تأثیر ماساژ درمانی با و بدون بانداژ کشی بر درد، ادم و مشکلات عضلات اسکلتی اندام فوقانی پس از رادیکال ماستکتومی تعدیل شده: کارآزمایی بالینی تصادفی شده

نوع مقاله : اصیل پژوهشی

نویسندگان

1 استاد گروه بیهوشی، دانشکده پزشکی، دانشگاه علوم پزشکی تبریز، تبریز، ایران

2 دانشیار گروه هوشبری، دانشکده پیراپزشکی، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

3 دانشیار گروه بیهوشی، دانشکده پزشکی، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

چکیده

مقدمه: درد و مشکلات سیستم اسکلتی عضلانی اندام فوقانی در زنان پس از ماستکتومی، از عوارض ناخوشایند و شایع هستند که پیشگیری از ‌آن می­تواند نتایج جراحی را تحت تأثیر قرار دهد. مطالعه حاضر با هدف بررسی ماساژ درمانی با و بدون بانداژ کشی بر درد، ادم و مشکلات عضلات اسکلتی اندام فوقانی پس از رادیکال ماستکتومی تعدیل شده انجام شد.
روش‌کار: این مطالعه کارآزمایی بالینی در سال 98-1397 در طی 18 ماه در بیمارستان امام رضا تبریز با مشارکت 90 زن انجام شد. بیماران به سه گروه ماساژ دستی تخلیه لنف، گروه ماساژ دستی تخلیه لنف + بانداژ کم فشار و گروه کنترل به صورت تصادفی تخصیص یافتند، سپس مداخله مربوطه به فرد همراه بیمار آموزش داده شد و مداخله از روز پس از جراحی آغاز شد (انجام روزانه در منزل). اطلاعات دموگرافیک، تست­های فیزیکال اندام فوقانی و چک‌لیست میزان ادم قبل و بعد از مداخله ثبت شد. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماریSPSS (نسخه 19) و آزمون آنالیز واریانس یک‌طرفه و خی دو انجام شد. میزان p کمتر از 05/0 معنادار در نظر گرفته شد.
یافته‌ها: هیچ کدام از متغیرهای مورد بررسی قبل از آغاز مداخله اختلاف آماری معناداری نداشتند (05/0<p) حال آنکه بررسی متغیرهای مورد مطالعه پس از پایان مداخله حاکی از آن بود که در متغیر­هایی همچون میزان ادم (009/0=p)، شدت درد (003/0=p)، هاوکینز کندی (005/0=p)، یرگاسون (003/0=p)، کراس اور (001/0=p)، فالن (019/0=p)، پروناتور (002/0=p) و مقاومت ایزومتریک (006/0=p) بین گروه­های مختلف اختلاف آماری معناداری وجود داشت. همچنین استفاده از بانداژ کشی بعد از ماساژ درمانی بهترین تأثیر را داشت (001/0=p).
نتیجه‌گیری: اقدامات توانبخشی همچون ماساژ درمانی و بانداژ کشی بلافاصله پس از ماساژدرمانی توانست موجب کاهش میزان لنف ادم، درد و عملکرد سیستم اسکلتی عضلانی دست پس از ماستکتومی شود.

کلیدواژه‌ها


عنوان مقاله [English]

Effect of massage therapy with and without bandaging on pain, edema and problems of upper extremity musculoskeletal system after modified radical

نویسندگان [English]

  • Mahmoud Eidi 1
  • Hassan Mohammadipour Anvari 2
  • Abbasali Dorosti 3
1 Professor, Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
2 Associate Professor, Department of Anesthesiology, School of Paramedical, Tabriz University of Medical Sciences, Tabriz, Iran.
3 Associate Professor, Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
چکیده [English]

ntroduction: Pain and problems of the upper limb musculoskeletal system in women after mastectomy are unpleasant and common complications that preventing it can affect the surgical outcomes. This study was performed with aim to evaluate the effect ofmassage therapy with and without bandaging on pain, edema and problems of upper extremity musculoskeletal system after modified radical mastectomy.
Methods: This clinical trial study was performed over 18 months (2018-2019) in Tabriz Imam Reza Hospital with participation of 90 women. The subjects were randomly divided into three groups of manual lymph drainage massage group, manual lymph drainage massage group + low pressure bandage and control group. Then, the intervention was trained to the patient and the intervention started the day after the surgery (doing daily at home). Demographic information, upper extremity physical tests and edema checklist were recorded before and after the intervention. Data were analyzed by SPSS software (version 19) and One-way ANOVA and X2tests. P<0.05 was considered statistically significant.
Results: None of the variables were statistically significant before the intervention (p>0.05), whereas evaluation of the variables after the end of the intervention indicated that in variables such as edema (p=0.009), pain severity (p=0.003), Hawkins Kennedy (p=0.005), Jergason (p=0.003), Crossover (p=0.001), Falun (p=0.019), protonator (p=0.002) and isometric resistance (p=0.006), a statistically significant difference was observed between the groups. Also, the use of bandages after massage therapy has the best effect.
Conclusion: Rehabilitation measures such as massage therapy and bandaging immediately after massage therapy reduced the amount of lymph nodes edema, pain, and function of the musculoskeletal system of the hand after mastectomy.

کلیدواژه‌ها [English]

  • Lymphedema
  • Massage therapy
  • Mastectomy
  • Musculoskeletal system
  • Pain
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