Lomber disk hernili hastalarda klasik fizik tedavi programına eklenen femoral ve siyatik sinir germe tedavisinin etkinliği: randomize kontrollü çalışma
Effectiveness of the femoral and sciatic nerve stretching treatment which is added into the classical physical treatment program in the patients with lumbar disk hernia: randomized controlled study
Yazar: ELİF GÜLİZ CAVLAK
Danışman: PROF. DR. MELEK GÜNEŞ YAVUZER
Haliç Üniversitesi / Sağlık Bilimleri Enstitüsü / Fizyoterapi ve Rehabilitasyon Ana Bilim Dalı
Derece: Yüksek Lisans, 2016
Konu: Fizyoterapi ve Rehabilitasyon = Physiotherapy and Rehabilitation
Dizin: Ağrı = Pain ; Ağrı ölçümü = Pain measurement ; Femoral sinir = Femoral nerve ; Fizik tedavi = Physical therapy ; Siyatik sinir = Sciatic nerve ; İntervertebral disk = Intervertebral disc ; İntervertebral disk deplasmanı = Intervertebral disc displacement

Özet:
Bu çalışmanın amacı, lomber disk hernili hastalarda klasik fizik tedavi programına eklenen femoral ve siyatik sinir germe tedavisinin etkinliğinin araştırılmasıdır. Özel Levent Hastanesi Fizik Tedavi ve Rehabilitasyon Ünitesi'nde Şubat-Haziran 2016 tarihleri arasında yürütülen çalışmaya bel ağrısı olan ve hekim tarafından lomber disk hernisi tanısı konulmuş, yaşları 24-65 yıl arasında değişen 28 hasta alındı. Hastalar rastgele yöntemle Grup I (n=13) ve Grup II (n=15) olmak üzere iki gruba ayrıldı. Tüm hastalara 15 seans boyunca klasik fizik tedavi programı uygulandı. Grup I'e klasik tedaviye ek olarak haftada 3 gün femoral ve siyatik sinir germe tedavisi uygulandı. Tedavi öncesi hastaların demografik ve klinik özellikleri sorgulandı. Ağrı şiddeti (VAS), bel ağrısına bağlı fonksiyonel kısıtlılık (Oswestry Skalası) ve lomber mobilite (Modifiye Schober testi) tedavi öncesi ve sonrası değerlendirildi. Çalışmanın başında gruplar arasında yaş, günlük çalışma süresi, şu anki bel ağrısının süresi, bel ağrısının nedeni ve VKİ açısından istatistiksel olarak anlamlı bir fark gözlenmedi (p˃0,05). Ancak bel ağrısının başlama zamanına bakıldığında Grup II, Grup I'e göre daha kronik bel ağrısına sahip bireylerden oluşmaktadır (p=0,017). Her iki grupta da tedavi öncesi ve sonrası tüm ölçümlerde olumlu düzeyde iyileşme gözlendi (p˂0,05). Gruplar arası değişim skoruna bakıldığında sadece Oswestry (p=0,001) ve Modifiye Schober (p=0,046) testlerinde Grup I lehine anlamlı düzeyde fark bulundu. Sonuç olarak bu çalışmada tedavi sonrası iki grubun da ağrı şiddeti, fonksiyonellik ve lomber mobilite düzeylerinde istatistiksel olarak anlamlı düzelme izlendi. Klasik tedaviye eklenen femoral ve siyatik sinir germe tedavisi lomber mobilite ve fonksiyonellik üzerine sadece klasik tedaviden daha etkilidir.

Anahtar Kelimeler: Lomber Disk Hernisi, VAS, Oswestry, Femoral ve siyatik sinir germe

Abstract:
The purpose of this study is to investigate the effectiveness of the femoral and sciatic nerve stretching treatment which is added to the classical physical treatment program in patients with lumbar disc hernia. The ages of the patients (n=28) vary between 24-65 years. Patients with back pain, diagnosed as lumbar disc hernia by a physician, participated in the study which is carried out between February – June / 2016 in the Physical Treatment and Rehabilitation Unit of Private Levent Hospital. Patients were randomized into two (2) groups as Group I and Group II. Group I is composed of thirteen (13) persons and the Group II is composed of fifteen (15) persons. The classical physical treatment program has been applied on all of the patients for fifteen (15) sessions. The femoral and sciatic nerve stretching treatment has been also applied for three (3) days in a week in addition to the classical medical treatment taken on the Group I. The demographical information and clinical characteristics of the patient is inquired before the treatment process. The pain severity (VAS), the functional limitations based on the back pain (Oswestry Scale) and the lumbar mobility (Modified Schober test) have been evaluated both before and after the treatment. In the beginning of the study, no statistically significant difference has been observed (p˃0,05) in terms of age between the groups, daily working period, period of the current back pain, reason of the back pain and the BMI. However, in terms of starting time of the back pain, Group II is composed of the individuals with more chronic back pain in comparison with the Group I (p=0,017). Positive degree of improvement has been observed in all of the measurements both before and after the treatment in both of two groups (p<0.05). Whenever the change score between the groups is examined, a significant level of difference has been found in favor of the Group I only in the Oswestry (p=0.001) and Modified Schober (p=0.046) tests. As a result of that, a statistically improvement has been observed in the pain severity, functionality and lumbar mobility levels in both of the groups after the treatment in this study. The femoral and sciatic nerve stretching treatment which is added to the classical treatment are more effective than the classical treatment only on the lumbar mobility and functionality.	

Keywords: Lumbar Disc Hernia, VAS, OSWESTRY, Femoral and sciatic nerve stretching



		









CAVLAK EG (2016) Effectiveness of the Femoral and Sciatic Nerve Stretching Treatment which is added into the Classical Physical Treatment Program in the Patients with Lumbar Disk Hernia: Randomized Controlled Study. Haliç University, Institute of Health Sciences, Major Branch of Physiotherapy and Rehabilitation, Master Thesis, Istanbul

		The purpose of this study is to investigate the effectiveness of the femoral and sciatic nerve stretching treatment which is added to the classical physical treatment program in patients with lumbar disc hernia. The ages of the patients (n=28) vary between 24-65 years. Patients with back pain, diagnosed as lumbar disc hernia by a physician, participated in the study which is carried out between February – June / 2016 in the Physical Treatment and Rehabilitation Unit of Private Levent Hospital. Patients were randomized into two (2) groups as Group I and Group II. Group I is composed of thirteen (13) persons and the Group II is composed of fifteen (15) persons. The classical physical treatment program has been applied on all of the patients for fifteen (15) sessions. The femoral and sciatic nerve stretching treatment has been also applied for three (3) days in a week in addition to the classical medical treatment taken on the Group I. The demographical information and clinical characteristics of the patient is inquired before the treatment process. The pain severity (VAS), the functional limitations based on the back pain (Oswestry Scale) and the lumbar mobility (Modified Schober test) have been evaluated both before and after the treatment. In the beginning of the study, no statistically significant difference has been observed (p˃0,05) in terms of age between the groups, daily working period, period of the current back pain, reason of the back pain and the BMI. However, in terms of starting time of the back pain, Group II is composed of the individuals with more chronic back pain in comparison with the Group I (p=0,017). Positive degree of improvement has been observed in all of the measurements both before and after the treatment in both of two groups (p<0.05). Whenever the change score between the groups is examined, a significant level of difference has been found in favor of the Group I only in the Oswestry (p=0.001) and Modified Schober (p=0.046) tests. As a result of that, a statistically improvement has been observed in the pain severity, functionality and lumbar mobility levels in both of the groups after the treatment in this study. The femoral and sciatic nerve stretching treatment which is added to the classical treatment are more effective than the classical treatment only on the lumbar mobility and functionality.	

Keywords: Lumbar Disc Hernia, VAS, OSWESTRY, Femoral and sciatic nerve stretching