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ORIJINAL ARAŞTIRMA

İnmeli Hastalarda İş-uğraşı Terapisinin Üst Ekstremite Fonksiyonu ve Günlük Yaşam Aktiviteleri Üzerine Etkisi
The Effect of Occupational Therapy on Upper Extremity Function and Daily Life Activities in Stroke Patients
Received Date : 24 Mar 2021
Accepted Date : 08 Aug 2021
Available Online : 18 Jun 2021
Doi: 10.31609/jpmrs.2021-83304 - Makale Dili: EN
J PMR Sci. 2022;25(1):27-33
ÖZET
Amaç: Bu çalışmanın amacı, hemiplejik hastalarda standart rehabilitasyon tedavilerine eklenen iş-uğraşı tedavisinin günlük yaşam aktiviteleri ve üst ekstremite fonksiyonları üzerine etkinliğini araştırmaktır. Gereç ve Yöntemler: Bu çalışma, Bolu Abant İzzet Baysal Üniversitesi Fizik Tedavi ve Rehabilitasyon Hastanesine başvuran ve serebrovasküler olay nedeniyle hemipleji gelişen, 20-80 yaşları arasındaki hastalar üzerinde gerçekleştirildi. Çalışma prospektif, randomize ve kontrollü bir klinik çalışma olarak planlandı. Çalışmaya inme sonrası hemipleji tanısı olan 50 hasta dâhil edildi. Hastalar 2 gruba ayrıldı. Birinci gruptaki hastalara standart rehabilitasyon (6 hafta süresince haftada 5 gün) ve ayrıca iş-uğraşı tedavisi (6 hafta süresince haftada 3 gün, günde 45 dk) uygulandı. İkinci grupta olan hastalara yalnızca standart rehabilitasyon uygulandı. Tüm hastalar tedavi öncesi ve tedavi sonrası olmak üzere değerlendirildi. Tedavi etkinliğini değerlendirmek için Barthel İndeksi (Bİ), Fugl-Meyer Motor Değerlendirme (FMD) Ölçeği ve Action Research Arm Test (ARAT) kullanıldı. Bulgular: Hem tedavi hem de kontrol grubunda bulunan hastaların tedavi öncesine göre Bİ, FMD Ölçeği ve ARAT skorlarında istatistiksel olarak anlamlı artış olduğu görüldü. FMD Ölçeği ve ARAT skorlarının tedavi öncesi ve sonrası gruplar arası karşılaştırmasında istatistiksel olarak anlamlı farklılık saptandı. Bİ skorları ise gruplar arasında anlamlı farklılık göstermedi. Sonuç: Standart rehabilitasyon uygulamalarına eklenen iş uğraşı tedavilerinin üst ekstremite motor fonksiyonlarının gelişmesine katkısı olduğunu saptadık.
ABSTRACT
Objective: This study aims to assess the effectiveness of occupational therapy (OT) added to standard rehabilitation treatments on hemiplegic stroke patients' daily life activities and upper extremity functions. Material and Methods: This prospective, randomized, controlled clinical study included 50 patients aged between 20 and 80 who had suffered a stroke and developed hemiplegia due to cerebrovascular accident and applied to Bolu Abant İzzet Baysal University Physical Therapy and Rehabilitation Hospital. The study patients were divided into two groups: an OT [treatment] group receiving standard rehabilitation (five days a week for six weeks) and OT (three days a week for six weeks, 45 minutes per day) and a standard treatment (ST) [control] group receiving standard rehabilitation only. All patients were evaluated before (at initial) and after the treatment (at the end of the 6-week treatment). The Barthel Index (BI), Fugl-Meyer Assessment of Motor Recovery (FMA) Scale, and Action Research Arm Test (ARAT) were used to investigate treatment effectiveness. Results: There was a significant increase in the post-treatment (at the end of the 6- week treatment) BI, FMA Scale, and ARAT scores in both OT and ST groups compared to the pre-treatment (at initial) scores. The FMA scale and ARAT scores significantly differed between groups 6 weeks after the treatment; the post-treatment ARAT and FMA scale scores were statistically significantly higher in the OT group than in the ST group. No significant difference was found between the groups in pre-treatment and post-treatment BI scores. Conclusion: The present study revealed that occupational therapies added to the standard rehabilitation practices contribute to developing motor functions of the upper extremity in hemiplegic stroke patients.
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