Lenfödem hastalarında fizik tedavi ve rehablitasyonun etkileri
Yükleniyor...
Dosyalar
Tarih
2015
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Lenfödem dokular arası sıvının, lenfatik dolaşımın bozulması sonucu ciltte ve subkutan dokuda birikmesi ile oluşur. Kronik ve tedavi edilmesi gereken bir durumdur. Tedavisi genellikle konservatif şekilde olmaktadır. Konservatif tedavi, fizik tedavi ve rehabilitasyon yaklaşımlarından olan; eğitim, egzersiz, diyet kontrolü, masaj, bandajlama ve fizik tedavi ajanlarının kullanımını içerir. Biz çalışmamızda lenfödem hastalarında fizik tedavi ve rehabilitasyonun etkilerini araştırmayı amaçladık. Sekonder lenfödem nedeni ile başvuran hastalar çalışmaya alındı. Hastaların yaş, vücut kitle indeksi, lenf nodu disseksiyon sayısı, kanser evresi, radyoterapi ve kemoterapi seans sayıları, lenfödem süresi, dominant ekstremite tutulumu, komorbite varlığı incelendi. Bunların başlangıç lenfödem şiddeti ve tedavi etkinliği ile olan ilişkisi araştırıldı. Değerlendirme parametreleri olarak çevre toplam fark, eklem hareket açıklığı, vücut kitle indeksi, short-form 36, Beck depresyon ölçeği kullanıldı. Değerlendirmeler tedavi öncesi, 1. ay ve 3. ayda yapıldı. 3. ayda ayrıca hasta ve doktor memnuniyeti değerlendirildi. 40 hastanın yaş ortalaması 53.4'idi. Başlangıç lenfödem şiddeti; vücut kitle indeksi ve lenfödem süresi ile ilişkiliydi. Diğer özellikler lenfödem şiddeti ile ilişkili bulunmadı. Lenfödem şiddetini belirleyen ekstremite çap farkı, 1 aylık tedavi sonunda anlamlı şekilde azaldı. 3. ay kontrolünde çap farkı 1. ay ile benzerdi. Eklem hareket açıklıkları, tedavi ile artış gösterdi. Yaşam kalitesi ve depresyon ölçeğinde düzelme gözlendi. Tedavi etkinliği vücut kitle indeksi ve lenfödem süresi ile ilişkiliydi. Hasta ve doktor memnuniyeti iyi düzeyde izlendi. Fizik tedavi ve rehabilitasyon yaklaşımlarının, lenfödem hastalarında ekstremite volümünü azaltmada, ekstremite eklem hareket açıklığını artırma ve korumada etkili olduğu tespit edildi. Aynı zamanda hastaların yaşam kalitesini artırdığı ve ruh sağlığını da olumlu yönde etkilediği düşünüldü.
Abstract
Lymphedema is caused by the interstitial liquid deposition due to the malfunction of lymphatic circulation between the skin subcutan tissues. It is a cronical situation and must be cured. It is generally treated conservatively. Conservative treatment is composed of pyhsical treatment and rehabilitation such as using physical treatment agents, bandaging, massage, diet control, exercise and education. In our study, we aimed to determine the effects of pyhsical treatment and rehabilitation on patients with lymphedema. The patients with secondary lymphedema were examined in this study. The patients' age, body mass index, the number of lymph node dissection, cancer stage, the number of radiotheraphy and chemotheraphy sessions, the duration of lymphedema, dominant extremity involvement, existence of comorbidity were examined. The correlation between these and the sufficeny of the treatment and initial lymphedema severity was examined. The total diameter difference, joint movement space, body mass index, short-form 36, Beck depression scale were used as the evaluation parameters. The evaluations were held during the 1st and the 3rd weeks. Moreover, in the 3rd week, the gratitude of the patients and the doctors were evaluated. The avarage of patients' age was 53.4. The initial lymphedema severity was related to the body mass index and duration of lymphedema. The other features were not examined as related to the lymphedema severity. The extremity diameter difference that states the lymphedema severity decreased significantly after 1 month treatment. In the 3rd month examination, the diameter difference was similar to the diameter difference of the 1st month. The joint movement space increased with the treatment. Improvement was observed in the life quality and depression scale. The treatment efficency was related to the body mass index and the duration of lymphedema. The patient and doctor gratitude was observed at a pleasant level. It was stated that the physical treatment and rehabilitation approaches were effective in decreasing the extremity volume of lymphedema patients, protecting and increasing the extremity joint movement space. Moreover, it was determined that the physical treatment and rehabilitation approaches increase the patients' life quality and effect the mental health positively.
Abstract
Lymphedema is caused by the interstitial liquid deposition due to the malfunction of lymphatic circulation between the skin subcutan tissues. It is a cronical situation and must be cured. It is generally treated conservatively. Conservative treatment is composed of pyhsical treatment and rehabilitation such as using physical treatment agents, bandaging, massage, diet control, exercise and education. In our study, we aimed to determine the effects of pyhsical treatment and rehabilitation on patients with lymphedema. The patients with secondary lymphedema were examined in this study. The patients' age, body mass index, the number of lymph node dissection, cancer stage, the number of radiotheraphy and chemotheraphy sessions, the duration of lymphedema, dominant extremity involvement, existence of comorbidity were examined. The correlation between these and the sufficeny of the treatment and initial lymphedema severity was examined. The total diameter difference, joint movement space, body mass index, short-form 36, Beck depression scale were used as the evaluation parameters. The evaluations were held during the 1st and the 3rd weeks. Moreover, in the 3rd week, the gratitude of the patients and the doctors were evaluated. The avarage of patients' age was 53.4. The initial lymphedema severity was related to the body mass index and duration of lymphedema. The other features were not examined as related to the lymphedema severity. The extremity diameter difference that states the lymphedema severity decreased significantly after 1 month treatment. In the 3rd month examination, the diameter difference was similar to the diameter difference of the 1st month. The joint movement space increased with the treatment. Improvement was observed in the life quality and depression scale. The treatment efficency was related to the body mass index and the duration of lymphedema. The patient and doctor gratitude was observed at a pleasant level. It was stated that the physical treatment and rehabilitation approaches were effective in decreasing the extremity volume of lymphedema patients, protecting and increasing the extremity joint movement space. Moreover, it was determined that the physical treatment and rehabilitation approaches increase the patients' life quality and effect the mental health positively.
Açıklama
Tıpta Uzmanlık Tezi
Anahtar Kelimeler
Ekstremite Çap Farkı, Yaşam Kalitesi, Lenfödem, Konservatif Tedavi, Vücut Kitle İndeksi, The Extremity Diameter Difference, Life Quality, Lymphedema, Conservative Treatment, Body Mass Index
