Semptomatik Rotator Kaf Yırtığı olan Hastalarda Santral Sensitizasyonun Omuz Ağrı ve Disabilite Üzerine Etkisi

Yıl 2023, Cilt: 5 Sayı: 2, 110 - 116, 28.06.2023

İsa Cüce , Rıdvan Yıldızhan , Enes Veziroğlu , Hasan Kara , Şuayb Celalettin Sayın , Mustafa Çalış

https://doi.org/10.52827/hititmedj.1285524

Öz

Amaç: Rotator kaf (RK) yırtığı olan hastalarda santral sensitizasyon (SS) varlığı şimdiye kadar araştırılmamıştır. Bu çalışmada, semptomatik RK yırtığı olan hastalarda SS varlığının omuz ağrısı ve disabilite üzerine etkisini araştırmak amaçlanmıştır.
Gereç ve Yöntem: Çalışmaya, kronik RK yırtığı olan 52 semptomatik hasta ve hastalar ile yaş/cinsiyet olarak eşleştirilmiş 35 sağlıklı kontrol dâhil edildi. SS varlığı ve şiddeti Santral Sensitizasyon Ölçeği (SSÖ) ile değerlendirildi. Ağrı duyarlılığı için lokal (etkilenen omuz) ve uzak (tibialis anterior) bölgelerden basınç-ağrı eşikleri (BAE) kaydedildi. Hasta grubunda ağrı ve disabilite, Vizüel Analog Skala (ağrı) ve Omuz Ağrı ve Disabilite İndeksi (OADİ) ile değerlendirildi.
Bulgular: Hasta grubunun kontrol grubuna göre SSÖ skorları anlamlı yüksek (p < 0,001) ve deltoidden ölçülen BAE değerleri anlamlı düşüktü (p = 0,040). SS (SSÖ skoru ≥ 40), hastaların 24 (%46,2)’ünde saptandı. SS’si olan hasta grubunda olmayanlara göre OADİ-ağrı skorları anlamlı yüksekti (p = 0,034). SSÖ skorları ile OADİ-ağrı skorları (r = 0,299) ve üst trapez (r = -0,302) ve deltoidden (r = -0,325) ölçülen BAE değerleri arasında orta derecede korelasyonlar saptandı (p < 0,05).
Sonuç: Bu çalışma, RK yırtığı olan hastaların yaklaşık yarısında SS olduğunu gösterdi. Buna karşın, lokal bölgeden (deltoid) ölçülen BAE değerinin sağlıklı kontrol grubundan anlamlı düşük bulunması sadece periferik sensitizasyon ile ilişkilendirilebilir. Ayrıca, RK yırtığına bağlı gelişen SS hastalarda disabiliteden ziyade artan ağrı yükü ile ilişkili gözükmektedir.

Anahtar Kelimeler

Kronik omuz ağrısı, rotator kaf yırtığı, santral sensitizasyon, ağrı duyarlılığı, disabilite

Destekleyen Kurum

Yoktur

Proje Numarası

Uygun Değil

Teşekkür

Yoktur

The Effect of Central Sensitization on Shoulder Pain and Disability in Patients with Symptomatic Rotator Cuff Tear

Öz

Objective: The presence of central sensitization (CS) in patients with rotator cuff tears has not been investigated thus far. This study aimed to investigate the effects of CS on shoulder pain and disability in patients with symptomatic rotator cuff (RC) tears.
Material and Method: The study included 52 symptomatic patients diagnosed with chronic RC tears and 35 age- and sex-matched healthy controls. CS was evaluated with the Central Sensitization Inventory (CSI). Pressure-pain thresholds (PPTs) were recorded at both local (affected shoulder) and remote (tibialis anterior) sites. Pain and disability were measured using the Visual Analogue Scale for pain, and the Shoulder Pain and Disability Index in the patient group.
Results: The patient group had significantly higher CSI scores (p < 0.001) and significantly lower deltoid PPT levels than the control group (p = 0.040). CS (CSI score ≥ 40) was detected in 24 (46.2%) of the patients. The SPADI-pain scores were significantly higher in patients with CS compared to those without (p = 0.034). The CSI scores moderately correlated with SPADI-pain scores (r = 0.299), and the upper trapezius (r = -0.302) and deltoid (r = -0.325) PPT levels (p < 0,05).
Conclusion: This study showed that approximately half of the patients with RC tear had CS. However, the significantly lower PPT levels at the local site (deltoid) compared to the control group may only be associated with peripheral sensitization. In addition, CS due to RC tear seems to be associated with increased pain rather than disability.

Anahtar Kelimeler

Chronic shoulder pain, rotator cuff tear, central sensitization, pain sensitivity, disability

Proje Numarası

Uygun Değil

Kaynakça

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