Modifiye zorunlu kullanım terapisi hemipleji hastalarında motor performansı iyileştirmede etkili midir?

Year 2023, Volume: 28 Issue: 1, 48 - 55, 20.01.2023

Emre Sahin , Merve Akdeniz Leblebicier , İsmail Saracoglu , Aysun Özlü

https://doi.org/10.21673/anadoluklin.1085612

Abstract

Amaç: Bu çalışmanın amacı, inmeye bağlı hemipleji gelişmiş hastalarda konvansiyonel rehabilitasyona ek olarak modifiye zorunlu kullanım terapisinin (mZKT) üst ekstremite motor iyileşme, performans ve fonksiyonel bağımsızlık üzerindeki etkisini araştırmaktı.

Yöntemler: Çalışmaya; çalışma grubu (64,45±9,18 yıl) 20 olgu, kontrol grubu (64,45±9,18 yıl) 20 olgu olacak şekilde toplam 40 kronik inme olgusu dâhil edilmiştir. Çalışma grubu düzenli fizyoterapi ile mZKT alırken, kontrol grubu sadece düzenli fizyoterapi aldı. Hastalar tedavi öncesi, tedavi sonrası ve tedavi sonrası 3. ayda Motor Aktivite Günlüğü-28 (MAG-28), Fonksiyonel Bağımsızlık Ölçümü (FBÖ) ve Fugl-Meyer Üst Ekstremite Skalası (FMÜES) ile değerlendirildi.

Bulgular: MAG-28 ve FBÖ skorları tedavi sonrası ve üçüncü ay takibinde başlangıç değerlerine kıyasla her iki grupta da istatistiksel açıdan anlamlı olarak arttı (p<0.05). Tedavi sonrası ve üçüncü ay takibinde, FMUES skorları başlangıç değerlerine göre her iki grupta da anlamlı olarak arttı (p<0.001).

Sonuç: Bu çalışma, konvansiyonel tedaviye eklenen mZKT’nin kronik inmeli hastalarda üst ekstremite motor fonksiyonunu, performansını ve fonksiyonel bağımsızlığını iyileştirdiğini göstermiştir; ancak, mZKTnin geleneksel tedaviye kıyasla ek bir faydası olmamıştır.

Keywords

Hemipleji, fiziksel fonksiyonel performans, inme rehabilitasyonu

Is modified constraint-induced movement therapy effective in improving motor performance in patients with hemiplegia?

Abstract

Aim: To investigate the effect of modified constraint-induced movement therapy (mCIMT) on upper extremity motor recovery, performance, and functional independence in addition to conventional rehabilitation in stroke patients.

Methods: The study included 40 participants, including 20 chronic stroke cases in the intervention group (IG) (64.45±9.18 years) and 20 chronic stroke cases in the control group (CG) (64.45±9.18 years) who met the selection criteria. IG received mCIMT with regular physiotherapy, while CG received only regular physiotherapy. The patients were evaluated with the Motor Activity Log-28 (MAL-28), the Functional Independence Measure (FIM), and the Fugl-Meyer Upper Extremity Scale (FMUES) before treatment, immediately after treatment (post-treatment), and at three months after treatment (follow-up).

Results: The MAL-28 and FIM scores significantly increased in both groups compared with the baseline values after treatment and at the third-month follow-up (p<0.05). After treatment and at the third-month follow-up, the FMUES scores significantly increased in both groups compared with the baseline values (p<0.001).

Conclusion: This study showed that mCIMT added to conventional therapy improved upper extremity motor function, performance, and functional independence in chronic stroke patients; however, mCIMT had no additional benefit to conventional therapy.

Keywords

Hemiplegia;, physical functional performance, stroke rehabilitation

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