ISSN: 1309 - 3843 E-ISSN: 1307 - 7384
FİZİKSEL TIP VE REHABİLİTASYON
BİLİMLERİ DERGİSİ
www.jpmrs.com
Kayıtlı İndexler


ORIJINAL ARAŞTIRMA

Serebral Palsili Çocukların Annelerinde Ağrı ve Fonksiyonel Kapasiteye Yönelik Eğitim ve Egzersiz Programının Bel Ağrısına Etkisi
Effects of Education and Exercise Program for Pain and Functional Capacity on Low Back Pain in Mothers of Children with Cerebral Palsy
Received Date : 28 Oct 2020
Accepted Date : 07 Feb 2021
Available Online : 13 Feb 2021
Doi: 10.31609/jpmrs.2020-79134 - Makale Dili: EN
J PMR Sci. 2021;24(2):107-13
ÖZET
lerinde bel ağrısı sıklığını ve bel ağrısı olanlarda eğitim ve egzersiz programlarının fonksiyonel kapasite ve ağrı üzerine etkilerini değerlendirmektir. Gereç ve Yöntemler: Çalışmaya, SP’li 164 çocuğun anneleri dâhil edildi. SP şiddetini sınıflandırmak için Kaba Motor Fonksiyon Sınıflandırma Sistemi kullanıldı. Annelere Nottingham Sağlık Profili ve Beck Depresyon Envanteri uygulandı. Bel ağrısı şiddeti Sayısal Derecelendirme Ölçeği (SDÖ) (0-10) ile değerlendirildi. Bel ağrısı olanlara Oswesty Disabilite İndeksi (ODİ) ve Leeds Nöropatik Semptom ve Bulgu Değerlendirmesi uygulandı. Bel ağrısı olan annelere bel koruma teknikleri ve egzersiz içeren eğitim programı verildi. Bu olgular, 3 ay sonra Sayısal Derecelendirme Ölçeği ve ODİ ile tekrar değerlendirildi. Bulgular: Yüz altmış dört annenin 78'inde bel ağrısı vardı. Bel ağrısı olan annelerde, NSP ağrı, uyku ve fiziksel aktivite skorları istatistiksel olarak daha yüksekti (p=0,001, p=0,049, p=0,001). Önerilere uyan ve egzersiz yapan 68 olgunun, başlangıç ve 3 ay sonra SDÖ ve ODİ puanları karşılaştırıldı. Üçüncü ayda SDÖ ve ODİ skorlarında anlamlı düzelme saptandı (sırasıyla p<0,001, p<0,001). Sonuç: SP'li çocukların annelerinde, bel ağrısı görülme sıklığı yüksektir. Anneler, eğitim ve uygun egzersiz programından yararlanır, fonksiyonel sınırlılıkları azalır ve yaşam kaliteleri artar.
ABSTRACT
Objective: Aim of this cross-sectional study is to evaluate low back pain (LBP) frequency in mothers of children with cerebral palsy (CP) and effects of education and exercise programs on functional capacity and pain in those with LBP. Material and Methods: Mothers of 164 children with CP were included in the study. Gross Motor Function Classification System was used to classify severity of CP. Nottingham Health Profile (NHP) and Beck Depression Inventory were applied to all of the mothers. Severity of LBP was assessed with NRS (Numeric Rating Scale) (0-10). Oswestry Disability Index (ODI) and Leeds Assessment of Neuropathic Symptoms and Signs were applied to the cases with LBP. Low back protection tecniques and education programme including exercises were given to mothers with LBP.Three months later, these cases were assessed again with NRS and ODI. Results: Seventy eight of 164 mothers had low back pain. NHP pain, NHP sleep and NHP physical activity scores were statistically higher in mothers with LBP (p=0.001, p=0.049, p=0.001, respectively). NRS and ODI scores of the 68 cases who followed the recomendations and exercised were compared at baseline and 3 months later. There was a significant improvement in NRS and ODI scores in the third month (p<0.001, p<0.001, respectively). Conclusion: LBP prevelance is high in mothers of children with CP. Mothers benefit from an education and proper exercise program, their functional limitations decrease and quality of life improves.
REFERENCES
  1. Krismer M, van Tulder M. Low Back Pain Group of the Bone and Joint Health Strategies for Europe Project. Strategies for prevention and management of musculoskeletal conditions. Low back pain (non-specific). Best Pract Res Clin Rheumatol. 2007;21:77-91. [Crossref]  [PubMed] 
  2. Loney PL, Stratford PW. The prevalence of low back pain in adults: a methodological review of the literature. Phys Ther. 1999;79:384-96. [Crossref]  [PubMed] 
  3. Fritz JM, George S. The use of a classification approach to identify subgroups of patients with acute low back pain. Interrater reliability and short-term treatment outcomes. Spine (Phila Pa 1976). 2000;25:106-14. [Crossref]  [PubMed] 
  4. Magee DJ. Lumbar Spine. Orthopedic Physical Assessment. 6th ed. Philadelphia: Saunders Company; 2014. p.555-62.
  5. Emel ÖY. Bel Ağrısı. Fiziksel Tıp ve Rehabilitasyon. Beyazova M, Gökçe KY, editörler. 1. Baskı. Ankara: Güneş Kitabevi; 2000. p. 1465-83.
  6. Rosenbaum P, Paneth N, Leviton A, et al. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl. 2007;109:8-14. Erratum in: Dev Med Child Neurol. 2007;49:480. [PubMed] 
  7. Sharan D, Ajeesh PS, Rameshkumar R, et al. Musculoskeletal disorders in caregivers of children with cerebral palsy following a multilevel surgery. Work. 2012;41:1891-5. [Crossref]  [PubMed] 
  8. Tong HC, Haig AJ, Nelson VS, et al. Low back pain in adult female caregivers of children with physical disabilities. Arch Pediatr Adolesc Med. 2003;157:1128-33. [Crossref]  [PubMed] 
  9. Ozguler A, Leclerc A, Landre MF, et al. Individual and occupational determinants of low back pain according to various definitions of low back pain. J Epidemiol Community Health. 2000;54:215-20. [Crossref]  [PubMed]  [PMC] 
  10. Terzi R, Tan G. Musculoskeletal system pain and related factors in mothers of children with cerebral palsy. Agri. 2016;28:18-24. [Crossref]  [PubMed] 
  11. Palisano RJ, Hanna SE, Rosenbaum PL, et al. Validation of a model of gross motor function for children with cerebral palsy. Phys Ther. 2000;80:974-85. [Crossref]  [PubMed] 
  12. Jensen MP, Karoly P, Braver S. The measurement of clinical pain intensity: a comparison of six methods. Pain. 1986;27:117-26. [Crossref]  [PubMed] 
  13. Küçükdeveci A, Kutlay Ş, Gürsel Y, et al. Adaptation on NPH for use in Turkey. The 8 World congress of international rehabilitation med. Ass. Abstract book. Kyoto; 1997. p. 373.
  14. Badia X, Alonso J, Brosa M, et al. Reliability of the Spanish Version of the Nottingham Health Profile in Patients with Stable Renal Disease. Social Science and Medicine.1994;38:153-8. [Crossref] 
  15. Hisli N. Beck Depresyon Envanterinin üniversite öğrencileri için geçerliliği, güvenirliği. Psikoloji Dergisi. 1989;7:3-13. [Link] 
  16. Fairbank JC, Couper J, Davies JB, et al. The Oswestry low back pain disability questionnaire. Physiotherapy. 1980;66:271-3. [Crossref]  [PubMed] 
  17. Duruöz MT, Özcan E, Ketenci A, et al. Cross cultural validation of the revised Oswestry pain questionnaire in a Turkish population. Arthritis δ Rheumatism. 1999;42:1200. [Link] 
  18. Yucel A, Senocak M, Kocasoy Orhan E, et al. Results of the Leeds assessment of neuropathic symptoms and signs pain scale in Turkey: a validation study. J Pain. 2004;5:427-32. [Crossref]  [PubMed] 
  19. Pakbaz M, Hosseini MA, Aemmi SZ, et al. Effectiveness of the back school program on the low back pain and functional disability of Iranian nurse. J Exerc Rehabil. 2019;15:134-138. [Crossref]  [PubMed]  [PMC] 
  20. Kaya K, Unsal-Delialioglu S, Ordu-Gokkaya NK, et al. Musculo-skeletal pain, quality of life and depression in mothers of children with cerebral palsy. Disabil Rehabil. 2010;32:1666-72. [Crossref]  [PubMed] 
  21. Radat F, Margot-Duclot A, Attal N. Psychiatric co-morbidities in patients with chronic peripheral neuropathic pain: a multicentre cohort study. Eur J Pain. 2013;17:1547-57. [Crossref]  [PubMed] 
  22. Yazıcı K, Tot Ş, Biçer A, et al. Bel ve boyun hastalarında anksiyete, depresyon ve yaşam kalitesi [Anxiety, depression and quality of life in patients with lowback pain and neck pair]. Klinik Psikiyatri Dergisi. 2003;6:95-101. [Link] 
  23. Al-Windi A. The relations between symptoms, somatic and psychiatric conditions, life satisfaction and perceived health. A primary care based study. Health Qual Life Outcomes. 2005;3:28. [Crossref]  [PubMed]  [PMC] 
  24. Pincus T, Burton AK, Vogel S, et al. A systematic review of psychological factors as predictors of chronicity/disability in prospective cohorts of low back pain. Spine (Phila Pa 1976). 2002;27:E109-20. [Crossref]  [PubMed] 
  25. Haliloğlu S, İçağasıoğlu A, Çarlıoğlu A, et al. Kronik Bel ağrısı nöropatik ağrı komponenti. Yeni Tıp Dergisi. 2013;30:148-51. [Link] 
  26. Cherif F, Zouari HG, Cherif W, et al. Depression Prevalence in Neuropathic Pain and Its Impact on the Quality of Life. Pain Res Manag. 2020;2020:7408508. [Crossref]  [PubMed]  [PMC] 
  27. Ones K, Yilmaz E, Cetinkaya B, et al. Assessment of the quality of life of mothers of children with cerebral palsy (primary caregivers). Neurorehabil Neural Repair. 2005;19:232-7. [Crossref]  [PubMed] 
  28. van Baar ME, Dekker J, Bosveld W. A survey of physical therapy goals and interventions for patients with back and knee pain. Phys Ther. 1998;78:33-42. [Crossref]  [PubMed] 
  29. van Tulder MW, Koes BW, Bouter LM. Conservative treatment of acute and chronic nonspecific low back pain. A systematic review of randomized controlled trials of the most common interventions. Spine (Phila Pa 1976). 1997;22:2128-56. [Crossref]  [PubMed] 
  30. Tavafian SS, Jamshidi AR, Montazeri A. A randomized study of back school in women with chronic low back pain: quality of life at three, six, and twelve months follow-up. Spine (Phila Pa 1976). 2008;33:1617-21. [Crossref]  [PubMed] 
  31. Sahin N, Albayrak I, Durmus B, et al. Effectiveness of back school for treatment of pain and functional disability in patients with chronic low back pain: a randomized controlled trial. J Rehabil Med. 2011;43:224-9. [Crossref]  [PubMed] 
  32. Hicks GE, Fritz JM, Delitto A, et al. Preliminary development of a clinical prediction rule for determining which patients with low back pain will respond to a stabilization exercise program. Arch Phys Med Rehabil. 2005;86:1753-62. [Crossref]  [PubMed]