Türkiye’deki Fizyoterapistlerin Nonspesifik Boyun Ağrısında Tedavi Tercihlerinin Belirlenmesi

Abstract

Amaç: Bu çalışmanın amacı; nonspesifik boyun ağrılı hastaları tedavi eden fizyoterapistlerin tedavideki tutum, tercih, bilgi ve primer müdahale seçimlerini belirlemektir. Gereç ve Yöntemler: Çalışmamız, fizyoterapistlerin boyun ağrısında tedavi tercihlerinin belirlenmesi için geliştirilen 18 soruluk kesitsel online bir anket ile yapıldı. Anket Google Formlar üzerinden Türkiye Fizyoterapistler Derneği aracılığı ile fizyoterapistlere gönderildi. Bulgular: Ankete toplam 115 fizyoterapist katıldı. Çalışmada fizyoterapistlerin, palpasyon ve postural değerlendirmeleri büyük oranda yaptığı, ilk tedavi seçeneği olarak boyun/üst göğüs germe ve postür egzersizlerini kullandığı, elektroterapi modalitelerinden en çok TENS ve sıcak uygulamayı tercih ettiği, manuel terapi yöntemlerinden ise mobilizasyon ve miyofasyal gevşetme tekniklerini çoğunlukla uyguladıkları bulundu. Yardımcı yöntem/ortez uygulamalarından bantlamayı tedaviye dahil ettikleri, ev ve iş yeri modifikasyonlarını sıklıkla önerdikleri, hastalarına ev eğitimini genellikle sözlü bilgilendirme şeklinde yaptıkları ve tercih edilen tüm bu yöntemlerin kullanılabilirliğinin yüksek olması sebebiyle uygulandığı belirlendi. Sonuç ve öneriler: Çalışmamızın sonuçlarından Türkiye'deki fizyoterapistlerin klasik yöntemlere ek olarak yenilikçi uygulamaları takip ettiği ve bu kapsamda da bilgilerini güncelledikleri çıkarımına varabiliriz.

Keywords

• Fizyoterapist
• Nonspesifik boyun ağrısı
• Tedavi tercihleri

Determination of Treatment Preferences of Physiotherapists in Turkey for Nonspecific Neck Pain

Abstract

Introduction: Neck pain is a common problem with an episodic course that affects a large part of the population. Aim: It was aimed to determine the attitudes, preferences, knowledge and primary intervention choices of physiotherapists who treat patients with neck pain. Material and Methods: Our study was conducted with an 18-question cross-sectional online questionnaire developed to determine the treatment preferences of physiotherapists for neck pain. The questionnaire was sent to physiotherapists through the Turkish Physiotherapists Association via Google Forms. Results: A total of 115 physiotherapists participated in the survey. In the study, physiotherapists mostly made palpation and postural evaluations, used neck/upper chest stretching and posture exercises as the first treatment option, preferred TENS and hot application among electrotherapy modalities, applied more mobilization and myofascial release techniques among manual therapy methods. It was determined that they included taping among the assisstive/orthes applications in the treatment programme, they frequently suggested home and workplace modifications, and home education programme to their patients in the form of verbal information, and all these preferred methods were applied because of their high availability. Conclusion and sugestions: The results we obtained from our study; it is concluded that physiotherapists in Turkey follow innovative practices as well as conventional approaches and keep their knowledge up to date.

Keywords

• Physiotherapist
• Nonspecific neck pain
• Treatment preferences

References

1. Bryans, R., Decina, P., Descarreaux, M., Duranleau, M., Marcoux, H., Potter, B., …, White, E. (2014). Evidence-based guidelines for the chiropractic treatment of adults with neck pain. Journal of Manipulative & Physiological Therapeutics, 37(1), 42–63. https://doi: 10.1016/j.jmpt.2013.08.010.
2. Carlesso, L. C., MacDermid, J. C., Gross, A. R., Walton, D. M., & Santaguida, P. L. (2014). Treatment preferences amongst physical therapists and chiropractors for the management of neck pain: results of an international survey. Chiropractic & Manual Therapies, 22(1), 1-15. https://doi: 10.1186/2045-709X-22-11
3. Carroll, L. J., Hogg-Johnson, S., van der Velde, G., Haldeman, S., Holm, L. W., Carragee, E. J., …, Cassidy, J. D. (2008). Course and prognostic factors for neck pain in the general population: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Spine (Phila Pa 1976), 33(4), 75-82. https://doi:10.1007/s00586-008-0627-8
4. Driessen, M. T., Proper, K. I., van Tulder, M. W., Anema, J. R., Bongers, P. M., van der Beek, A. J. (2010). The effectiveness of physical and organisational ergonomic interventions on low back pain and neck pain: a systematic review. Occupational and Environmental Medicine, 67, 277–285. https://doi: 10.1136/oem.2009.047548.
5. D’Sylva, J., Miller, J., Gross, A., Burnie, S.J., Goldsmith, C.H., Graham, N., …, for the Cervical Overview G. (2010). Manual therapy with or without physical medicine modalities for neck pain: a systematic review. Manual Therapy, 15, 415–433. https://doi:10.1016/j.math.2010.04.003
6. Furlan, A. D., Yazdi, F., Tsertsvadze, A., Gross, A., Van Tulder, M., Santaguida L, …, Tsouros S. (2012). A systematic review and meta-analysis of efficacy, cost-effectiveness, and safety of selected complementary and alternative medicine for neck and low-back pain. Evidence-Based Complementary and Alternative Medicine, 2012, 953139. https://doi:10.1155/2012/953139.
7. Goode, A. P., Freburger, J., Carey, T. (2010). Prevalence, practice patterns, and evidence for chronic neck pain. Arthritis Care Research (Hoboken), 62, 1594–1601. https://doi: 10.1002/acr.20270
8. Graham, N., Gross, A., Goldsmith, C. H., Klaber Moffett, J., Haines, T,, Burnie, S. J., Peloso, P. M. (2008). Mechanical traction for neck pain with or without radiculopathy. Cochrane Database of Systematic Reviews, 3, CD006408. https://doi: 10.1002/14651858

9. Graham, N., Gross, A. R., Carlesso, L. C., Santaguida, P. L., Macdermid, J. C., Walton, D,, Ho, E. (2013) An ICON overview on physical modalities for neck pain and associated disorders. The Open Orthopaedics Journal, 7, 440–460. https://doi: 10.2174/1874325001307010440
10. Gross, A., Goldsmith, C., Hoving, J., Haines, T., Peloso, P., Aker, P., …, Myers, C. (2007). Conservative management of mechanical neck disorders: a systematic review. The Journal of Rheumatology, 34, 1083–1102. PMID: 17295434.
11. Gross, A., Miller, J., D’Sylva, J., Burnie, S. J., Goldsmith, C. H., Graham, N., …, COG. (2010). Manipulation or mobilization for neck pain: a cochrane review. Manual Therapy, 15,315–333. https://doi: 10.1016/j.math.2010.04.002
12. Gross, A. R., Dziengo, S., Boers, O., Goldsmith, C. H., Graham, N., Lilge, L., ..., White, R. (2013). Low Level Laser Therapy (LLLT) for Neck Pain: a systematic review and meta-regression. The Open Orthopaedics Journal, 7, 396–419. https://doi: 10.2174/1874325001307010396
13. Gross, A. R., Kaplan, F., Huang, S., Khan, M., Santaguida, P. L., Carlesso, L.C., …, Hartvigsen, J. (2013). Psychological care, patient education, orthotics, ergonomics and prevention strategies for neck pain: an systematic overview update as part of the ICON project. The Open Orthopaedics Journal, 7, 530–561. https://doi: 10.2174/1874325001307010530
14. Hincapié, C. A., Cassidy, J. D., Côté, P., Carroll, L. J., Guzmán, J. (2010). Whiplash injury is more than neck pain: a population-based study of pain localization after traffic injury. Journal of Occupational and Environmental Medicine, 52(4), 434-40. https://doi: 10.1097/JOM.0b013e3181bb806d
15. Hoe, V. C., Urquhart, D. M., Kelsall, H.L., Sim, M. R. (2012). Ergonomic design and training for preventing work-related musculoskeletal disorders of the upper limb and neck in adults. Cochrane Database of Systematic Reviews, 8, CD008570. https://doi: 10.1002/14651858
16. Hogg-Johnson, S., van der Velde, G., Carroll, L. J., Holm, L. W., Cassidy, J. D., Guzman, J., …, Peloso, P. (2009). The burden and determinants of neck pain in the general population: results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders. Journal of Manipulative and Physiological Therapeutics, 32(2), 46-60. https://doi: 10.1097/BRS.0b013e31816454c8
17. Hoy, D. G ., Protani, M., De, R., Buchbinder, R. (2010). The epidemiology of neck pain. Best Practice & Research Clinical Rheumatology, 24, 783–792. https://doi: 10.1016/j.berh.2011.01.019
18. Kay, T. M., Gross, A., Goldsmith, C. H., Rutherford, S., Voth, S., Hoving, J. L., …, Santaguida, P. L. (2012). Exercises for mechanical neck disorders. Cochrane Database of Systematic Reviews, 8, CD004250. https://doi: 10.1002/14651858
19. Kroeling, P., Gross, A., Goldsmith, C. H., Burnie, S. J., Haines, T., Graham, N., Brant, A. (2009). Electrotherapy for neck pain. Cochrane Database of Systematic Reviews, 4, CD004251. https://doi: 10.1002/14651858
20. Miller, J., Gross, A., D’Sylva, J., Burnie, S. J., Goldsmith, C. H., Graham, N., …, Hoving, J. L. (2010). Manual therapy and exercise for neck pain: a systematic review. Manual Therapy, 15: 334–354. PMID: 20593537.
21. Sidenius Brockhusen, S., Bussières, A., French, S. D., Christensen, H. W., Jensen, T. S. (2017). Managing patients with acute and chronic non-specific neck pain: are Danish chiropractors compliant with guidelines?. Chiropractic & Manual Therapies, 28. https://doi: 10.1186/s12998-017-0148-9
22. Verhagen, A. P., Karels, C., Bierma-Zeinstra, S. M., Feleus, A., Dahaghin, S., Burdorf, A., …, Koes, B. W. (2007). Ergonomic and physiotherapeutic interventions for treating work-related complaints of the arm, neck or shoulder in adults. A Cochrane systematic review. Europa Medicophysica, 43, 391–405. PMID: 17921965.