İnme Hastalarında Kısıtlayıcı Zorunlu Hareket Tedavisi Temelli Telerehabilitasyon Uygulamaları

Year 2022, Volume: 6 Issue: 2, 394 - 404, 31.05.2022

Fettah Saygılı , Sefa Eldemir , Arzu Güçlü Gündüz

https://doi.org/10.46237/amusbfd.1022290

Abstract

İnme sonrası üst ekstremitede meydana gelen fonksiyonel bozukluklar hastaların günlük yaşamlarını büyük oranda etkilemektedir. İnme sonrası üst ekstremitede fonksiyonel geri dönüşü hedefleyen pek çok yaklaşım bulunmaktadır. Bobath, Kısıtlayıcı Zorunlu Hareket Tedavisi (KZHT), Proprioseptif Nöromusküler Fasilitasyon (PNF) gibi nörogelişimsel yaklaşımlar başta olmak üzere, sanal gerçeklik, robotik rehabiliasyon ve telerehabilitasyon gibi teknoloji temelli yaklaşımlar bu yaklaşımların başında gelmektedir. Literatürü incelediğimizde bu yaklaşımlar arasında kanıt düzeyi en yüksek yöntem KZHT’dir.
KZHT kanıt değeri yüksek, klinik çıktıları çok fazla olduğu bilinen bir yöntem olsa da Covid-19 pandemisinin yaşamlarımıza girmesi ve yüz yüze fizyoterapi uygulamalarının riskli hale gelmesi ile akla gelen en önemli soru bu yaklaşımın telerehabilitasyon yolu ile aynı etkin sonuçlar elde edecek şekilde uygulayıp uygulayamayacağımız olmuştur. Araştırmacıların pandemi öncesinde de bu soruyu sordukları ve pilot çalışmalar seviyesinde olsa da bazı çalışmaları başlattıkları görülmektedir. Bu derlemenin amacı KZHT’nin ve telerehabilitasyonun temel prensiplerini incelemek ve bu iki uygulamanın kombinasyonu ile ilgili literatür incelemesi yaparak sunmaktır.

Keywords

İnme, Üst ekstremite, Telerehabilitasyon, Modifiye-Kısıtlayıcı Zorunlu Hareket Tedavisi

Supporting Institution

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Project Number

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Thanks

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Constraint Induced Movement Therapy Based Telerehabilitation Practices in Stroke Patients

Abstract

Functional disorders in the upper extremity after stroke greatly affect the daily lives of patients. There are many approaches that target functional recovery in the upper extremity after stroke. Technology-based approaches such as virtual reality, robotic rehabilitation and telerehabilitation, especially neurodevelopmental approaches such as Bobath, Constraint Induced Movement Therapy (CIMT), Proprioceptive Neuromuscular Facilitation (PNF), are among these approaches. When we examine the literature, the method with the highest level of evidence among these approaches is CIMT.
Although CIMT is a method with high evidence value and known to have very high clinical outcomes, the most important question that comes to mind with the Covid-19 pandemic entering our lives and face-to-face physiotherapy applications becoming risky has been whether we can apply this approach in a way to achieve the same effective results as telerehabilitation. It is seen that researchers asked this question before the pandemic and started some studies, albeit at the level of pilot studies. The aim of this review is to examine the basic principles of CIMT and telerehabilitation and to present the combination of these two applications by reviewing the literature.

Keywords

Stroke, Upper Extremity, Telerehabilitation, Modified-Constraint Induced Movement Therapy.

Project Number

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