Primer Total Diz Artroplastisi Hastalarında Rehabilitasyon Protokolüne Ek Olarak Uygulanan Manuel Lenfatik Drenajının Etkileri: Klinik Ön Sonuçlar

Abstract

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.

Keywords

• Total diz artroplastisi
• manuel lenfatik drenaj
• kinezyofobi
• ağrı
• yaşam kalitesi

Outcomes with Additional Manual Lymphatic Drainage to Rehabilitation Protocol in Primary Total Knee Arthroplasty Patients: Preliminary Clinical Results

Abstract

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.

Keywords

• Total knee arthroplasty
• manual lymphatic drainage
• kinesiophobia
• pain
• quality of life

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