Kronik bel ağrılı bireylerde yoga ve fizyoterapi programının yaşam kalitesi, denge, ağrı düzeyi ve uyku kalitesi üzerine etkilerinin karşılaştırılması

Esra Atılgan; Fatih Erbahçeci

Araştırma Makalesi

Kronik bel ağrılı bireylerde yoga ve fizyoterapi programının yaşam kalitesi, denge, ağrı düzeyi ve uyku kalitesi üzerine etkilerinin karşılaştırılması

Yıl 2018, Cilt: 5 Sayı: 3, 158 - 166, 25.12.2018

Esra Atılgan Fatih Erbahçeci

Öz

Amaç: Bu çalışmada, Kronik Bel Ağrısı (KBA) olan bireylerde yoga ve fizyoterapi programlarının yaşam kalitesi, denge, ağrı düzeyi ve uyku kalitesi üzerine olan etkilerini araştırmak amaçlandı.

Yöntem: Çalışmaya KBA tanısı konulan 40 birey alındı. Bireyler rastgele yöntemle iki gruba ayrıldı. İlk gruba 4 hafta, haftada 5 gün olmak üzere yoga programı yaptırıldı. İkinci gruba ise haftada 5 gün iki hafta hotpack, ultrason ve egzersizden oluşan fizyoterapi programı uygulandı ve iki haftalık tedaviyi takiben, iki hafta boyunca haftada 5 gün egzersiz tedavisine devam edildi. Çalışmaya katılan tüm bireylere dengenin değerlendirilmesi için tek ayak üstünde durma testi, ağrı şiddetinin değerlendirilmesi için Vizüel Analog Skalası, uyku kalitesinin değerlendirilmesi için Pittsburg Uyku Kalitesi Ölçeği, fonksiyonun değerlendirilmesi için Oswestry Fonksiyonel Yetersizlik Skalası, ve yaşam kalitesinin değerlendirilmesi için Kısa Form - 36 kullanıldı. Ölçümler tedavi öncesi ve sonrası tekrarlandı.

Bulgular: Tedavi sonrasında her iki grupta da ağrı şiddetinde, denge skorlarında, fonksiyonel yetersizlik ve yaşam kalitesi parametrelerinde düzelme olduğu tespit edildi (p<0,05). Gruplar arası karşılaştırmalarda ağrı şiddetindeki farkın fizyoterapi grubu lehine anlamlı olduğu bulundu (p<0,05). Uyku kalitesi açısından iki grupta da anlamlı fark bulunamadı (p>0.05).

Sonuç: Çalışmanın sonuçları, her iki tedavi programının KBA’lı bireylerde denge, ağrı şiddeti, fonksiyon ve yaşam kalitesi üzerine olumlu etkileri olduğunu göstermiştir. Çalışmanın sonuçları ışığında, KBA’lı bireylerin tedavi sürecine fizyoterapi programlarına benzer olumlu etkilerinin görülmesinden ötürü yoga da önerilebilir.

Anahtar Kelimeler

Bel Ağrısı, Fizyoterapi, Yoga, Uyku, Yaşam kalitesi

Kaynakça

1. Norastek AA. Low Back Pain. Croatia, Janeza Trdine, 2012.
2. Bogduk N. Management of chronic low back pain. Med J Aust. 2004;180:79-83.
3. Veehof MM, Oksam MJ, Schreurs KMG, et al. Acceptance-based interventions fort the treatment of chronic pain: A systemic review and meta analysis. Pain. 2011;152: 533-542.
4. Hurley DA, Eadie J, O’Donoghue G, et al. Physiotherapy for sleep disturbance in chronic low back pain: a feasibility randomised controlled trial. BMC Musculoskelet Disord. 2010;11:70.
5. Marty M, Rozenberg S, Duplan B, et al. Quality of sleep in patient with chronic low back pain:a case –control study. Eur Spine J. 2008; 17:839-844.
6. Mayer J, Money V, Dagenais S. Evidenceinformed management of chronic back pain with lumbar extensor strengthening exercises. Spine J. 2008; 8:96-113.
7. Brinkhaus B, Lewith G, Rehberg B, et al. How to treat a patient with chronic low back painmethodology and results of the first international case conference of integrative medicine. Complement Ther Med. 2011;19:54-62.
8. Qaseem A, Wilt TJ, McLean RM, et al. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017;166:514-530.
9. McKivigan, J. Efficacy of Yoga therapy in treating low back pain. Ann Yoga Phys Ther. 2017;2:1034.
10. Field T. Yoga clinical research review. Complement Ther Clin Pract. 2011;17:1-8.
11. Evans DD, Carter M, Panico R, et al. Characteristics and predictors of short-term outcomes in individuals self-selecting yoga or physical therapy for treatment of chronic low back pain. PM R. 2010;2:1006-1015.
12. Wieland LS, Skoetz N, Pilkington K, et al. Yoga treatment for chronic non-specific low back pain. Cochrane Database Syst Rev. 2017;13:4.
13. Wall PD, Melzack R. Testbook of Pain. Churchill Livingstone: Edinburg;1984.
14. Ergun N, Baltacı G. Spor Yaralanmalarında Fizyoterapi ve Rehabilitasyon Prensipleri. Hacettepe Üniversitesi Fizik Tedavi Rehabilitasyon Yüksekokulu Yayınları: Ankara; 1997.
15. Ağargün MY, Kara H, Anlar O. Pittsburg Uyku Kalitesi İndeksi’nin geçerliliği ve güvenirliği. Turk Psikiyatri Derg.1996;7:107-111.
16. Koçyiğit H, Aydemir Ö, Fişek G, et al. Kısa form-36’nın Türkçe versiyonunun güvenilirliği ve geçerliliği. İlaç ve Tedavi. 1999;12:102-106.
17. Yakut E, Düger T, Öksüz Ç et al. Validation of Turkish version of the Oswestry Disability Index for patients with low back pain. Spine, 2004;29:581-585.
18. Nagarathna R, Nagendra HR. Integrated approach of yoga therapy fo positive health. Swami Vivekananda Yoga Prakashana: Bangalore;2007.
19. Altınel L, Köse KÇ, Ergan V et al. Afyonkarahisar ilinde erişkinlerde bel ağrısı sıklığı ve etkileyen faktörler. Acta Orthop Traumatol Turc. 2008;42:328-333.
20. Gür A, Nas K, Çevik R et al. Kronik bel ağrılı bireylerımizin etyolojik yönden değerlendirilmesi. Romatizma. 2000;15:191-198.
21. Salmon P, Lush E, Jablonski M et al. Yoga and mindfulness: clinical aspects of an ancient mind/body practice. Cogn Behav Pract. 2009;16:59-72.
22. Schultz LH, Uyterhoeven S, Khalsa SBS. Evaluation of yoga program for back pain. J Yoga Phys Ther. 2011;1:e103.
23. Belanger A. Evidence-based guide to therapeutic physical agents. Philadelphia: Lippincott Williams & Wilkins, 2002.
24. Şimşek N. Elektroterapi Ders Notları. Ankara: Başkent Üniversitesi Sağlık Bilimleri Fakültesi Fizik Tedavi ve Rehabilitasyon Bölümü Yayınları. Ankara; 2003.
25. Tekur P, Nagarathna R, Chametcha S, et al. A comprehensive yoga programs improves pain, anxiety and depression in chronic low back painpatients more than exercise: an RCT. Complement Ther Med. 2012;20:107-118.
26. Aydoğan S. Bel ağrında farklı fizyoterapi programlarının etkinliğinin karşılaştırılması. Yüksek Lisans Tezi, Hacettepe Üniversitesi: Ankara; 2009.
27. Ülger Ö, Vardar NY. Effect of yoga on balance and gait properties in women with musculoskeletal problems: a pilot study. Complement Ther Clin Pract. 2011;17:13-15.
28. Sorosky S, Stilp S, Akuthota V. Yoga and Pilates in the management of low back pain. Curr Rev Musculoskelet Med. 2008;1:39-47.
29. Tekur P, Singphow C, Nagendra HR, el al. Effect of short-term intensive yoga program on pain, functional disability and spinal flexibility in chronic low back pain: a randomized control study. J Altern Complement Med. 2008;14:637-644.
30. Unsgaard-Tondel M, Fladmark AM, Salvesen Q, et al. Motor control exercises, sling exercises, and general exercises for patients with chronic low back pain. a randomized controlled trial with 1-year follow-up. Phys Ther. 2010;90:1426-1440.
31. Tilbrook HE, Cox H, Hewitt CE, et al. Yoga for chronic low back pain. Ann Intern Med. 2011;155:569-578.
32. Tezvaran Z. Kronik Bel ve boyun ağrısı olan üniversite öğrencilerinde depresyon, anksiyete ve yaşam kalitesi düzeyleri. Uzmanlık Tezi. Yeditepe Üniversitesi: İstanbul; 2010.
33. Nambi GS, Inbasekaran D, Khuman R, et al. Changes in pain intensity and health related quality of life with Iyengar yoga in nonspecific chronic low back pain: A randomized controlled study. Int J Yoga.2014;7:48-53.
34. Saper RB, Sherman KJ, Cullum-Dugan D, et al. Yoga for chronic low back pain in a predominantly minority population: a pilot randomized controlled trial. Altern Ther Health Med. 2009;15:18-27.
35. Marty M, Rozenberg S, Duplan B, et al. Quality of Sleep in patients with chronic low back pain: a case-control study. Eur Spine J. 2008;17:839-844.

Comparison of the effects of yoga and physiotherapy program on quality of life, balance, pain level, and sleep quality in individuals with chronic low back pain

Yıl 2018, Cilt: 5 Sayı: 3, 158 - 166, 25.12.2018

Esra Atılgan Fatih Erbahçeci

Öz

Purpose: In this study, it was aimed to investigate the effects of yoga and physiotherapy programs on quality of life, balance, pain level and sleep quality in individuals with chronic low back pain (CLBP).

Methods: Forty individuals who were diagnosed with CLBP were included in the study. Individuals were divided into two groups randomly. Yoga program was practiced in first group for 5 days a week over 4 weeks. Physiotherapy program, which is consisting of hotpack, ultrasound and exercise, was practiced in second group for 5 days a week over 2 weeks, following 2 weeks treatment; exercise therapy was continued for 5 days a week over 2 weeks. One Leg Stance test for examination of balance, Visual Analog Scale for assessment of pain severity, Pittsburg Sleep Quality Scale for evaluation of sleep quality, Oswestry Functional Disability Scale for assessment of function and Short Form - 36 for evaluation of quality of life were used in the present study. Measurements were repeated before and after treatment.

Results: It was determined that pain severity, balance scores, functional disability and quality of life parameters improved in both groups after treatment (p<0.05). In comparison between the groups, the difference in the severity of pain was found to be significant in favor of the physiotherapy group (p<0.05). No significant difference has been found in quality of sleep in both groups (p>0.05).

Conclusion: The results of the study showed that both treatment programs had positive effects on balance, pain severity, function and quality of life in individuals with CLBP. In light of the results of the study, yoga can also be recommended to the management of treatment on individuals with CLBP due to the similar positive effects as physiotherapy programs.

Anahtar Kelimeler

Low back pain, Physiotherapy, Yoga, Sleep, Quality of life

Kaynakça

1. Norastek AA. Low Back Pain. Croatia, Janeza Trdine, 2012.
2. Bogduk N. Management of chronic low back pain. Med J Aust. 2004;180:79-83.
3. Veehof MM, Oksam MJ, Schreurs KMG, et al. Acceptance-based interventions fort the treatment of chronic pain: A systemic review and meta analysis. Pain. 2011;152: 533-542.
4. Hurley DA, Eadie J, O’Donoghue G, et al. Physiotherapy for sleep disturbance in chronic low back pain: a feasibility randomised controlled trial. BMC Musculoskelet Disord. 2010;11:70.
5. Marty M, Rozenberg S, Duplan B, et al. Quality of sleep in patient with chronic low back pain:a case –control study. Eur Spine J. 2008; 17:839-844.
6. Mayer J, Money V, Dagenais S. Evidenceinformed management of chronic back pain with lumbar extensor strengthening exercises. Spine J. 2008; 8:96-113.
7. Brinkhaus B, Lewith G, Rehberg B, et al. How to treat a patient with chronic low back painmethodology and results of the first international case conference of integrative medicine. Complement Ther Med. 2011;19:54-62.
8. Qaseem A, Wilt TJ, McLean RM, et al. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017;166:514-530.
9. McKivigan, J. Efficacy of Yoga therapy in treating low back pain. Ann Yoga Phys Ther. 2017;2:1034.
10. Field T. Yoga clinical research review. Complement Ther Clin Pract. 2011;17:1-8.
11. Evans DD, Carter M, Panico R, et al. Characteristics and predictors of short-term outcomes in individuals self-selecting yoga or physical therapy for treatment of chronic low back pain. PM R. 2010;2:1006-1015.
12. Wieland LS, Skoetz N, Pilkington K, et al. Yoga treatment for chronic non-specific low back pain. Cochrane Database Syst Rev. 2017;13:4.
13. Wall PD, Melzack R. Testbook of Pain. Churchill Livingstone: Edinburg;1984.
14. Ergun N, Baltacı G. Spor Yaralanmalarında Fizyoterapi ve Rehabilitasyon Prensipleri. Hacettepe Üniversitesi Fizik Tedavi Rehabilitasyon Yüksekokulu Yayınları: Ankara; 1997.
15. Ağargün MY, Kara H, Anlar O. Pittsburg Uyku Kalitesi İndeksi’nin geçerliliği ve güvenirliği. Turk Psikiyatri Derg.1996;7:107-111.
16. Koçyiğit H, Aydemir Ö, Fişek G, et al. Kısa form-36’nın Türkçe versiyonunun güvenilirliği ve geçerliliği. İlaç ve Tedavi. 1999;12:102-106.
17. Yakut E, Düger T, Öksüz Ç et al. Validation of Turkish version of the Oswestry Disability Index for patients with low back pain. Spine, 2004;29:581-585.
18. Nagarathna R, Nagendra HR. Integrated approach of yoga therapy fo positive health. Swami Vivekananda Yoga Prakashana: Bangalore;2007.
19. Altınel L, Köse KÇ, Ergan V et al. Afyonkarahisar ilinde erişkinlerde bel ağrısı sıklığı ve etkileyen faktörler. Acta Orthop Traumatol Turc. 2008;42:328-333.
20. Gür A, Nas K, Çevik R et al. Kronik bel ağrılı bireylerımizin etyolojik yönden değerlendirilmesi. Romatizma. 2000;15:191-198.
21. Salmon P, Lush E, Jablonski M et al. Yoga and mindfulness: clinical aspects of an ancient mind/body practice. Cogn Behav Pract. 2009;16:59-72.
22. Schultz LH, Uyterhoeven S, Khalsa SBS. Evaluation of yoga program for back pain. J Yoga Phys Ther. 2011;1:e103.
23. Belanger A. Evidence-based guide to therapeutic physical agents. Philadelphia: Lippincott Williams & Wilkins, 2002.
24. Şimşek N. Elektroterapi Ders Notları. Ankara: Başkent Üniversitesi Sağlık Bilimleri Fakültesi Fizik Tedavi ve Rehabilitasyon Bölümü Yayınları. Ankara; 2003.
25. Tekur P, Nagarathna R, Chametcha S, et al. A comprehensive yoga programs improves pain, anxiety and depression in chronic low back painpatients more than exercise: an RCT. Complement Ther Med. 2012;20:107-118.
26. Aydoğan S. Bel ağrında farklı fizyoterapi programlarının etkinliğinin karşılaştırılması. Yüksek Lisans Tezi, Hacettepe Üniversitesi: Ankara; 2009.
27. Ülger Ö, Vardar NY. Effect of yoga on balance and gait properties in women with musculoskeletal problems: a pilot study. Complement Ther Clin Pract. 2011;17:13-15.
28. Sorosky S, Stilp S, Akuthota V. Yoga and Pilates in the management of low back pain. Curr Rev Musculoskelet Med. 2008;1:39-47.
29. Tekur P, Singphow C, Nagendra HR, el al. Effect of short-term intensive yoga program on pain, functional disability and spinal flexibility in chronic low back pain: a randomized control study. J Altern Complement Med. 2008;14:637-644.
30. Unsgaard-Tondel M, Fladmark AM, Salvesen Q, et al. Motor control exercises, sling exercises, and general exercises for patients with chronic low back pain. a randomized controlled trial with 1-year follow-up. Phys Ther. 2010;90:1426-1440.
31. Tilbrook HE, Cox H, Hewitt CE, et al. Yoga for chronic low back pain. Ann Intern Med. 2011;155:569-578.
32. Tezvaran Z. Kronik Bel ve boyun ağrısı olan üniversite öğrencilerinde depresyon, anksiyete ve yaşam kalitesi düzeyleri. Uzmanlık Tezi. Yeditepe Üniversitesi: İstanbul; 2010.
33. Nambi GS, Inbasekaran D, Khuman R, et al. Changes in pain intensity and health related quality of life with Iyengar yoga in nonspecific chronic low back pain: A randomized controlled study. Int J Yoga.2014;7:48-53.
34. Saper RB, Sherman KJ, Cullum-Dugan D, et al. Yoga for chronic low back pain in a predominantly minority population: a pilot randomized controlled trial. Altern Ther Health Med. 2009;15:18-27.
35. Marty M, Rozenberg S, Duplan B, et al. Quality of Sleep in patients with chronic low back pain: a case-control study. Eur Spine J. 2008;17:839-844.

Toplam 35 adet kaynakça vardır.

Ayrıntılar

Birincil Dil	Türkçe
Konular	Sağlık Kurumları Yönetimi
Bölüm	Makaleler
Yazarlar	Esra Atılgan Fatih Erbahçeci
Yayımlanma Tarihi	25 Aralık 2018
Gönderilme Tarihi	13 Nisan 2018
Yayımlandığı Sayı	Yıl 2018 Cilt: 5 Sayı: 3

Kaynak Göster

Vancouver	Atılgan E, Erbahçeci F. Kronik bel ağrılı bireylerde yoga ve fizyoterapi programının yaşam kalitesi, denge, ağrı düzeyi ve uyku kalitesi üzerine etkilerinin karşılaştırılması. JETR. 2018;5(3):158-66.

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