Hemiplejik omuzda bantlama ile nöromüsküler elektrik stimülasyon sonuçlarının karşılaştırılması: randomize kontrollü çalışma

Yıl 2020, Cilt: 7 Sayı: 2, 99 - 108, 31.08.2020

Gül Öznur Karabıçak , Burcu Talu

Öz

Amaç: Omuz fonksiyonu, inme sonrası hayatta kalanların bağımsızlık kazanmaları için önemli bir rol oynar. Bu çalışmanın
amacı, inme geçiren hastalarda omuz bantlama (Tp) ve nöromüsküler elektrik stimülasyonunun (NMES) omuz fonksiyonu, motor
aktivite ve ağrı üzerindeki etkilerini karşılaştırmaktır.

Yöntem: Çalışmaya üst ekstremite tutulumu olan inme hastaları alındı. Altmış hasta, inmeden 1-3 ay sonra bantlama grubu
(TpG), NMES veya kontrol gruplarına (CG) rasgele ayrıldı. Tedavi süresi 4 hafta idi. Omuz fonksiyonel değerlendirmede Fugl–
Meyer Duyu Motor Değerlendirme Ölçeği (FMDDÖ) ve Motor Aktivite Log-28 (MAL) kullanıldı. Omuz ağrısı değerlendirmesinde
Görsel Analog Skala kullanıldı.

Bulgular: Grup içi karşılaştırmalarda FMDDÖ (TpG p≤0,001; NMES p=0,002; CG p≤0,001) ve MAL skorlarında (TpG p≤0,001;
NMES p≤0,001; CG p ≤0,001) istatistiksel açıdan anlamlı gelişmeler bulundu. Grup içi karşılaştırmalar hem istirahatte omuz
ağrısı yoğunluğunda (TpG p=0,007 ve NMES p=0,014) hem de aktivite ile (TpG p≤0,01 ve NMES p=0,016) anlamlı bir azalma
gösterirken, CG’de hem istirahatte hem de aktivite ağrısı ile anlamlı bir azalma saptanmadı (her ikisi için p=0,054). Gruplar
arası karşılaştırmalar, FMDDÖ'lerde TpG lehine önemli bir değişiklik (p=0,0026) gösterdi (p≤0,001). Grup karşılaştırmalarında
MAL'de fark saptanmadı (p>0,05).

Sonuç: İnme hastalarının konservatif tedavisinde, etkilenen omuzda izole motor aktivitesini arttırmak için bantlama ve NMES
kullanılabilir; ancak, fonksiyon için destekleyici bantlama daha etkili olacaktır.

Anahtar Kelimeler

Hemipleji, Omuz, Atletik Bant, Elektrik Stimulasyonu, Motor Aktivitesi

A comparison of taping and neuromuscular electric stimulation outcomes in hemiplegic shoulder: a randomized controlled trial

Öz

Purpose: Aim of this study is to compare the effects of shoulder taping (Tp) and neuromuscular electric stimulation (NMES) on shoulder function, motor activity, and pain in patients with hemiplegia.

Methods: Outpatients with ischemic stroke with upper extremity involvement were enrolled in the study. Sixty patients were randomly assigned to supported taping (TpG), NMES, or control groups (CG) within 1-3 months of stroke. Treatment duration was 4 weeks. The Fugl–Meyer Sensorimotor Assessment Scale (FMSAS) and the Motor Activity Log-28 (MAL) were used for shoulder functional assessment. A Visual Analog Scale was used for shoulder pain assessment.

Results: Statistically significant improvements in the FMSAS (TpG p ≤ 0.001; NMES p=0.002; CG p ≤ 0.001) and MAL scores (TpG p ≤ 0.001; NMES p ≤ 0.001; CG p ≤ 0.001) were found in within-group comparisons. Within-group comparisons showed a significant decrease in shoulder pain intensity both at rest (TpG p = 0.007 and NMES p = 0.014) and with activity (TpG p≤ 0.01 and NMES p= 0.016), whereas no significant decrease was found in the CG either at rest or with activity pain (p = 0.054 for both). Between-group comparisons revealed a significant change (p=0.0026) in the FMSAS in favor of TpG (p ≤ 0.001). No difference was found in the MAL in between-group comparisons (p>0.05).

Conclusion: In the treatment of symptomatic shoulders in patients with hemiplegia, both options could be used to increase isolated motor activity; however, if function is desired, supportive taping would be more effective.

Anahtar Kelimeler

Hemiplegia, Shoulder, Athletic Tape, Electric Stimulation, Motor Activity

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