Adolesan İdiopatik Skolyozda Kostal Mobilizasyonun Etkisi: Pilot Çalışma

Yıl 2023, Cilt: 5 Sayı: 3, 375 - 384, 25.12.2023

Özden Canbay Gökçek , Mine Argalı Denız , Mine Gülden Polat , Hasan Hallaceli , Raif Özden

Öz

Amaç: Çalışmada idiyopatik skolyozda kostal mobilizasyon tekniğinin solunum kas kuvveti, fonksiyonel kapasite ve yaşam kalitesi üzerine etkisini incelemeyi amaçladık.
Yöntem: Çalışmaya skolyoz tanısı olan 12-18 yaş arası sekiz çocuk dahil edildi. Egzersiz ve kostal mobilizasyon grubu (n=4), egzersiz grubu (n=4). Çocukların demografik bilgileri kaydedildi. Solunum kas kuvveti ağız basınç ölçüm cihazı, fonksiyonel kapasite 6 dk yürüme testi, dispne şiddeti modifiye borg skalası, yaşam kalitesi SRS-22 formu ile değerlendirildi. İkinci değerlendirme 6 hafta sonra yapıldı.
Bulgular: Çalışmamızda yer alan çocukların yaş ortalaması; kostal mobilizasyon grubunda 14,00±2,44 yıl, kontrol grubunda 16,75±0,50 yıl idi. Solunum kas kuvveti değerleri tedavi sonrası kostal mobilizasyon grubunda egzersiz grubuna göre daha fazla artış olduğu görüldü. Ayrıca tedavi sonrasında kostal mobilizasyon grubunda SRS-22 formunun alt parametrelerinden vücut imajı, sağlığı ve tedaviden tatmin olma daha iyiydi. 6 dk yürüme mesafesinde egzersiz grubuna göre daha fazla artış, dispne şiddetinde azalma olduğu görüldü (p=0,046).
Sonuç ve Öneriler: Konvansiyonel egzersizler ile birlikte yapılan kostal mobilizasyon uygulamasının skolyozda solunum kas kuvvetinde ve yaşam kalitesinde artış, dispne şiddetinde azalma olduğu sağladığı belirlendi.

Anahtar Kelimeler

Egzersiz, Skolyoz, Mobilizasyon, Solunum, Kas kuvveti

The Effect of Costal Mobilization on Adolescent Idiopathic Scoliosis: A Pilot Study

Öz

Purpose: In this study, we aimed to examine the effect of costal mobilization technique on respiratory muscle strength, functional capacity and quality of life in idiopathic scoliosis.
Method: Eight individuals aged 12-18 years, diagnosed with scoliosis, were enrolled in the study. They were divided in to two groups: the exercise and costal mobilization group (n=4) and exercise-only group (n=4). Demographic information for all participants was recorded. Respiratory muscle strength was assessed using a mouth pressure measuring device, functional capacity was evaluated through the 6 minute walking test, dyspnea severity was measured using the modified borg scale, and quality of life was assessed with SRS-22 form. The second evaluation was conducted six weeks later.
Results: The average age of the individuals in our study was 14.00±2.44 years in the costal mobilization group and 16.75±0.50 years in the control group. It was observed that respiratory muscle strength values increased more in the costal mobilization group after treatment compared to the exercise group. Furthermore, after treatment, the costal mobilization group showed greater improvements in the sub-parameters of the SRS-22 form, including body image, health, satisfaction with the treatment, and the 6-minute walking distance, compared to the exercise group. Notably, there was a decrease in the severity of dyspnea in the costal mobilization group (p=0.046).
Conclusion and Suggestion: The addition of costal mobilization to scoliosis exercises led to increased respiratory muscle strength, improved quality of life, and a reduction in the severity of dyspnea in individual with scoliosis.

Anahtar Kelimeler

Exercises, Scoliosis, Mobilization, Respiratory, Muscle Strength

Kaynakça

• Abdelaal, A. A. M., Abd El Kafy, E. M. A. E. S., Elayat, M. S. E. M., Sabbahi, M., & Badghish, M. S. S, (2018). Changes in pulmonary function and functional capacity in adolescents with mild idiopathic scoliosis: observational cohort study. The Journal of İnternational Medical Research. 46(1). 381–391. https://doi.org/10.1177/0300060517715375
• Alanay, A., Cil, A., Berk. H.. Acaroglu. R. E.. Yazici. M.. Akcali. O.. Kosay. C.. Genc. Y.. & Surat. A. (2005). Reliability and validity of adapted Turkish Version of Scoliosis Research Society-22 (SRS-22) questionnaire. Spine. 30(21). 2464–2468. https://doi.org/10.1097/01.brs.0000184366.71761.84
• Alanazi. M. H.. Parent. E. C.. & Dennett. E. (2018). Effect of stabilization exercise on back pain. disability and quality of life in adults with scoliosis: a systematic review. European Journal of Physical and Rehabilitation Medicine. 54(5). 647–653. https://doi.org/10.23736/S1973-9087.17.05062-66
• Alves, V. L. D. S., & Avanzi, O. (2016). Respıratory muscle strength ın ıdıopathıc scolıosıs after traınıng program. Acta Ortopedica Brasileira. 24(6). 296–299. https://doi.org/10.1590/1413-785220162406120752
• Asher, M. A., & Burton, D. C. (2006). Adolescent idiopathic scoliosis: natural history and long term treatment effects. Scoliosis. 1(1). 2. https://doi.org/10.1186/1748-7161-1-2
• ATS/ERS Statement on Respiratory Muscle Testing. (2002). American journal of respiratory and critical care medicine, 166(4), 518-624. https://doi.org/10.1164/rccm.166.4.518
• Babina, R., Mohanty, P. P., & Pattnaik, M. (2016). Effect of thoracic mobilization on respiratory parameters in chronic non-specific low back pain: A randomized controlled trial. J Back Musculoskelet Rehabil, 29(3), 587-595. https://doi.org/10.3233/bmr-160679
• Borg, G. A. (1982). Psychophysical bases of perceived exertion. Med Sci Sports Exerc, 14(5), 377-381. https://pubmed.ncbi.nlm.nih.gov/7154893/
• Burwell, R. G., Aujla, R. K., Grevitt, M. P., Dangerfield, P. H., Moulton, A., Randell, T. L., & Anderson, S. I. (2009). Pathogenesis of adolescent idiopathic scoliosis in girls-a double neuro-osseous theory involving disharmony between two nervous systems, somatic and autonomic expressed in the spine and trunk: possible dependency on sympathetic nervous system and hormones with implications for medical therapy. Scoliosis, 4(1), 1-40. https://doi.org/10.1186/1748-7161-4-24
• Cheshire, J., Gardner, A., Berryman, F., & Pynsent, P. (2017). Do the SRS-22 self-image and mental health domain scores reflect the degree of asymmetry of the back in adolescent idiopathic scoliosis? Scoliosis and Spinal Disorders, 12, 1-7. https://doi.org/10.1186/s13013-017-0144-9
• Cynthia Chiarello. Spinal Disorders. Editor(s): Michelle H. Cameron. Linda G. Monroe. Physical Rehabilitation. Evidence-Based Examination. Evaluation. and Intervention 2007. Pages 140-193 ISBN 9780721603612. Dalkılınç, M., Elbasan, B., Çıtak Karakaya, İ., Yurdalan, U. (2014) Nöromuskuloskeletal Muayene ve Değerlendirme Fizyoterapistler için El Kitabı. Hiper Tıp Kitapevi.
• Dogar, F., Argun, M., Erdem, S., Gurbuz, K., Argun, A. S., & Kafadar, I. H. (2021). Clinical and radiological results of surgically treated patients with adolescent idiopathic scoliosis and the effects of pulmonary rehabilitation on respiration functions. Medicine (Baltimore), 100(7), e24675. https://doi.org/10.1097/md.0000000000024675
• Dos Santos Alves, V. L., & Avanzi, O. (2009). Objective assessment of the cardiorespiratory function of adolescents with idiopathic scoliosis through the six-minute walk test. Spine, 34(25), E926-E929. https://doi.org/10.1097/BRS.0b013e3181afd1b2
• Geiger, R., Strasak, A., Treml, B., Gasser, K., Kleinsasser, A., Fischer, V., Geiger, H., Loeckinger, A., & Stein, J. I. (2007). Six-minute walk test in children and adolescents. The Journal of Pediatrics. 150(4). 395–399.e3992. https://doi.org/10.1016/j.jpeds.2006.12.052
• Gibbons, W. J., Fruchter, N., Sloan, S., & Levy, R. D. (2001). Reference values for a multiple repetition 6-minute walk test in healthy adults older than 20 years. J Cardiopulm Rehabil, 21(2), 87-93. https://pubmed.ncbi.nlm.nih.gov/11314289/
• Guyatt, G. H., Sullivan, M. J., Thompson, P. J., Fallen, E. L., Pugsley, S. O., Taylor, D. W., & Berman, L. B. (1985). The 6-minute walk: a new measure of exercise capacity in patients with chronic heart failure. Canadian Medical Association journal. 132(8). 919–923. https://pubmed.ncbi.nlm.nih.gov/3978515/
• Kim, Y. J., Lenke, L. G., Bridwell, K. H., Kim, K. L., & Steger-May, K. (2005). Pulmonary function in adolescent idiopathic scoliosis relative to the surgical procedure. JBJS, 87(7), 1534-1541. https://doi.org/10.2106/JBJS.C.00978
• Kotwicki, T., Szulc, A., Dobosiewicz, K., & Rapała, K. (2002). The pathomechanism of idiopathic scoliosis: the importance of physiological thoracic kyphosis. Ortopedia. Traumatologia. Rehabilitacja. 4(6). 758–765. https://pubmed.ncbi.nlm.nih.gov/18034107/
• Kwan, K. Y. H., Cheng, A. C., Koh, H. Y., Chiu, A. Y., & Cheung, K. M. C. (2017). Effectiveness of Schroth exercises during bracing in adolescent idiopathic scoliosis: results from a preliminary study-SOSORT Award 2017 Winner. Scoliosis and Spinal Disorders. 12. 32. https://doi.org/10.1186/s13013-017-0139-6
• Lee, D. G. (2015). Biomechanics of the thorax - research evidence and clinical expertise. The Journal of Manual & Manipulative Therapy. 23(3). 128–138. https://doi.org/10.1179/2042618615Y.0000000008
• Leelapattana, P., Keorochana, G., Johnson, J., Wajanavisit, W., & Laohacharoensombat, W. (2011). Reliability and validity of an adapted Thai version of the Scoliosis Research Society-22 questionnaire. Journal of Children's Orthopaedics. 5(1). 35–40. https://doi.org/10.1007/s11832-010-0312-4
• Lonstein, J. E. (2006). Scoliosis: surgical versus nonsurgical treatment. Clinical Orthopaedics and Related Research. 443. 248–259. https://doi.org/10.1097/01.blo.0000198725.54891.73
• Martínez-Llorens, J., Ramírez, M., Colomina, M., Bagó, J., Molina, A., Cáceres, E., & Gea, J. (2010). Muscle dysfunction and exercise limitation in adolescent idiopathic scoliosis. The European Respiratory Journal. 36(2). 393–400. https://doi.org/10.1183/09031936.00025509
• Negrini, S., Aulisa, A. G., Aulisa, L., Circo, A. B., De Mauroy, J. C., Durmala, J., Grivas, T. B., Knott, P., Kotwicki, T., & Maruyama, T. (2012). 2011 SOSORT guidelines: Orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis. 7(1). 3. https://doi.org/10.1186/1748-7161-7-3
• Negrini, S., De Mauroy, J., Grivas, T., Knott, P., Kotwicki, T., Maruyama, T., O'Brien, J., Rigo, M., & Zaina, F. (2014). Actual evidence in the medical approach to adolescents with idiopathic scoliosis. European Journal of Physical and Rehabilitation Medicine. 50(1). 87–92. https://pubmed.ncbi.nlm.nih.gov/24622050/
• O’Connor, K. M. A. (2011). Principles of joint treatment. Principles of Neuromusculoskeletal Treatment and Management, A Handbook for Therapists with PAGEBURST Access, 2: Principles of Neuromusculoskeletal Treatment and Management, 57.
• Otman, S., & Köse, N. (2016) Tedavi Hareketlerinde Temel Değerlendirme Prensipleri. Hipokrat Kitapevi. Rigo, M. D., & Grivas, T. B. (2010). "Rehabilitation schools for scoliosis" thematic series: describing the methods and results. Scoliosis. 5. 27. https://doi.org/10.1186/1748-7161-5-27
• Schwab, F., Dubey, A., Pagala, M., Gamez, L., & Farcy, J. P. (2003). Adult scoliosis: a health assessment analysis by SF-36. Spine. 28(6). 602–606. https://doi.org/10.1097/01.BRS.0000049924.94414.BB
• Shapiro, G. S., Taira, G., & Boachie-Adjei, O. (2003). Results of surgical treatment of adult idiopathic scoliosis with low back pain and spinal stenosis: a study of long-term clinical radiographic outcomes. Spine. 28(4). 358–363. https://doi.org/10.1097/01.BRS.0000048502.62793.0C
• Shi, B., Mao, S., Sun, X., Xu, L., Zhu, F., Zhu, Z., Qian, B., Wang, W., & Qiu, Y. (2017). Both bilateral breast volume discrepancy and asymmetric anterior chest wall shape contribute to the unsightly breast contour in female right thoracic idiopathic scoliosis. Clinical Spine Surgery, 30(4), E344-E350. https://doi.org/10.1097/BSD.0000000000000128
• Smith, F. M., Latchford, G. J., Hall, R. M., & Dickson, R. A. (2008). Do chronic medical conditions increase the risk of eating disorder? A cross-sectional investigation of eating pathology in adolescent females with scoliosis and diabetes. The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine. 42(1). 58–63. https://doi.org/10.1016/j.jadohealth.2007.08.008
• Tsiligiannis, T., & Grivas, T. (2012). Pulmonary function in children with idiopathic scoliosis. Scoliosis. 7(1). 7. https://doi.org/10.1186/1748-7161-7-7
• Watanabe, K., Michikawa, T., Yonezawa, I., Takaso, M., Minami, S., Soshi, S., Tsuji, T., Okada, E., Abe, K., & Takahashi, M. (2017). Physical activities and lifestyle factors related to adolescent ıdiopathic scoliosis. The Journal of Bone and Joint Surgery. American Volume. 99(4). 284–294. https://doi.org/10.2106/JBJS.16.00459
• Weinstein, S. L., Dolan, L. A., Spratt, K. F., Peterson, K. K., Spoonamore, M. J., & Ponseti, I. V. (2003). Health and function of patients with untreated idiopathic scoliosis: a 50-year natural history study. JAMA. 289(5). 559–567. https://doi.org/10.1001/jama.289.5.559
• Weiss, H. R. (1991). The effect of an exercise program on vital capacity and rib mobility in patients with idiopathic scoliosis. Spine. 16(1). 88–93. https://doi.org/10.1097/00007632-199101000-00016
• Yildirim, S., Ozyilmaz, S., Elmadag, N. M., & Yabaci, A. (2022). Effects of core stabilization exercises on pulmonary function, respiratory muscle strength, peripheral muscle strength, functional capacity and perceived appearance in children with adolescent ıdiopathic scoliosis: A randomized controlled trial. American Journal of Physical Medicine & Rehabilitation. 101(8). 719–725. https://doi.org/10.1097/PHM.0000000000001984
• Zarzycka, M., Rozek, K., & Zarzycki, M. (2009). Alternative methods of conservative treatment of idiopathic scoliosis. Ortopedia. Traumatologia. Rehabilitacja. 11(5). 396–412. https://pubmed.ncbi.nlm.nih.gov/19920282/