KRONİK BEL AĞRILI HASTALARIN FİZYOTERAPİ REHABİLİTASYONUNDA MANUEL TEDAVİYE İLAVE AKUPRESSURE UYGULAMASININ ETKİLERİNİN İNCELENMESİ
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The aim of this study was to investigate the effects of acupressure in combination with mauel therapy in patients with chronic low back pain (CLBP) and to compare the effects of these treatments alone and combined use. Sixty patients diagnosed with CLBP participated in the study. The subjects were randomly divided into 4 groups: 1 control and 3 applications. All patients (including the control group) underwent a standard physiotherapy program consisting of low back training and spine strengthening and stabilization exercises. The control group received no treatment other than this standard physiotherapy program. In addition to this program, acupressure was applied to the first group, manual treatment was applied to the second group, and manual treatment and acupressure were combined to the third group. The patients were treated for a total of 6 weeks, 2 sessions per week. The level of pain severity of the participants was determined by Visual Pain Scale (VAS) and Algometer. The level of muscle strength was measured by muscle dynamometer. Oswestry Disability Index (ODI) was used for functional evaluation; Beck Depression Inventory was used for anxiety level; Quality of Life Questionnaire (SF-36) was used for quality of life, and Tampa Kinesophobia Scale (TKS) was used for fear of movement. These assessments were administered to the patients at the beginning and end of the 6-week treatment program and the data obtained were recorded. In the control group, the difference between the pre- and post-treatment measurements was statistically significant (p <0.05) in terms of all variables except for the TKS variable. In the acupressure group, the difference between pre- and post-treatment measurements was statistically significant (p <0.05) in terms of all variables except TKS, Energy-Vitality-Vitality and Mental Health variables. In the Manual Therapy group, the difference between the pre-and post-treatment measurements was statistically significant (p <0.05) in terms of all variables except for the TKS variable. In the Acupressure + Manual Therapy group, the difference between pre and post-treatment measurements in terms of pain, muscle strength, kinesiophobia, depression and quality of life was found statistically significant (p <0.05). When the groups after treatment were compared with each other, it was seen that the best group in terms of VAS activity was the acupressure + manual treatment group, the two best groups in terms of pain threshold were the manual treatment and acupressure + manual treatment group, and the best group in terms of quality of life was the manual treatment group.