PATELLOFEMORAL AĞRI SENDROMU VE GÜNCEL TEDAVİ YAKLAŞIMLARI

Year 2022, , 20 - 27, 15.12.2022

Onur Turan Hilal Denizoğlu Külli

https://doi.org/10.54270/atljm.2022.24

Abstract

Patellofemoral ağrı sendromu (PFAS) patellofemoral eklemde (PFE) yüklenme oluşturan aktiviteler ile provoke olan, patella çevresinde ve arkasında ağrı tariflenen, diğer ayırıcı patolojilerin yokluğunda bahsedilen, diz önünde ısrarcı ağrıya sebep olan kronik bir kas iskelet sistemi problemi olarak tanımlanmaktadır. Çömelme, uzun süreli dizler fleksiyonda oturma ve merdiven inme ve çıkma gibi PFE’ye yük bindiren aktiviteler sırasında ve sonrasında artan bir ağrı söz konusudur. Ortopedi ve travmatoloji, spor hekimliği, ortopedik ve sportif rehabilitasyon kliniklerine ön diz ağrısı ile başvurunun en sık karşılaşılan sebebidir. Görülme sıklığını araştıran kısıtlı sayıda çalışma bulunmasına rağmen PFAS alt ekstremitedeki en sık rastlanan ağrı nedeni olarak gösterilmektedir. PFA’nın tüm toplumu etkileyebildiği düşünülmekle beraber özellikle adolösanlar, genç aktif yetişkinler, elit atletler, askeri personelde ve yüksek insidans ve prevelans ile kadınlarda görülmektedir. PFAS’ın güncel tedavisinde fizyoterapinin önemli bir rol oynadığı konservatif tedaviye odaklanılmaktadır. Fizyoterapi PFAS’taki disfonksiyonun yönetilmesinde ve hastalar tarafından deneyimlenen ağrının azaltılmasına sıklıkla başvurulan bir tedavi yöntemidir ve ağrıyı azaltmak ve diz fonksiyonunu geliştirmek için egzersiz yaklaşımlarını ön planda tutar. Konservatif tedavinin en büyük amacı patellayı optimal bir biyomekanik dizilime getirmek ve diz çevresi kas yapısının tekrardan güçlenmesini sağlamaktır. Tedavide sıklıkla egzersiz yoluyla PFE mekaniklerini geliştirme, bantlama, tabanlıklar, biyofeedback ve diğer adjuvan tedavilerle desteklenen kombine bir yaklaşım benimsenmektedir. Geleneksel olarak quadriceps femoris kaslarında güç ve koordinasyon üzerinde duran diz odaklı egzersizler kullanılırken kalça odaklı egzersizler de son zamanlarda oldukça ilgi odağı haline gelmiş durumdadır

Keywords

Patellofemoral Ağrı Sendromu, Egzersiz, Fizyoterapi, Fonksiyon, Ağrı

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