Alt Ekstremite Tendinopatilerinde Uygulanan Ekstrakorpereal Şok Dalga Tedavisinin Kas Kuvveti, Esnekliği ve Mimari Özelliklerine Olan Etkisinin Araştırılması

Abstract

NİZİPLİOĞLU A. Investigation of the effect of extracorporeal shock wave therapy muscle strength, flexibility and architectural features in lower extremity tendinopathies. Hacettepe Universty, Graduate School, Health Sciences Institute Sports Physiotherapist, Master’s Thesis, Ankara, 2019.The aim of this study was to investigate the effect of extracorporeal shock wave therapy applied to tendon and muscle on lower extremity tendinopathies on the architectural properties, muscle strength and flexibility of the muscle. Twenty individuals diagnosed with tendinopathy from hamstring, quadriceps or gastrokinemius muscles participated in the study. Evaluations were made three times, before the applications, after the first application and end of the extracorporeal shock wave treatment. Muscle thickness, pennation angle and fiber length were evaluated by radiologist by ultrasonography. Muscle strength was measured with digital dynamometer and muscle flexibility was measured with tape measure. Patients were included in the standard physiotherapy program in addition to MSDT. The application of MSDT resulted in decrease in muscle strength (p = 0.0001), decrease in muscle flexibility (p = 0.0003) and increase in muscle thickness in one session (p = 0.0001). The relationship between the change in muscle force and muscle thickness was significant at the end of the single session MSCT (r: -0,609, p = 0.004). When evaluated the effectiveness of each muscle applied isolates, hamstring group; There was an increase in muscle strength (p = 0.015) and flexibility (p = 0.029), no change in muscle thickness. In quadriceps, an increase in muscle strength (p = 0.0001) and a decrease in flexibility (p = 0.001) were found. Increased muscle strength (p = 0.039), increased pennation angle (p = 0.039) and decreased muscle thickness (p = 0.018) were found in gastrocnemius. In particular, single session ESWT reduces fiber strength, flexibility, and increases fiber length, pennation angle, and muscle thickness for the gastrokinemius; Increases muscle thickness for hamstring and quadriceps. This rapid change in muscle function may affect muscle loading after ESWT administration. We think that physiotherapy approaches should be planned before and after the application of muscle tissue.

Keywords: Tendinopathy, Extracorporeal shock wave therapy, Muscle architecture