KRONİK BEL AĞRILI HASTALARDA LOMBER STABİLİZASYON EGZERSİZLERİNİN ETKİSİ

Abstract

Amaç Bu çalışmanın amacı kronik bel ağrısı olan hastalarda lomber stabilizasyon egzersizlerinin (LSE) ağrı, fonksiyonel kapasite, yaşam kalitesi ve denge üzerine etkisini araştırmak, ayrıca lomber multifidus kası kesitsel alanına etkisini değerlendirmektir. Gereç ve Yöntem Çalışmaya kronik bel ağrısı tanısı alan 66 hasta alındı. Hastalar randomize edilerek iki gruba ayrıldı. Birinci gruba (Grup 1, n=28) lomber stabilizasyon egzersizleri, TENS ve Hotpack tedavileri, ikinci gruba (Grup 2, n=37) ise sadece TENS, Hotpack tedavileri verildi. Hastalar tedavi öncesi ve tedavi sonrası 8. haftada değerlendirildi. Ağrı için Visuel Analog Skala (VAS), fonksiyonel dizabilite için Roland Morris Sorgulama Anketi ve Oswestry Özürlülük İndeksi, yaşam kalitesi için Kısa Form-36 (SF-36) ile değerlendirme yapıldı. Denge değerlendirmesinde Tetrax® posturografi cihazı (SunlightMedicalLtd, İsrail) kullanıldı ve düşme indeksi (FI) hesaplandı. Multifidus kası kesit alanı ultrasonografi ile ölçüldü. Bulgular Gruplar arası karşılaştırıldığında multifidus kası kesitsel alanı, SF-36`nın fiziksel rol güçlüğü, ağrı, ruhsal sağlık ve enerji/vitalite/ canlılık alt parametrelerinde LSE alan hastalarda daha anlamlı iyileşme gözlendi( p˂0.05). Düşme indeksi, VAS skorları, Roland Morris Sorgulama Anketi ve Oswestry Özürlülük İndeksi skorlarında gruplar arasında anlamlı farklılık saptanmadı. Sonuç Lomber stabilizasyon egzersizleri, kronik bel ağrısı olan hastalarda multifidus kesit alanını ve yaşam kalitesini olumlu yönde etkilemektedir. Bizim örneklemimiz için lomber stabilizasyon egzersizlerinin konvansiyonel fizik tedavi programına eklenmesi denge, ağrı ve dizabilite açısından ek katkı sağlamamaktadır.

Keywords

• Denge
• Kronik bel ağrısı
• Lomber stabilizasyon egzersizleri
• Multifidus kası
• Yaşam kalitesi

THE EFFECT OF LUMBAR STABILIZATION EXERCISES ON CHRONIC LOW BACK PAIN PATIENTS

Abstract

Objective The aim of this study is to investigate the effect of lumbar stabilization exercises (LSE) on pain, functional capacity, quality of life, and balance in patients with chronic low back pain (CLBP), and also to evaluate the effect on the cross-sectional area of the lumbar multifidus muscle. Material and Method Sixty-six patients with CLBP were enrolled, randomized, and divided into two groups. LSE, transcutaneous electrical nerve stimulation (TENS), and hot pack treatments were performed in Group 1 (n=28). In Group 2 (n=37), TENS and hot pack treatments were performed only. Pre and 8-week post-treatment assessments were made. Visual Analog Scale (VAS) was used to evaluate pain. Modified Oswestry Disability Index (ODI) and Roland Morris Disability Questionnaire (RMDQ) were used to evaluate the functional disability. Short Form-36 (SF-36) was used to measure the quality of life. In the assessment of balance, a Tetrax® posturography device (Sunlight Medical Ltd, Israel) was used and fall index (FI) was calculated. The cross-sectional area of multifidus muscles was measured by ultrasonography. Results Significant improvements regarding the crosssectional area of multifidus musclesand subparameters of SF-36 named physical role, pain, mental health, and energy/vitality were determined in Group 1 compared to Group 2 (p˂0.05). No significant difference was present between the groups regarding FI, VAS score, RMDQ, ODI, and balance. Conclusion Lumbar stabilization exercises in patients with chronic low back pain multifidus positively affects crosssectional area and quality of life. For our sample, the addition of lumbar stabilization exercises to the conventional physical therapy program does not provides an additional contribution in terms of balance, pain and disability.

Keywords

• Lumbar stabilization exercises
• chronic low back pain
• quality of life
• balance
• multifidus muscle

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