Non-farmakolojik Kombine Tedavi Yöntemlerinin Fibromiyaljili Hastalarda Serum Beta-Endorfin Düzeyi, Ağrı, Depresyon, Uyku Kalitesi ve Fonksiyonel Durum Üzerine Etkisi

Year 2021, Volume: 31 Issue: 4, 354 - 359, 15.12.2021

Fahrettin Bostancı Ahmet Karadağ Halef Okan Doğan

https://doi.org/10.54005/geneltip.1036557

Abstract

Amaç: Bu çalışmanın amacı FMS tedavisinde kullanılan non-farmakolojik kombine tedavi metodlarının etkinliğini serum β–Endorfin, ağrı, depresyon, uyku kalitesi ve fonksiyonel durumu değerlendirerek karşılaştırmaktır.

Yöntemler: Çalışmaya FMS tanısı almış 60 kadın hasta ve 30 sağlıklı kadın gönüllü dahil edildi. FMS'li hastalar rastgele 30 kişiden oluşan iki eşit gruba ayrıldı. İlk hasta grubuna fizik tedavi ve balneoterapi uygulanırken, ikinci gruba fizik tedavi, balneoterapi ve aerobik egzersiz programı uygulandı. FMS hastaları tedavi öncesi ve sonrası, ağrı için Görsel Analog Skala (GAS), Fibromiyalji Etki Anketi (FEA), Beck Depresyon Ölçeği (BDÖ) ve Pittsburgh Uyku Kalitesi İndeksi (PUKİ) anketleriyle değerlendirildi. Serum β-Endorfin seviyeleri, sağlıklı kontrol grubunda bir kez, FMS hastalarında tedavi öncesi ve sonrası iki kez ölçüldü.

Bulgular: FMS’li hasta gruplarında β-Endorfin düzeyi sağlıklı kontrol grubuna göre daha düşüktü ve bu istatistiksel olarak anlamlıydı (p<0.001). Fizik tedavi ve balneoterapi alan FMS’li grubunun ve fizik tedavi, balneoterapi ve aerobik egzersiz tedavisi alan FMS’li grubunun tedavi sonrası β-Endorfin düzeyleri tedavi öncesine göre daha yüksekti ve bu fark istatistiksel olarak anlamlıydı (p<0.001). Bununla birlikte fizik tedavi, balneoterapi ve aerobik egzersiz tedavisi alan FMS’li grupta fizik tedavi ve balneoterapi alan FMS’li gruba oranla tedavi sonrası β-Endorfin düzeyi daha yüksekti ve bu istatistiksel olarak anlamlıydı (p<0.001). Her iki hasta grubunda, tedavi sonrası FEA, GAS, BDÖ ve PUKİ değerini tedavi öncesine göre azalmıştı ve bu istatistiksel olarak anlamlıydı (p<0.001).

Tartışma: FMS hastalarında serum β-Endorfin düzeyleri daha düşük bulundu. FMS tedavisinde aerobik egzersiz ve balneoterapi etkili yöntemlerdir. Bu sonuçlar, FMS etiyopatogenezi ve tedavisi ile ilgili ileri klinik çalışmalar için yol gösterici olabilir.

Keywords

Fibromyalji, aerobik egzersiz, balneoterapi, fizik tedavi, tedavi

The Effect of Non-pharmacological Combine Treatment Methods on Serum Beta-Endorphin Level, Pain, Depression, Sleep Quality and Functional Status in Patients with Fibromyalgia

Abstract

Abstract

Objective: This study aims to compare the effectiveness of non-pharmacological combined treatment methods used in Fibromyalgia syndrome (FMS) treatment by evaluating serum β -Endorphine, pain, depression, sleep quality and functional status.

Methods: The study included 60 patients diagnosed with FMS and 30 healthy female volunteers. The patients with FMS were divided into two equal groups of 30 subject. The first group of patients received physical therapy and balneotherapy, while the second group received physical therapy, balneotherapy and aerobic exercise program. FMS patients evaluated before and after treatment, by Visual Analogue Scale for Pain (VAS), Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Scale (BDI) and Pittsburgh Sleep Quality Index (PSQI) questionnaires. Serum β-Endorphin levels were measured once in the healthy control group and twice before and after treatment in FMS patients.

Results: The β-Endorfin level was lower in both FMS groups than the control group and this was statistically significant (p <0.001). Post-treatment β-Endorphin levels were high in the both FMS group and this difference was statistically significant (p <0.001). However, in the FMS group receiving physical therapy, balneotherapy and aerobic exercise, post-treatment β-Endorphin levels were higher than the FMS group receiving physical therapy and balneotherapy, and this was statistically significant (p <0.001). In both groups, we found that the scores of FIQ, VAS, BDI and PSQI after treatment were decreased compared to pretreatment and this was statistically significant (p <0.001).

Conclusion: The serum β-Endorphin levels were found to be lower in the FMS patients. Aerobic exercise and balneotherapy are effective methods in the treatment of FMS. These results can be of guidance for further clinical studies of the etiopathogenesis and treatment of FMS.

Keywords

Fibromyalgia, aerobic exercise, balneotherapy, physical therapy, treatment

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