ISSN: 1309 - 3843 E-ISSN: 1307 - 7384
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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
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.
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.
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