Myofasiyal ağrı sendromunun tedavisinde transkutanöz elektriksel sinir stimülasyonunun etkisi
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Date
1997
Authors
Çırpanlı, Gürel
Journal Title
Journal ISSN
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Publisher
Uludağ Üniversitesi
Abstract
Çalışmamızı Uludağ Üniversitesi Tıp Fakültesi Fiziksel Tıp ve Rehabilitasyon Polikliniği ile Atatürk Rehabilitasyon Merkezi Kükürtlü Kaplıcaları Polikliniğine başvuran ve trapezius kası üst bölümündeki tetik noktalara bağlı olarak gelişen MAS'lu 48 hasta üzerinde yaptık. Hastalarımızı rastgele 16'şar kişilik (14 kadın, 2 erkek) üç guruba ayırdık. I. Gruba 100 Hz, 100 usn, duyum eşiğinin biraz üzerinde; II. gruba 2 Hz, 100 usn, duyum eşiğinin biraz üzerinde TENS uyguladık. Kontrol gurubuna da (III. grup) plasebo TENS uyguladık. Tüm hastaları 2 hafta boyunca izledik. Tedavi öncesi, ilk tedaviden hemen sonra, 1. hafta sonunda ve 2. hafta sonunda toplam dört kez değerlendirdik. Çalışmada kullanılan parametreler; ağrı (VAS ve 5 Nokta Skalası), duyarlılık (algometre ile ölçme ve basmakla yapılan değerlendirme), servikal lateral fleksiyonlar (ağrılı yöne ve ağrının karşı yönüne) idi. Çalışmanın sonunda; MAS'da belirti ve bulguların giderilmesinde TENS' in her iki şeklinin yararlı sonuçlarını gözledik. Ancak yüksek frekanslı TENS'in yararlı etkilerinin daha erken başladığını belirledik. 2. Haftanın sonunda, ağrı azalmasında ve hareket açıklığının genişlemesinde plasebo TENS'in diğer iki TENS şekli kadar etkili olduğunu saptadık. Lokal duyarlılıktaki azalmanın, yüksek frekans uygulanan grupta daha erken ortaya çıktığım ve diğer iki gruba göre daha belirgin olduğunu gözledik. Ayrıca düşük59 frekanslı grupta, kontrol grubuna göre daha erken ortaya çıktığını, fakat 2. haftanın sonunda aralarında istatiksel olarak anlamlı bir fark olmadığını belirledik. Sonuç olarak; TENS'in MAS'nun tedavisinde etkili, güvenilir, ucuz ve kolay uygulanabilir bir yöntem olduğunu vurgulayabiliriz. Ayrıca yüksek frekansta uygulanan TENS'in (100 Hz'lik), düşük frkansta uygulanan TENS'e (2 Hz'lik) ve plasebo TENS'e göre MAS'nun belirti ve bulgularının giderilmesinde daha etkili olduğunu söyleyebiliriz.
We performed our study on 48 patients who applied to Uludağ University Faculty of Medicine Physical Medicine and Rehabilitation Polyclinic and Atatürk Rehabilitation Center Sulfur Hot Springs Polyclinic and developed due to trigger points in upper part of trapezius muscle. We randomly divided our patients into three groups (16 females (14 females, 2 males)). I. Group 100 Hz, 100 usn, slightly above the sensing threshold; II. 2 Hz, 100 usn, TENS slightly above the sensing threshold. We applied placebo TENS to the control group (group III). We followed all the patients for 2 weeks. We evaluated a total of four times before treatment, immediately after the first treatment, at the end of week 1 and at the end of week 2. The parameters used in the study; pain (VAS and 5-point scale), sensitivity (measuring with an algometer and evaluation by pressing), cervical lateral flexions (painful direction and opposite direction of pain). At the end of the study; We observed the beneficial results of both forms of TENS in the resolution of signs and symptoms in MAS. However, we found that the beneficial effects of high-frequency TENS began earlier. At the end of the 2nd week, we found that placebo TENS was as effective as two other TENS forms in pain reduction and range of motion. We observed that the decrease in local sensitivity occurred earlier in the high frequency group and was more pronounced than the other two groups. We also found that it appeared earlier in the low-frequency group than the control group, but there was no statistically significant difference between them at the end of the 2nd week. As a result; We can emphasize that TENS is an effective, reliable, inexpensive and easily applicable method in the treatment of MAS. We can also say that high frequency TENS (100 Hz) is more effective in relieving the signs and symptoms of MAS than low frequency TENS (2 Hz) and placebo TENS.
We performed our study on 48 patients who applied to Uludağ University Faculty of Medicine Physical Medicine and Rehabilitation Polyclinic and Atatürk Rehabilitation Center Sulfur Hot Springs Polyclinic and developed due to trigger points in upper part of trapezius muscle. We randomly divided our patients into three groups (16 females (14 females, 2 males)). I. Group 100 Hz, 100 usn, slightly above the sensing threshold; II. 2 Hz, 100 usn, TENS slightly above the sensing threshold. We applied placebo TENS to the control group (group III). We followed all the patients for 2 weeks. We evaluated a total of four times before treatment, immediately after the first treatment, at the end of week 1 and at the end of week 2. The parameters used in the study; pain (VAS and 5-point scale), sensitivity (measuring with an algometer and evaluation by pressing), cervical lateral flexions (painful direction and opposite direction of pain). At the end of the study; We observed the beneficial results of both forms of TENS in the resolution of signs and symptoms in MAS. However, we found that the beneficial effects of high-frequency TENS began earlier. At the end of the 2nd week, we found that placebo TENS was as effective as two other TENS forms in pain reduction and range of motion. We observed that the decrease in local sensitivity occurred earlier in the high frequency group and was more pronounced than the other two groups. We also found that it appeared earlier in the low-frequency group than the control group, but there was no statistically significant difference between them at the end of the 2nd week. As a result; We can emphasize that TENS is an effective, reliable, inexpensive and easily applicable method in the treatment of MAS. We can also say that high frequency TENS (100 Hz) is more effective in relieving the signs and symptoms of MAS than low frequency TENS (2 Hz) and placebo TENS.
Description
Keywords
Miyofasyal ağrı sendromları, Transkütanöz elektriksel sinir stimülasyonu, Myofascial pain syndromes, Transcutaneous electric nerve stimulation
Citation
Çırpanlı, G. (1997). Myofasiyal ağrı sendromunun tedavisinde transkutanöz elektriksel sinir stimülasyonunun etkisi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.