ACL Rüptüründe Ameliyat Öncesi Düzeltici Egzersiz Eğitimi: Ağrı, Stabilite ve Fonksiyonel Sonuçlar Üzerindeki Etkileri: Tek Kör, Randomize Kontrollü Bir Çalışma

Abstract

Amaç: Bu çalışma, ön çapraz bağ (ACL) yırtığı olan hastalarda rutin egzersizlere ek olarak verilen düzeltici egzersiz eğitiminin etkisini araştırmayı amaçladı. Yöntem: Çalışmaya 36 ÖÇB rüptürü olan katılımcı dahil edilmiştir. Hastalar rastgele egzersiz ve kontrol gruplarına ayrılmıştır. Egzersiz grubu (n=18), rutin egzersiz programına ek olarak haftada 5 gün, 8 hafta boyunca düzeltici egzersiz eğitimi almıştır. Kontrol grubu (n = 18) ise yalnızca rutin egzersiz programını uygulamıştır. Çalışmada demografik bilgiler, ağrı ve instabilite hissi için Görsel Analog Skalası, Tegner Aktivite Ölçeği, Lysholm Diz Skorlama Sistemi, Kujala Patellofemoral Skorlama Sistemi ve Fonksiyonel Hareket Tarama değerlendirmeleri yapılmıştır. Değerlendirmeler, egzersiz eğitimi öncesinde ve 8 haftalık program sonunda tekrarlanmıştır. Bulgular: Katılımcıların ortalama yaşı egzersiz grubunda 26,5 yıl, kontrol grubunda ise 28,3 yıl olarak bulunmuştur. Gruplar arasında stabilite hissi ve FMS toplam puanı açısından istatistiksel olarak anlamlı bir fark tespit edilmiştir. Ancak, egzersiz sonrası ağrı parametreleri, Lysholm skoru ve Kujala skoru açısından gruplar arasında anlamlı bir fark bulunmamıştır (p<0.05). Grup içi karşılaştırmalarda hem egzersiz hem de kontrol grubunda stabilite hissi ve FMS toplam puanı açısından anlamlı gelişmeler gözlemlenmiştir. Bununla birlikte, egzersiz sonrası aynı parametrelerde gruplar arasında da belirgin bir fark saptanmıştır. Ağrı, Lysholm ve Kujala skorlarında anlamlı iyileşme yalnızca düzeltici egzersiz grubunda gözlenmiştir. Sonuç: Ön çapraz bağ yaralanması olan hastalarda, ameliyat öncesi uygulanan FMS tabanlı düzeltici egzersiz tedavisi, ağrı, diz stabilitesi, fonksiyon ve eklem hareket açıklığında önemli iyileşmelere yol açmıştır.

Keywords

• Düzeltici Egzersiz
• Fonksiyonel Hareket Taraması
• Ön Çapraz Bağ Rüptürü

Preoperative Corrective Exercise Training in ACL Rupture: Effects on Pain, Stability, and Functional Outcomes: A Single-Blind Randomized Controlled Trial

Abstract

Aim: This study aimed to investigate the effect of corrective exercise training in addition to routine exercises on patients with anterior cruciate ligament (ACL) rupture. Method: 36 ACL ruptured participants were included in the study. Patients were randomly divided into exercise and control groups. The exercise group (n=18) received corrective exercise training 5 days a week for 8 weeks in addition to the routine exercise program. The control group (n=18) received a routine exercise program. Demographic information, Visual Analog Scale for pain and instability feeling, Tegner Activity Scale, Lysholm Knee Scoring System, Kujala Patellofemoral Scoring System, and Functional Movement Screen evaluations were done. Evaluations were repeated before exercise training, at the end of the Results: The average age of the participants was 26.5 years in the exercise group and 28.3 years in the control group. A statistically significant difference was found between the groups in the feeling of stability and FMS total score parameters. However, no difference was found between the groups in the pain parameters, Lysholm score, and Kujala score after exercise (p<0.05). In intra-group comparisons before and after exercise, a significant difference was observed in the feeling of stability and FMS total score values in both groups, and in the same parameter, a considerable difference was found between the two groups after exercise. A significant difference was observed in pain, Lysholm and Kujala scores only in the corrective exercise group. Conclusion: Pre-operatively applied FMS-based corrective exercise therapy in patients with ACL injury led to significant improvements in pain, knee stability, function, and range of motion.

Keywords

• Anterior Cruciate Ligament Tear
• Corrective Exercise
• Functional Movement Screen

Ethical Statement

ETHICAL STATEMENT: This study was carried out with the approval of the Ethics Committee of University of Health Sciences Hamidiye Non-Interventional Research Ethics Committee, dated 25/01/2019 and numbered 19/03. A signed subject consent form in accordance with the Declaration of Helsinki was obtained from each participant.

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