Diz osteoartritine bağlı nöropatik ağrısı olan hastalarda whirlpool’un etkinliği

Öz

Amaç: Hem nöropatik hem de nosiseptif mekanizmalar osteoartritteki ağrıya neden olabilir. Bu çalışmanın amacı diz osteoartritine bağlı nöropatik ağrısı olan hastalarda whirlpool uygulamasının ağrı, dizabilite, yaşam kalitesi ve uyku üzerine olan etkinliğini değerlendirmektir.

Yöntemler: Bu çalışma randomize, placebo kontrollü prospektif bir çalışmadır. Diz osteoartritine bağlı nöropatik ağrısı olan 60 hasta çalışmaya alındı ve iki gruba randomize edildi. Grup 1’deki hastalar (n=30) sıcak whirlpool, Grup 2’deki hastalar (n=30) plasebo whirlpool ile 20 dakika süreyle 15 seans boyunca tedavi edildi. Primer sonuç ölçütü ağrı idi ve görsel analog skala (GAS) ve Western Ontario and McMaster Universities  Osteoarthritis (WOMAC) indeksi ağrı skoru ile değerlendirildi. Fonksiyonel abilite için WOMAC dizabilite ve fiziksel fonksiyon skorları, yaşam kalitesi için Kısa-Form 36 (KF-36) ile; uyku, için Pittsburgh Uyku Kalitesi İndeksi (PUKİ) kullanıldı. Nöropatik ağrı varlığı DN4 anketi ile belirlendi. Değerlendirmeler tedavi öncesi ve sonrası yapıldı. 

Bulgular: Tedavinin sonunda her iki grupta da KF-36, PUKİ ve DN4 skorları ile diz EHA değerlerindeki düzelme istatiksel olarak anlamlı bulundu (p<0.05). Gruplar arasında, KF-36’nın genel sağlık skoru dışındaki tüm alt bileşenleri, PUKİ ve DN4 skorlarındaki düzelme açısından istatiksel olarak anlamlı farklılık saptanırken (p<0.05); GAS, WOMAC indeksi ve KF-36 genel sağlık skoru ile diz EHA değerlerinde istatiksel olarak anlamlı farklılık saptanmadı (p>0.05).

Sonuç: Diz osteoartritine bağlı nöropatik ağrısı olan hastalarda whirlpool tedavisinin yaşam kalitesi, uyku, nöropatik ağrı ve dizabilite üzerine olumlu etkileri mevcuttur.

Anahtar Kelimeler

• Nöropatik ağrı,Osteoartrit,Uyku,Yaşam Kalitesi,Whirlpool

The effectiveness of whirlpool for patients with neuropathic pain due to knee osteoarthritis

Abstract

Aim: Both neuropathic and nociceptive mechanisms may contribute to the OA pain experience. The aim of this study is to determine the efficacy of warm whirlpool on pain, disability, quality of life (QoL) and sleep for patients with neuropathic pain. 

Methods: This is a randomized, placebo controlled prospective study. Sixty patients with neuropathic pain due to knee OA were included and randomized into two groups. Group 1 (n=30) were treated with warm whirlpool and Group 2 (n=30) were treated with placebo for 20 minutes during 15 sessions. Patients were evaluated according to pain, knee range of motions (ROM), quality of life (QoL) and sleep quality. The primer outcome measure was pain severity and was assessed using a visual analogue scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). WOMAC disability and functional scores for functional ability, Short Form-36 Health Survey (SF-36) for QoL, Pittsburgh Sleep Quality Index (PSQI) for sleep, DN4 for neuropathic pain were used for assessments. Patients were evaluated at baseline and the end of the 15 day intervention. 

Results: At the end of the therapy, there were statistically significant improvements in SF-36, PSQI, DN4 and knee ROM (active and passive) scores (p<0.05) for both groups. Also there were a statistically significant improvement for SF-36 scores except for general health score, PSQI and DN4 scores between groups (p<0.05);but this improvement was not statistically significant for VAS, WOMAC, SF-36 general health score and knee ROM between groups (p>0.05). 

Conclusion: Whirlpool provided significant improvements in QoL, sleep, neuropathic pain and disability for patients with neuropathic pain due to knee OA.

Keywords

• Neuropathic pain,Osteoarthritis,Sleep,Quality of life,Whirlpool

Kaynakça

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