Adölesan İdiyopatik Skolyozda Emekleme (KLAPP) Egzersizleri (KLAPP)

Öz

Skolyoz tedavisinde emekleme (Klapp) egzersizleri klinik uygulamada fizyoterapistler tarafından sıklıkla hastalara önerilmektedir. 1900’lü yılların başlarında Klapp egzersizleri ilk kez Profesör Raudolf Klapp tarafından hayvanlar gözlemlenerek geliştirilmiş “emekleme” egzersizleridir. Temelinde lateral fleksiyon deformitesinin konveks tarafında yer alan kasların gerilmesini içerir. Medikal arama motorları tarandığında emekleme egzersizlerinin skolyoz tanılı bireylerde uygulandığı herhangi bir araştırmaya rastlanamamıştır. Literatürde yer alan mevcut iki çalışmaya dahil edilen bireylerin skolyoz tanıları radyografik inceleme ile doğrulanmamıştır. Günümüzde mevcut literatür bilgileri ışığında, emekleme egzersizlerinin skolyozda kemik yapıda meydana gelen üç boyutlu deformite üzerine etkili olamayacağı söylenebilir. Anatomi ve biyomekanik bilgiler ışığında ise kas ve ligaman gibi omurga stabilizayonunda görev alan yumuşak dokuların yapışma yerlerindeki farklılıklar nedeniyle konkav taraftaki tüm kas yapısının kısaldığını söylemek ve bu düşünce ile egzersiz modeli oluşturmak doğru ve etkili olmayacaktır. Bu anlamda fizyoterapistlerin eğitim müfredatlarının güncellenmesini ve bu alanda çalışan fizyoterapistlerin kanıta dayalı tedavi yaklaşımları ile ilgili bilgi düzeylerinin arttırılmasını önermekteyiz.

Anahtar Kelimeler

• egzersiz
• fizyoterapi
• skolyoz

CRAWLING (KLAPP) EXERCISES IN ADOLESCENT IDIOPATHIC SCOLIOSIS

Öz

Crawling (Klapp) exercises in the treatment of scoliosis are often recommended to patients by physiotherapists in clinical practice. In the early 1900s, Klapp exercises are "crawling" exercises that were first developed by Professor Raudolf Klapp by observing animals. It basically involves stretching the muscles located on the convex side of the lateral flexion deformity. When medical search engines were scanned, no study was found in which crawling exercises were applied to individuals with a diagnosis of scoliosis. Scoliosis diagnoses of individuals included in the two existing studies in the literature were not confirmed by radiographic examination. In the line of current literature, it can be said that crawling exercises cannot be effective on the three-dimensional deformity of the bone structure in scoliosis. According to anatomy and biomechanical informations, it will not be correct and effective to say that the entire muscle structure on the concave side is shortened and to create an exercise model with this thought in mind due to the differences in the attachment points of the soft tissues that take part in the stabilization of the spine, such as muscles and ligaments. In this sense, we recommend updating the training curricula of physiotherapists and increasing the knowledge level of physiotherapists working in this field about evidence-based treatment approaches.

Anahtar Kelimeler

• exercise
• physiotherapy
• scoliosis

Kaynakça

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