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Akut Mekanik Bel Ağrılı Hastalarda Lomber Korse Kullanımının Klinik Değişkenlikler Üzerinde Etkinliği: Randomize Kontrollü Çalışma
The Efficacy of Lumbar Corset Use on Clinical Variability in Patients with Acute Mechanical Low Back Pain: A Randomized Controlled Study
Received Date : 18 Oct 2019
Accepted Date : 13 Dec 2019
Available Online : 01 May 2020
Doi: 10.31609/jpmrs.2019-71921 - Makale Dili: TR
J PMR Sci
ÖZET
Amaç: Akut mekanik kökenli bel ağrılı hastalarda lomber korse tedavisinin hastaların lomber eklem hareket açıklığı, fonsiyonel dizabilite düzeyi, hasta-hekim memnuniyeti ve ağrı düzeyi üzerindeki etkinliğini değerlendirmektir. Gereç ve Yöntemler: Çalışmaya yaş aralığı 18-65 yıl olan, son 4 haftada korse kullanımı, malignite, travma, enfeksiyon ve spinal cerrahi öyküsü bulunmayan akut mekanik kökenli bel ağrılı 52’si kadın, 48’i erkek 100 hasta dâhil edildi. Sosyodemografik özellikler kaydedildi. Hastalar kapalı zarf çekme işlemi uygulanarak 2 gruba randomize edildi. Bir gruba nonsteroid antiinflamatuar ilaçlar (NSAİİ)+egzersiz, diğer gruba NSAİİ+egzersiz+lomber korse tedavisi uygulandı. Tedavi öncesi, tedavinin 10. gününde ve 30. gününde olmak üzere 3 kez lomber eklem hareket açıklığı ölçümü, ağrı düzeyi ve fonksiyonel değerlendirme yapıldı. İstatistiksel analizler SPSS versiyon 20 paket yazılımı kullanılarak yapılmıştır. Bulgular: İstirahat, gece ve hareket vizüel analog skala (VAS) skorlarında, lomber fleksiyon, ekstansiyon ve lateral fleksiyon hareket açıklıklarında artma tedavinin 30. gününde korse grubunda, kontrol grubuna göre istatistiksel olarak anlamlı düzeyde bulundu (istirahat VAS p=0,043 gece VAS p=0,003 hareket VAS p=0,001 lomber fleksiyon, ekstansiyon ve lateral fleksiyon p=0,000). Bel ağrısının yol açtığı fonksiyonel dizabiliteyi değerlendirdiğimiz Modifiye Oswestry skorlarında, tedavinin 30. gününde korse grubunda, kontrol grubuna göre istatistiksel olarak anlamlı bir düzelme gözlendi (p=0,026). Sonuç: Çalışma sonuçlarımız, lomber korse kullanımının akut dönem bel ağrılı hastalarda konservatif tedavi protokolu içerisinde yer almasının tedavi etkinliğini artırdığını göstermektedir.
ABSTRACT
Objective: The purpose of this study was to evaluate the efficacy of lumbar corset treatment on the range of motion of the lumbar joint, functional disability level, patient-physician satisfaction and pain level in patients with acute mechanical low back pain. Material and Methods: Total of 100 patients, 52 female and 48 male, between 18-65 years of age and without any history of malignancy, trauma, infection, spinal surgery and corset use in the past four weeks were included in the study. Sociodemographic characteristics of the patients were recorded. Patients were randomized into 2 groups by using sealed envelope randomization method. Nonsteroid anti-inflammatory drug (NSAID)+exercise treatment regiment was applied for one group and NSAID+exercise+lumbar corset for the other group. Lumbar joint range of motion measurement, pain level and functional evaluation were performed before the treatment and on the 10th and 30th day of the treatment. Statistical analyses were performed by using SPSS version 20 package software. Results: In at rest, night and movement visual analog scale (VAS) scores; increased range of motion in lumbar flexion, extension and lateral flexion on the 30th day of the treatment was found to be statistically significantly higher in the corset group than the control group (at reset VAS p=0.043, night VAS p=0.003, movement VAS p=0.001; lumber flexion, extension and lateral flexion p=0.000). In the Modified Oswestry scores, which we used to evaluate functional disability caused by the low back pain, statistically significant improvement was observed in the corset group on the 30th day of the treatment when compared against the control group (p=0.026). Conclusion: Our study results indicate that including lumbar corset use in the conservative treatment protocol for acute low back pain patients increases the efficacy of treatment.
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