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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
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 (p0,05). 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.
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.
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