Multipl Skleroz Hastalarında Telerehabilitasyon Yöntemi İle Verilen Dokuma Eğitiminin El Becerileri, Kognisyon Ve Yaşam Kalitesi Üzerine Etkileri

Yıl 2024, Cilt: 2 Sayı: 1, 1 - 8, 17.12.2024

Nursel Öziri , Tuba Can Akman , Fırat Neziroğlu , Fatma Ünver

https://doi.org/10.5281/zenodo.14516905

Öz

Amaç: Tüm dünyada önemli bir pandemi olarak koronavirüs (COVİD-19) otoimmün hastalıklar grubundaki multipl skleroz (MS) hastalarının tanı, tedavi ve rehabilitasyona ulaşımda sorunlara yol açmıştır. Bu çalışmanın amacı pandemi sürecinde sosyal izolasyona maruz kalan multipl sklerozlu bireylerde dokuma ile sanat terapinin telerehabilitasyon yöntemiyle sunulması sonucu bireylerdeki el becerisi, kognitif fonksiyonlar, depresyon ve yaşam kalitesi değişikliklerini araştırmaktır.
Yöntem: Yaş ortalaması 51.00± 8,19 yıl olan 14 gönüllü MS tanılı bireyin katıldığı çalışmada toplam 10 haftada 2 gün/ 1 saat dokuma eğitimi verildi. Katılımcılar ev ziyareti yapılarak değerlendirildi. El ince motor becerilerinin değerlendirilmesinde 9 delikli PEG testi, parmak çimdikleme kuvveti değerlendirmesinde pinçmetre, yorgunluk durumu ölçümünde ise yorgunluk şiddeti ölçeği (YŞÖ) kullanıldı. Beck Depresyon Anketi (BDİ) ile depresyon, Yaşam Kalitesi Kısa Form (SF-36) ile yaşam kalite algısı ve Hızlandırılmış İşitsel Seri Ekleme Testi (PASAT-3) ile de kognitif durum değerlendirildi.
Sonuçlar: 10 haftalık çalışmanın sonuç değerlendirmesinde SF-36 fiziksel fonksiyon, ruhsal sağlık, genel sağlık, ağrı ve sosyal işlevsellik alt parametrelerinde ve YŞÖ, PASAT-3 ve parmak çimdikleme kuvvetlerinde istatistiksel olarak anlamlı fark bulunmuştur (p<0.05).
Tartışma: Telerehabilitasyon yöntemi ile dokuma eğitimi MS’li bireylerin ruhsal durumlarını, kognitif fonksiyonlarını iyileştirmiş, günlük yaşam aktivitelerindeki el becerilerini geliştirmiştir. Telerehabilitasyonla sanat terapi uygulamaları fizyoterapi programlarına ilave olarak MS hastalarının rehabilitasyonuna katkı sunabilir.

Anahtar Kelimeler

telerehabilitasyon, multipl skleroz, dokuma, yorgunluk, yaşam kalitesi

Kaynakça

• 1. Koriem KMM. Koriem KMM. Multiple sclerosis: New insights and trends. Asian Pac J Trop Biomed. 2016;6(5):429-440. doi: 10.1016/J.APJTB.2016.03.009. Asian Pac J Trop Biomed [Internet]. 2016 May 1 [cited 2018 May 28];6(5):429–40. Available from: https://www.sciencedirect.com/science/article/pii/S2221169116302453
• 2. Feinstein A, Freeman J, Lo AC. Treatment of progressive multiple sclerosis: what works, what does not, and what is needed. Lancet Neurol. 2015 Feb;14(2):194–207.
• 3. Johansson S, Ytterberg C, Claesson IM, Lindberg J, Hillert J, Andersson M, et al. High concurrent presence of disability in multiple sclerosis: Associations with perceived health. J Neurol. 2007;254(6):767–73.
• 4. Dezfuli MG, Akbarfahimi M, Nabavi SM, Mehraban AH, Jafarzadehpur E. Can hand dexterity predict the disability status of patients with multiple sclerosis? [Internet]. Available from: http://mjiri.iums.ac.ir
• 5. Swinnen SP, Wenderoth N. Two hands, one brain: cognitive neuroscience of bimanual skill. Trends Cogn Sci. 2004 Jan;8(1):18–25.
• 6. Månsson E, Lexell J. Performance of activities of daily living in multiple sclerosis. Disabil Rehabil. 2004 May 20;26(10):576–85.
• 7. Chruzander C, Johansson S, Gottberg K, Einarsson U, Fredrikson S, Holmqvist LW, et al. A 10-year follow-up of a population-based study of people with multiple sclerosis in Stockholm, Sweden: Changes in disability and the value of different factors in predicting disability and mortality. J Neurol Sci. 2013 Sep;332(1–2):121–7.
• 8. Uttley L, Scope A, Stevenson M, Rawdin A, Taylor Buck E, Sutton A, et al. Systematic review and economic modelling of the clinical effectiveness and cost-effectiveness of art therapy among people with non-psychotic mental health disorders. Health Technol Assess (Rockv). 2015 Mar;19(18):1–120.
• 9. 일반대학원 작업치료학과인제대학교, Jang TY, Park BR, Yang YA. 수공예 작업치료 프로그램 활동이 급성기 뇌졸중 환자의 손 기능에 미치는 효과 Effects of Occupational Therapeutic Craft Activity on improvement cognitive function and hand function in acute patients with stroke. Journal of the Korea Academia-Industrial cooperation Society [Internet]. 2017;18(5):355–65. Available from: https://doi.org/10.5762/KAIS.2017.18.5.355
• 10. Kongkasuwan R, Voraakhom K, Pisolayabutra P, Maneechai P, Boonin J, Kuptniratsaikul V. Creative art therapy to enhance rehabilitation for stroke patients: a randomized controlled trial. Clin Rehabil. 2016 Oct 11;30(10):1016–23.
• 11. Gatti R, Tettamanti A, Lambiase S, Rossi P, Comola M. Improving Hand Functional Use in Subjects with Multiple Sclerosis Using a Musical Keyboard: A Randomized Controlled Trial. Physiotherapy Research International. 2015 Jun 7;20(2):100–7.
• 12. Winter DA. Biomechanics and motor control of human movement. Wiley; 2009. 370 p.
• 13. Keele SW. Movement control in skilled motor performance. Psychol Bull. 1968 Dec;70(6 PART 1):387–403.
• 14. De Biase S, Cook L, Skelton DA Witham M, ten Hove R. The COVID-19 rehabilitation pandemic. Age Ageing. 2020 Aug 24;49(5):696–700.
• 15. Fisk JD, Ritvo PG, Ross L, Haase DA, Marrie TJ, Schlech WF. Measuring the Functional Impact of Fatigue: Initial Validation of the Fatigue Impact Scale. Clinical Infectious Diseases. 1994 Jan 1;18(Supplement_1):S79–83.
• 16. Armutlu K, Cetisli Korkmaz N, Keser I, Sumbuloglu V, Irem Akbiyik D, Guney Z, et al. The validity and reliability of the Fatigue Severity Scale in Turkish multiple sclerosis patients. International Journal of Rehabilitation Research. 2007 Mar;30(1):81–5.
• 17. Hisli N. Beck Depresyon Envanterinin gecerliligi uzerine bit calisma (A study on the validity of Beck Depression Inventory.). Psikoloji Dergisi [Internet]. 1988 [cited 2024 Mar 18]; 6:118–22. Available from: https://cir.nii.ac.jp/crid/1573105975299874432.bib?lang=ja
• 18. Benedict RH, Fishman I, McClellan MM, Bakshi R, Weinstock-Guttman B. Validity of the Beck Depression Inventory-Fast Screen in multiple sclerosis. Multiple Sclerosis Journal. 2003 Aug 2;9(4):393–6.
• 19. Tombaugh T. A comprehensive review of the Paced Auditory Serial Addition Test (PASAT). Archives of Clinical Neuropsychology. 2006 Jan;21(1):53–76.
• 20. Ozakbas S, Cinar BP, Gurkan MA, Ozturk O, Oz D, Kursun BB. Paced auditory serial addition test: National normative data. Clin Neurol Neurosurg. 2016 Jan; 140:97–9.
• 21. Lamers I, Kelchtermans S, Baert I, Feys P. Upper Limb Assessment in Multiple Sclerosis: A Systematic Review of Outcome Measures and their Psychometric Properties. Arch Phys Med Rehabil. 2014 Jun;95(6):1184–200.
• 22. Kocyigit H. Kisa Form-36 (KF-36)’nm Turkce versiyonunun guvenilirligi ve gecerliligi. Ilac ve Tedavi Dergisi [Internet]. 1999 [cited 2024 Mar 18]; 12:102–6. Available from: https://cir.nii.ac.jp/crid/1571417125523916160.bib?lang=ja
• 23. Haidar SG, Kumar D, Bassi RS, Deshmukh SC. Average versus Maximum Grip Strength: Which is more Consistent? Journal of Hand Surgery. 2004 Feb 10;29(1):82–4.
• 24. Bernini S, Stasolla F, Panzarasa S, Quaglini S, Sinforiani E, Sandrini G, et al. Cognitive Telerehabilitation for Older Adults With Neurodegenerative Diseases in the COVID-19 Era: A Perspective Study. Front Neurol. 2021 Jan 14;11.
• 25. Kahraman T, İzmir Kâtip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Fizyoterapi ve Rehabilitasyon Bölümü D. Koronavirüs Hastalığı (COVID-19) Pandemisi ve Telerehabilitasyon Coronavirus Disease (COVID-19) Pandemic and Telerehabilitation. Vol. 5. 2020.
• 26. Maria Xiang X, Bernard J. Telehealth in Multiple Sclerosis Clinical Care and Research. 1910; Available from: https://doi.org/10.1007/s11910-021-01103-4
• 27. Gelaw AY, Janakiraman B, Gebremeskel BF, Ravichandran H. Effectiveness of Home-based rehabilitation in improving physical function of persons with Stroke and other physical disability: A systematic review of randomized controlled trials. Journal of Stroke and Cerebrovascular Diseases. 2020 Jun;29(6):104800.
• 28. Nora M, Giannarelli M, Zicchinella C, Mammi P, Ranza E, Brianti R. An Experience of Multiple Sclerosis Telerehabilitation During the COVID-19 Pandemic. Am J Phys Med Rehabil. 2021 Mar;100(3):214–214.
• 29. Amatya B, Galea MP, Kesselring J, Khan F. Effectiveness of telerehabilitation interventions in persons with multiple sclerosis: A systematic review. Mult Scler Relat Disord. 2015 Jul;4(4):358–69.
• 30. Levy CE, Spooner H, Lee JB, Sonke J, Myers K, Snow E. Telehealth-based creative arts therapy: Transforming mental health and rehabilitation care for rural veterans. Arts Psychother. 2018 Feb; 57:20–6.
• 31. Collier AF. The Well-Being of Women Who Create With Textiles: Implications for Art Therapy. Art Therapy. 2011 Sep;28(3):104–12.
• 32. Fraser C, Keating M. The Effect of a Creative Art Program on Self-Esteem, Hope, Perceived Social Support, and Self-Efficacy in Individuals With Multiple Sclerosis. Journal of Neuroscience Nursing. 2014 Dec;46(6):330–6.