0,571, p<0,001). Sonuç: Çalışmamızın sonuçları KBAS’ ın, her iki
cinsiyeti ve farklı yaş gruplarını etkileyebilen bir hastalık olduğunu, üst
ekstremitenin alt ekstremiteye göre daha fazla etkilendiğini; etyolojide
belirlenen en sık etkenin yumuşak doku travmaları olduğunu göstermektedir.
Kadınlarda menopoz, erkeklerde ise sigara kullanımı belirlenen
en sık iki risk faktörü idi. Hastalığın epidemiyolojik özelliklerinin
belirlenerek riskli hastaların öngörülebilmesi, erken tanı ve tedaviyi
mümkün kılacaktır.
Anahtar Kelimeler: Kompleks bölgesel ağrı sendromu, fizik tedavi, rehabilitasyon, sakatlık
ABSTRACT
Objective: The aim of our study was to determine the
demographic and clinical characteristics of the patients with complex
regional pain syndrome (CRPS) and to reveal the epidemiological
features of CRPS. Material and Methods: Eighty-eight patients
with CRPS, admitting to our clinic between January 2010 and December
2018 were included in the study. Patients were evaluated retrospectively
in terms of demographics, symptom characteristics
(sensory, vasomotor, sudomotor/edema and motor/trophic), involved
extremity and side; etiological factors (orthopedic surgery history,
soft tissue trauma, stroke, immobilization, cast using), possible risk
factors (smoking, menopause, migraine, osteoporosis, asthma and
anxiety disorders) and used therapeutic modalities. Results: Mean
age of the patients was 51.14±15.25 years (min:18, max: 82). In
60.2% (n: 53) of the patients, upper extremity was involved but there
was no statistically significant difference in terms of the involved side
(p: 0.754). Soft tissue traumas were the most common factor in etiology
in both genders. Most of the patients presented with sensory
symptoms. The most common risk factor was menopause in females
and smoking in males. Fifty patients (56.8%) had a history of cast
using and the mean duration of cast using was 41.60±11.33 days (min:
20 days; max: 70 days). While 63.6% (n: 56) of the patients were included
in a physical therapy program; the mean number of the physical
therapy sessions was 33.42±10.70 (min: 20 sessions; max: 60
sessions). There was a statistically significant positive correlation between
the duration of cast using and the number of physical therapy
sessions (r: 0.571, p <0.001). Conclusion: The results of our study
suggest that CRPS can affect both genders and different age groups,
and that the upper extremity is involved more than the lower extremity.
The most common etiological factor is soft tissue traumas.
Menopause in females and smoking in males were the two most common
risk factors. The determination of the epidemiological characteristics
of the patients with CRPS will enable to predict the risky
patients and early diagnosis and treatment of the disease.
Keywords: Complex regional pain syndrome; physical therapy; rehabilitation, disability
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