3.TRİMESTİRDE GEBELİKLE İLİŞKİLİ BEL AĞRISININ AZALTILMASI, YAŞAM VE UYKU KALİTESİNİ ARTTIRILMASINDA KİNESİO-TERAPİ VE EV EGZERSİZİNİN KARŞILAŞTIRILMASI

Yıl 2018, Cilt: 5 Sayı: 3, 120 - 125, 28.09.2018

İrem Şenyuva Meryem Kösehasanoğulları Nihal Yılmaz Ezel Günay Ali Yavuz Karahan

Öz

Amaç:
Bu çalışmanın amacı gebeliğin 3.
trimestirinde gebelikle ilişkili bel ağrısını azaltması, yaşam ve uyku
kalitesini arttırılmasında Kinesio-terapi ile ev egzersizinin etkinliğinin
karşılaştırılmasıdır.

Yöntem: Retrospektif
olarak kayıtları incelenen gebeliğin 3. trimestirinde bulunan 50 gebe hasta
çalışma grubunu oluşturmuştur. Hastalar 2 gruba ayrılmıştır. Bel ağrısı için
bel bölgesine haftada bir kez 4 hafta boyunca ‘I’ şeklinde Kinesio-terapi
uygulanan hastalar Kinesio-terapi tedavi grubu (KTTG), bel ağrısı için günlük 4
hafta boyunca oturma pozisyonunda ve ayakta pelvik tilt ev egzersiz programı verilen
olgular kontrol grubunu (KG) oluşturmuştur. Her iki
grup hastalar demografik özellikler ve sosyokültürel statü, VAS (Visual
Analog Skala), SF-36(yaşam kalitesi ölçeği), PUKİ (Pittsburgh Uyku Kalite
İndeksi), Oswestry Bel Ağrısı Engellilik Anketi
skorları açısından karşılaştırılmıştır.

Bulgular: VAS
ve SF-36 skor değerleri her iki grup açısından karşılaştırıldığında istatistiksel
olarak anlamlı bulunmamıştır. (P>0,05). PUKİ ve Oswestry skor değerleri kontrol
grubu için istatistiksel olarak anlamlı bulunmuştur. (P<0,05).

Sonuç: Üçüncü
trimestirde gebelikle ilişkili bel ağrısı tedavisinde Kinesio-terapi
uygulamasının bel ağrısını azaltmada, yaşam ve uyku kalitesini arttırmada ev
egzersizine üstünlüğü gösterilememiştir. Bel ağrısı   ve uyku kalitesi üzerine olan etkisi
açısından ev egzersizleri, Kinesio-terapiye  göre üstün bulunmuştur.

COMPARISON OF KINESIO-THERAPY AND
HOME EXERCISE IN REDUCING PREGNANCY RELATED LOW BACK PAIN AND INCREASING
QUALITY OF LIFE AND SLEEP QUALITY in the THIRD TRIMESTER.

Objective: The aim of this
study is to investigate the effect of Kinesio-therapy, which is a non-pharmacological method, versus home
exercises in reducing pregnancy-related low back pain and increasing quality of
life and sleep quality in the third trimester.

Material and Method: As retrospectively fifty pregnant patients examined records were
composed in this study group. Patients were separated into 2 groups. Patients
with ‘I' shape application once a week during 4 weeks as Kinesio-Tape Treatment
Group (KTTG), patients with follow-up by sitting and standing daily
pelvic tilt home exercises during 4 weeks as a control group (CG). Two groups
were compared with demographic features and socio-cultural status, VAS (Visual
Analog Scale), Quality of life scale SF-36 (Short-form 36), PUKI (Pittsburgh
sleep quality index) and Oswestry Disability
Index (ODI).

Results: There
were no significant differences between KTTG and CG in terms of VAS and SF-36
score. (P>0,05). There were significant differences in CG for PUKI and Oswestry
score. (P<0,05).

Conclusion:
Kinesio-Therapy wasn’t more effective than home exercises in terms of reducing pregnancy-related
low back pain and increasing quality of life and sleep quality. But, home
exercises were more effective than Kinesio-Therapy in terms of low back pain
and sleep quality in the third-trimester pregnancy-related low back pain.

Anahtar Kelimeler

gebelik, kinesio-terapi, bel ağrısı, egzersiz, , pregnancy, low back pain, kinesio-therapy

Kaynakça

• 1-Casagrande D, Gugala Z, Clark SM, Lindsey RW. - Low Back Pain and Pelvic Girdle Pain in Pregnancy.J Am Acad Orthop Surg 2015;23(9):539-49.
• 2-Levenoğlu F. Gebelik ve Rehabilitasyon. Fiziksel Tıp ve Rehabilitasyon. Güneş Tıp Kitabevi, Ankara,2011: 1745-65.
• 3- Depledge J, McNair PJ, Keal-Smith C, Williams M. Management of symphysis pubis dysfunction during pregnancy using exercise and pelvic support belts.Phys Ther 2005 ;85(12):1290-300.
• 4- Mørkved S, Salvesen KA, Schei B, Lydersen S, Bø K. Does group training during pregnancy prevent lumbopelvic pain? A randomized clinical trial.Acta Obstet Gynecol Scand 2007;86(3):276-82.
• 5- Richards E, van Kessel G, Virgara R, Harris P. Does antenatal physical therapy for pregnant women with low back pain or pelvic pain improve functional outcomes? A systematic review.Acta Obstet Gynecol Scand 2012 Sep;91(9):1038-45.
• 6- Kaplan Ş, Alpayci M, Karaman E, Çetin O, Özkan Y, et.al. Short-Term Effects of Kinesio Taping in Women with Pregnancy-Related Low Back Pain: A Randomized Controlled Clinical Trial.Med Sci Monit 2016 Apr 18; 22:1297-301.
• 7- Kalinowski P, Krawulska A. Kinesio Taping vs. Placebo in Reducing Pregnancy-Related Low Back Pain: A Cross-Over Study.Med Sci Monit 2017 26; 23:6114-6120.
• 8-Downie WW, Leatham PA, Rhind VM, Wright V, Branco JA ,et.al. Studies with pain rating scales. Annals Rheumatic Diseases 37: 378-381, 1978. 9- Demiral Y, Ergor G, Unal B, Semin S, Akvardar Y, et.al. Normative data and discriminative properties of short-form 36(SF-36) in Turkish urban population.BMC Public Health 2006,6:247.
• 10- Buyssee Daniel J, Reynolds III F.C, Monk T.H, Berman S. R, Kupfer D.J. The Pittsburgh Sleep Quality Index.A New Instrument for Psychiatric Practise and Research.Psychiatry Research 28,193-213.
• 11- Jeremy C. T. Fairbank, MD, FRCS, Paul B. Pynsent, PhD. The Oswestry Disability Index.SPINE 25(22): 2940–53. 12-Karahan AY, Yildirim P, Kucuksarac S, Ordahan B, Turkoglu Y, et.al. Effect of Kinesio taping on elbow muscle strength in healthy individuals: A randomized trial1. J Back Musculoskelet Rehabil 2017;30(2):317-323.
• 13-Kase K, Wallis J, Kase T: Clinical therapeutic application of the kinesio taping method. Tokyo (Japan): Ken Ikai Co Ltd; 2003.
• 14-Karahan AY, Sahin N, Baskent A. Comparison of effectiveness of different exercise programs in treatment of failed back surgery syndrome: A randomized controlled trial. J Back Musculoskelet Rehabil 2017;30(1):109-120.
• 15-Kaynak Sahin N, Albayrak I, Karahan AY, Ugurlu H. Kronik bel ağrılı hastalarda fizik tedavinin etkinliği. Genel Tıp Derg 2011;21(1):17-20.
• 16-Wu WH, Meijer OG, Uegaki K, Mens JM, van Dieën JH, et.al. Pregnancy-related pelvic girdle pain (PPP), I: Terminology, clinical presentation, and prevalence.Eur Spine J 2004;13(7):575-89.
• 17-Vermani E, Mittal R, Weeks A. Pelvic girdle pain and low back pain in pregnancy: a review. Pain Pract 2010 ;10(1):60-71.
• 18-Kanakaris NK, Roberts CS, Giannoudis PV. Pregnancy-related pelvic girdle pain: an update.BMC Med 2011 15; 9:15. 19 -Sabino J, Grauer JN. Pregnancy and low back pain. -Curr Rev Musculoskelet Med 2008 ;1(2):137-41.
• 20- Mantle MJ, Greenwood RM, Currey HL. Backache in pregnancy.Rheumatol Rehabil 1977;16(2):95-101.
• 21- Chang HY, Jensen MP, Lai YH. How do pregnant women manage lumbopelvic pain? Pain management and their perceived effectiveness.J Clin Nurs 2015 ;24(9-10):1338-46.
• 22- Gutke A, Ostgaard HC, Oberg B. Predicting persistent pregnancy-related low back pain.Spine (Phila Pa 1976) 2008 20;33(12): E386-93.
• 23- Vermani E, Mittal R, Weeks A. Pelvic girdle pain and low back pain in pregnancy: a review.Pain Pract 2010 ;10(1):60-71.
• 24-. Gutke A, Betten C, Degerskär K, Pousette S, Olsén MF.Treatments for pregnancy-related lumbopelvic pain: a systematic review of physiotherapy modalities. Acta Obstet Gynecol Scand 2015 ;94(11):1156-67.
• 25- Stafne SN, Salvesen KÅ, Romundstad PR, Stuge B, Mørkved S. Does regular exercise during pregnancy influence lumbopelvic pain? A randomized controlled trial. Acta Obstet Gynecol Scand 2012 ;91(5):552-9.
• 26-van Benten E, Pool J, Mens J, Pool-Goudzwaard A. Recommendations for physical therapists on the treatment of lumbopelvic pain during pregnancy: a systematic review. Orthop Sports Phys Ther 2014 ;44(7):464-73.
• 27- Kline CE, Irish LA, Krafty RT, Sternfeld B, Kravitz HM, et.al. Consistently high sports/exercise activity is associated with better sleep quality, continuity and depth in midlife women: the SWAN sleep study.Sleep 2013 1;36(9):1279-88.
• 28- Reyhan AÇ, Dereli EE, Çolak TK. Low back pain during pregnancy and Kinesio tape application. J Back Musculoskelet Rehabil 2017;30(3):609-613.
• 29-Sabbour A and Omar H. The Effect of Kinesiotaping therapy Augmented with Pelvic Tilting Exercises on Low back pain in primigravidas during the third trimester. Bull Fac Ph Th Cario Univ 2011:16(1):53-61.
• 17