Kronik bel aðrýsý olan hastalarda kayropraksik manuel tedavinin etkinliðinin deðerlendirilmesi

GÝRÝÞ ve AMAÇ: Bel aðrýsý sýk görülen, kostalarýn alt sýnýrýyla aþaðý gluteal kývrýmlar arasýnda lokalize olabilen ve bacaklara da yansýyabilen sakatlýðýn önemli nedenlerinden biridir. Kayropraksi bel aðrýsýnda kullanýlan non invaziv ve ucuz bir tedavi metodudur. Çalýþmamýzýn amacý bel aðrýsýnda kayropraksi ve izometrik egzersizin aðrý ve fonksiyonellik üzerine etkisini deðerlendirmektir.
YÖNTEM ve GEREÇLER: Poliklinikte bel aðrýsý tanýsý almýþ hastalar çalýþmaya alýndý. 30 kadýn ve 30 erkekten oluþan 60 hasta randomize olarak iki gruba ayrýldý. Birinci gruba bel bölgesine kayropraksi uygulamasý ve bel izometrik egzersiz, ikinci gruba bel izometrik egzersiz programý oluþturuldu. Egzersiz programý her iki gruba da 4 hafta boyunca haftada 5 gün fizyoterapist tarafýndan yaptýrýldý. Kayropraksi tedavisi 4 hafta boyunca haftada 2 gün ayný doktor tarafýndan uygulandý. Uygulama sýrasýnda kayroprakside yüksek hýzlý düþük amplitüdlü manipülasyon tekniði kullanýldý. Tedavi öncesi ve sonrasý aðrýyý deðerlendirmek için VAS (Vizüel Aðrý Skalasý), fonksiyonel durumu deðerlendirmek için de Oswestry özürlülük indeksi uygulandý. Eklem hareket açýklýðý gonyometre ölçümü ile deðerlendirildi.
BULGULAR: Tedavi öncesi ve tedavi sonrasý VAS ve Oswestry deðerleri her iki grupta tedavi ile istatistiksel olarak anlamlý þekilde azalýrken beldeki eklem hareket açýklýðý deðerleri belirgin þekilde artmýþtý. Egzersiz ve kayropraksi alan hastalarda sadece egzersiz alan hastalara göre VAS istirahat, VAS hareket ve Oswestry deðerlerinin istatistiksel olarak anlamlý derecede daha düþük düzeylerde ve eklem hareket açýklýðýndaki artýþýn ise daha yüksek düzeylerde olduðu saptandý. Tedavi sýrasýnda herhangi bir yan etkiye rastlanmadý.
TARTIÞMA ve SONUÇ: Kayropraksi ve egzersizin bel aðrýsýnda aðrý ve fonksiyonellik üzerine etkili olduðunu ve birlikte uygulandýðýnda daha etkili olduðunu düþünmekteyiz.

Evaluation of the effectiveness of chiropractic manual treatment in patients with chronic low back pain

INTRODUCTION: Low back pain that is localized between the inferior costal margin and inferior gluteal folds and that can reflect legs is a common health problem and a leading cause of disability. Chiropractic is a non-invasive and inexpensive treatment method used for low back pain. The aim of our study was to evaluate the effects of chiropractic and isometric exercises on pain and functionality related to low back pain.
METHODS: Patients diagnosed with low back pain in the policlinic examination were taken in the study. Sixty patients consisting of 30 females and 30 males were randomly divided into two groups. Chiropractic application and lumbar isometric exercise were created for the first group, and a lumbar isometric exercise program was created for the second group. The exercise program was applied to both groups five days a week for four weeks by a physiotherapist. Chiropractic treatment was applied by the same doctor two days a week for four weeks. During the application, a high-speed, low amplitude manipulation technique was used in chiropractic. Visual Analog Scale (VAS) was used to score pain, and Oswestry Disability Index (ODI) was used to evaluate functionality before and after treatment. The range of motion was evaluated by goniometer measurement.
RESULTS: VAS and ODI scores decreased statistically significantly with treatment in both groups, while the range of motion in the lumbar spine increased significantly before and after treatment. VAS rest, VAS motion, and ODI scores were statistically significantly lower, and the increase in range of motion was higher in patients who received exercise and chiropractic compared to patients who only received exercise. Any adverse effect did not appear in both groups during the treatment.
DISCUSSION AND CONCLUSION: We think that chiropractic and exercise are effective on pain and functionality in low back pain, and they are more effective when applied together.