Lateral Epikondilitli Hastalarda Ekstrakorporeal Şok Dalga Tedavisi, Ultrason ve Deksametazon İyontoforezinin Karşılaştırılması

Yıl 2025, Cilt: 7 Sayı: 1, 1 - 9, 25.02.2025

Pınar Başaran , Ayşe Doğan

https://doi.org/10.52827/hititmedj.1462592

Öz

Amaç: Bu çalışmanın amacı, lateral epikondilitli hastalarda ekstrakorporeal şok dalga tedavisi (ESWT), ultrason (US) ve deksametazon iyontoforez tedavilerinin ağrı, kavrama gücü, fonksiyonellik ve yaşam kalitesi üzerindeki etkinliğini belirlemek ve hangi tedavinin daha etkili olabileceğini belirlemeyi amaçladık.
Gereç ve Yöntem: Bu tek kör, prospektif, randomize çalışmaya lateral epikondilit tanısı konan 78 hasta dahil edildi. Hastalar üç gruba randomize edildi. Bu tek kör, prospektif, randomize çalışmaya lateral epikondilit tanısı konan 78 hasta dahil edildi. Hastalar üç gruba randomize edildi. Tüm gruplar sıcak paketler, transkütanöz elektriksel sinir stimülasyonu (TENS) ve gözetimli egzersizleri içeren bir fizyoterapi programı uygulandı. Tüm egzersizler deneyimli bir fizyoterapist gözetiminde gerçekleştirildi. 10 günlük fizyoterapi programına ek olarak, 1. gruba her 5 günde bir toplam 3 seans ESWT, 2. gruba 10 gün US ve 3. gruba 10 gün deksametazon iyontoforez tedavisi uygulandı. Değerlendirmeler tedaviden önce ve 1 ayın sonunda yapıldı. Ağrı şiddeti sayısal derecelendirme ölçeği (NRS) ile, özürlülük kol, omuz ve el hızlı özürlülük ölçeği (Quick DASH) ile, yaşam kalitesi Nottingham Sağlık Profili (NHP) ile, kavrama gücü dinamometre ile ve parmak gücü pinchmetre ile ölçüldü.
Bulgular: Gruplar demografik ve klinik özellikler açısından benzerdi. Tedaviden sonraki ilk ayda ağrı şiddeti, özürlülük, kavrama gücü ve yaşam kalitesi açısından üç grupta da anlamlı iyileşme saptandı. Tedavi sonrası birinci ayda bu tedavilerin etkinliği karşılaştırıldığında, deksametazon iyontoforez, ağrı, özürlülük ve yaşam kalitesi açısından US ve ESWT’den istatistiksel olarak üstün olarak saptandı (sırasıyla, p<0.001, p=0.007, p<0.001, p<0.001). Ayrıca, US yaşam kalitesi açısından ESWT’den daha üstün olarak saptandı (p<0.001).
Sonuç: Deksametazon iyontoforezi lateral epikondilitli hastaların tedavisinde fonksiyonel ve klinik iyileşmede daha etkilidir.

Anahtar Kelimeler

deksametazon iyontoforezi, ekstrakorporeal şok dalga tedavisi, Lateral epikondilit, tenisçi dirseği, ultrason

Etik Beyan

Çalışma için 14/06/2023 tarihinde Hitit Üniversitesi Klinik Araştırmalar Etik Kurulu’ndan onay alınmıştır. Karar no: 2023-77.

Destekleyen Kurum

Herhangi bir mali destek alınmamıştır

Comparison of extracorporeal shock wave therapy, ultrasound, and dexamethasone iontophoresis in patients with lateral epicondylitis

Öz

Objective: The purpose of this study is to determine the effectiveness of extracorporeal shock wave therapy (ESWT), ultrasound (US), and dexamethasone iontophoresis treatments on pain, grip strength, functionality, and quality of life in patients with lateral epicondylitis, and overdetermine the superiority of the treatments to each other.
Material and Method: This single-blind, prospective study included 78 patients who were diagnosed with lateral epicondylitis. The patients were randomized into three groups. The same physiotherapy program consisted of hot packs, transcutaneous electrical nerve stimulation (TENS), and exercises were administered to all groups. All exercises were performed under the supervision of a qualified physiotherapist. In addition to a 10-day physiotherapy program, every 5 days, a total 3 sessions of ESWT were conducted to the 1st group, 10 days of US applied to the 2nd group, and 10 days of dexamethasone iontophoresis therapy to the 3rd group. Evaluations were carried out before, and 1 month after treatment. Pain severity levels were measured using the numeric rating scale (NRS), disability using the Quick Disabilities of the Arm, Shoulder, and Hand (Quick DASH), quality of life using the Nottingham Health Profile (NHP), and grip strength using a dynamometer and pinch strength using a pinch meter.
Results: The groups were similar in demographic and clinical characteristics. A significant temporal change was found in three groups in terms of pain severity, disability, grip strength, and quality of life at the first month after treatment. When the efficacy of these treatments was compared after treatment in the first month, dexamethasone iontophoresis was statistically superior to US, and ESWT in terms of pain, and quality of life (p<0.001, p=0.007, p<0.001, p<0.001 respectively). Also, the US was superior to ESWT in terms of quality of life (p<0.001).
Conclusion: Dexamethasone iontophoresis is more effective in functional and clinical improvement in the treatment of patients with lateral epicondylitis.

Anahtar Kelimeler

Lateral epicondylitis, ultrasound, dexamethasone iontophoresis, extracorporeal shock wave therapy, tennis elbow

Etik Beyan

Approval for the study was obtained from the Hitit University Clinical Research Ethics Committee on 14/06/2023. Decision no:2023-77.

Kaynakça

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