Kalkaneal spurda radial şok dalga tedavisinin uygulanma sıklığının tedaviye etkileri
Yükleniyor...
Dosyalar
Tarih
2023
Kurum Yazarları
Çakı, Emre
Süreli Yayın başlığı
Süreli Yayın ISSN
Cilt Başlığı
Yayınevi
Bursa Uludağ Üniversitesi
Özet
Bu çalışmada kalkaneal spurda şok dalga tedavisinin uygulanma sıklığının etkinliğini ve güvenilirliğini değerlendirmek ve tedavi süresini kısaltmak amaçlanmıştır. Yaşları 40-75 arasında olan, en az 6 aydır topuk plantar yüzde ağrı yaşayan, kalkaneal röntgenle spur tanısı konmuş 68 gönüllü, hızlandırılmış ESWT (n=34) ve klasik ESWT (n=34) gruplarına randomize edilmiştir. Tüm gönüllülere ayrıca plantar fasyaya yönelik egzersiz programı verilmiştir. Klasik ESWT grubundaki gönüllülere haftada bir, maksimum tolere edilebilen dozda, 3 seans, 8 Hz, 2000'er atım tedavi uygulanmış; hızlandırılmış ESWT grubundakilere ise doz, seans sayısı, frekans ve atım sayısı değiştirilmeden iki günde bir tedavi uygulanmıştır. Gönüllülerin tedavi öncesi ve sonrası fiziksel durum değişiklikleri vücut kitle indeksi (VKİ) ile, ağrı durumu görsel analog skala (VAS) ile, fonksiyonel durumu Roles-Maudsley (RM) skoru ve Ayak Fonksiyon İndeksi (AFİ) ile, kalkaneal spur uzunluk değişimleri lateral kalkaneal röntgenogram ile veplantar fasya kalınlığı değişimleri ultrason ile değerlendirilmiştir. Her iki grupta tedavi sonrası VAS skorlarında, RM skorlarında ve AFİ skorlarında tedavi öncesine göre istatistiksel anlamlı iyileşmeler saptanmış olup; tedavi sonuçlarının gruplar arası kıyaslamasında istatistiksel anlamlı fark saptanmamıştır. Tedavi öncesi ile tedavi sonrası kalkaneal spur uzunlukları grup içinde istatistiksel olarak anlamlı oranda azalmasına rağmen, plantar fasya kalınlıklarında grup içi ve gruplar arası istatistiksel anlamlı farklılık saptanmamıştır. Bu çalışmanın sonucunda, kalkaneal spur tedavisinde ESWT'nin ağrıyı azaltmada ve fonksiyonel kapasiteyi arttırmada etkili olduğu gözlemlenmiş olup; seans sıklığını arttırmanın tedavi sonucuna etki etmediği gösterilmiştir. Bununla birlikte seans sıklığını arttırmanın herhangi bir yan etki göstermemesi; güvenilir ve etkili bir tedavi yöntemi olduğunu göstermiştir. Ayrıca hızlandırılmış protokolde hastanın ve hekimin zaman yönetimi açısından olumlu etkiler gözlemlenmiştir.
The aim of this study was to evaluate the efficacy and safety of the frequency of application of shock wave therapy in calcaneal spur and to shorten the duration of treatment. Sixty-eight volunteers aged between 40 and 75 years, experiencing pain on the plantar aspect of the heel for at least 6 months, and diagnosed with calcaneal spur by X-ray were randomized into accelerated ESWT (n=34) and conventional ESWT (n=34) groups. All volunteers were also given an exercise program for plantar fascia. Volunteers in the classical ESWT group received treatment once a week, at the maximum tolerated dose, 3 sessions, 8 Hz, 2000 pulses; those in the accelerated ESWT group received treatment every other day without changing the dose, number of sessions, frequency and number of pulses. Pre- and post-treatment physical status changes were evaluated by body mass index (BMI), pain status by visual analog scale (VAS), functional status by Roles-Maudsley (RM) score and Foot Function Index (FFI), calcaneal spur length changes by lateral calcaneal roentgenogram and plantar fascia thickness changes by ultrasound. In both groups, statistically significant improvements were found in VAS scores, RM scores and AFI scores after treatment compared to pretreatment; however, no statistically significant difference was found in the comparison of treatment results between groups. Although the calcaneal spur lengths decreased statistically significantly between the pre-treatment and post-treatment groups, there was no statistically significant difference in plantar fascia thickness within and between the groups. As a result of this study, it was observed that ESWT was effective in reducing pain and increasing functional capacity in the treatment of calcaneal spur; and it was shown that increasing the frequency of sessions did not affect the treatment outcome. However, the fact that increasing the frequency of sessions did not show any side effects showed that it is a safe and effective treatment method. In addition, positive effects were observed in terms of time management of the patient and the physician in the accelerated protocol.
The aim of this study was to evaluate the efficacy and safety of the frequency of application of shock wave therapy in calcaneal spur and to shorten the duration of treatment. Sixty-eight volunteers aged between 40 and 75 years, experiencing pain on the plantar aspect of the heel for at least 6 months, and diagnosed with calcaneal spur by X-ray were randomized into accelerated ESWT (n=34) and conventional ESWT (n=34) groups. All volunteers were also given an exercise program for plantar fascia. Volunteers in the classical ESWT group received treatment once a week, at the maximum tolerated dose, 3 sessions, 8 Hz, 2000 pulses; those in the accelerated ESWT group received treatment every other day without changing the dose, number of sessions, frequency and number of pulses. Pre- and post-treatment physical status changes were evaluated by body mass index (BMI), pain status by visual analog scale (VAS), functional status by Roles-Maudsley (RM) score and Foot Function Index (FFI), calcaneal spur length changes by lateral calcaneal roentgenogram and plantar fascia thickness changes by ultrasound. In both groups, statistically significant improvements were found in VAS scores, RM scores and AFI scores after treatment compared to pretreatment; however, no statistically significant difference was found in the comparison of treatment results between groups. Although the calcaneal spur lengths decreased statistically significantly between the pre-treatment and post-treatment groups, there was no statistically significant difference in plantar fascia thickness within and between the groups. As a result of this study, it was observed that ESWT was effective in reducing pain and increasing functional capacity in the treatment of calcaneal spur; and it was shown that increasing the frequency of sessions did not affect the treatment outcome. However, the fact that increasing the frequency of sessions did not show any side effects showed that it is a safe and effective treatment method. In addition, positive effects were observed in terms of time management of the patient and the physician in the accelerated protocol.
Açıklama
Anahtar kelimeler
Plantar ayak ağrısı, Kalkaneal spur, Ekstrakorporeal şok dalga tedavisi, Plantar foot pain, Calcaneal spur, Extracorporeal shock wave therapy
Alıntı
Çakı, E. (2023). Kalkaneal spurda radial şok dalga tedavisinin uygulanma sıklığının tedaviye etkileri. Yayınlanmamış tıpta uzmanlık tezi. Bursa Uludağ Üniversitesi Tıp Fakültesi.