Gebelikle İlişkili Lumbopelvik Ağrı ve Güncel Fizyoterapi Yöntemleri: Geleneksel Derleme

Abstract

Gebelikle ilişkili lumbopelvik ağrı, gebelik döneminde yaşanan bel ve pelvik kuşak ağrısının birlikte tanımlanması için kullanılan bir terimdir. Gebelikle ilişkili lumbopelvik ağrının insidansı %86’dır ve gebelikte yaygın görülen şikâyetlerden biridir. Lumbopelvik ağrı genellikle gebeliğin 24 ile 36. haftaları arasında en yüksek seviyeye ulaşmaktadır. Gebelikle ilişkili lumbopelvik ağrıya, relaksin hormonunun, gebelikte alınan kilonun neden olabileceği düşünülmektedir. Beden Kütle İndeksinin fazla olması, gebelikte depresyon, bel ağrısı öyküsünün bulunması ve gebelik sırasında ağır iş yükü öyküsü lumbopelvik ağrının gelişimi için bilinen risk faktörleridir. Lumbopelvik ağrı, gebelerin günlük aktivitelerini, yaşam kalitelerini ve cinsel yaşamını olumsuz etkilemektedir. Tedavi edilmediği takdirde ise kronik hale gelmektedir. Bu derlemenin amacı, gebeliğe bağlı lumbopelvik ağrının tedavisinde uygulanan güncel fizyoterapi yöntemlerini gözden geçirmek, etkinliklerini incelemek ve etkinlikleri hakkında bilgi vermektir. Gebelikle ilişkili lumbopelvik ağrının farklı birçok tedavi yönteminin olmasının yanı sıra fetüse ve kadına zarar vermemesi/komplikasyonu bulunmaması nedeniyle günümüzde fizyoterapi yöntemlerinin önemi artmaktadır. Su içi aerobik egzersiz, pelvik tilt, diz çekme, kegel egzersizi, squat, adduktör germe, pelvik elevasyon, pelvik rotasyon ve bacak kaldırma gibi germe ve güçlendirme egzersizleri, yoga, sakroiliak eklem mobilizasyonu, Transkutanöz Elektriksel Sinir Stimülasyonu (TENS), manuel terapi, ortez ve hasta eğitiminin, gebelikle ilişkili lumbopelvik ağrı tedavisinde uygulanan güncel fizyoterapi yöntemleri arasında bulunmaktadır. Ancak bu fizyoterapi yöntemlerinden hangisinin daha etkili olduğuna dair kesin kanıt bulunmamaktadır. Bu nedenle daha fazla randomize kontrollü çalışmalara ihtiyaç duyulmaktadır.

Keywords

• Gebelik
• lumbopelvik ağrı
• fizyoterapi

Pregnancy-Related Lumbopelvic Pain and Current Physiotherapy Methods

Abstract

Pregnancy-related lumbopelvic pain is a term used to describe low back and pelvic girdle pain experienced during pregnancy. The incidence of pregnancy-associated lumbopelvic pain is 86% and is a common complaint during pregnancy. Lumbopelvic pain usually peaks between 24 and 36 weeks of gestation. It is thought that pregnancy-related lumbopelvic pain may be caused by relaxin hormone and weight gain during pregnancy. A high body mass index, depression during pregnancy, a history of low back pain and a history of heavy workload during pregnancy are known risk factors for the development of lumbopelvic pain. Lumbopelvic pain negatively affects the daily activities, quality of life and sexual life of pregnant women. If left untreated, it becomes chronic. The aim of this review is to review the current physiotherapy methods applied in the treatment of pregnancy-related lumbopelvic pain, to examine their effectiveness and to provide information about their effectiveness. The importance of physiotherapy methods is increasing today since there are many different treatment modalities for pregnancy-related lumbopelvic pain and it does not harm the fetus and the woman/there are no complications. Stretching and strengthening exercises such as in-water aerobic exercise, pelvic tilt, knee pull, kegel exercise, squats, adductor stretching, pelvic elevation, pelvic rotation and leg raises, yoga, sacroiliac joint mobilization, Transcutaneous Electrical Nerve Stimulation (TENS), manual therapy, orthotics and patient education are among the current physiotherapy methods applied in the treatment of pregnancy-related lumbopelvic pain. However, there is no conclusive evidence on which of these physiotherapy methods is more effective. Therefore, more randomized controlled trials are needed.

Keywords

• Pregnancy
• lumbopelvic pain
• physiotherapy

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