Fizyoterapi ve Rehabilitasyon Bölümü Koleksiyonu

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https://hdl.handle.net/20.500.13055/54

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Effects of osteopathic manipulative treatment alone or in combination with respiratory training on chest wall expansion, functional mobility, and dyspnea level in patients with pulmonary arterial hypertension
(American Thoracic Society, 2024) Naci, Baha; Demir, Rengin; Önder, Ömer Önder; Sinan, Ümit Yaşar; Küçükoğlu, Mehmet Serdar
RATIONALE: While exercise training has been extensively investigated for nonpharmacologic treatment of pulmonary arterialhypertension (PAH), osteopathic manipulative treatment (OMT) has not been adequately examined. The purpose of this study wasto explore the efficacy of OMT alone or in association with respiratory training on chest wall expansion, functional mobility, anddyspnea level in patients with PAH. METHODS: 48 patients under PAH-targeted medical therapy for at least 3 months, betweenthe ages 20-74 (mean [SD] age: 48.4 [12.1] years) and with the World Health Organization functional class I to III were involved inthe study. Chest wall expansion was evaluated with a cloth tape measure at maximal inhalation and exhalation at 3 levels of the ribcage (axillary line, xiphoid process, lateral lower edge of the tenth costae) by subtracting the end-expiratory diameter from theend-inspiratory diameter. Functional mobility was assessed using 5-repetition sit-to-stand test. Dyspnea level was determinedwith the modified Medical Research Council scale. Patients were divided into OMT, combined intervention, and control groups,with 18 patients in each group. Rib raising, diaphragm release, suboccipital decompression, first rib mobilization, mediastinummobilization and thoracic inlet myofascial release techniques were applied to the OMT group twice weekly for 8 weeks. In additionto OMT, a yoga respiratory training session including nadishodhana, ujjayi, and bhramari pranayama was undertaken by thecombined intervention group. The breathing exercises were also performed once daily for the remaining days as home exercises.Control group received no additional intervention. All patients received an educational lecture. For between-group comparisonsand within-group differences of baseline with 8 weeks, one-way ANOVA with between-subject factor and the paired samples t testwere used, respectively. Pairwise multiple comparisons were conducted using Bonferroni post hoc tests.RESULTS: All outcomemeasures improved significantly in both intervention groups (p<0.01), whereas the control group showed no significant difference(p>0.05). Improvements for functional mobility and all the chest wall expansion data were significantly higher in combinedintervention group than other groups, and also in OMT group than control group (p<0.05) (Table 1). Improvement for dyspnea levelwas significantly higher in both intervention groups compared with the control group (p<0.05) (Table 1). CONCLUSION: This studydemonstrated that the addition of respiratory training to OMT revealed further benefit to chest wall expansion and functionalmobility compared to OMT alone and that the OMT might be an effective therapeutic method for dyspneic patients havingdifficulties in participating cardiopulmonary rehabilitation programs.
Sporcularda sık görülen omuz sorunları
(Türkiye Klinikleri, 2024) Kayıran, Sadi; Aydoğ, Sedat Tolga; Güven, Zeynep
Sportif hareketler, yüksek beceri isteyen hareketler olup maksimum koordinasyon, senkronizasyon ve nöromüsküler uyum ister. Bunun yanı sıra hareketlerin maksimum hız ve kuvvette olması gerekir. Antrenman bilimindeki gelişmeler, sporculara daha etkin antrenman yapma olanağı sunarken, spor hekimliği, fiziksel tıp ve rehabilitasyon alanındaki gelişmeler de spor yaralanmalarının oluşmasını engellemeye ve/veya oluşan yaralanmaların hızlı iyileşmesine katkı sağlar. Tüm bu gelişmeler, sporcuların küçük yaşlardan itibaren daha çok yüklenmesine ve uzun bir spor yaşamının olmasının önünü açar. Omuz eklemi, özellikle skapula, atış ve vurma gibi hareket içeren sporlarda geçiş eklemi olarak işlev görür ve kinetik zincirin çok önemli bir parçasıdır. Spor yaralanmalarına ait son yıllarda yapılan epidemiyolojik çalışmalar, sporda görülen omuz yaralanmaların travmatik yaralanmalardan aşırı kullanım yaralanmalarına döndüğünü göstermektedir. Yapılan sporun niteliğine göre, yaralanmanın görüldüğü anatomik bölge değişmekle birlikte özellikle voleybol, basketbol, hentbol, yüzme, tenis gibi baş üstü hareket içeren sporlarda üst ekstremite ve omuz ekleminin daha çok etkilendiği görülmektedir. Bu derlemede sporcularda görülen omuz ağrıları, bunların altında yatan nedenler ve kısmen tedavilerinden bahsedilecektir.
The relationship of painful shoulder development in hemiplegia with glenohumeral subluxation and functional state
(Uşak Cerrahi Derneği, 2020) Şahin, Nilay; Eroğlu, Mehmet; Yalıman, Ayşe; Eskiyurt, Fatma Nurten
OBJECTIVE: The aim of the study is to determine the relationship between hemiplegic shoulder pain (HSP) and glenohumeral (GH) subluxation, to evaluate the factors that may affect the development of HSP and GH subluxation, and to determine the effects of HSP on functional independence and activities of daily living (ADL). MATERIALS AND METHODS: Sixty-one hemiplegic patients who admitted to the cerebrovascular accident clinic were included in the study. Shoulder pain, frequency of subluxation, and spasticity were evaluated with anamnesis and clinical examination. Upper limb functions Brunnstrom motor stage; Activities of daily living and independence were evaluated with Functional Independence Scale (FIM) and Modified Barthel Index (MBI). RESULTS: The HSP was not associated with the duration of cerebrovascular accident, the Brunnstrom motor stage of the upper extremity, the presence of GH subluxation, or spasticity (p> 0.05), but a statistically significant relationship was found between the limitation of shoulder abduction and flexion movements and the development of pain in the shoulder (p <0.05). GH subluxation was not found to be associated with the presence and degree of spasticity (p> 0.05), but it was found to be significantly associated with the Brunnstrom motor stage of the upper extremity (p <0.01). It was found that as the Brunnstrom motor recovery stage of the upper extremity increased, the incidence of subluxation decreased. There was also no significant relationship between FIM, MBI scores and shoulder pain and GH subluxation (p> 0.05). CONCLUSION: In this study, the relationship between shoulder pain and GH subluxation was not determined, but the relationship between limitation of motion and HSP suggests possible soft tissue lesions, and in this respect, education for shoulder protection should be given importance in rehabilitation programs. Considering the relationship between GH subluxation and motor development, early activation of shoulder muscles should be emphasized in the rehabilitation program.
The effects of manual therapy and inspiratory muscle training on respiratory parameters in young adults with postural problems: A randomized trial
(Duzce University, 2022) Yıldız, Şeyda; Ataş Balcı, Leyla; Özkurt, Seçil
Objective: It was aimed to compare the effects of manual therapy (MT) and Inspiratory Muscle Training (IMT) on respiratory functions and postural problems of young adults in this study. Material-Method: Thirty-five volunteers were randomly allocated into IMT and MT groups. All participants received twenty minutes of IMT twice a week for four weeks. Eight sessions of manual therapy were applied to the MT group in addition to IMT. Forced Expiratory Volume in 1 Second (FEV1), Forced Vital Capacity (FVC), FEV1/FVC ratio, Peak Expiratory Flow (PEF), forward head posture (FHP), and thoracic hyperkyphosis were evaluated before and after the treatments. Results: Although there were significant improvements in the FEV1, FVC, FEV1/FVC ratio, and PEF scores of the MT group (p<0.05), no significant difference was found in the IMT group at the post-treatment (p>0.05). The comparisons of post-treatment scores of the FEV1, FVC, FEV1/FVC ratio, and PEF between the groups revealed greater improvements in the MT group than IMT group (p<0.05). Significant changes were demonstrated in postural problems in the two groups (p<0.05). However, no significant differences were analyzed between the group in the comparison of the post-treatment postural changes (p>0.05). Conclusion: We observed in our study that IMT and MT might be effective in correcting FHP and thoracic hyperkyphosis in young adults. It was recommended to add MT to IMT for the young adults with thoracic hyperkyphosis and FHP, due to greater improvements shown in the respiratory functions in our study.
Effects of diaphragmatic mobilization and diaphragmatic breathing exercises on pain and quality of life in individuals with shoulder pain: a randomized controlled trial
(Nevzat Demirci, 2021) Şahin, Okan; Kocamaz, Deniz
Purpose: This study aimed to investigate the effects of diaphragmatic mobilization and diaphragmatic breathing exercises on pain and quality of life in individuals with shoulder pain. Methods: A total of 72 individuals with shoulder pain were included in the study. The individuals included in the study were randomly divided into 3 groups as Diaphragmatic Mobilization Group (DMG) (n=24), Diaphragmatic Breathing Group (DBG) (n=24), and control group (n=24). In addition to classical physiotherapy treatment, diaphragmatic mobilization to mobilization group and diaphragmatic breathing exercises to breathing group were applied by the physiotherapist 3 days a week for 8 weeks. On the other hand, only classical physiotherapy treatments were applied to the control group. Individuals were evaluated in terms of pain and quality of life. Pain levels assessed with the Visual Analogue Scale (VAS) and quality of life assessed with Short Form-36 (SF-36). Results: In our study, it was observed that the pain level was reduced and the quality of life was improved in all groups (p<0.05). When DMG and DBG were compared with the control group, there was found a significant difference among groups in terms of reducing pain and improving quality of life in favor of DMG and DBG (p<0.05). When DMG and DBG were compared, no statistically significant difference was found between the groups (p>0.05). Conclusion: The study results demonstrated that diaphragmatic mobilization and diaphragmatic breathing exercises are found to be effective in reducing pain and improving quality of life in individuals with shoulder pain.
Effects of adding respiratory training to osteopathic manipulative treatment on exhaled nitric oxide level and cardiopulmonary function in patients with pulmonary arterial hypertension
(Elsevier, 2022) Baha, Naci; Demir, Rengin; Sinan, Ümit Yaşar; Küçükoğlu, Mehmet Serdar; Önder, Ömer Önder
Limited research exists regarding nonpharmacologic management of pulmonary arterial hypertension (PAH), except for exercise training. The objective of this study was to investigate the effects of osteopathic manipulative treatment (OMT) alone and combined with respiratory training on fractional exhaled nitric oxide (FeNO), and cardiopulmonary function in patients with PAH. This single-blind, prospective, randomized controlled study included 54 patients with PAH who were randomly allocated to OMT, combined intervention, and control groups. The OMT group (n = 16) and combined intervention group (n = 16) received OMT and yoga respiratory training plus OMT, respectively, twice a week for 8 weeks. The control group (n = 16) received no intervention. All patients undertook an educational lecture. FeNO level, pulmonary function, 6-minute walk distance (6MWD), maximal inspiratory and expiratory pressures, and handgrip strength were assessed at baseline and 8 weeks. Combined intervention and OMT groups significantly improved all outcome measures after 8 weeks of treatment (p <0.01), except mean forced expiratory flow between 25% and 75% of forced vital capacity, which did not change in the OMT group (p >0.05). The control group showed significant deteriorations in 6MWD, inspiratory and peripheral muscle strength, and pulmonary function except peak expiratory flow at 8 weeks (p <0.05). The combined intervention group revealed significantly greater improvements of FeNO, 6MWD, respiratory and peripheral muscle strength, and pulmonary function except mean forced expiratory flow between 25% and 75% of forced vital capacity compared with the OMT group (p <0.05). All outcomes significantly improved in both intervention groups versus the control group (p <0.05). Our study demonstrated that adding respiratory training to OMT provided further benefit to FeNO level and cardiopulmonary function compared with OMT alone and that the OMT might be a useful and safe intervention for patients who cannot attend cardiac rehabilitation programs.

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