ROTATOR MANŞET PATOLOJİLERİ: TÜRKİYE’DE MEVCUT FİZYOTERAPİ UYGULAMALARI

Öz

Amaç: Rotator manşet patolojilerinde (RMP) fizyoterapi programına yön veren en önemli faktörlerden biri, bilimsel kanıtlar ışığında fizyoterapistin klinik tercihleridir. Bununla birlikte yönetim parametreleri fizyoterapistler arasında oldukça değişkendir. Bu çalışmada Türk fizyoterapistlerin RMP tedavisi için kullandıkları mevcut fizyoterapi uygulamalarının tanımlanması ve bu uygulamaların literatür kanıtları ve Avrupa ülkelerindeki klinik bakış açısı ile paralelliğinin incelenmesi amaçlandı. Yöntem: RMP semptomları olan tipik bir hastayı tanımlayan bir klinik senaryoya dayalı kesitsel bir online anket Temmuz/Ağustos 2020 tarihleri arasında uygulandı. Yüz dört fizyoterapistin tanımlayıcı yanıtları, RMP ile ilgili daha fazla klinik deneyime veya eğitime sahip olan (SI) ve olmayan fizyoterapistler (NSI) olarak iki gruba ayrılarak raporlandı ve analiz edildi. Sonuçlar: En çok tercih edilen yaklaşımlar mobilizasyon (82), skapular stabilizasyon egzersizleri (82), tavsiye/eğitim (71) ve bantlamaydı (62). Soğuk uygulama (χ2=4,303, p=0,038) ve izometrik egzersiz (χ2=4,248, p=0,039) tercih oranı SI grubundaki fizyoterapistler için NSI grubuna göre anlamlı olarak yüksekti. Tartışma: En çok tercih edilen yönetim stratejileri olan mobilizasyon, egzersiz ve tavsiye/eğitim Avrupa ülkelerindeki fizyoterapistlerin tercihleri ve güncel literatür kanıtlarıyla uyumlu olarak bulundu. Ancak pasif modaliteler de yüksek oranda tercih edilmişti ve SI ve NSI gruplarındaki fizyoterapistlerin yönetim stratejileri de farklılık gösteriyordu. RMP hastaları için fizyoterapistler arasındaki yüksek oranda uygulama değişkenliği ve pasif tedavi tercihi, güncel literatür kanıtlarının düzenli olarak takip edilmemesine bağlı olabilir.

Anahtar Kelimeler

• Rotator Manşet
• Omuz
• Anket

ROTATOR CUFF DISORDERS: A SURVEY OF CURRENT PHYSIOTHERAPY PRACTICE IN TURKIYE

Abstract

Purpose: One of the most important factors guiding the physiotherapy program for rotator cuff disorders (RCD) is the clinical preferences of the physiotherapist in light of the evidence. However, the management parameters are remarkably variable between physiotherapists. It was aimed to describe the current physiotherapy practice of Turkish physiotherapists for the management of RCD and to explore its parallelism with the research evidence, and with the clinical perspective in European countries. Methods: A cross-sectional online survey based on a clinical scenario that describes a typical patient with symptoms of RCD was conducted during July/August 2020. Descriptive responses of 104 physiotherapists were reported and analyzed by grouping physiotherapists with special interest (SI) who have further clinical experience or specialized training on RCD and no special interest (NSI). Results: The most preferred approaches were mobilization (82), scapular stabilization exercises (82), advice/education (71), and taping (62). The preference rate of cold therapy (χ2=4.303, p=0.038) and isometric exercises (χ2=4.248, p=0.039) were significantly higher for physiotherapists with SI rather than NSI group. Conclusions: The most preferred management strategies of mobilization, exercise, and advice/education have been aligned with the preferences of physiotherapists from European countries and the current research evidence. However, passive modalities were also highly preferred. The management strategies differ between the physiotherapists who have SI and NSI. The high degree of practice variability and passive treatment preference of physiotherapists for the patients with RCD might be due to a lack of following the current literature evidence regularly.

Keywords

• Rotator Cuff
• Shoulder
• Survey/s

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