Charcot-Marie-Tooth Hastalığında Ortez Yaklaşımları
Özet
Charcot-Marie-Tooth (CMT) distal kas zayıflığı ve duyusal kayıp ile karakterize en yaygın herediter periferik nöropatidir. Hastalık genellikle hayatın ilk iki dekadında ortaya çıkmakta ve yavaş bir progresyon göstermektedir. CMT1 ve CMTX en sık olmakla birlikte birçok formu bulunmaktadır. Bu formların belirlenmesinde klinik fenotipi tanımlama, elektrofizyolojik inceleme ve moleküler analiz gibi yöntemler kullanılmaktadır. Hastanın fonksiyonel durumu, hastalık progresyonu ve uygulanan tedavilerin etkinliğini belirlemek için CMT İnfant Skalası, CMT Pediatrik Skalası ve CMT Nöropati Skoru gibi hastalığa spesifik sonuç ölçümleri mevcuttur. Net bir tedavisi olmayan CMT’de fizyoterapi ve rehabilitasyon hastalık yönetiminde önemli bir yer tutmaktadır. Deformiteleri düzeltme, instabiliteyi önleme ve zayıf kasları destekleme görevleri olan ortezler fizyoterapi ve rehabilitasyon modalitelerinden birisidir. CMT’de hastanın rehabilitasyonu için çok farklı ortez yaklaşımı olmasına rağmen en sık tercih edilen ayak bileği-ayak ortezlerinin eklem hareket açıklığı, yürüyüş özellikleri, eklem stabilitesi ve denge üzerine olumlu etkileri bulunmaktadır. Bu etkileri optimize etmek için ortez yaklaşımlarının medikal tedavi ve diğer fizyoterapi ve rehabilitasyon modaliteleri ile kombine bir şekilde uygulanması önerilmektedir.
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