Diz Osteoartrit Tedavisinde Fizyoterapi ve Rehabilitasyon
Özet
Diz osteoartriti, dünya genelinde ağrı, fonksiyon kaybı ve yaşam kalitesinde düşüşe yol açan en yaygın kas-iskelet sistemi hastalıklarından biridir. Konservatif tedavisinde fizyoterapi yöntemleri ilk basamak müdahaleler arasında yer almakta ve giderek artan kanıtlarla desteklenmektedir. Bu bölümde hasta eğitimi, kara temelli aerobik egzersizler, kuvvetlendirme, denge ve propriosepsiyon egzersizleri, davranışsal temelli müdahaleler, elektrofiziksel modaliteler (TENS, NMES, düşük yoğunluklu ultrason) ve teknoloji destekli yaklaşımlar (mSağlık uygulamaları, tele-rehabilitasyon, giyilebilir sensörler) özetlenmektedir. Hasta eğitiminde biyopsikososyal yaklaşımın benimsenmesi, bireyin inançlarının, hedeflerinin ve günlük yaşam zorluklarının katılımcı ve güçlendirici bir dille ele alınması önemlidir. Egzersiz programlarında aerobik, kuvvetlendirme ve denge bileşenlerinin kişiselleştirilmesi, davranış değişikliği teknikleriyle (hedef belirleme, kademeli ilerleme, problem çözme vb.) desteklenmesi uzun dönem uyum açısından kritik görülmektedir. Elektrofiziksel ajanlar ve teknoloji temelli uygulamalar umut verici olmakla birlikte, etkinliklerinin ve maliyet-etkinliklerinin daha net anlaşılabilmesi için daha yüksek metodolojik kaliteye sahip, uzun süreli ve çok merkezli randomize kontrollü çalışmalara gereksinim duyulmaktadır.
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