The effect of occupational therapy on upper extremity function and activities of daily living in hemiplegic patients

Yıl 2023, , 350 - 354, 30.08.2023

Ayşe Gülşen Doğan

https://doi.org/10.47582/jompac.1327960

Cited By: 2

Öz

Aims: We aimed to investigate the effectiveness of occupational therapy (OT) added to traditional rehabilitation treatments on activities of daily living and upper extremity functions in hemiplegic patients in this study.
Methods: This study was carried out within eighty hemiplegic patients. In the evaluation of the patients before the therapy, age, gender, body mass index (BMI), occupation, education, duration of stroke, stroke etiology, symptomatic side, the presence of systemic diseases and dominant hand data were recorded. The patients were randomized into two groups according to the sealed envelope method. While standard rehabilitation (ST) (50 minutes five days a week for 6 weeks) was applied to the first group, ST (50 minutes five days a week for 6 weeks) and OT (40 minutes three days a week for 6 weeks) were applied to the second group. Functional Independence Scale (FIM), Fugl-Meyer Upper Extremity Assessment of Motor Recovery Scale (FMA) and Action Research Arm Test (ARAT) were evaluated before the treatment and on the 45th day after the end of the treatment.
Results: Our study included 35 male and 45 female patients. There was no significant difference between the two groups in terms of age, gender, symptom duration and stroke etiology. FIM, ARAT and FMA values were found to be increased in both groups compared to pre-treatment (ST; FIM p=0.003, ARAT p=0.011, FMA p= 0.002 OT; FIM p=0.023, ARAT p=0.024, FMA p= 0.012 ). While there was no significant difference in terms of FIM, ARAT and FMA values before treatment in comparisons between groups, all parameters were found to be significantly increased in the OT group compared to ST on the 45th day of treatment (FIM p=0.017, ARAT p=0.021, FMA p= 0. 004).
Conclusion: In this study, OT was applied three times a week for 40 extremity dexterity. While the increase in FIM, FMA and ARAT was significant after treatment in both groups, the increase in the OT group was higher when compared to ST. The results of our study show that both ST and OT are effective in stroke rehabilitation. In addition, it has been clearly proven that more effective results are obtained in upper extremity functions with OT added to ST.

Anahtar Kelimeler

Hemiplegia, occupational therapy, upper limb

Hemiplejik hastalarda ergoterapinin üst ekstremite fonksiyonu ve günlük yaşam aktivitelerine etkisi

Öz

Amaç: Bu çalışmada hemiplejik hastalarda geleneksel rehabilitasyon tedavilerine eklenen uğraşı terapisinin (OT) günlük yaşam aktiviteleri ve üst ekstremite fonksiyonları üzerindeki etkinliğini araştırmayı amaçladık.
Yöntemler: Bu çalışma 60 hemiplejik hasta üzerinde yürütüldü. Hastaların tedavi öncesi değerlendirmelerinde yaş, cinsiyet, vücut kitle indeksi (VKİ), meslek, eğitim, inme süresi, semptomatik taraf, sistemik hastalık varlığı ve baskın el bilgileri kaydedildi. Hastalar kapalı zarf yöntemine göre randomize olarak iki gruba ayrıldı. Birinci gruba standart rehabilitasyon (ST) (haftada beş gün 50 dakika) uygulanırken, ikinci gruba ST (haftada beş gün 50 dakika) ve OT (haftada üç gün 40 dakika) uygulandı. Tedavi öncesi ve tedavi bitiminden sonraki 45. günde Fonksiyonel Bağımsızlık Ölçeği (FIM), Fugl-Meyer Üst Ekstremite Motor İyileşme Ölçeği (FMA) ve Eylem Araştırması Kol Testi (ARAT) değerlendirildi.
Bulgular: Çalışmamıza 35 erkek ve 45 kadın hasta dahil edildi. İki grup arasında yaş, cinsiyet, semptom süresi ve inme etiyolojisi açısından anlamlı fark yoktu. FIM, ARAT ve FMA değerleri her iki grupta da tedavi öncesine göre artmış bulundu (ST; FIM p=0,003, ARAT p=0,011, FMA p= 0,002 OT; FIM p=0,023, ARAT p=0,024, FMA p = 0,012). Gruplar arası karşılaştırmalarda tedavi öncesi FIM, ARAT ve FMA değerleri açısından anlamlı fark bulunmazken, tedavinin 45. gününde tüm parametreler OT grubunda ST'ye göre anlamlı olarak yüksek bulundu (FIM p=0,017, ARAT) p=0.021, FMA p= 0.004).
Sonuç: Bu çalışmada 40 ekstremite el becerisi için haftada üç kez OT uygulandı. Tedavi sonrası FIM, FMA ve ARAT artışı her iki grupta da anlamlı iken, OT grubundaki artış ST'ye göre daha fazlaydı. Çalışmamızın sonuçları inme rehabilitasyonunda hem ST hem de OT'nin etkili olduğunu göstermektedir. Ayrıca ST'ye eklenen OT ile üst ekstremite fonksiyonlarında daha etkin sonuçlar alındığı açıkça kanıtlanmıştır.

Anahtar Kelimeler

Hemipleji, mesleki terapi, üst ekstremite

Kaynakça

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