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ORIJINAL ARAŞTIRMA

Kompleks Bölgesel Ağrı Sendromunda Medikal ve Fizik Tedavi Kombinasyonunun Sonucu
The Result of Combination of Medical and Physical Therapy in Complex Regional Pain Syndrome
Received Date : 29 Jan 2021
Accepted Date : 05 Jul 2021
Available Online : 09 Jul 2021
Doi: 10.31609/jpmrs.2021-81791 - Makale Dili: EN - Medline No: J PMR SCI
J PMR Sci. 2021;24(3):251-9
ÖZET
Amaç: Kompleks bölgesel ağrı sendromu (KBAS), diğer kronik ağrı durumlarından, ağrılı bölgedeki otonom ve inflamatuar değişiklikleri temsil eden işaretlerin varlığı ile ayrılır. Tedavisinde farmakolojik, fizik tedavi, mesleki ve psikolojik tedavilerin kombinasyonunu içeren multidisipliner bir yaklaşımı gerektirir. Bu nedenle bu çalışmanın amacı, KBAS Tip 1 hastalarında kombine medikal ve fizik tedavinin iyileşme sürecine etkisini değerlendirmektir. Gereç ve Yöntemler: KBAS Tip 1’e sahip olan 75 hasta (40 kadın, 35 erkek) retrospektif olarak toplandı. Tüm hastalara medikal ve fizik tedavi verilmişti. Tedavilerden önce ve tedavilerden 1 ve 3 ay sonraki hastaların sağlık durumu (çok iyi, iyi, orta, kötü, çok kötü) ile vizüel analog skala (VAS) değerleri geriye yönelik tıbbi kayıtlardan toplandı. Bulgular: Hastaların ortalama yaşı 54,47±11,30 yıl idi. Tedaviden önce ve tedaviden 1 ve 3 ay sonraki VAS skorları sırasıyla 8,59±0,50, 0,49±0,50 ve 0,49±0,50 idi. Tedaviden sonraki 1. ve 3. aydaki VAS skorları, başlangıçtaki VAS düzeyine kıyasla istatistiksel olarak anlamlı derecede azalmıştı (p<0,001). Tedaviden önce ve tedaviden sonraki 3 ay içindeki sağlık durumu arasında da istatistiksel olarak anlamlı fark vardı (p<0,001). Sonuç: KBAS’ın arkasındaki patofizyoloji açısından daha çok hedefe yönelik tedavilerin belirlenmesi gerekmektedir. KBAS'ın karmaşık patolojik mekanizması ve genellikle zayıflatıcı seyri ve tedaviye dirençli yapısı nedeniyle multidisipliner bir yaklaşım daha iyi sonuçlar sağlayabilir. Ayrıca erken ve uygun tedavi, sendromun çözülmesine ve uzun süreli ağrının, fonksiyon kaybının ve sakatlığın önlenmesine yardımcı olabilir.
ABSTRACT
Objective: Complex regional pain syndrome (CRPS) is distinguished from other chronic pain conditions with the existence of indications presenting inflammatory and autonomic changes in the painful area. The treatment contains a multidisciplinary approach covering a combination of pharmacological, physical, occupational, and psychological therapies. Therefore, the purpose of the trial is to evaluate the impact of combination of medical and physical therapy on the recovery process in patients with CRPS Type 1. Material and Methods: 75 patients (40 female, 35 male) with CRPS Type 1 were retrospectively collected. All patients were treated with medical and physical therapy. The state of health (very good, good, moderate, bad, very bad) and visual analog scale (VAS) before the treatments, 1 and 3 months after the treatments were collected from medical records. Results: In the study, the average age of patients was 54.47±11.30 years. VAS scores in the baseline, 1 and 3 months after the treatments were 8.59±0.50, 0.49±0.50, and 0.49±0.50, respectively. VAS in 1 and 3 months following the therapies statistically significantly reduced according to baseline (p<0.001). There was a statistically significant difference in health status 3 months after treatment compared to baseline (p<0.001). Conclusion: More targeted therapies should be determined in terms of the pathophysiology behind CRPS. Because of the complex pathological mechanism and often debilitating course and treatmentresistant nature of CRPS, a multidisciplinary approach may provide better results. Moreover, early and appropriate treatment can help resolve the syndrome and prevent prolonged pain, loss of function, and disability.
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