ORIJINAL ARAŞTIRMA
Servikal Miyofasiyal Ağrı Sendromlu Hastalarda Servikal Spinal Lordozun Kuru İğneleme Uygulamasının Etkinliği Üzerindeki Etkisinin Araştırılması
Investigation of the Effect of Cervical Spinal Lordosis on the Effectiveness of Dry Needling in Patients with Cervical Myofascial Pain Syndrome
Received Date : 07 May 2021
Accepted Date : 24 Sep 2021
Available Online : 04 Oct 2021
Serdar KILINÇa
aBolu Abant İzzet Baysal Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon ABD, Bolu, TÜRKİYE
Doi: 10.31609/jpmrs.2021-84337 - Makale Dili: TR
J PMR Sci. 2022;25(1):82-8
ÖZET
Amaç: Farklı servikal spinal lordoz açılarına sahip servikal miyofasiyal
ağrı sendromlu (MAS) hastalarda uygulanan kuru iğneleme
tedavisinin etkinliğinin retrospektif olarak karşılaştırılması amaçlanmıştır.
Gereç ve Yöntemler: Servikal MAS nedeniyle kuru iğneleme
uygulanmış 20-70 yaş aralığındaki 66 hasta çalışmaya alındı. Hastalar,
servikal spinal lordoz açılarına göre 2 gruba ayrıldı. 18,55° üstünde açıya
sahip hastalar, lordotik gruba (n=33), altındakiler nonlordotik gruba
(n=33) dâhil edildi. Bilateral olarak üst trapezius kasındaki 2 aktif tetik
nokta bölgesine, tek seans olacak şekilde derin kuru iğneleme uygulandı.
Hastalar ağrı için vizüel analog skala (VAS), disabilite için Boyun Özürlülük
İndeksi [Neck Disability Index (NDI)] ile tedavi öncesi, tedavi
sonrası 1 ve 3. ayda değerlendirildi. Elde edilen veriler; Kolmogorov-
Smirnov testi, Student t-testi, Friedman analizi, Wilcoxon testi ve Mann-
Whitney U testi ile analiz edildi (p0,05). Bulgular: Her iki grupta da 1
ve 3. ayda yapılan kontrollerde, VAS ve NDI skorlarında tedavi öncesi
duruma göre anlamlı iyileşmeler tespit edildi (p<0,05). Gruplar arasında
1 ve 3. ayda VAS ve NDI skorları açısından yapılan karşılaştırmada anlamlı
bir fark gözlenmedi. Sonuç: Servikal MAS’a sahip hastalarda,
tetik noktanın derin kuru iğneleme yöntemi tedavisiyle, lordotik ve nonlordotik
gruplarda kısa dönem takiplerde VAS ve NDI skorlarında anlamlı
iyileşmeler tespit edilmiştir. Fakat gruplar arasında etkinlik
açısından anlamlı bir fark bulunmamıştır. Servikal lordoz açısının lordotik
veya nonlordotik olma durumunun, kuru iğnelemenin ağrı ve disabilite
üzerindeki etkisi açısından anlamlı fark yaratmadığı
görülmüştür. Servikal MAS’a sahip hastalarda, nonfarmakolojik tedavi
stratejisi olarak kuru iğneleme tedavisinin seçilmesinde, servikal lordoz
açı durumunun öncelik oluşturmadığı sonucuna varılmıştır.
Anahtar Kelimeler: Servikal miyofasiyal ağrı sendromu; servikal spinal lordoz; kuru iğneleme; disabilite; tetik nokta
ABSTRACT
Objective: It was aimed to compare the effectiveness of
dry needling treatment retrospectively in patients with cervical myofascial
pain syndrome (MPS) with different angles of cervical spinal lordosis.
Material and Methods: Sixty-six patients, between 20 and 70 years of
age, who underwent dry needling for cervical MPS were included in the
study. Patients were divided into 2 groups according to their cervical spinal
lordosis angles. Patients with an angle above 18.55° were included in the
lordotic group (n=33) and those below were included in the non-lordotic
group (n=33). Deep dry needling was applied to 2 active trigger points in
the upper trapezius muscle bilaterally in a single session. Patients were
evaluated with visual analogue scale (VAS) for pain and Neck Disability
Index (NDI) for disability before treatment, at 1 month and 3 months after
treatment. The data obtained were analyzed using Kolmogorov-Smirnov
test, Student t-test, Friedman analysis, Wilcoxon test and Mann-Whitney
U test (p<0.05). Results: Significant improvements were found in VAS
and NDI scores in the 1st and 3rd month controls in both groups compared
to the pre-treatment situation (p<0.05). No significant difference
was observed between the groups in terms of VAS and NDI scores at the
1st and 3rd months. Conclusion: In patients with cervical MPS, with deep
dry needling treatment of the trigger point, significant improvements in
VAS and NDI scores were detected in the lordotic and non-lordotic groups
during short-term follow-up. However, no significant difference was
found between the groups in terms of effectiveness. It was observed that
the cervical lordosis angle being lordotic or nonlordotic did not create a
significant difference in terms of the effect of dry needling on pain and disability.
It has been concluded that the cervical lordosis angle is not a priority
in the selection of dry needling treatment as a non-pharmacological
treatment strategy in patients with cervical MPS.
Keywords: Cervical myofascial pain syndrome; cervical spinal lordosis; dry needling; disability; trigger point
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