Kronik boyun ağrısında bakış yönü tanıma egzersizlerinin ağrı şiddeti, eklem hareket açıklığı ve izometrik kas enduransına etkisi

Year 2019, Volume: 44 Issue: 2, 439 - 446, 30.06.2019

Şule Şimşek , Mehmet Duray Filiz Altuğ

https://doi.org/10.17826/cumj.451482

Abstract

Amaç: Çalışmamızın amacı kronik boyun ağrılı olgularda bakış yönü tanıma egzersizlerinin ağrı şiddeti, eklem hareket açıklığı ve izometrik kas enduransına etkisini araştırmaktır. 

Gereç ve Yöntem:  Çalışmamıza yaşları 29-54(yaş ort:44.98±6.38) arasında değişen toplam 40 katılımcı (32 kadın, 8 erkek) gönüllü olarak katılmıştır. Katılımcılar randomize olarak iki gruba (BYTE Grubu ve Kontrol Grubu) ayrılmıştır. Her iki tedavi grubuna kombine fizyoterapi programı uygulanmıştır. Her iki grup haftada 5 gün ve 3 hafta olmak üzere toplam 15 seans tedaviye alınmıştır. BYTE Grubuna ilave olarak 15 seans Bakış Yönü Tanıma Egzersizleri uygulanmıştır. Ağrı şiddeti (Görsel Analog Skalası), eklem hareket açıklığı (üniversal gonyometre), izometrik kas enduransı (kraniyoservikal test), Bakış yönü tanıma test değerlendirmeleri tedavi öncesi, sonrası ve 6 hafta sonrasında tekrar edilmiştir.

Bulgular: Her iki grupta tedavi programı sonrasında ağrı şiddeti, fleksiyon, ekstansiyon, lateral fleksiyon, sola rotasyon eklem hareket açıklığı, izometrik kas enduransı bakımından iyileşme kaydedilmiştir (p<0.05). İki Grup arasında ağrı şiddeti, fleksiyon, her iki yöne lateral fleksiyon, sağa rotasyon eklem hareket açıklığı ve kas endurası ve bakış yönü tanıma test skorları bakımından istatistiksel olarak anlamlı fark kaydedilmiştir ( p<0.05).

Sonuç: Kombine fizyoterapi programına ilave olarak uygulanan Bakış Yönü Tanıma Egzersizleri tedavinin etkinliğini artırmıştır. 

Keywords

Bakış Yönü Tanıma Egzersizi, Ağrı Şiddeti, Kronik Boyun Ağrısı

Effect of the gaze direction recognition task on pain intensity, range of motion and isometric muscle endurance in chronic neck pain

Abstract

Purpose: The aim of this study was to evaluate the effect of the Gaze Direction Recognition Task on pain intensity, range of motion and isometric muscle endurance in patients with chronic neck pain. 

Materials and Methods: A total of 40 participants (32 female, 8 male) aged between 29-54 years (mean age: 44.98 ± 6.38) participated voluntarily in our study. Participants were randomly divided in two groups (GDRT Group and Control Group). Both groups underwent combined physiotherapy program. Both groups received in total 15 sessions of therapy during 3 weeks, 5 days per week. The GDRT Group has additionally underwent 15 sessions of Gaze Direction Recognition Tasks. Pain Intensity (Visual Analog Scale), range of motion (universal goniometer), isometric muscle endurance (craniocervical test) and the Gaze direction recognition task assessments were repeated before, after and 6 weeks after the treatment programme.

Results: After therapy, improvement was observed in terms of pain intensity, flexion, extension, lateral flexion, left rotation range of motion and isometric muscle endurance in both groups (p<0.05). Statistically significant differences were recorded in terms of pain intensity, flexion, lateral flexion of both direction, right rotation range of motion, muscle strength and gaze direction recognition task scores between two groups (p<0.05).

Conclusion: The Gaze Direction Recognition Tasks given additionally to the combined physiotherapy program has increased the efficiency of the treatment. 

Keywords

Gaze Direction Recognition Task, Pain Intensity, Chronic Neck Pain

References

• 1. Hoy DG, Protani M, De R, Buchbinder R. The Epidemyology of Neck Pain. Best Practice & Research Clinical Rheumatology 2010; 24:783–792.
• 2. Akgüder A. Boyun ağrısı nedenleri. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi 2000; 3:21-28.
• 3. Douglass AB, Bope ET. Evaluation and treatment of posterior neck pain in family practice. J Am Board Fam Pract 2004; 17:13-22.
• 4. Bryans R, Decina P, Descarreaux M, Duranleau M, Marcoux H, Potter B, et al. Evidence-based guidelines for the chiropractic treatment of adults with neck pain. J Manipulative Physiol Ther 2014; 37(1):42-63.
• 5. Schenk R, Bhaidani T, Boswell M, Kelley J, Kruchowsky T. Inclusion of Mechanical Diagnosis and Therapy (MDT) in the Management of Cervical Radiculopathy: A Case Report. The Journal of Manual & Manipulative Therapy 2008;16 (1): E2–E8.
• 6. Jette AM, Delito A. Physical therapy treatment choices for musculoskeletal impairments. Physical Therapy 1997; 77(2):145-154.
• 7. Chou R, Qaseem A, Snow V, Casey D, Cross JT Jr, Shekelle P, et al. “Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society,” Annals of Internal Medicine 2007;147(7):478–491.
• 8. Daffada PJ, Walsh N, Mc Cabe CS, Palmer S. The impact of cortical remapping interventions on pain and disability in chronic low back pain: a systematic review. Physiotherapy2015; 101(1):25-33.
• 9. Harris AJ. Cortical origin of pathological pain. Lancet 1999; 354:1464-1466.
• 10. Ramachandran VS, Rodgers-Ramachandran D. “Synaesthesia in phantom limbs induced with mirrors,” Proceedings of the Royal Society 1996; 263(1369):377-86.
• 11. Nobusako S, Matsuo A, Morioka S. Effectiveness of the gaze direction recognition task for chronic neck pain and cervical range of motion: a randomized controlled pilot Study. Rehabil Res Pract 2012; 2012:1-13. 12. Lotze M, Montoya P, Erb M, Hülsmann E, Flor H, Klose U, et al. “Activation of cortical and cerebellar motor areas during executed and imagined hand movements: an fMRI study. J Cogn Neurosci. 1999; 11(5):491-501.
• 13. Buccino G, Binkofski F, Fink GR, Fadiga L, Fogassi L, Gallese V, et al. “Action observation activates premotor and parietal areas in a somatotopic manner: an fMRI study”. European Journal of Neuroscience 2001; 13(2):400-404.
• 14. Nobusako S, Shimizu S, Miki K, Tamaki H, Morioka S. Neural basis for perception of gaze direction by observation from behind: a study using functional near-infrared spectroscopy. Rigakuryoho Kagaku 2010; 25:419-425.
• 15. Cunha AC, Burke TN, França FJ, Marques AP. Effect of global posture reeducation and of static stretching on pain, range of motion, quality of life in women with chronic neck pain: a randomized clinical trial. Clinics 2008; 63(6):763-70.
• 16. Chaves TC, Nagamine HM, Belli JFC, de Hannai MCT, Bevilaqua-Grossi D, de Oliveira AS. Reliability of fleximetry and goniometry for assessing cervical range of motion among children. Rev Bras Fisioter 2008; 12:283-9.
• 17. Jull GA, O’Leary SP, Falla DL. Clinical assessment of the deep cervical flexor muscles: the craniocervical flexion test. J Manipulative Physiol Ther 2008; 31(7):525-33.
• 18. Sümbüloğlu K, Sümbüloğlu ., Biyoistatistik, 9. Baskı, Ankara, 2000, 1-6.
• 19. Wand BM, Parkitny L, O’Connell NE, Loumajoki H, McAuley JH, Thacker M, et al. “Cortical changes in chronic low back pain: current state of the art and implications for clinical practice. Manual Therapy 2011; 16(1):15–20.
• 20. Saab CY. Pain-related changes in the brain: diagnostic and therapeutic potentials. Trends Neurosci.2012; 35(10):629-37.
• 21. Moseley GL. Graded motor imagery for pathologic pain: a randomized controlled trial. Neurology 2006; 67(12):2129–34.
• 22. Dickstein R, Dunsky A, Marcovitz E. Motor imagery for gait rehabilitation in post-stroke hemiparesis. Physical Therapy 2004;84(12):1167–77.
• 23. Yue G, Cole KJ. Strength increases from the motor program: comparison of training with maximal voluntary and imagined muscle contractions. Journal of Neurophysiology 1992;67(5):1114–1123.
• 24. O’leary S, Jull G, Kim M, Vicenzino B. Cranio-cervical flexor muscle impairment at maximal, moderate, and low loads is a feature of neck pain. Man Ther 2007;12:34–39.