Kronik Boyun Ağrılı bireylerde manuel tedavinin solunum parametreleri, ağrı, postür ve yaşam kalitesi üzerine Etkisi

Abstract

Tamer, S., The effect of manual therapy on respiratory parameters, pain, posture and quality of life in individuals with chronic neck pain, Hacettepe University Graduate School of Health Science Physical Therapy and Rehabilitation Program Ph.D. Thesis, Ankara, 2019. The aim of this study was to investigate the effect of manual therapy on respiratory parameters, pain, posture and quality life in patients with chronic neck pain. 46 patients with chronic neck pain were divided into three groups by block randomization as, Cervical Mobilization+Exercise Group (SM+E G, n=15, 32.06±2.79 yrs), Thoracic&Cervical Mobilization+Exercise Group (TM+SM+EG, n=16, 31.86±2.98 yrs) and Exercise Group (E G, n=15, 32.73±3.23 yrs). For the manual therapy, Maitland mobilization techniques were applied; for the exercise program, stabilization, neck and scapulo-thoracic strengthening were used. All patients included in the study were treated 2 sessions/week for 6 weeks; and they were evaluated before and after the treatment. Pain severity was evaluated by Visual Analogue Scale (VAS), cervical range of motion through universal goniometer, neck deep flexor muscle endurance (DFK) by pressure biofeedback and posture (head anterior tilt), photography method. Short Form-36 (SF-36) and Neck Disability Index (NDI) were used for quality of life and disability. Thoracic expansion and respiratory functions were measured with tape and spirometer. Maximal inspiratory (MIP) and expiratory pressure (MEP) were measured by mouth pressure device. Respiratory functions improved in both manuel therapy groups, except the Exercise Group, and axillary expansion showed no improvement in any of the groups after the treatment. There were significant improvements in all parameters in three groups. Especially, TM+SM+E was found the most effective method in terms of respiratory functions, MIP, MEP, subcostal expansion, activity pain, cervical left lateral flexion and right rotation, anterior tilt of the head, DFK endurance, NDI, SF-36 (p<0.05). TM+SM+E and SM+E Groups had similar effects for MIP, subcostal expansion and resting pain (p>0.05). SM+E Group was superior to the E Group method on respiratory functions, MIP, subcostal expansion, resting and activity pain, right rotation and left lateral flexion, anterior tilt, DFK endurance; but they had similar effects on MEP, DFK strength, NDI and SF-36 (p>0.05). Our study showed that all three treatments have benefits in chronic neck pain patients; however, manual therapy, especially included thoracic region is the most effective method for all parameters, especially respiratory parameters. Keywords: Neck pain, manual therapy, respiratory function tests, respiratory muscle, quality of life