Tibialis Posterior Tendon Transferi Uygulanmış Olan Düşük Ayak Hastalarında Geç Dönem Fizyoterapi Uygulamalarının Sonuçları

Year 2021, Volume: 8 Issue: 2, 115 - 123, 10.09.2021

Safiye Özkan , Nilgün Bek , Türker Özkan , Ömer Berköz

https://doi.org/10.15437/jetr.711328

Abstract

Amaç: Bu çalışma periferik sinir yaralanması sonrasında düşük ayak gelişmiş bireylerde uygulanan tibialis posterior tendon transferlerinde, geç dönemde meydana gelen biyomekanik sorunlar ve bu sorunların tedavisi için uygulanan, geç dönem fizyoterapinin etkinliğini belirlemek amacıyla planlandı.

Yöntem: Çalışmaya tendon transferi yapılmış ve 6 ay ve üzeri süreyi doldurmuş olan 22 birey dahil edildi. Bireylerle ilgili demografik bilgi ve komplikasyonlar kayıt edilerek, ayak bileği kas kuvveti, eklem hareket açıklığı ölçüldü. Ayrıca bireylerde eklem pozisyon hissi, denge ve yaşam kalitesi değerlendirildi. Cerrahi sonrası başarı için Stanmore Sistem Sorgulaması kullanıldı. Olgulara genel olarak, ısı modaliteleri, nöromuskuler elektrik stimülasyonu, egzersiz, bantlama ve ortezlemeyi içeren, bireylerin spesifik gereksinimleri gözetilerek planlanan fizyoterapi programı uygulandı. Tedavilere 6 hafta süreyle haftada 3 gün olmak üzere devam edildi. Tedavi öncesi yapılan değerlendirmeler, 4., 6. haftalarda ve 3 ayda tekrar edildi.

Bulgular: Çalışma süresi içerisinde bireylerin ayak bileği kas kuvveti, her iki ayakta da arttı. Bunlara ek olarak, propriyosepsiyon ve dengede olumlu gelişmeler meydana geldi. Tüm bu gelişmeler sayesinde, olguların yaşam kalitesi de pozitif yönde etkilendi.

Sonuç: Çalışma sonucunda, tendon transferi sonrası geç dönemde uygulanan fizyoterapi programının, geç dönemde olgularda görülen problemler üzerinde etkin olduğu gösterildi. Detaylı değerlendirme ile planlanan fizyoterapi programının, hasta memnuniyetini ve cerrahi başarıyı arttırdığı belirlendi.

Keywords

Düşük ayak, Tendon transferi, Tibialis posterior, Rehabilitasyon, Yaşam kalitesi

Results of late-period physical therapy practice in foot-drop patients who underwent tibialis posterior tendon transfer

Abstract

Purpose: This study was planned to determine the efficacy of late-period physiotherapy for late-period biomechanical problems in foot-drop patients who underwent tibialis posterior tendon transfer after peripheral nerve injury.

Methods: Twenty-two patients who were operated and followed up at least 6 months were included to the study. Demographic data and complications about patients were recorded and muscle force and ankle range-of-motion were evaluated. In addition, sense of joint position, balance, and quality of life were evaluated. In order to determine post-surgery success, Stanmore System Questionnaire was used. A physiotherapy program specifically based on individual patients’ needs included heat modalities, neuromuscular electrical stimulation, exercise, taping, and orthoses. Treatments were carried out 3 days a week, for the duration of 6 weeks. All pre-treatment evaluations were repeated in the 4th and 6th weeks and at the end of 3rd month to determine the effects of treatment.

Results: During the study, muscle strength increased in ankle muscles of both affected and intact sides. In addition, proprioception, and balance improved. Quality-of-life was affected positively related with these changes.

Conclusion: This study has revealed that late-period physical therapy practice in foot-drop patients who underwent tibialis posterior tendon transfer was effective on the late-period problems of the patients. This study has determined that the physiotherapy programs that are planned with detailed evaluation will improve patient satisfaction and surgical success.

Keywords

Foot drop, Tendon transfer, Tibialis posterior, Rehabilitation, Quality of life.

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