California Tri-Pull Kinezyo bantlamanın İnme Sonrası Glenohumeral Omuz Subluksasyonunu Azaltmadaki Etkinliği: AB tasarımı

Abstract

Amaç: Glenohumeral subluksasyon (GHS), inme sonrası hemiplejinin sık görülen bir komplikasyonudur. İnme hastalarında omuzun inferiora sublukse olması en sık karşılaşılan GHS'dir ve humerusu yeniden konumlandırdıktan sonra daha iyi stabiliteyi sağlamak için uygun tedaviyi seçmek önemlidir. Amacımız, hemiplejik GHS hastalarında, California tri-pull bantlama yöntemi ile uygulanan elastik kinezyo bantlama (CTPK) ile hastalardaki ağrı, hareket geri kazanımı ve günlük yaşam aktiviteleri üzerine kısa süreli etkisini değerlendirmektir.
Gereç ve Yöntem: Bu çalışmaya katılan GHS'li on dört hemiplejik hastaya haftada en az üç kez geleneksel yatarak nörorehabilitasyon uygulandı. Rehabilitasyon programı sırasında GHS'li tüm hastalara üç hafta boyunca beş gün arayla dört kez kinezyo bantlama yapıldı. Hastalar, sözel tanımlayıcı ağrı skalası (VPDS), günlük yaşam aktivitelerinde Katz bağımsızlık indeksi ve radyolojik görüntüleme ve fizik muayene ile değerlendirildi.
Bulgular: Katılımcılar arasında cinsiyet, yaş, inme süresi ve VPDS puanları açısından anlamlı fark bulunamadı (p>0,05). Tedavi ile CTPK sonrası motor iyileşme evreleri düzeldi, ağrı skorları azaldı ve Katz indeksi arttı. Omuzun pasif ROM'ları önemli ölçüde arttı. Subluksasyonun palpasyonla düzeldiği bulundu, ancak herhangi bir radyografik değişiklik gözlenmedi.
Sonuç: CTPK ağrıyı azaltabilir ve yaşam kalitesini, pasif ROM'u ve subluksasyonu iyileştirebilir. Bulgularımız subluksasyonun radyolojik derecelendirmesinin yeterince hassas olmadığını ve inme hastalarında inferior subluksasyonun iyileşmesini değerlendirmek için kullanılmaması gerektiğini göstermektedir. 

Keywords

• inme
• omuz
• subluksasyon
• kinezyo bantlama

The Effectiveness of California Tri-Pull Kinesiotaping In Reducing Glenohumeral Shoulder Subluxation After Stroke: AB design

Abstract

Background and Purpose: Glenohumeral subluxation (GHS) is a common complication of hemiplegia after stroke. The inferior dislocation is the most frequently encountered GHS in stroke patients, and it is important to choose the proper treatment to promote better stability after repositioning the humerus. To evaluate the short term effect of the California tri-pull taping method with elastic kinesiotape (CTPK) on pain, recovery of movement and daily life activities in Turkish hemiplegic patients. Methods: Fourteen hemiplegic participants with GHS involved in this study All patients had at least three weeks of conventional inpatient neurorehabilitation. During the rehabilitation program, all patients with GHS had kinesiotaping four times with five-day interval for three weeks. Outcome measures were a verbal descriptive pain scale (VPDS), the Katz index of independence in activities of daily living, and a radiologic and physical examination. Results: No significant difference was found between the participants with regard to sex, age, duration of stroke, and VPDS scores (p>0.05). Motor recovery stages were improved after CTPK, pain scores decreased, and Katz index increased with the treatment. Passive ROMs of the shoulder were significantly increased. Subluxation was found by palpation to be improved but did not show any radiographic changes. Conclusion: CTPK can reduce pain and improve quality of life, passive ROM and subluxation. Our findings suggest that radiological grading of subluxation is not sensitive enough and should not be used to evaluate improvement of inferior subluxation in stroke patients.

Keywords

• stroke
• shoulder
• kinesiotaping
• subluxation

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