Demokratik Kongo Cumhuriyeti, Kinshasa'da endüklenmiş stres terapisi programının hemiplejik hastaların üst ekstremitesinin fonksiyonel ve motor olarak iyileşmesi üzerindeki etkisi

Year 2018, , 239 - 243, 01.09.2018

Teddy Bofosa , Eric Kam , François Njimbu Ponce Mpefi Tharcis Kayembe Betty Miangindula

https://doi.org/10.28982/josam.417843

Abstract

Amaç: İnme, önemli bir sakatlık sebebidir. Rehabilitasyonun bir sonucu olarak, hemiplejik hastaların %80'i özellikle iyileşmektedir, oysa sadece %28 ila %57'lik oranlarda kavrama iyileşmektedir. Bu çalışmanın amacı: indüklenmiş stres tedavisinin hemiplejik üst ekstremitenin motor ve fonksiyonel geri kazanım üzerindeki etkilerini değerlendirmek, indüklenmiş stres terapisine tabi tutulan hemiplejikler arasında iyileşme hızını ve üst ekstremite otonomisini karşılaştırmak ve stres terapisine maruz kalmamak ve üst ekstremite nöromüsküler komplikasyonların ve bozuklukların önlenmesinde bu tedavinin etkisini değerlendirmektir.

Yöntemler: Bu, Kinshasa Üniversitesi Kliniklerinde ve 6 ay boyunca Kinshasa Genel Referans Hastanesi'nde takip edilen 30 hemiplejik vasküler hastada yapılan girişimsel bir çalışmadır. İyileşme hızı Demeurisse motor indeksi ile değerlendirildi. Sonuçları karşılaştırmak için Pearson'un ki - kare değerini kullandık. Anlamlılık düzeyi p≤0.05 değeri için kabul edildi.

Bulgular: Olguların yaş ortalaması 57.5 ± 10.5 yıldı ve erkek ağırlığı %63.3 idi. Bu hastaların çoğunluğu memur (%23.3), tüccar (%16.7) ve öğretmen (%16.7), üst ekstremiteyi sık kullanan esnaflardır. 6 aylık yeniden eğitimden sonra, strese bağlı tedavi uygulanan hastalarda tonda belirgin bir artış görülmezken (p = 0.34), karşılaştırma grubunda tonus artışı çok anlamlıydı (p = 0.01); İndüklenmiş stres tedavisi grubunda motor fonksiyonda çok önemli bir iyileşme (p = 0.001) ve karşılaştırma grubu için anlamlı (p = 0.05) bir artış gözlendi. Ağrının ilerlemesi, indüklenmiş stres tedavisi grubuna (p = 0.02) ve indüklenmiş stres tedavisine maruz kalmayan hastalar için negatif idi (p = 0.5).

Sonuç: Bu çalışmanın sonucunda, vasküler hemiplejik üst ekstremitede nöro-motor bozuklukların fonksiyonel iyileşmesinde ve önlenmesinde indüklenmiş stres tedavisinin etkili olduğu bulunmuştur.

Keywords

İnme, Hemipleji, Üst ekstremite, İndüklenmiş stres tedavisi

Impact of a program of induced stress therapy on the motor and functional recovery of the upper limb of hemiplegic patients in Kinshasa, Democratic Republic of Congo

Abstract

Aim: Stroke is a major cause of disability. As a result of rehabilitation, 80% of hemiplegic patients recover in particular, whereas only 28% to 57% recover the grip. Aim of this study is to evaluate the effects of induced stress therapy on motor and functional recovery of the hemiplegic upper limb, to compare the pace of recovery and upper limb autonomy between hemiplegics subjected to induced stress therapy and not subject to induced stress therapy and evaluate the impact of this therapy in the prevention of upper limb neuromuscular complications and disorders.

Methods: This is an interventional study conducted in 30 hemiplegic vascular patients followed at the University Clinics of Kinshasa and at the General Reference Hospital of Kinshasa for 6 months. The pace of recovery was evaluated by the motor index of Demeurisse. We used Pearson's chi - square to compare the results. The significance level was considered for the value of p≤0.05.

Results: The mean age of these patients was 57.5 ± 10.5 years, with a male predominance (63.3%). The majority of these patients were civil servants (23.3%), traders (16.7%) and teachers (16.7%), trades making frequent use of the upper limb. After 6 months of re-education, there was no significant increase in tone in patients undergoing stress-induced therapy (p = 0.34), whereas, for the comparison group, the increase in tone was very significant (p = 0.01); a very significant improvement in motor function (p = 0.000) was observed for the group of induced stress therapy, and significant (p = 0.05) for the comparison group. The progression of pain was good for the group of induced stress therapy (p = 0.02), and negative for patients not subjected to induced stress therapy (p = 0.5).

Conclusion: In the course of this study, it was found that induced stress therapy is effective in the functional recovery and prevention of neuro-motor disorders of the upper limb of the vascular hemiplegic.

Keywords

Stroke, Hemiplegia, Upper limb, Induced stress therapy

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