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Polimiyaljia romatika tanısı olan kadın hastada egzersiz eğitimi etkisi: vaka raporu

Yıl 2021, Cilt: 8 Sayı: 1, 106 - 113, 07.05.2021

Öz

Polimiyaljia Romatika (PMR), özellikle geriatrik populasyonu etkileyen, proksimal vücut bölümlerinde şiddetli ağrı ve tutukluk ile karakterize etiyolojisi bilinmeyen inflamatuar bir hastalıktır. PMR ile ilgili kılavuzlar bireyselleştirilmiş egzersiz programlarının gerekliliğini ifade etse de ilgili çalışmaların yokluğu nedeniyle literatürdeki ihtiyaç açıktır. Bu vaka raporunun amacı 66 yaşında PMR tanılı kadın bireyde bireyselleştirilmiş reformer egzersiz eğitiminin hastalık semptomları üzerine etkisini araştırmaktı. Değerlendirmeler kapsamında kas kuvveti için; "Manual Muscle Tester", fonksiyonel test olarak, denge ve düşme riskini değerlendirmek için; fonksiyonel uzanma testi (FUT) ile zamanlı kalk yürü testi (TUG), alt ekstremite kuvveti ve dinamik balansı değerlendirmek için; sandalyeden oturma ve kalkma testi (30s-CST), kardiorespiratuar endurans için; 6 dakika yürüme testi, anksiyete ve depresyon seviyesi için; Hastane Depresyon ve Anksiyete Skalası, yaşam kalitesinin çeşitli yönleriyle değerlendirilmesi için; Kısa Form-36 ve Oswestry Bel Ağrısı Ölçeği (ODI), biyopsikososyal etkilenim düzeyini belirlemek için; BETY-Biyopsikososyal Ölçeği, sağlığın ve özür durumunun değerlendirmesi amacıyla ise; Sağlık Değerlendirme Anketi uygulandı. Hasta altı hafta boyunca, haftanın üç günü, birer saat reformer eğitimine alındı. Tüm değerlendirmeler başlangıçta ve 6 hafta sonunda uygulandı. Eğitim sürecinin sonunda, reformer kullanılarak uygulanan gövde stabilizasyon egzersiz eğitiminin, hastanın değerlendirilen tüm parametrelerinde artış ile sonuçlandığı görüldü. Özellikle kesme değerleri bilinen FUT, TUG ve 30s-CST fonksiyonel testlerinde ve ODI ölçeğinde sonuç değerleri klinik anlamlılık gösterdi (Sırasıyla; 5,6 cm artış, 2,96 sn azalma, 5 tekrar artış, 10 puan azalma). Bu vaka raporu PMR tanılı bireylerde uygulanabilecek egzersiz programı ve etkinliği hakkında bir görüş sunmaktadır. PMR ile ilgili, hastalığa spesifik egzersiz rejimlerinin çalışılmasına ve uzun dönem takiplere ihtiyaç vardır.

Destekleyen Kurum

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Proje Numarası

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Teşekkür

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Kaynakça

  • 1. Castañeda S, García-Castañeda N, Prieto-Peña D, et al. Treatment of polymyalgia rheumatica. Biochem Pharmacol. 2019.
  • 2. Camellino D, Giusti A, Girasole G, et al. Pathogenesis, Diagnosis and Management of Polymyalgia Rheumatica. Drugs Aging. 2019;23:1-12.
  • 3. Matteson EL, Dejaco C. Polymyalgia rheumatica. Ann Intern Med. 2017;166:65-80.
  • 4. Muratore F, Pazzola G, Pipitone N, et al. Recent advances in the diagnosis and treatment of polymyalgia rheumatica. Expert Rev Clin Immunol. 2016;12:1037-1045.
  • 5. Helliwell T, Hider SL, Mallen CD. Polymyalgia rheumatica: diagnosis, prescribing, and monitoring in general practice. Br J Gen Pract. 2013;63:361-366.
  • 6. González-Gay MA, Matteson EL, Castañeda S. Polymyalgia rheumatica. Lancet. 2017;390:1700-1712.
  • 7. Braun J, van den Berg R, Baraliakos X, et al., 2010 update of the ASAS/EULAR recommendations for the management of ankylosing spondylitis. Ann Rheum Dis. 2011:70:896-904.
  • 8. Osthoff, Anne-Kathrin Rausch, et al. "2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis." Ann Rheum Dis. 2018:77:1251-1260.
  • 9. Perandini, L.A., et al., Exercise as a therapeutic tool to counteract inflammation and clinical symptoms in autoimmune rheumatic diseases. Autoimmun Rev. 2012;12:218-224.
  • 10. Benatti FB, Pedersen BK. Exercise as an anti-inflammatory therapy for rheumatic diseases—myokine regulation. Nat. Rev. Rheumatol. 2015;11:86-97.
  • 11. Dejaco C, Singh YP, Perel P, et al. 2015 Recommendations for the management of polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative. Arthritis Rheum. 2015;67:2569-2580.
  • 12. Duncan PW, Weiner DK, Chandler J, et al. Functional reach: a new clinical measure of balance. J Gerontol. 1990;45:192-197.
  • 13. Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39:142-148.
  • 14. Jones CJ, Rikli RE, Beam WC. A 30-s chair-stand test as a measure of lower body strength in community-residing older adults. Res Q Exercise Sport. 1999;70:113-119.
  • 15. Aydemir Ö, Güvenir T, Küey L, et al. Hospital Anxiety and Depression Scale Turkish Form: validation and reliability study. Türk Psikiyatri Der. 1997;8:280-287.
  • 16. Küçükdeveci AA, Sahin H, Ataman S, et al. Issues in cross‐cultural validity: Example from the adaptation, reliability, and validity testing of a Turkish version of the Stanford Health Assessment Questionnaire. Arthritis Care Res. 2004;51:14-19.
  • 17. Kocyigit H. Kisa Form-36 (KF-36)'nm Turkce versiyonunun guvenilirligi ve gecerliligi. İlaç ve tedavi dergisi. 1999;12:102-106.
  • 18. Ünal E, Arın G, Karaca NB, et al. Romatizmalı hastalar için bir yaşam kalitesi ölçeğinin geliştirilmesi: madde havuzunun oluşturulması. J Exerc Ther Rehabil. 2017;4:67-75.
  • 19. Yakut E, Düger T, Öksüz Ç, et al. Validation of the Turkish version of the Oswestry Disability Index for patients with low back pain. Spine. 2004;29:581-585.
  • 20. ATS committee on proficiency standarts for clinical pulmonary function laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002;166:111-117.
  • 21. Redelmeier D, Bayoumi A, Goldstein R, et al. Interpreting small differences in functional status: the Six Minute Walk test in chronic lung disease patients. Am J Respir Crit Care Med. 1997; 155:1278-1282.
  • 22. O'Keeffe ST, Lye M, Donnellan C, et al. Reproducibility and responsiveness of quality of life assessment and six minute walk test in elderly heart failure patients. Heart. 1998; 80:377-382.
  • 23. Karaca NB. Ankilozan Spondilitli Hastalarda Anti-TNF Tedavisi Ile Eş Zamanlı Başlatılan Bilişsel Egzersiz Terapi Yaklaşımı'nın Hastalığın Semptomları Üzerine Etkilerinin Araştırılması. 2018.
  • 24. Mora JC, Valencia WM. Exercise and older adults. Clin Geriatr Med. 2018;34:145-162.
  • 25. Huang CC, Lee JD, Yang DC, et al. Associations between geriatric syndromes and mortality in community dwelling elderly: results of a national longitudinal study in Taiwan. J Am Med Dir Assoc. 2017;18:246-251.
  • 26. Thomas S, Mackintosh S, Halbert J. Does the ‘Otago exercise programme’reduce mortality and falls in older adults?: a systematic review and meta-analysis. Age ageing. 2010;39:681-687.
  • 27. Lee PG, Jackson EA, Richardson CR. Exercise Prescriptions in Older Adults. Am Fam Physician. 2017;95:425-432.
  • 28. Howe TE, Shea B, Dawson LJ, et al. Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database Syst. Rev. 2011;7.
  • 29. Parikh CM, Arora M. Role of Pilates in rehabilitation: A literature review. Int J Rehabil Res. 2016;5:77-83.
  • 30. Roh SY. Effect of a 16-week Pilates exercise program on the ego resiliency and depression in elderly women. J Exerc Rehabil. 2016;12:494-498.

Effect of exercise training in a female patient diagnosed with polymyalgia rheumatica: a case report

Yıl 2021, Cilt: 8 Sayı: 1, 106 - 113, 07.05.2021

Öz

Polymyalgia Rheumatica (PMR) is an inflammatory disease of unknown etiology that mainly affects the geriatric population, characterized by severe pain and stiffness in proximal body parts. Although the guidelines on PMR express the importance of individualized exercise programs, the need in the literature is clear due to the lack of relevant studies. This case report aimed to investigate the effect of individualized reformer exercise training on disease symptoms in a 66-year-old female patient with PMR diagnosis. To assess muscle strength; Manual Muscle Tester, to evaluate balance and fall risk; Functional Reach Test and Timed Up and Go Test, to evaluate lower extremity strength and dynamic balance; sit and stand up test, for cardiorespiratory endurance; 6-minute walk test, to determine the level of anxiety and depression; Hospital Depression and Anxiety Scale, to evaluate the quality of life; Short Form-36 and Oswestry Low Back Pain Scale, to determine the biopsychosocial level; BETY-Biopsychosocial Scale, to evaluate the health and disability status; Health Assessment Questionnaire was applied. The patient was included in reformer training for six weeks, three days a week, one hour. All evaluations were performed at baseline and at the end of 6 weeks. At the end of the training process, reformer exercise training with trunk stabilization resulted in an increase in all parameters evaluated. FUT, TUG and 30s-CST functional tests and ODI scale with known cut-off values showed clinical significance (5.6 cm increase, 2.96-sec decrease, 5-repeat increase, 10-point decrease, respectively). This case report provides an insight into the exercise program and its effectiveness in individuals with PMR. Disease-specific exercise regimens and long-term follow-up are needed.

Proje Numarası

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Kaynakça

  • 1. Castañeda S, García-Castañeda N, Prieto-Peña D, et al. Treatment of polymyalgia rheumatica. Biochem Pharmacol. 2019.
  • 2. Camellino D, Giusti A, Girasole G, et al. Pathogenesis, Diagnosis and Management of Polymyalgia Rheumatica. Drugs Aging. 2019;23:1-12.
  • 3. Matteson EL, Dejaco C. Polymyalgia rheumatica. Ann Intern Med. 2017;166:65-80.
  • 4. Muratore F, Pazzola G, Pipitone N, et al. Recent advances in the diagnosis and treatment of polymyalgia rheumatica. Expert Rev Clin Immunol. 2016;12:1037-1045.
  • 5. Helliwell T, Hider SL, Mallen CD. Polymyalgia rheumatica: diagnosis, prescribing, and monitoring in general practice. Br J Gen Pract. 2013;63:361-366.
  • 6. González-Gay MA, Matteson EL, Castañeda S. Polymyalgia rheumatica. Lancet. 2017;390:1700-1712.
  • 7. Braun J, van den Berg R, Baraliakos X, et al., 2010 update of the ASAS/EULAR recommendations for the management of ankylosing spondylitis. Ann Rheum Dis. 2011:70:896-904.
  • 8. Osthoff, Anne-Kathrin Rausch, et al. "2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis." Ann Rheum Dis. 2018:77:1251-1260.
  • 9. Perandini, L.A., et al., Exercise as a therapeutic tool to counteract inflammation and clinical symptoms in autoimmune rheumatic diseases. Autoimmun Rev. 2012;12:218-224.
  • 10. Benatti FB, Pedersen BK. Exercise as an anti-inflammatory therapy for rheumatic diseases—myokine regulation. Nat. Rev. Rheumatol. 2015;11:86-97.
  • 11. Dejaco C, Singh YP, Perel P, et al. 2015 Recommendations for the management of polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative. Arthritis Rheum. 2015;67:2569-2580.
  • 12. Duncan PW, Weiner DK, Chandler J, et al. Functional reach: a new clinical measure of balance. J Gerontol. 1990;45:192-197.
  • 13. Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39:142-148.
  • 14. Jones CJ, Rikli RE, Beam WC. A 30-s chair-stand test as a measure of lower body strength in community-residing older adults. Res Q Exercise Sport. 1999;70:113-119.
  • 15. Aydemir Ö, Güvenir T, Küey L, et al. Hospital Anxiety and Depression Scale Turkish Form: validation and reliability study. Türk Psikiyatri Der. 1997;8:280-287.
  • 16. Küçükdeveci AA, Sahin H, Ataman S, et al. Issues in cross‐cultural validity: Example from the adaptation, reliability, and validity testing of a Turkish version of the Stanford Health Assessment Questionnaire. Arthritis Care Res. 2004;51:14-19.
  • 17. Kocyigit H. Kisa Form-36 (KF-36)'nm Turkce versiyonunun guvenilirligi ve gecerliligi. İlaç ve tedavi dergisi. 1999;12:102-106.
  • 18. Ünal E, Arın G, Karaca NB, et al. Romatizmalı hastalar için bir yaşam kalitesi ölçeğinin geliştirilmesi: madde havuzunun oluşturulması. J Exerc Ther Rehabil. 2017;4:67-75.
  • 19. Yakut E, Düger T, Öksüz Ç, et al. Validation of the Turkish version of the Oswestry Disability Index for patients with low back pain. Spine. 2004;29:581-585.
  • 20. ATS committee on proficiency standarts for clinical pulmonary function laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002;166:111-117.
  • 21. Redelmeier D, Bayoumi A, Goldstein R, et al. Interpreting small differences in functional status: the Six Minute Walk test in chronic lung disease patients. Am J Respir Crit Care Med. 1997; 155:1278-1282.
  • 22. O'Keeffe ST, Lye M, Donnellan C, et al. Reproducibility and responsiveness of quality of life assessment and six minute walk test in elderly heart failure patients. Heart. 1998; 80:377-382.
  • 23. Karaca NB. Ankilozan Spondilitli Hastalarda Anti-TNF Tedavisi Ile Eş Zamanlı Başlatılan Bilişsel Egzersiz Terapi Yaklaşımı'nın Hastalığın Semptomları Üzerine Etkilerinin Araştırılması. 2018.
  • 24. Mora JC, Valencia WM. Exercise and older adults. Clin Geriatr Med. 2018;34:145-162.
  • 25. Huang CC, Lee JD, Yang DC, et al. Associations between geriatric syndromes and mortality in community dwelling elderly: results of a national longitudinal study in Taiwan. J Am Med Dir Assoc. 2017;18:246-251.
  • 26. Thomas S, Mackintosh S, Halbert J. Does the ‘Otago exercise programme’reduce mortality and falls in older adults?: a systematic review and meta-analysis. Age ageing. 2010;39:681-687.
  • 27. Lee PG, Jackson EA, Richardson CR. Exercise Prescriptions in Older Adults. Am Fam Physician. 2017;95:425-432.
  • 28. Howe TE, Shea B, Dawson LJ, et al. Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database Syst. Rev. 2011;7.
  • 29. Parikh CM, Arora M. Role of Pilates in rehabilitation: A literature review. Int J Rehabil Res. 2016;5:77-83.
  • 30. Roh SY. Effect of a 16-week Pilates exercise program on the ego resiliency and depression in elderly women. J Exerc Rehabil. 2016;12:494-498.
Toplam 30 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Case Reports
Yazarlar

Nur Banu Karaca 0000-0001-9025-4722

Edibe Ünal 0000-0003-2992-0698

Proje Numarası -
Yayımlanma Tarihi 7 Mayıs 2021
Gönderilme Tarihi 27 Aralık 2019
Yayımlandığı Sayı Yıl 2021 Cilt: 8 Sayı: 1

Kaynak Göster

Vancouver Karaca NB, Ünal E. Polimiyaljia romatika tanısı olan kadın hastada egzersiz eğitimi etkisi: vaka raporu. JETR. 2021;8(1):106-13.