Primer Total Diz Artroplastisi Hastalarında Rehabilitasyon Protokolüne Ek Olarak Uygulanan Manuel Lenfatik Drenajının Etkileri: Klinik Ön Sonuçlar
Yıl 2021,
, 319 - 329, 25.12.2021
Emine Cihan
,
Necmiye Ün Yıldırım
,
Onur Bilge
,
Yeşim Bakar
,
Mahmut Doral
Öz
Amaç: Bu çalışma total diz artroplasti (TDA) cerrahisi sonrası uygulanan manuel lenf drenajı (MLD) tekniğinin ağrı, kinezyofobi ve yaşam kalitesi üzerine olan klinik sonuçlarını değerlendirmek amacıyla yapılmıştır.
Metod: TDA cerrahisi geçiren hastalar randomize olacak şekilde kontrol grubu (n:10) ve MLD grubuna (n:11) ayrıldı. Her iki gruba standart postoperatif rehabilitasyon protokolü uygulandı. MLD grubunun rehabilitasyon protokolüne ek olarak cerrahiden sonra üç gün boyunca MLD uygulaması eklendi. Klinik değerlendirme postoperatif 3. gün ve 6. haftada yapıldı. Dizdeki ağrıyı değerlendirmesi için Vizüel Analog Skala (VAS), hareket korkusunu değerlendirmesi için Tampa Kinezyofobi Skalası (TKS) ve yaşam kalitesi değerlendirmesi için Nottingham Sağlık Profili (NSP) anketleri kullanıldı.
Bulgular: MLD grubunun 3. gün ve 6. haftadaki VAS ve TKS puanları kontrol grubuna göre anlamlı olarak düşük bulundu (p<0,05). Aynı şekilde, MLD grubunun 6. hafta NHP puanları kontrol grubuna göre anlamlı olarak düşük bulundu (p<0,05). Süreçlere göre grup içi ve gruplar arası her üç değerlendirme sonucunda elde edilen skor için de MLD grubunun etki büyüklüğü kontrol grubundan daha büyüktür.
Sonuç: Çalışmanın sonucunda, TDA cerrahilerinden sonra uygulanan standart rehabilitasyon protokolüne ek olarak MLD tekniğinin eklenmesinin iyileşme sürecini olumlu etkilediği ve ayrıca postoperatif kinezyofobi ve ağrı düzeyini azaltarak yaşam kalitesini iyileştirdiğini görüldü. TDA cerrahilerinden sonra bu özel tekniğin rehabilitasyon programına eklenmesi hasta memnuniyetini sağlayacak ve klinik sonuçların iyileşmesine olumlu katkı sağlayacaktır.
Kaynakça
- [1] Papakostidou I, Dailiana ZH, Papapolychroniou T, Liaropoulos L, Zintzaras E, Karachalios TS, et al. Factors affecting the quality of life after total knee arthroplasties: a prospective study. BMC Musculoskelet. Disord. 2012;13(1):116.
- [2] Lamplot JD, Wagner ER and Manning DW. Multimodal Pain Management in Total Knee Arthroplasty: A Prospective Randomized Controlled Trial. J Arthroplasty. 2014; 29: 329-34.
- [3] Luque-Suarez A, Martinez-Calderon J and Falla D. Role of kinesiophobia on pain, disability and quality of life in people suffering from chronic musculoskeletal pain: a systematic review. Br J Sports Med. 2019; 53: 554-9.
- [4] Flanigan DC, Everhart JS, Pedroza A, Smith T and Kaeding CC. Fear of reinjury (kinesiophobia) and persistent knee symptoms are common factors for lack of return to sport after anterior cruciate ligament reconstruction. Arthroscopy. 2013; 29: 1322-9.
- [5] Doury-Panchout F, Metivier JC and Fouquet B. Kinesiophobia negatively influences recovery of joint function following total knee arthroplasty. Eur J Phys Rehabil Med. 2015; 51: 155-61.
- [6] Ebert JR, Joss B, Jardine B and Wood DJ. Randomized Trial Investigating the Efficacy of Manual Lymphatic Drainage to Improve Early Outcome After Total Knee Arthroplasty. Arch Phys M. 2013; 94: 2103-11.
- [7] Pichonnaz C, Bassin J-P, Lécureux E, et al. Effect of manual lymphatic drainage after total knee arthroplasty: a randomized controlled trial. Arch. Phys. Med. 2016; 97: 674-82.
- [8] Kessler T, de Bruin E, Brunner F, Vienne P and Kissling R. Effect of manual lymph drainage after hindfoot operations. Physiother Res Int. 2003; 8: 101-10.
- [9] Härén C, Backman M, Wiberg K. Effect Of Manual Lymph Drainage As Describe By Vodder On Oedema Of The Hand After Fracture Of The Distal Radius: A Prospective Clinical Study. Scand J Plast Reconstr Surg. 2000; 34: 367-72.
- [10] Korosec BJ. Manual Lymphatic Drainage Therapy. Home Health Care Manag Pract. 2004; 16: 499-511.
- [11] Canata GL, Casale V and Chiey A. Pain management in total knee arthroplasty: efficacy of a multimodal opiate-free protocol. Joints. 2016; 04: 222-7.
- [12] Vairo GL, Miller SJ, Rier NMCI and Uckley WBI. Systematic Review of Efficacy for Manual Lymphatic Drainage Techniques in Sports Medicine and Rehabilitation: An Evidence-Based Practice Approach. J. Man. Manip. Ther. 2009; 17: 80E-9E.
- [13] Crichton N. Visual analogue scale (VAS). J Clin Nurs. 2001; 10: 706-6
- [14] Yilmaz ÖT, Yakut Y, Uygur F and Uluğ N. Tampa Kinezyofobi Ölçeği’nin Türkçe versiyonu ve test-tekrar test güvenirliği. TJPR. 2011; 22: 44-9.
- [15] Kücükdeveci AA, McKenna SP, Kutlay S, Gürsel Y, Whalley D and Arasil T. The development and psychometric assessment of the Turkish version of the Nottingham Health Profile. Int J Rehabil Res. 2000; 23: 31-8.
- [16] Cohen J. Statistical power analysis for the behavioral sciences. Academic Press, 2013.
- [17] Fujiura T, Nagasawa H and Wakabayashi H. Effect of manual lymph drainage for up to 10 days after total knee arthroplasty: Arandomized controlled trial. Phys.Ther.Res. 2020: E9992.
- [18] Danoff JR, Goel R, Sutton R, Maltenfort MG and Austin MS. How much pain is significant? Defining the minimal clinically important difference for the visual analog scale for pain after total joint arthroplasty. J Arthroplasty. 2018; 33: S71-S5. e2.
- [19] Priganc VW and Ito MA. Changes in edema, pain, or range of motion following manual edema mobilization: a single-case design study. J Hand Ther. 2008; 21: 326-35.
- [20] Filardo G, Merli G, Roffi A, et al. Kinesiophobia and depression affect total knee arthroplasty outcome in a multivariate analysis of psychological and physical factors on 200 patients. KSSTA. 2017; 25: 3417-23.
- [21] Monticone M, Ferrante S, Rocca B, et al. Home-based functional exercises aimed at managing kinesiophobia contribute to improving disability and quality of life of patients undergoing total knee arthroplasty: a randomized controlled trial. Arch Phys Med Rehabil. 2013; 94: 231-9
- [22] Terry RH, Niven CA, Brodie EE, Jones RB and Prowse MA. Memory for pain? A comparison of nonexperiential estimates and patients’ reports of the quality and intensity of postoperative pain. J Pain. 2008; 9: 342-9.
- [23] Bąbel P, Pieniążek L and Zarotyński D. The effect of the type of pain on the accuracy of memory of pain and affect. Eur J Pain. 2015; 19: 358-68.
- [24] Yildiz N, Topuz O, Gungen GO, Deniz S, Alkan H and Ardic F. Health-related quality of life (Nottingham Health Profile) in knee osteoarthritis: correlation with clinical variables and self-reported disability. Rheumatol int. 2010; 30: 1595-600.
- [25] Cho Y, Do J, Jung S, Kwon O and Jeon JY. Effects of a physical therapy program combined with manual lymphatic drainage on shoulder function, quality of life, lymphedema incidence, and pain in breast cancer patients with axillary web syndrome following axillary dissection. Support Care in Cancer. 2016; 24: 2047-57
Outcomes with Additional Manual Lymphatic Drainage to Rehabilitation Protocol in Primary Total Knee Arthroplasty Patients: Preliminary Clinical Results
Yıl 2021,
, 319 - 329, 25.12.2021
Emine Cihan
,
Necmiye Ün Yıldırım
,
Onur Bilge
,
Yeşim Bakar
,
Mahmut Doral
Öz
Objective: This study was carried out to evaluate the clinical outcomes such as pain, kinesiophobia and quality of life of additional manual lymph drainage (MLD) technique in the after total knee arthroplasty (TKA) surgery.
Methods: Twenty-one TKA patients were randomly allocated to a control group (n:10) and MLD group (n:11). Both groups received routine postoperative rehabilitation. MLD group also received MLD in the first three days after surgery. Clinical assessment was undertaken on postoperative 3rd day and at 6th week. This included knee pain using Visual Analog Scale (VAS), kinesiophobia using Tampa Kinesiophobia Scale (TKS) and quality of life using Nottingham Health Profile (NHP).
Results: VAS and TKS values of the MLD group on the 3rd day and at the 6th week were found to be significantly lower than the control group (p<0.05). The 6th week NHP values of the MLD group were found to be significantly lower than the control group (p<0.05). For all three values, within-group, and between-group according to processes the effect size of the MLD group is greater than the control group.
Conclusion: The results of the present study demonstrated that addition of MLD application to the standard rehabilitation protocol of TKA positively affected the healing process and it also improved the quality of life by reducing postoperative kinesiophobia and pain level. Adding this special technique to the rehabilitation program in TKA surgeries will provide patient satisfaction and contribute positively to the improvement in clinical outcomes.
Kaynakça
- [1] Papakostidou I, Dailiana ZH, Papapolychroniou T, Liaropoulos L, Zintzaras E, Karachalios TS, et al. Factors affecting the quality of life after total knee arthroplasties: a prospective study. BMC Musculoskelet. Disord. 2012;13(1):116.
- [2] Lamplot JD, Wagner ER and Manning DW. Multimodal Pain Management in Total Knee Arthroplasty: A Prospective Randomized Controlled Trial. J Arthroplasty. 2014; 29: 329-34.
- [3] Luque-Suarez A, Martinez-Calderon J and Falla D. Role of kinesiophobia on pain, disability and quality of life in people suffering from chronic musculoskeletal pain: a systematic review. Br J Sports Med. 2019; 53: 554-9.
- [4] Flanigan DC, Everhart JS, Pedroza A, Smith T and Kaeding CC. Fear of reinjury (kinesiophobia) and persistent knee symptoms are common factors for lack of return to sport after anterior cruciate ligament reconstruction. Arthroscopy. 2013; 29: 1322-9.
- [5] Doury-Panchout F, Metivier JC and Fouquet B. Kinesiophobia negatively influences recovery of joint function following total knee arthroplasty. Eur J Phys Rehabil Med. 2015; 51: 155-61.
- [6] Ebert JR, Joss B, Jardine B and Wood DJ. Randomized Trial Investigating the Efficacy of Manual Lymphatic Drainage to Improve Early Outcome After Total Knee Arthroplasty. Arch Phys M. 2013; 94: 2103-11.
- [7] Pichonnaz C, Bassin J-P, Lécureux E, et al. Effect of manual lymphatic drainage after total knee arthroplasty: a randomized controlled trial. Arch. Phys. Med. 2016; 97: 674-82.
- [8] Kessler T, de Bruin E, Brunner F, Vienne P and Kissling R. Effect of manual lymph drainage after hindfoot operations. Physiother Res Int. 2003; 8: 101-10.
- [9] Härén C, Backman M, Wiberg K. Effect Of Manual Lymph Drainage As Describe By Vodder On Oedema Of The Hand After Fracture Of The Distal Radius: A Prospective Clinical Study. Scand J Plast Reconstr Surg. 2000; 34: 367-72.
- [10] Korosec BJ. Manual Lymphatic Drainage Therapy. Home Health Care Manag Pract. 2004; 16: 499-511.
- [11] Canata GL, Casale V and Chiey A. Pain management in total knee arthroplasty: efficacy of a multimodal opiate-free protocol. Joints. 2016; 04: 222-7.
- [12] Vairo GL, Miller SJ, Rier NMCI and Uckley WBI. Systematic Review of Efficacy for Manual Lymphatic Drainage Techniques in Sports Medicine and Rehabilitation: An Evidence-Based Practice Approach. J. Man. Manip. Ther. 2009; 17: 80E-9E.
- [13] Crichton N. Visual analogue scale (VAS). J Clin Nurs. 2001; 10: 706-6
- [14] Yilmaz ÖT, Yakut Y, Uygur F and Uluğ N. Tampa Kinezyofobi Ölçeği’nin Türkçe versiyonu ve test-tekrar test güvenirliği. TJPR. 2011; 22: 44-9.
- [15] Kücükdeveci AA, McKenna SP, Kutlay S, Gürsel Y, Whalley D and Arasil T. The development and psychometric assessment of the Turkish version of the Nottingham Health Profile. Int J Rehabil Res. 2000; 23: 31-8.
- [16] Cohen J. Statistical power analysis for the behavioral sciences. Academic Press, 2013.
- [17] Fujiura T, Nagasawa H and Wakabayashi H. Effect of manual lymph drainage for up to 10 days after total knee arthroplasty: Arandomized controlled trial. Phys.Ther.Res. 2020: E9992.
- [18] Danoff JR, Goel R, Sutton R, Maltenfort MG and Austin MS. How much pain is significant? Defining the minimal clinically important difference for the visual analog scale for pain after total joint arthroplasty. J Arthroplasty. 2018; 33: S71-S5. e2.
- [19] Priganc VW and Ito MA. Changes in edema, pain, or range of motion following manual edema mobilization: a single-case design study. J Hand Ther. 2008; 21: 326-35.
- [20] Filardo G, Merli G, Roffi A, et al. Kinesiophobia and depression affect total knee arthroplasty outcome in a multivariate analysis of psychological and physical factors on 200 patients. KSSTA. 2017; 25: 3417-23.
- [21] Monticone M, Ferrante S, Rocca B, et al. Home-based functional exercises aimed at managing kinesiophobia contribute to improving disability and quality of life of patients undergoing total knee arthroplasty: a randomized controlled trial. Arch Phys Med Rehabil. 2013; 94: 231-9
- [22] Terry RH, Niven CA, Brodie EE, Jones RB and Prowse MA. Memory for pain? A comparison of nonexperiential estimates and patients’ reports of the quality and intensity of postoperative pain. J Pain. 2008; 9: 342-9.
- [23] Bąbel P, Pieniążek L and Zarotyński D. The effect of the type of pain on the accuracy of memory of pain and affect. Eur J Pain. 2015; 19: 358-68.
- [24] Yildiz N, Topuz O, Gungen GO, Deniz S, Alkan H and Ardic F. Health-related quality of life (Nottingham Health Profile) in knee osteoarthritis: correlation with clinical variables and self-reported disability. Rheumatol int. 2010; 30: 1595-600.
- [25] Cho Y, Do J, Jung S, Kwon O and Jeon JY. Effects of a physical therapy program combined with manual lymphatic drainage on shoulder function, quality of life, lymphedema incidence, and pain in breast cancer patients with axillary web syndrome following axillary dissection. Support Care in Cancer. 2016; 24: 2047-57