Schroth Yönteminin Adolesan İdiyopatik Skolyozlu Bireylerde Ağrı, Beden Farkındalığı ve Yaşam Kalitesi Üzerindeki Kısa Dönem Etkisi: Kontrollü Bir Çalışma

Öz

Giriş: Skolyoz tedavisinde düzenli takip, cerrahi, korseleme, elektrik stimülasyonu ve egzersiz yöntemleri yaygın olarak kullanılmaktadır. Adolesan idiyopatik skolyoz (İS) hastalarında Schroth yönteminin ağrı üzerindeki etkinliği belirsizliğini korumaktadır. Bu çalışma, Schroth egzersizlerinin adolesan (10-18 yaş) İS’li bireylerde ağrı, beden farkındalığı ve yaşam kalitesi üzerindeki etkilerini araştırmayı amaçlamaktadır. Yöntemler: İS tanısı konmuş toplam 31 birey iki gruba ayrılmıştır: çalışma grubu (n=16) ve kontrol grubu (n=15). Çalışma grubuna 6 hafta boyunca haftada 3 gün, günde 1 saat Schroth egzersizleri uygulanırken, kontrol grubu geleneksel egzersizleri yapmıştır. Ağrı şiddeti Görsel Analog Skala (VAS) ile, basınç-ağrı eşiği algometre ile, beden farkındalığı Beden Farkındalığı Anketi (BAQ) ile ve yaşam kalitesi Skolyoz Araştırma Derneği-22 (SRS-22) anketi ile değerlendirilmiştir. Bulgular: Her iki grupta da ağrı şiddeti ve basınç-ağrı eşiğinde istatistiksel olarak anlamlı iyileşmeler gözlenirken, çalışma grubunda 6 hafta sonunda ağrı şiddetinde daha fazla azalma ve ağrı eşiğinde daha fazla artış kaydedilmiştir (p<0.05). BAQ sonuçları gruplar arasında anlamlı bir fark göstermemiştir (p>0.05). SRS-22 skorları her iki grupta da iyileşme göstermiştir; ancak ağrı ile ilişkili yaşam kalitesi, tedavi memnuniyeti, alt toplam ve toplam SRS-22 skorları tedavi sonrası çalışma grubunda anlamlı derecede daha yüksek bulunmuştur (p<0.05). Sonuçlar: Schroth yönteminin kısa dönem (<6 ay) yoğun uygulanması, adolesan İS’li bireylerin tedavisinde ağrı ve yaşam kalitesi üzerinde olumlu terapötik etkiler göstermiştir

Anahtar Kelimeler

• Skolyoz
• Ağrı
• Yaşam Kalitesi
• Beden Farkındalığı
• Schroth Egzersizi

Short-Term Effect of Schroth Method on Pain, Body Awareness, and Quality of Life in Adolescent Individuals with Idiopathic Scoliosis: A Controlled Trial

Öz

Introduction: Monitoring with regular follow-ups, surgery, bracing, electrical stimulation, and exercise modalities has been widely used in the treatment of scoliosis. The effectiveness of the Schroth method for pain in adolescent patients with idiopathic scoliosis (IS) remains unclear. This study aimed to investigate the effects of Schroth exercises on pain, body awareness, and quality of life in adolescents individuals (10-18 years) with IS. Methods: A total of 31 individuals diagnosed with IS were divided into two groups: study (n=16) and control (n=15). Schroth exercises were prescribed to the study group for 1 h, 3 times a week, for 6 weeks, while the control group performed traditional exercises. Pain severity was evaluated using the Visual Analog Scale, pressure-pain threshold with an algometer, body awareness with Body Awareness Questionnaire (BAQ), and quality of life using the Scoliosis Research Society-22 (SRS22). Results: Both groups showed statistically significant improvements in pain severity and pressure-pain threshold, while the study group showed a further decline in pain severity and increase in pain threshold after 6 weeks (p<0.05). The BAQ results did not show any significant differences between groups (p>0.05). SRS22 scores were improved in both groups, while pain-related quality of life, treatment satisfaction, and subtotal and total SRS22 scores were significantly better in the study group after treatment (p<0.05). Conclusions: The short-term (<6 months) intensive application of the Schroth method demonstrated positive therapeutic effects on pain and quality of life in the treatment of adolescent individuals with IS.

Anahtar Kelimeler

• Scoliosis
• Pain
• Quality Of Life
• Body Awareness
• Schroth Exercise

Kaynakça

1. 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
2. Arefirad, T., Seif, E., Sepidarkish, M., Mohammadian Khonsari, N., Mousavifar, S. A., Yazdani, S., Rahimi, F., Einollahi, F., Heshmati, J., & Qorbani, M. (2022). Effect of exercise training on nitric oxide and nitrate/nitrite (NOx) production: A systematic review and meta-analysis. Frontiers in physiology, 13, 953912. https://doi.org/10.3389/fphys.2022.953912
3. Asher, M., Lai, S. M., Burton, D., & Manna, B. (2003). The reliability and concurrent validity of the scoliosis research society-22 patient questionnaire for idiopathic scoliosis. Spine, 28(1), 63-69. https://doi.org/10.1097/00007632-200301010-00015.
4. Balagué, F., & Pellisé, F. (2016). Adolescent idiopathic scoliosis and back pain. Scoliosis and spinal disorders, 11, 1-15. DOI:10.1186/s13013-016-0086-7
5. Begum, M. R., & Hossain, M. A. (2019). Validity and reliability of visual analogue scale (VAS) for pain measurement. Journal of Medical Case Reports and Reviews, 2(11).
6. Ceballos-Laita, L., Carrasco-Uribarren, A., Cabanillas-Barea, S., Perez-Guillen, S., Pardos-Aguilella, P., & Del Barrio, S. J. (2023). The effectiveness of Schroth method in Cobb angle, quality of life and trunk rotation angle in adolescent idiopathic scoliosis: a systematic review and meta-analysis. EuropEan Journal of physical and rehabilitation medicine, 59(2), 228. https://doi.org/10.23736/S1973-9087.23.07654-2
7. Chan, P., Skaggs, D. L., Sanders, A. E., Villamor, G. A., Choi, P. D., Tolo, V. T., & Andras, L. M. (2017). Pain is the greatest preoperative concern for patients and parents before posterior spinal fusion for adolescent idiopathic scoliosis. Spine, 42(21), E1245-E1250. https://doi.org/10.1097/BRS.0000000000002147
8. Choi, J.-H., Oh, E.-G., & Lee, H.-J. (2011). Comparisons of postural habits, body image, and peer attachment for adolescents with idiopathic scoliosis and healthy adolescents. Child Health Nursing Research, 17(3), 167-173. https://doi.org/10.4094/jkachn.2011.17.3.167

9. Cilli, K., Tezeren, G., Taş, T., Bulut, O., Oztürk, H., Oztemur, Z., & Unsaldi, T. (2009). School screening for scoliosis in Sivas, Turkey. Acta Orthop Traumatol Turc, 43(5), 426-430. https://doi.org/10.3944/AOTT.2009.426
10. Cobb, J. (1948). Outline for the study of scoliosis. Instructional course lecture.
11. Karaca, S., & Bayar, B. (2021). Turkish version of body awareness questionnaire: validity and reliability study. Türk Fizyoterapi ve Rehabilitasyon Dergisi, 32(1), 44-50. https://doi.org/10.21653/tjpr.660186
12. Kastrinis, A., Koumantakis, G., Tsekoura, M., Nomikou, E., Katsoulaki, M., Theodosopoulos, E., Strimpakos, N., & Dimitriadis, Z. (2022). The Effect of Schroth Method on Postural Control and Balance in Patients with Adolescent Idiopathic Scoliosis: A Literature Review. Worldwide Congress on “Genetics, Geriatrics and Neurodegenerative Diseases Research",
13. Kim, K.-D., & Hwangbo, P.-N. (2016). Effects of the Schroth exercise on the Cobb’s angle and vital capacity of patients with idiopathic scoliosis that is an operative indication. Journal of physical therapy science, 28(3), 923-926. https://doi.org/10.1589/jpts.28.923
14. Konieczny, M. R., Senyurt, H., & Krauspe, R. (2013). Epidemiology of adolescent idiopathic scoliosis. Journal of children's orthopaedics, 7(1), 3-9. https://doi.org/10.1007/s11832-012-0457
15. Lebel, A., & Lebel, V. A. (2016). Severe progressive scoliosis in an adult female possibly secondary thoracic surgery in childhood treated with scoliosis specific Schroth physiotherapy: Case presentation. Scoliosis and spinal disorders, 11(2), 67-71. https://doi.org/10.1186/s13013-016-0098-3
16. Monticone, M., Ambrosini, E., Cazzaniga, D., Rocca, B., & Ferrante, S. (2014). Active self-correction and task-oriented exercises reduce spinal deformity and improve quality of life in subjects with mild adolescent idiopathic scoliosis. Results of a randomised controlled trial. European Spine Journal, 23(6), 1204-1214. https://doi.org/10.1007/s00586-014-3241-y
17. Negrini, S., Minozzi, S., Bettany‐Saltikov, J., Chockalingam, N., Grivas, T. B., Kotwicki, T., Maruyama, T., Romano, M., & Zaina, F. (2015). Braces for idiopathic scoliosis in adolescents. Cochrane Database of Systematic Reviews (6). https://doi.org/10.1002/14651858.CD006850.pub3
18. Potter, L., McCarthy, C., & Oldham, J. (2006). Algometer reliability in measuring pain pressure threshold over normal spinal muscles to allow quantification of anti-nociceptive treatment effects. International journal of osteopathic medicine, 9(4), 113-119. https://doi.org/10.1016/j.ijosm.2006.11.002
19. Ramirez, J. M., & Eberson, C. P. (2017). The role of rehabilitation in the management of adolescent idiopathic scoliosis. RI Med J, 100(11), 22-25.
20. Reeves, B., & Gaus, W. (2004). Guidelines for reporting non-randomised studies. Complementary Medicine Research, 11(Suppl. 1), 46-52. https://doi.org/10.1159/000080576
21. Rrecaj-Malaj, S., Hykolli, A., Lumi, S., & Murtezani, A. (2018). Quality of life in adolescent’s idiopathic scoliosis before and after physical therapy: a preliminary study. Sport Mont, 16(2), 69-72. https://doi.org/10.26773/smj.180612
22. Schreiber, S., Parent, E. C., Hedden, D. M., Moreau, M., Hill, D., & Lou, E. (2014). Effect of Schroth exercises on curve characteristics and clinical outcomes in adolescent idiopathic scoliosis: protocol for a multicentre randomised controlled trial. Journal of physiotherapy, 60(4), 234. https://doi.org/10.1016/j.jphys. 2014.08.005
23. Shields, S. A., Mallory, M. E., & Simon, A. (1989). The body awareness questionnaire: reliability and validity. Journal of personality Assessment, 53(4), 802-815. https://doi.org/10.1207/s15327752jpa5304_16
24. Takakusaki, K. (2017). Functional neuroanatomy for posture and gait control. Journal of movement disorders, 10(1), 1. https://doi.org/10.14802/jmd.16062
25. Théroux, J., Le May, S., Hebert, J. J., & Labelle, H. (2017). Back pain prevalence is associated with curve-type and severity in adolescents with idiopathic scoliosis: a cross-sectional study. Spine, 42(15), E914-E919. https://doi.org/10.1097/BRS.0000000000001986
26. Theroux, J., Stomski, N., Hodgetts, C. J., Ballard, A., Khadra, C., Le May, S., & Labelle, H. (2017). Prevalence of low back pain in adolescents with idiopathic scoliosis: a systematic review. Chiropractic & manual therapies, 25, 1-6. https://doi.org/10.1186/s12998-017-0143-1
27. Wang, L., Wang, Y., Yu, B., Zhang, J., Shen, J., Qiu, G., & Li, Y. (2014). Relation between self-image score of SRS-22 with deformity measures in female adolescent idiopathic scoliosis patients. Orthopaedics & Traumatology: Surgery & Research, 100(7), 797-801. https://doi.org/10.1016/j.otsr.2014.06.014
28. Weinstein, S. L. (2019). The natural history of adolescent idiopathic scoliosis. Journal of Pediatric Orthopaedics, 39, S44-S46. https://doi.org/10.1097/BPO.0000000000001350
29. Weiss, H.R., Lenhert-Schroth, C., Moramarco, M., and Moramarco, K. (2022). Schorth Therapy, Advancements in Conservative Scoliosis Treatment, BP International. [3rd ed.]. https://doi.org/10.9734/bpi/mono/978-93-5547-321-9
30. Yagci, G., Ayhan, C., & Yakut, Y. (2018). Effectiveness of basic body awareness therapy in adolescents with idiopathic scoliosis: A randomized controlled study. Journal of back and musculoskeletal rehabilitation, 31(4), 693-701. https://doi.org/10.3233/BMR-170868
31. Yaman, O., & Dalbayrak, S. (2014). Idiopathic scoliosis. Turkish neurosurgery, 24(5). https://doi.org/10.5137/1019-5149.JTN.8838-13.0
32. Zapata, K. A., Wang-Price, S. S., & Sucato, D. J. (2017). Six-month follow-up of supervised spinal stabilization exercises for low back pain in adolescent idiopathic scoliosis. Pediatric Physical Therapy, 29(1), 62-66. https://doi.org/10.1097/PEP.0000000000000325