Gonartrozlu hastalarda izometrik ve izokinetik egzersizlerin etkinliğinin karşılaştırılması
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Date
2012
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Trakya Üniversitesi Tıp Fakültesi
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info:eu-repo/semantics/openAccess
Abstract
Osteoartrit, tüm dünyada en sık görülen ve fiziksel bozukluğa yol açan eklem hastalığıdır. Osteoartrit, eklem yüzlerinde ve köşelerinde reaktif yeni kemik oluşumları ile birlikte eklem kıkırdağının inflamatuvar olmayan bozulması ile karakterizedir. Diz osteoartritinde kuadriseps kas atrofisi erken bulgulardandır. Kas gücünü arttırmak ve atrofiyi engellemek için egzersizlerden yararlanılır. Bu amaçla kullanılan terapötik egzersizler izotonik, izometrik ve izokinetik egzersiz tiplerinde olabilir. Bilateral gonartrozlu hastalarda uygulanan izokinetik ve izometrik egzersiz programlarının ağrı, fonksiyonel kapasite, kas gücü ve yaşam kalitesi üzerine olan etkilerini karşılaştırmayı amaçladık. Çalışmaya bilateral diz osteoartritli kırk hasta dahil edildi. Randomize olarak iki gruba ayrıldı. Birinci gruba izokinetik egzersiz, ikinci gruba izometrik egzersiz programı uygulandı. Tedavi süresi haftada 3 gün, toplam 4 hafta olarak belirlendi. Hastalar başlangıçta, 4. ve 10.hafta kontrollerinde istirahat ve aktivite sırasındaki Visüel Analog Skala, Lequesne Index, Western Ontario and McMasters Universities Osteoarthritis Index, Short Form 36 skorları, eklem hareket açıklığı, kas kitlesi ve diz ekstansör ve fleksör kas gruplarının maksimum kas güçleri yönünden değerlendirildi. İzometrik ve izokinetik egzersiz gruplarının her ikisinde de ağrı, fonksiyonel durum, kas gücü, kas kitlesi, eklem hareket açıklığı ve yaşam kalitesi düzelme gösterdi. İzokinetik egzersiz uygulanan grupta kas gücü ve kitlesindeki artış daha belirgindi ve tedavi sonrasındaki devamlılık açısından izokinetik grup daha üstündü. Diz osteoartritli hastalarda egzersizler klinik düzelme sağlar. İzokinetik egzersizlerin kas gücü ve kitlesine etkisi izometrik egzersizlerden daha üstündür. Hastanın ve şartların uygunluğu durumuna göre her iki egzersiz tipine de diz osteoartriti tedavisinde yer verilmesinin yararlı olacağı kanaatindeyiz.
Abstract
Osteoarthritis is the most common joint disease causing disability in the world. Osteoarthritis is characterized by a noninflammatory deterioration of the articular cartilage with reactive new bone formation at the joint?s surface and margins. Quadriceps muscle atrophy is an early finding in knee osteoarthritis. Exercises are used to improve muscle strength and prevent muscle atrophy. Therapeutic exercises used for this purpose can be isotonic, isometric and isokinetic exercise. We aimed to compare the effect of isometric and isokinetic exercise programs on pain, functional capacity, quality of life and muscle strength of patients with bilateral knee osteoarthritis. Fourty patients with bilateral knee osteoarthritis were included in the study. The patients were randomly assigned to two groups. The patients in the first group performed isokinetic, the second group performed isometric exercise, 3 days a week for 4 weeks. We performed to all patients visual analogue scale at rest and activity, Lequesne index, Western Ontario and McMasters Universities Osteoarthritis Index, Short Form 36 scores, range of motion, muscle mass and maximal muscle strength of knee extensor and flexor muscle groups, measurements at the beginning and after at 4th, 10th weeks. Pain, functional status, muscle strength, muscle mass, range of motion and quality of life were dedicated to improve in both of the groups, isometric and isokinetic exercise. Muscle strength and muscle mass increase were more superior and sustainable in group treated with isokinetic exercise. Exercises provide clinical improvement in patients with knee osteoarthritis. Effectiveness of the isokinetic exercise on muscle strength and muscle mass is more superior than isometric exercise. We believe that both types of exercise in the treatment of osteoarthritis of the knee can be useful, according to suitability of the patient and conditions.
Abstract
Osteoarthritis is the most common joint disease causing disability in the world. Osteoarthritis is characterized by a noninflammatory deterioration of the articular cartilage with reactive new bone formation at the joint?s surface and margins. Quadriceps muscle atrophy is an early finding in knee osteoarthritis. Exercises are used to improve muscle strength and prevent muscle atrophy. Therapeutic exercises used for this purpose can be isotonic, isometric and isokinetic exercise. We aimed to compare the effect of isometric and isokinetic exercise programs on pain, functional capacity, quality of life and muscle strength of patients with bilateral knee osteoarthritis. Fourty patients with bilateral knee osteoarthritis were included in the study. The patients were randomly assigned to two groups. The patients in the first group performed isokinetic, the second group performed isometric exercise, 3 days a week for 4 weeks. We performed to all patients visual analogue scale at rest and activity, Lequesne index, Western Ontario and McMasters Universities Osteoarthritis Index, Short Form 36 scores, range of motion, muscle mass and maximal muscle strength of knee extensor and flexor muscle groups, measurements at the beginning and after at 4th, 10th weeks. Pain, functional status, muscle strength, muscle mass, range of motion and quality of life were dedicated to improve in both of the groups, isometric and isokinetic exercise. Muscle strength and muscle mass increase were more superior and sustainable in group treated with isokinetic exercise. Exercises provide clinical improvement in patients with knee osteoarthritis. Effectiveness of the isokinetic exercise on muscle strength and muscle mass is more superior than isometric exercise. We believe that both types of exercise in the treatment of osteoarthritis of the knee can be useful, according to suitability of the patient and conditions.
Description
Tıpta Uzmanlık Tezi
Keywords
Diz Osteoartriti, İzometrik Egzersiz, İzokinetik Egzersiz, Knee Osteoarthritis, İsometric Exercise, İsokinetic Exercise
