İnmeli Hastalarda Ayna Tedavisinin Üst Ekstremitede Motor İyileşme ve Fonksiyona Etkisi

Year 2018, Volume: 2 Issue: 2, 173 - 181, 31.08.2018

Nevcivan Bulmuş Demirbaş Şenay Özdolap Selda Sarıkaya , Füruzan Köktürk

Abstract

İnmeli hastalarda üst ekstremite motor fonksiyonlarının
iyileştirilmesinde ayna tedavisinin etkinliğini değerlendirmek.
Çalışmaya kliniğimizde yatarak rehabilitasyona alınan 53 inme
hastası dahil edildi. Hastalardan 30’u çalışma grubuna, 23’ü ise
kontrol grubuna alındı. Tüm hastalar 4 hafta boyunca 60 dk süre ile,
haftada beş gün konvansiyonel rehabilitasyon programına alındı.
Çalışma grubunda yer alan hastalar ek olarak haftada beş gün, 4 hafta
boyunca 30 dk ayna tedavisi aldı. Hastalar rehabilitasyon
programının başlangıcında (tedavi öncesi), 4. hafta sonunda (tedavi
sonrası) ve 12 hafta sonra (takip) değerlendirildi. Üst ekstremite ve
el motor iyileşmesi Brunnstrom motor evrelemesi ile değerlendirildi.
El bilek fleksör kas spastisite düzeyini belirlemek için Modifiye
Ashworth Skalası (MAS) kullanıldı. Hastaların engellilik düzeyleri
Fonksiyonel Bağımsızlık Ölçütü (FBÖ) ile değerlendirildi.
Çalışmaya dahil edilen hastaların 30’u kadın, 23’ü erkekti ve yaş
ortalaması 59.91±4.04 (55-66) yıl idi. Grupların zaman içindeki
değişimi incelendiğinde, tedavi sonrası ve takipte hem çalışma
grubunda hem de kontrol grubunda Brunnstrom üst esktremite ve el
motor evresinin ve FBÖ motor ve total skorunun istatistiksel olarak
anlamlı düzeyde arttığı saptandı (tümü için p<0.001). İki grupta
Brunnstrom üst esktremite ve el motor evresinin ve FBÖ motor ve
total skorunun tedavi sonu ve takipte elde edilen artışları birbiriyle
karşılaştırıldığında istatistiksel olarak anlamlı fark saptanmadı
(sırasıyla p=0.607, p=0.790, p=0.146, p=0.123 ). Tedavi sonrası ve
takipte hem çalışma grubunda hem de kontrol grubunda el bilek
fleksör spastisitesinde istatistiksel olarak anlamlı değişiklik
saptanmadı (p=0.240). İki grupta el bilek fleksör kaslarının
spastisitesinde tedavi sonu ve takipte elde edilen değişiklikler
birbiriyle karşılaştırıldığında istatistiksel olarak anlamlı fark
saptanmadı (p=0.731).
Bu araştırmada kronik inme hastalarında konvansiyonel
rehabilitasyona eklenen 4 haftalık ayna tedavisinin motor ve
fonksiyonel iyileşmeye katkısının olmadığı saptanmıştır. Ayna
tedavisinin inme rehabilitasyonunda gelecekte daha etkin olarak
kullanılabilmesi için standardizasyonunu sağlayacak iyi planlanmış
araştırmalara halen ihtiyaç bulunmaktadır.

Keywords

İnme, Rehabilitasyon, Ayna tedavis

The Effect of Mirror Therapy on Upper Extremity Motor Function and Motor Recovery in Stroke Patients

Abstract

To evaluate the effectiveness of mirror therapy on improvement of
motor functions of the upper extremity in patients with stroke.
Fifty-three stroke patients were included this study. Patients were
assigned to either an mirror therapy group (n=30) or a control group
(n=20). All patients were enrolled in a conventional rehabilitation
program for 4 weeks, 60 minutes, and 5 days a week. Patients in the
study group received additional 30 minutes of mirror therapy for five
days a week for four weeks. Patients were evaluated at the beginning
of the rehabilitation program (pre-treatment), at the end of the 4th
week (after the treatment) and 12 weeks (follow-up). Brunnstrom
recovery stage of arm and hand, Functional Independence Measure
(FIM) and Modified Ashworht Scale (MAS) were used to evaluate
the patient’s upper extremity motor recovery, function and spasticity.
After one month of treatment and follow-up evaluation patients of
both groups showed statistically significant improvement in all the
variables except spasticity (all for p<0.001). No significant
differences in Brunnstrom stage, FIM were found between groups
(Respectively sırasıyla p=0.607, p=0.790, p=0.146, p=0.123). There
was no statistically significant change in wrist flexor spasticity in
both the study group and the control group after treatment (p =
0.240). There was no statistically significant difference in the
spasticity of the wrist flexor muscles were found between groups (p
= 0.731).
In our study, the superiority of mirror therapy to conventional
therapy was not determined. There is still a need for well-planned
studies to standardize mirror therapy so that it can be used more
effectively in stroke rehabilitation in the future.

Keywords

Stroke, Rehabilitation, Mirror therapy

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