ORIJINAL ARAŞTIRMA
Miyofasiyal Tetik Noktalarda Ekstrakorporeal Şok Dalga Tedavisi ve Geleneksel Fizyoterapinin Etkinliğinin Karşılaştırılması
Comparison of the Efficacy of Extracorporeal Shock Wave Therapy and Traditional Physiotherapy in Myofascial Trigger Points
Received Date : 22 Sep 2021
Accepted Date : 01 Feb 2022
Available Online : 09 Feb 2022
Kadir GÜLERa, Hayal GÜLERa, Mustafa Turgut YILDIZGÖRENa, Ayça SEYFETTİNb,
Sinem KARAZİNCİRb, Ayşe Dicle TURHANOĞLUa
aDepartment of Physical Medicine and Rehabilitation, Hatay Mustafa Kemal University Faculty of Medicine, Hatay, TURKIYE
bDepartment of Radiology, Hatay Mustafa Kemal University Faculty of Medicine, Hatay, TURKIYE
Doi: 10.31609/jpmrs.2021-86330 - Makale Dili: EN
J PMR Sci. 2022;25(2):197-204
ÖZET
Amaç: Bu çalışmanın amacı, üst trapez kasındaki miyofasiyal tetik
noktaların tedavisinde radyal-ekstrakorporeal şok dalga tedavisi [radial-extracorporeal
shock wave therapy (r-ESWT)] ve geleneksel fizyoterapinin
(GF) etkinliğini karşılaştırmaktır. Gereç ve Yöntemler: Miyofasiyal tetik
noktaları olan toplam 74 hasta, randomize şekilde ESWT (n=37) ve GF
(n=37) olarak 2 gruba ayrıldı. Her iki grupta 2 hafta tedavi aldı. Çalışmayı
66 (ESWT, n=30; GF, n=36) hasta tamamladı. Boyun ağrısı ve disabilite
Vizüel Analog Skala (VAS), Kol, Omuz ve El Hızlı Engellilik Anketi (QDASH)
ve Nottingham Sağlık Profili (NHP) ile değerlendirildi. Ayrıca tüm
hastaların aktif tetik noktaları shear wave elastografi (SWE) kullanılarak
değerlendirildi. Tüm ölçümler tedaviden önce, tedavi bitiminde (2. hafta)
ve tedavinin tamamlanmasından 1 ay sonra değerlendirildi. Bulgular: Her
iki grupta tedavi sonunda tüm değerlendirme zamanlarında VAS, Q-DASH,
NHP ve SWE skorlarında anlamlı iyileşmeler gözlendi. Gruplar arasında
değişim miktarları karşılaştırıldığında, TP grubunda VAS, Q-DASH ve NHP
puanlarındaki iyileşme ESWT grubuna göre anlamlı olarak daha yüksekti.
SWE’deki değişim miktarı yönünden gruplar arasında anlamlı fark yoktu.
Sonuç: GF, miyofasiyal tetik noktaların tedavisinde ESWT’den daha etkili
görünse de her iki yöntem de ağrıyı azaltmada, fonksiyonu iyileştirmede ve
miyofasiyal tetik noktalarda SWE’yi azaltmada etkilidir.
Anahtar Kelimeler: Ekstrakorporeal şok dalga tedavisi; miyofasiyal tetik nokta; geleneksel fizyoterapi
ABSTRACT
Objective: The main purpose of this study is to compare the
efficacy of radial-extracorporeal shock wave therapy (r-ESWT) and traditional
physiotherapy (TP) in the treatment of myofascial trigger points in
the upper trapezius muscle. Material and Methods: A total of 74 patients
with myofascial trigger points were randomly separated into the ESWT
(n=37) group and the TP (n=37) group. The groups received treatment for
2 weeks. A total of 66 (r-ESWT, n=30; TP, n=36) patients completed the
study. Neck pain and disability were evaluated with Visual Analogue Scale
(VAS), Quick-Disabilities of Arm, Shoulder and Hand Questionnaire (QDASH),
and the Nottingham Health Profile (NHP). Active trigger points
were evaluated using ultrasound shear wave elastography (SWE). All outcome
measurements were assessed before treatment, then at 2 weeks, and 1
month after the completion of the treatment. Results: Significant improvements
of VAS, Q-DASH, NHP, and SWE scores were observed at all time
points after treatment in both treatment groups. When the change levels were
compared between the groups, the decrease in VAS, and the improvement
in Q-DASH and NHP scores were significantly higher in the TP group than
in the ESWT group. There was no significant difference between the groups
in terms of the amount of change in SWE. Conclusion: The both methods
were useful in alleviating pain, improving function, and reducing shear modulus
in myofascial trigger points, although TP seemed to be more effective
than ESWT.
Keywords: Extracorporeal shock wave therapy; myofascial trigger point; traditional physiotherapy
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