Adezif Kapsülit Tedavisinde Anestezi Altında Manipülasyon Sonrası Fizyoterapinin Etkinliği

Yıl 2023, Cilt: 10 Sayı: 1, 47 - 50, 10.04.2023

Gökhan İlyas , Oğuzhan Gökalp

https://doi.org/10.47572/muskutd.1107782

Öz

Bu çalışmada omuzun adezif kapsülit hastalığı tedavisinde, fizyoterapinin izole uygulanması ile anestezi altında manipülasyon sonrasında uygulanması karşılaştırılmıştır. Primer adezif kapsülit olup, dışlanma kriterlerine sahip olmayan 32 hasta, izole fizyoterapi (İF) alan ve anestezi altında manipülasyon (AAM) sonrası erken dönem fizyoterapi alanlar olmak üzere 2 gruba ayrılarak ağrı ve fonksiyon skorları retrospektif karşılaştırmalı olarak değerlendirildi. İF grubuna kıyasla, fizyoterapinin AAM sonrası uygulanması, erken dönemde istatistiksel olarak daha etkin bir modalite olarak görülmüştür. İstatistiksel analizde SPSS 24. versiyon Mann-Whitney-U testinin kullanıldığı çalışmamızda tedaviler öncesi, tedaviler sonrası 1. hafta, 6. hafta ve 6. ayda Vizüel Analog Skala (VAS) ve Constant Murley Skoru (CMS) karşılaştırmaları yapılmış ve p değerinin 0.05’ten küçük olması anlamlı kabul edilmiştir. Tedaviler öncesi değerlendirmelerde; istatistiksel anlamlı fark yokken (VAS p=0.322, CMS p=0.663), tedaviler sonrası 1. haftada (VAS p<0.001, CMS p=0.018) ve 6. haftada (VAS p=0.002, CMS p<0.001) AAM’un İF grubuna kıyasla istatistiksel olarak daha etkin olduğu, 6. ayda ise anlamlı farkın kaybolduğu görülmüştür (VAS p=0.758, CMS p=0.408). AAM sonrası uygulanan fizyoterapinin, primer adezif kapsülit tedavisinde erken dönemde, İF hastalarına kıyasla ağrıda azalma ve fonksiyonda artış açısından belirgin etkin olduğu görülmüştür. Özellikle aktif genç erişkinlerde erken dönemin daha az ağrılı ve daha fonksiyonel olarak geçirilmesi işgücü kaybının azalmasını sağlayacaktır.

Anahtar Kelimeler

Adezif Kapsülit, Anestezi Altında Manipülasyon, Donuk Omuz, Fizyoterapi

Destekleyen Kurum

-

Proje Numarası

-

Teşekkür

Çalışma arkadaşlarıma teşekkür ederim.

The Efficacy of Physiotherapy After Manipulation Under Anesthesia in The Treatment of Adhesive Capsulitis

Öz

This study compared the administration of isolated physiotherapy and its administration after manipulation under anesthesia in the treatment of shoulder adhesive capsulitis. 32 patients with primary adhesive capsulitis and who do not meet the exclusion criteria were divided into two groups the ones receiving isolated physiotherapy (IF) and the ones receiving early physiotherapy after manipulation under anesthesia (MUA) then their pain and function scores were compared retrospectively. The administration of physiotherapy after MUA was found to be a statistically more efficient modality in the early period when compared to IF. In our study in which the Mann-Whitney-U test was used for statistical analysis, Visual Analog Scale (VAS) and Constant Murley Score (CMS) evaluations were done in the pre-treatment period, and in the first week, sixth week, and sixth month after treatment. Whereas there is no statistically significant difference in pre-treatment evaluations (VAS p=0.322, CMS p=0.663), it was identified that MUA was statistically more efficient in the first-week post-treatment (VAS p<0.001, CMS p=0.018) and in the sixth week (VAS p=0.002, CMS p<0.001); and was found that the significant difference faded out in the sixth month (VAS p=0.758, CMS p=0.408). It was found that physiotherapy after MUA was distinctly efficient in terms of decrease in pain and increase in function in the early period of primary adhesive capsulitis treatment when compared to IF patients. Undergoing the early period with less pain and more function, especially in active young adults will help the labor loss decrease.

Anahtar Kelimeler

Adhesive Capsulitis, Manipulation Under Anesthesia, Frozen Shoulder, Physiotherapy

Proje Numarası

-

Kaynakça

• 1. Baykal YB, Atay T, Kocadal O. Donuk/donmuş omuz. TOTBİD Derg. 2013;46:379–84.
• 2. Bhargav D, Murrell GAC. Basic science of adhesive capsulitis. Tech Shoulder Elb Surg. 2011;12(4):126–9.
• 3. Lynch TS, Edwards SL. Adhesive capsulitis: current concepts in diagnosis and treatment. Curr Orthop Pract. 2013;24(4):365–9.
• 4. Chambler AF, Carr AJ. The role of surgery in frozen shoulder. J Bone Joint Surg Br. 2003;85(6):789–95.
• 5. Ascani C, Passaretti D, Scacchi M, et al. Can adhesive capsulitis of the shoulder be a consequence of COVID-19? Case series of 12 patients. J Shoulder Elbow Surg. 2021;30(7):e409-13.
• 6. Neviaser AS, Hannafin JA. Adhesive capsulitis: a review of current treatment. Am J Sports Med. 2010;38(11):2346–56.
• 7. Zhang J, Zhong S, Tan T, et al. Comparative efficacy and patient-specific moderating factors of nonsurgical treatment strategies for frozen shoulder: an updated systematic review and network meta-analysis. Am J Sports Med. 2021;49(6):1669-79.
• 8. Challoumas D, Biddle M, McLean M, et al. Comparison of treatments for frozen shoulder: a systematic review and meta-analysis. JAMA Netw Open. 2020;3(12):e2029581.
• 9. Wei L, Zhu M, Peng T, et al. Different acupuncture therapies combined with rehabilitation in the treatment of scapulohumeral periarthritis: A protocol for systematic review and network meta-analysis. Medicine. 2020;99(51):e23085.
• 10. Sivasubramanian H, Chua CXK, Lim SY, et al. Arthroscopic capsular release to treat idiopathic frozen shoulder: How much release is needed? Orthop Traumatol Surg Res. 2021;107(1):102766.
• 11. Lädermann A, Piotton S, Abrassart S, et al. Hydrodilatation with corticosteroids is the most effective conservative management for frozen shoulder. Knee Surg Sports Traumatol Arthrosc. 2021;29:2553-63.
• 12. Kim DH, Song KS, Min BW, et al. Early clinical outcomes of manipulation under anesthesia for refractory adhesive capsulitis: comparison with arthroscopic capsular release. Clin Orthop Surg. 2020;12(2):217-23.
• 13. Schoch B, Huttman D, Syed UA, et al. Surgical treatment of adhesive capsulitis: a retrospective comparative study of manipulation under anesthesia and/or capsular release. Cureus. 2020;12(7):e9032.
• 14. D. Gould et al. Examining the validity of pressure ulcer risk assessment scales: developing and using illustrated patient simulations to collect the data. J Clin Nurs. 2001;10(5):697-706.
• 15. Çelik D. Turkish version of the modified Constant-Murley score and standardized test protocol: Reliability and validity. Acta Orthop Traumatol Turc. 2016;50(1):69–75.
• 16. Song C, Song C, Li C. Outcome of manipulation under anesthesia with or without intra-articular steroid injection for treating frozen shoulder: A retrospective cohort study. Medicine. 2021;100(13):e23893.
• 17. Ko YW, Park JH, Youn SM, et al. Effects of comorbidities on the outcomes of manipulation under anesthesia for primary stiff shoulder. J Shoulder Elbow Surg. 2021;30(8):482-92.