FİBROMİYALJİ HASTALARINDA DENGE-PROPRİOSEPSİYON VE AEROBİK EGZERSİZ UYGULAMALARININ FONKSİYONEL DURUM, AĞRI VE DENGE ÜZERİNE ETKİSİ- RANDOMİZE KONTROLLÜ ÇALIŞMA

Year 2023, Volume: 86 Issue: 4, 368 - 375, 01.12.2023

Hadi Yavuz , Türker Şahinkaya , Musa Doruk , Mert Zure , Şensu Dinçer , Ayşegül Ketenci , Gökhan Metin

https://doi.org/10.26650/IUITFD.1275105

Abstract

Amaç: Fibromiyalji hastalarında yaygın ağrıya ek olarak günlük aktiviteleri gerçekleştirmede güçlük ve denge kaybı sık görülen şikayetlerdir. Çalışmamızda fibromiyaljideki bu şikayetler üzerine etkili olabileceğini düşündüğümüz farklı tip egzersiz programlarının (aerobik ve denge-propriyosepsiyon) ağrı, fonksiyonel durum ve denge parametreleri üzerine etkilerini karşılaştırmayı amaçladık. Bu nedenle randomize kontrollü, paralel gruplar içeren, tek merkezli ve tek kör bir çalışma tasarladık.
Gereç ve Yöntem: Üniversitenin fizik tedavi ve rehabilitasyon bölümü kliniğine başvuran fibromiyalji sendromlu kadın hastalar uygunluk açısından değerlendirildi. Hastalar aerobik egzersiz grubu ve denge-propriyosepsiyon grubu olarak iki gruba ayrıldı. Bu iki grup haftada 3 gün fizyoterapist gözetiminde toplam 6 hafta egzersiz yaptı. Ağrı şiddeti için Visual Analog Scale (VAS), fonksiyonel durum değerlendirmesi için Fibromiyalji Etki Anketi (FEA), denge durumu değerlendirmesi için denge-stabilite sistemi (Biodex Balance System) kullanıldı. Her ölçüm tedavi öncesi ve sonrası olmak üzere iki kez tekrarlandı ve sonuçlar karşılaştırıldı.
Bulgular: Aerobik egzersiz grubunda 26 ve denge-propriyosepsiyon grubunda 25 hasta çalışmayı tamamladı. Hem aerobik egzersiz hem de denge propriyosepsiyon egzersiz gruplarında, FIQ'da (sırasıyla 34,63±11,85, 29,60±12,77) VAS'ta (sırasıyla 4,54±1,83; 4,28±1,92), gözler kapalı OSI (sırasıyla 0,85±0,53, 0,80±0,33, p<0,001), gözler kapalı MLSI (sırasıyla 0,41±043, 035,±0,19, p=0,39), gözler kapalı APSI (sırasıyla 0,65±0,32, 0,62±0,29, p<0,001), gözler açık MLSI (sırasıyla 0,15±0,07, 0,14±0,05) parametrelerinde iyileşme saptandı. Tedavi öncesi bulgulara benzer şekilde tedavi sonrasında da FIQ, VAS ve denge skorlarında gruplar arasında istatistiksel olarak anlamlı fark yoktu (p>0,05).
Sonuç: Hem aerobik egzersiz hem de denge-propriyosepsiyon egzersizleri, FMS'li hastaların ağrı, fonksiyonel durum ve denge yeteneklerini iyileştirmede etkili yöntemlerdir. FMS tedavisinde günümüzde sıklıkla reçete edilen aerobik egzersiz programlarının yanı sıra denge-propriyosepsiyon egzersizlerinden oluşan programlar da tercih edilebilir.

Keywords

Fibromiyalji, aerobik egzersiz, denge-propriyosepsiyon egzersizi, ağrı, fonksiyonel durum

A COMPARISON OF THE EFFECTS OF BALANCE– PROPRIOCEPTION AND AEROBIC EXERCISES ON FUNCTIONAL STATUS, PAIN, AND BALANCE IN PATIENTS WITH FIBROMYALGIA SYNDROME - A RANDOMIZED CONTROLLED STUDY

Abstract

Objective: Difficulty in performing daily activities and loss of balance are common complaints in addition to generalized pain in fibromyalgia syndrome (FMS) patients. Exercise is an effective treatment for fibromyalgia. There are a variety of forms of exercise used to treat fibromyalgia. This study aimed to compare the effects of aerobic and balance-proprioception exercises on pain, functional status, and balance in female patients with fibromyalgia.
Material and Method: Female patients with fibromyalgia syndrome who applied to the university physical medicine and rehabilitation department clinic were evaluated for eligibility. Patients were allocated into two groups: the aerobic exercise group and balance-proprioception group. These two groups exercised under the supervision of a physiotherapist three days a week for a total of 6 weeks. Visual Analogue Scale (VAS) was used for pain severity, Fibromyalgia Impact Questionnaire (FIQ) was used for functional status assessment, and balance-stabilidisty system (Biodex Balance System) was used for balance status assessment. Each measurement was repeated twice, before and after the treatment, and the results were compared.
Result: Fifty-one patients were enrolled including 26 patients in the aerobic exercise group and 25 patients in the balance-proprioception group. Both aerobic exercise and balance proprioception exercise groups showed significant improvement following the treatment in FIQ ((34.63±11.85, 29.60±12.77, respectively, p<0.001) and VAS (4.54±1.83; 4.28±1.92, respectively, p<0.001), all Eyes-Closed Mediolateral Stability Index (EC-MLSI) (0.41±0.43, 0.35±0.19, respectively, p=0.39), Eyes Closed Overall Stability Index (EC-OSI) (0.85±0.53; 0.80±0.33, respectively, p<0,001), Eyes Closed Anteroposterior (EC-APSI) Stability Index (0.65±0.32, 0.62±0.29, respectively, p<0.001) and Eyes-Opened Mediolateral Stability (EO-MLSI) (0.15±0.07, 0.14±0.05, respectively, p=0.019). Similar to before-treatment findings, there was no statistically significant difference between groups in the FIQ, VAS, and balance scores after treatment (p>0.05).
Conclusion: Both aerobic exercise and balance-proprioception exercises are effective methods in improving pain, functional status, and balance abilities of patients with FMS. In addition to aerobic exercise programs that are often prescribed nowadays, programs consisting of balance–proprioception exercises can also be a preferable option in FMS treatment.

Keywords

Fibromyalgia, aerobic exercise, balance-proprioception exercise, pain, functional status

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