Karpal tünel sendromlu hastalarda kinezyofobinin biseps braki,triseps braki kas kalınlıklarına ve üst ekstremite fonksiyonelliğine etkisi
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Date
2024
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Publisher
Kırıkkale Üniversitesi
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info:eu-repo/semantics/openAccess
Abstract
Giriş: Karpal tünel sendromu (KTS), median sinirin karpal tünel içinde sıkışması sonucu oluşan klinik semptom ve bulgular bütünüdür. KTS en sık görülen tuzak nöropatidir. Tuzak nöropatiler sinirin küçük bir bölümünü etkilemesine rağmen önemli fiziksel, ekonomik ve psikolojik sonuçlara neden olabilmektedir. Kinezyofobi 'ağrılı yaralanma ve tekrar yaralanmaya karşı oluşan hassasiyet hissinden kaynaklanan aktivite ve fiziksel harekete karşı gelişen kaygı' olarak ifade edilmiştir. Vücudun herhangi bir bölümü yaralanmaya maruz kaldığında ağrı yaralanma sonrası hareketi kısıtlar, hatta iyileşmenin sonrasında bile hareket korkusu oluşturabilir. Kişinin ağrı algısı yaşam kalitesini olumsuz etkiler. KTS tanılı hastalarda ağrı bağlı kinezyofobi gelişebilir. Bu çalışmada KTS tanılı hastalarda kinezyofobinin biseps braki, triseps braki kas kalınlıklarına ve üst ekstremite fonksiyonelliğine etkisini değerlendirilmesi planlanmıştır. Gereç ve yöntem: Çalışmaya EMG ile tek taraflı KTS tanısı konulmuş 55 kadın hasta dahil edildi. Fizik muayenede tinel ve phalen testleri, motor muayenesi, derin tendon refleksleri ve patolojik refleksler yapılarak kaydedildi. Hastaların KTS'li ekstremitesi patolojik ekstremite olarak kaydedildi. Ağrı şiddetini değerlendirmek için VAS, kinezyofobi değerlendirmek için Tampa Kinezyofobi Ölçeği kullanıldı. Hastaların bilateral biseps braki ve triseps braki kas kalınlıkları ultrasonografi ile değerlendirildi. Jamar el dinamometresi ile el kavrama gücü ölçüldü. Boston Karpal Tünel Anketi ve Quick DASH anketleri yapılarak skorları kaydedildi. Bulgular: Çalışmaya dahil edilen hastaların yaş ortalaması 49,6±8,64 yıl; EMG sonuçlarına göre %70,9'unun sağ ekstremitesinin ve %29,1'inin sol ekstremitesinin patolojik olduğu saptandı. KTS şiddetine göre %56,4'ünün hafif ve %43,6'sının orta şiddete KTS olduğu görüldü. Tampa Kinezyofobi Ölçeği skoru ile Boston Semptom Şiddet Skalası, Boston Fonksiyonel Durum Skalası ve Quick DASH skorları arasında anlamlı, pozitif yönlü ilişki tespit edildi (p<0,05). Tampa Kinezyofobi Ölçeği skoru ile biseps braki ve triseps braki kas kalınlıklarının değişimi arasında pozitif yönlü ilişki tespit edildi. Tampa Kinezyobi Ölçeği skoru ile VAS-Gündüz ve VAS-Gece skorları arasında istatistiksel olarak anlamlı ilişki görülürken el kavrama gücü değişimi arasında istatistiksel olarak anlamlı ilişki görülmedi. Sonuç: Karpal tünel sendromlu hastalarda ağrıya bağlı kinezyofobi gelişebilir. Kinezyofobi hareket etme korkusuna neden olarak biseps braki, triseps braki kas kalınlıklarında azalmaya yol açabilir. Aynı zamanda kinezyofobi bu hasta grubunda üst ekstremite fonksiyonelliğini olumsuz yönde etkilenmesine neden olabilir. KTS tanılı hastalarda kinezyofobinin olumsuz etkileri göz önünde bulundurularak proksimal kasların da değerlendirilmeye alınması ve buna yönelik tedavi programlarının düzenlemesinin faydalı olacağını düşünmekteyiz.
Introduction: Carpal tunnel syndrome (CTS) is a set of clinical symptoms and findings that occur as a result of the relaxation of the median nerve within the carpal tunnel. CTS is the most common entrapment neuropathy. Entrapment neuropathies can cause physical, economic and psychological suffering despite the fact that a small part of the nerve is affected. Kinesiophobia is defined as 'anxiety about breaking into activity and physical movement resulting from the feeling of emotion resulting from painful injury and re-injury'. When injured in any part of the body, there are painful post-sports movement restrictions and even fear of movement even after recovery. A person's perception of pain negatively affects living conditions. Kinesiophobia may develop due to the variability diagnosed with CTS. In this study, it was planned to evaluate the effect of kinesiophobia on biceps brachii, triceps brachii muscle thickness and upper extremity functionality in patients diagnosed with CTS. Materials and methods: 55 female patients diagnosed with unilateral CTS by EMG were included in the study. During the physical examination, tinel and phalen tests, motor examination, deep tendon reflexes and pathological reflexes were performed and recorded. Extremities of patients with CTS were recorded as pathological extremities. VAS was used to evaluate pain severity, and Tampa Kinesiophobia Scale was used to evaluate kinesiophobia. The bilateral biceps brachii and triceps brachii muscle thicknesses of the patients were evaluated by ultrasonography. Handgrip strength was measured with a Jamar hand dynamometer. Boston Carpal Tunnel Questionnaire and Quick DASH questionnaires were performed and their scores were recorded. Results: The average age of the patients included in the study was 49.6±8.64 years; According to the EMG results, it was determined that the right extremities of 70.9% and the left extremities of 29.1% were pathological. According to the severity of CTS, 56.4% had mild and 43.6% had moderate CTS. A significant, positive relationship was detected between the Tampa Kinesiophobia Scale score and the Boston Symptom Severity scale, Boston Functional Status scale and Quick DASH scores (p<0.05). A positive relationship was detected between the Tampa Kinesiophobia Scale score and the change in biceps brachii and triceps brachii muscle thickness. While a statistically significant relationship was observed between the Tampa Kinesiology Scale score and VAS-Day and VAS-Night scores, there was no statistically significant relationship between handgrip strength change. Conclusion: Pain-related kinesiophobia may develop in patients with carpal tunnel syndrome. Kinesiophobia causes fear of movement and can lead to a decrease in biceps brachii and triceps brachii muscle thickness. At the same time, kinesiophobia may negatively affect upper extremity functionality in this patient group. Considering the negative effects of kinesiophobia in patients diagnosed with CTS, we think that it would be beneficial to evaluate the proximal muscles and organize treatment programs accordingly.
Introduction: Carpal tunnel syndrome (CTS) is a set of clinical symptoms and findings that occur as a result of the relaxation of the median nerve within the carpal tunnel. CTS is the most common entrapment neuropathy. Entrapment neuropathies can cause physical, economic and psychological suffering despite the fact that a small part of the nerve is affected. Kinesiophobia is defined as 'anxiety about breaking into activity and physical movement resulting from the feeling of emotion resulting from painful injury and re-injury'. When injured in any part of the body, there are painful post-sports movement restrictions and even fear of movement even after recovery. A person's perception of pain negatively affects living conditions. Kinesiophobia may develop due to the variability diagnosed with CTS. In this study, it was planned to evaluate the effect of kinesiophobia on biceps brachii, triceps brachii muscle thickness and upper extremity functionality in patients diagnosed with CTS. Materials and methods: 55 female patients diagnosed with unilateral CTS by EMG were included in the study. During the physical examination, tinel and phalen tests, motor examination, deep tendon reflexes and pathological reflexes were performed and recorded. Extremities of patients with CTS were recorded as pathological extremities. VAS was used to evaluate pain severity, and Tampa Kinesiophobia Scale was used to evaluate kinesiophobia. The bilateral biceps brachii and triceps brachii muscle thicknesses of the patients were evaluated by ultrasonography. Handgrip strength was measured with a Jamar hand dynamometer. Boston Carpal Tunnel Questionnaire and Quick DASH questionnaires were performed and their scores were recorded. Results: The average age of the patients included in the study was 49.6±8.64 years; According to the EMG results, it was determined that the right extremities of 70.9% and the left extremities of 29.1% were pathological. According to the severity of CTS, 56.4% had mild and 43.6% had moderate CTS. A significant, positive relationship was detected between the Tampa Kinesiophobia Scale score and the Boston Symptom Severity scale, Boston Functional Status scale and Quick DASH scores (p<0.05). A positive relationship was detected between the Tampa Kinesiophobia Scale score and the change in biceps brachii and triceps brachii muscle thickness. While a statistically significant relationship was observed between the Tampa Kinesiology Scale score and VAS-Day and VAS-Night scores, there was no statistically significant relationship between handgrip strength change. Conclusion: Pain-related kinesiophobia may develop in patients with carpal tunnel syndrome. Kinesiophobia causes fear of movement and can lead to a decrease in biceps brachii and triceps brachii muscle thickness. At the same time, kinesiophobia may negatively affect upper extremity functionality in this patient group. Considering the negative effects of kinesiophobia in patients diagnosed with CTS, we think that it would be beneficial to evaluate the proximal muscles and organize treatment programs accordingly.
Description
Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Ana Bilim Dalı
Keywords
Fiziksel Tıp ve Rehabilitasyon, Physical Medicine and Rehabilitation
