The Effect of Mirror Therapy on Shoulder Pain and Function in Patients Undergoing Thoracotomy
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 70
- 试验地点
- 1
- 主要终点
- Change of Active Shoulder Range of Motion
研究概览
简要总结
After thoracotomy, limitation in shoulder functions, ipsilateral shoulder pain, decrease in shoulder muscle strength and deterioration in quality of life occur. The exercise program applied after thoracotomy includes active range of motion exercises, postural correction activities, scapular strengthening exercises, and stretching of the chest and shoulder muscles. Mirror therapy can improve motor functions and reduce unilateral pain. This study aims to evaluate the effects of upper extremity exercises based on mirror therapy after thoracotomy on ipsilateral shoulder pain, shoulder joint range of motion, shoulder muscle strength, shoulder function, quality of life, movement and fear of re-injury. The patients were divided into 2 groups as "mirror therapy group" and "control group", by choosing a simple randomization so that they could not see what was written on their pre-prepared papers. Standard medical treatment, care and pulmonary rehabilitation program were applied to both groups. In addition to the routine rehabilitation program after thoracotomy, the study group received a total of 24 sessions of foal therapy, 3 sessions a week, for 8 weeks. Data were collected using the Personal Information Form including the demographic characteristics of the patients, Tampa Kinesiophobia Scale, Numerical Pain Rating Scale (NPRS), Shoulder Active Range of Motion, Pain Catastrophization Scale, Shoulder Pain and Disability Index, Shoulder muscle strength, SF-12. performed before and after treatment.
详细描述
Pelvic examination has been a worrisome examination for women since the first years of gynecology science until today. Previous studies have discussed patient anxieties experienced during interventions such as radiological imaging, endoscopy, colonoscopy, bronchoscopy, and invasive cardiac interventions. Short informative videos that do not cause any cost loss or harm increase the tolerance with these applications and reduce patient anxiety. Additionally, many studies have emphasized that doctors have no time to provide information trainings for the vaginal examination among their intense practices. Information that cannot be provided before the gynecologic examination due to limited time causes pelvic pain in women due to the anxiety experienced during the examination. In the literature, the concept of chronic pelvic pain is defined as non-cyclical pain that lasts longer than six months and develops the area below the umbilicus and between the gluteal lines; however, pelvic pain is observed depending on the excessive activity of pelvic floor muscles during the examination in patients who have the fear of the gynecologic examination.
The aim of this study is to evaluate the effect of multimedia patient information training provided before the gynecologic examination on the patient's pelvic pain, anxiety, and fear.
The present study is designed as a randomized controlled single-blind prospective experimental study to examine the effects of patient training provided before the gynecologic examination on the patient's anxiety, fear, and pelvic pain.
The study is conducted with 80 voluntary patients in the age range of 18-50 years, who applied to the gynecology and obstetrics clinic.
The inclusion criteria are as follows; having no known cerebrovascular disease, having no morbid obesity and heart disease that would pose an obstacle to the study, having no cognitive disorder that would pose an obstacle to communication, having no stroke and the associated influence, and agreeing to participate in the study.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- Single (Participant)
入排标准
- 年龄范围
- 25 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients who were hospitalized in Akdeniz University Hospital Thoracic Surgery Clinic and underwent lung resection with standard posterolateral thoracotomy (lobectomy, segmentectomy or wedge resection),
- •Those between the ages of 25-65,
- •Hemodynamically stable,
- •Those who were extubated at the 2nd or 3rd postoperative hour and who did not develop any complications after extubation,
- •No known cerebrovascular disease,
- •Not having morbid obesity and heart disease that will prevent working,
- •Does not have cognitive and cognitive impairments that will prevent communication,
- •No previous paralysis and related effects,
- •Individuals who agree to participate in the study.
排除标准
- •Those who stayed in the intensive care unit for more than 4 days in the postoperative period,
- •Those who have had another surgical procedure within 6 months,
- •Those with postoperative cooperation problems such as delirium,
- •Those with Rotator Cuff injuries,
- •Those with cervical radiculopathy,
- •Those with rheumatological diseases,
- •Those with neurological disease,
- •Those with a history of dislocation, subluxation,
- •Those with a history of fracture,
- •Those with congenital deformity,
- •Those who have a history of surgery related to the shoulder,
- •Those who have trouble perceiving tests and exercises
研究组 & 干预措施
Control group
The control group consisted of patients who underwent thoracotomy and underwent routine rehabilitation in the post-surgical period. routine respiratory rehabilitation program; It consists of a) positioning, b) general body exercises, c) airway clearance techniques, d) breathing exercises, e) incentive spirometry and f) mobilization applications.
Study group
The study group consisted of patients who would receive mirror therapy in addition to the routine rehabilitation program described above and applied to the control group in the post-thoracotomy period.
干预措施: Mirror therapy (Device)
结局指标
主要结局
Change of Active Shoulder Range of Motion
时间窗: Change from Baseline Active Shoulder Range of Motion at 8 weeks.
Active shoulder range of motion of the patients will be evaluated with a digital goniometer (Baseline Digital Absolute \& Axis Goniometer) using a standard protocol. Total shoulder motion that allows motion of all joints in the shoulder complex will be measured, glenohumeral motion will not be isolated. Flexion, abduction, external and internal rotation of the shoulder will be evaluated. Preoperative period, postoperative 7th day, postoperative 4th week and postoperative 8th week will be repeated.
Change of Shoulder Muscle Strength
时间窗: Change from Baseline Shoulder Muscle Strength at 8 weeks.
Shoulder muscle strength will be measured using a dynamometer (MicroFET 2 Manual Muscle Tester). Force measurements will be taken for shoulder flexion, abduction, internal and external rotation. Before starting the test, patients will be informed about how to perform the test. Preoperative period, postoperative 7th day, postoperative 4th week and postoperative 8th week will be repeated.
Change of Shoulder, Pain and Disability Index Score
时间窗: Change from Baseline Shoulder, Pain and Disability Index Score at 8 weeks.
Shoulder function will be measured using the Shoulder, Pain and Disability Index , a self-rated questionnaire designed to measure shoulder pain and disability. Shoulder Pain and Disability Index is a reliable questionnaire evaluating shoulder pain and disability. Turkish reliability and validity were performed by Bumin et al. in 2008. There are 2 subscales and 13 items in total in the index. 5 of them evaluate pain and 8 evaluate disability. The items of both subscales are measured with a visual analog scale from 0 to 10. The scores given by the individual are added together and calculated as a percentage. Higher scores indicate more severe pain and higher disability. Preoperative period, postoperative 7th day, postoperative 4th week and postoperative 8th week will be repeated
Change of Quality of Life Score
时间窗: Change from Baseline Quality of Life Score at 8 weeks.
The quality of life of our patients will be evaluated using the Short Form-12. Health-related
Change of Pain Score
时间窗: Change from Baseline Pain Score at 8 weeks.
Numerical Pain Rating Scale (NPRS) was used as a one-dimensional scale for pain
Change of Tampa Kinesiophobia Scale
时间窗: Change from Baseline Tampa Kinesiophobia Scale Score at 8 weeks.
This scale, which is frequently used in the literature, is based on avoidance due to fear, fear in work-related activities, fear of movement or re-injury. Tampa Kinesiophobia Scale is a 17-item scale developed to measure fear of movement and re-injury. The scale includes parameters of injury/re-injury and fear-avoidance in work-related activities. The fact that it is an important outcome parameter for physiotherapists in evaluating the success of the treatment and especially the social participation of the patients, and being a scale that can be used in various patient groups, makes Tampa Kinesiophobia Scale a valuable measurement parameter in the clinic. Tampa Kinesiophobia Scale is a 4-point Likert scale scored as 1-strongly disagree, 2-disagree, 3-agree, 4-strongly agree. The total score is calculated after questions 4, 8, 12 and 16 are reverse scored one by one. The total score is between 17-68. A high value in Tampa Kinesiophobia Scale indicates a high level of kinesiophobia.
次要结局
- Weight in Kilograms(Initial assessment before surgery.)
- Body Mass Index (BMI) in kg/m^2(Initial assessment before surgery)
- Height in Meters(Initial assessment before surgery.)
研究者
Neriman Temel Aksu
Research Assistant (Expert Physiotherapist)
Akdeniz University