ARTROSKOPİK ROTATOR KILIF TAMİRİ YAPILAN HASTALARDA TEK SEANS PERTURBASYON EGZERSİZİNİN OMUZ AKTİF EKLEM POZİSYON HİSSİ VE TRAPEZİUS KAS AKTİVASYONU ÜZERİNE ETKİSİ

Öz

Amaç: Rehabilitasyonun ileri aşamalarında yapılan perturbasyon egzersizleri nöromuskuler kontrolü artırır. Bu çalışmanın amacı 6 ay önce artroskopik rotator kılıf tamiri yapılan hastalarda tek seans uygulanan perturbasyon egzersizinin aktif eklem pozisyon hissi ve trapezius kasının elektromiyografik aktivasyonu üzerine erken etkisini incelemektir. Yöntem: Artroskopik rotator kılıf tamiri yapılan 12 kişi çalışma grubu olarak (yaş: 54.83±3.5), asemptomatik omuz eklemi olan 13 kişi kontrol grubu olarak (yaş: 49.07±4.5) çalışmaya dahil edildi. Tüm katılımcılar, tek seanslık pertürbasyon egzersizinden önce ve sonra değerlendirildi. 90° omuz fleksiyonunda ve abdüksiyonda aktif eklem pozisyonu hissi, lazer imleç yardımlı açı tekrarlama testi kullanılarak değerlendirildi. Bu test sırasında trapezius kaslarının aktivasyonu yüzeyel elektromiyografi cihazıyla kaydedildi. Egzersiz öncesi ve sonrası değerler grup içi Wilcoxon signed rank testi, grup karşılaştırmaları Mann-Whitney U testi kullanılarak analiz edildi. Bulgular: Pertürbasyon egzersizi öncesi ve sonrası aktif açı tekrarlama testinde gruplar arasında fark yok idi (fleksiyon p:0.124; abduksiyon p:0.421). Egzersiz sonrası elektromiyografi aktivasyonları karşılaştırıldığında, cerrahi yapılan taraf üst trapez ve diğer taraf alt trapez aktivasyonu azaldı (p:0.01). Trapezius kasının elektromiyografi aktivasyonu ile aktif eklem pozisyon hissi arasında korelasyon yoktu (fleksiyon p:0.657; abduksiyon p:0.662). Sonuç: Rotator kılıf tamiri sonrası altıncı ayda tek seans pertürbasyon egzersizlerinin aktif eklem pozisyon hissi üzerine erken etkisinin olmadığı görüldü.

Anahtar Kelimeler

• Elektromyografi
• Perturbasyon
• Propriosepsiyon
• Rotator Kılıf Yaralanmaları

THE EFFECT OF SINGLE-STAGE PERTURBATION EXERCISE ON THE SHOULDER JOINT POSITION SENSE AND TRAPEZIUS MUSCLE ACTIVATION IN PATIENTS WITH ARTHROSCOPIC ROTATOR CUFF REPAIR

Öz

Objective: Perturbation exercises conducted on mobile surfaces in the latter period of the rehabilitation increase the neuromuscular control. The purpose of the study was to investigate the effects of single session perturbation exercises’ on active joint position sense and on the electromyography activation of the trapezius muscle in patients who underwent arthroscopic rotator cuff repair in the previous 6 months. Method: 12 individuals who underwent arthroscopic rotator cuff repair were included in the study as the study group (age: 54.83±3.5), and 13 individuals with in an asymptomatic shoulder joint were included as the control group (age: 49.07±4.5). All subjects were evaluated before and after single-session perturbation exercise. Active joint position sense at 90° shoulder flexion and abduction was assessed using a laser pointer-assisted angle reproduction test. The activation of the trapezius muscles during this test was recorded by the superficial electromyography tool. The pre-exercise and post-exercise values were analyzed using an in-group Wilcoxon signed-rank test. The Mann–Whitney U test was used for group comparisons. Results: There was no difference between groups in the active angle reproduction test before and after the perturbation exercise (flexion p:0.124; abduction p:0.421). When electromyography activations after the exercise were compared, the activation of the operated upper trapezius (p:0.01) and the non-operated lower trapezius decreased (p:0.024). There was no correlation between the electromyography activation of the trapezius muscle and active joint position sense (flexion p:0.657; abduction p:0.662).

Anahtar Kelimeler

• Electromyography
• Perturbation
• Proprioception
• Rotator Cuff Injuries

Kaynakça

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