MULTİPL SKLEROZ HASTALARINDA ZİHİN-BEDEN EGZERSİZLERİNİN YORGUNLUK, DENGE VE YAŞAM KALİTESİ ÜZERİNE ETKİSİ: SİSTEMATİK DERLEME VE META-ANALİZ

Öz

Amaç: MS hastalarının rehabilitasyonunda giderek yaygınlığı artan yoga ve pilates gibi zihin-beden egzersizleri (ZBE), iskelet kaslarında germe ve gevşeme, fiziksel koordinasyon eğitimi, nefes alma, hareket kontrolü ve dikkatin yönetimini içeren orta düzeyde aerobik egzersizlerdir. Bu çalışma, ZBE'lerin MS hastalarında yorgunluk, denge ve sağlıkla ilgili yaşam kalitesi (HRQoL) üzerindeki etkilerini araştırmayı amaçlamaktadır. Yöntemler: Pubmed, Science Direct, Web of Science ve Ulakbim veritabanları tarandı. Çalışmalardan arama, seçim ve veri çıkarma işlemleri iki bağımsız değerlendirici tarafından gerçekleştirildi. Bu meta-analizde, analizler için rastgele etkiler modeli kullanıldı ve etki büyüklükleri Standartlaştırılmış Ortalama Fark (SMD) olarak raporlandı. Sonuçlar: Meta-analiz, toplam 791 katılımcıyla 19 randomize kontrollü klinik çalışmayı içermektedir. ZBE, MS hastalarında yorgunluk (SMD: 0,14, %95 CI=–0,07, 0,34, I2=0%) ve denge (SMD: 0,51, %95 CI=0,00, 1,02, I2=73%) üzerine fiziksel egzersizle benzer etki gösterdi. ZBE, egzersiz yapmayan gruba göre yorgunluğu (SMD: 0,82, %95 CI = –1,23, –0,41, I2=71%) ve dengeyi (SMD: 1,36, %95 CI = 0,39, 2,32, I2=88%) geliştirmede daha etkili bulundu, ancak fiziksel (SMD: 0,04, %95 CI = –0,42, 0,34, I2=0%) veya mental HRQoL (SMD: 0,04, %95 CI = –0,42, 0,34, I2=0%) için daha etkili değildir. Tartışma: Bu meta-analizin sonuçları, ZBE'nin MS hastalarında yorgunluk ve denge üzerinde fiziksel egzersizlerle benzer faydalar sağladığı ve egzersiz yapmamaya kıyasla daha etkili olduğunu göstermiştir. Ayrıca, ZBE’nin HRQoL üzerinde ek bir yarar sağlamadığı görülmektedir.

Anahtar Kelimeler

• denge
• egzersiz
• yorgunluk
• multipl skleroz
• yaşam kalitesi

EFFECT OF MIND-BODY EXERCISES ON FATIGUE, BALANCE, AND QUALITY OF LIFE IN PEOPLE WITH MULTIPLE SCLEROSIS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Öz

Purpose: Mind-body exercises (MBEs) such as Yoga and Pilates, which are increasingly used in the rehabilitation in people with MS (pwMS), are moderate aerobic exercises that include stretching and relaxation in skeletal muscle, physical coordination training, breathing, movement control, and attention regulation. This study aims to investigate the effects of MBEs on fatigue, balance, and health-related quality of life (HRQoL) in pwMS. Methods: Pubmed, Science Direct, Web of Science, Ulakbim databases were searched. Search, selection, and data extraction from the studies were performed by two independent reviewers. The random effects model for meta-analysis, reporting effect sizes as Standardized Mean Difference (SMD) were used in this meta-analysis. Results: This meta-analysis included 19 randomized clinical trials with 791 participants in total. MBEs had similar effects on fatigue (SMD: 0.14, 95% CI=–0.07, 0.34, I2=0%) and balance (SMD: 0.51, 95% CI=0.00, 1.02, I2=73%) as physical exercise in pwMS. MBEs are more effective compared to no exercise for improving fatigue (SMD: 0.82, 95% CI = –1.23, –0.41, I2=71%) and balance (SMD: 1.36, 95% CI = 0.39, 2.32, I2=88%) but not physical (SMD: 0.04, 95% CI = –0.42, 0.34, I2=0%) or mental HRQoL (SMD: 0.04, 95% CI = –0.42, 0.34, I2=0%) in pwMS. Conclusion: This meta-analysis concluded that MBEs have similar benefits as physical exercises on fatigue and balance in pwMS and are more effective than no exercise. They do not appear to provide any additional benefits for HRQoL.

Anahtar Kelimeler

• balace
• exercise
• fatigue
• multiple sclerosis
• quality of life

Kaynakça

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