Manuel Terapilerin Cerrahi Bakımda Kullanımı
Özet
Manuel terapiler, kas-iskelet sistemi bozukluklarının tanı ve tedavisinde kullanılan geleneksel ve tamamlayıcı tıp uygulamaları arasında yer almaktadır. Kayropraktik, kraniosakral ve osteopatik tedaviler önemli manuel terapilerdir. Manuel Terapilerin etki mekanizmaları; nörofizyolojik, mekanik, nöroimmünolojik ve psikososyal süreçlerle ilişkilidir. Ağrı kontrolü, dolaşımın artırılması, kas gevşemesi ve fonksiyonel iyileşme manuel terapilerin başlıca hedeflerindendir. Cerrahi bakımda kullanılan manuel terapi, özellikle ameliyat sonrası dönemde ağrı yönetimi, mobilizasyonun desteklenmesi ve hastanede kalış süresinin azaltılmasını sağlayan bir geleneksel ve tamamlayıcı tıp uygulamasıdır. Hemşireler, manuel terapinin uygulanmasında hasta değerlendirmesi, ağrı yönetimi, eğitim ve etik sorumluluklar açısından önemli roller üstlenmektedir. Ayrıca hastalara terapi süreci hakkında bilgi vererek tedaviye uyumunu artırmakta, taburculuk sonrası egzersizlerle iyileşme sürecini desteklemekte ve diğer sağlık profesyonelleriyle iş birliği içinde bütüncül bakım sunmaktadır. Bu nedenle manuel terapi disiplinler arası bir yaklaşımla yürütülmeli ve hasta güvenliği ön planda tutulmalıdır.
Manual therapies are a traditional and complementary method used for diagnosing and treating musculoskeletal disorders. Chiropractic, craniosacral and osteopathic treatments are important forms of manual therapy. The mechanisms by which manual therapy works are associated with neurophysiological, mechanical, neuroimmunological and psychosocial processes. The primary goals of manual therapies are pain control, increased circulation, muscle relaxation, and functional improvement. In surgery, manual therapy are very important, especially after surgery, because they help with pain, movement, and how long patients stay in hospital. Nurses play important roles in the implementation of manual therapy in terms of patient assessment, pain management, education and ethical responsibilities. They also improve treatment adherence by informing patients about the therapy process, supporting recovery through post-discharge exercises, and providing holistic care in collaboration with other healthcare professionals. Therefore, manual therapy should be implemented using a multidisciplinary approach, with patient safety being the top priority.
Referanslar
Nazlıkul H, Nazlıkul FGU, Okur SÇ, et al. Lokomotor sistem hastalıklarında kayropraktik yaklaşımlar. Bilimsel Tamamlayıcı Tıp Regülasyon ve Nöral Terapi Dergisi. 2020;14(2):47-52.
Çiftci MM, Çiftci N. Bir manuel tedavi yöntemi: Osteopati. Anadolu Tıbbı Dergisi. 2023;2(1):10-14. doi:10.5505/anadolutd.2023.57966
Bergman TF, Peterson DH. Principles of adjustive technique. In: Bergman TF, Peterson DH (eds.) Chiropractic technique. 4th ed. St. Louis, MO: Mosby Elsevier; 2011. p.85.
Özkan G. Kronik boyun ağrılı kadınlarda aletli klinik pilates egzersizlerinin ve manuel terapi uygulamalarının etkinliğinin karşılaştırılması: Randomize kontrollü tek kör çalışma. 2024. [Yayınlanmamış Yüksek Lisans Tezi]. 2024. Pamukkale Üniversitesi.
Marcon AR, Murdoch B, Caulfield T. The "subluxation" issue: An analysis of chiropractic clinic websites. Arch Physiother. 2019; 9:11. doi:10.1186/s40945-019-0064-5
Akalın B, İrban A, Özargun G. Türkiye’de geleneksel ve tamamlayıcı tıp uygulamalarının mevcut standartları ve iyileştirme önerileri. Sağlık Profesyonelleri Araştırma Dergisi. 2023;5(1):49-69.
Hofstetter L, Fontana M, Tomlinson GA, et al. A Bayesian analysis integrating expert beliefs to better understand how new evidence ought to update what we believe: A use case of chiropractic care and acute lumbar disc herniation with early surgery. BMC Med Res Methodol. 2024;24(1):281. doi:10.1186/s12874-024-02359-3
Upledger JE, Vredevoogd JD. Craniosacral therapy. Vol. 236. Seattle: Eastland Press; 1983. p.1-5.
Green C, Martin CW, Bassett K, et al. A systematic review of craniosacral therapy: Biological plausibility, assessment reliability and clinical effectiveness. Complement Ther Med. 1999;7(4):201-207. doi:10.1016/s0965-2299(99)80002-8
Matarán-Peñarrocha GA, Castro-Sánchez AM, García GC, et al. Influence of craniosacral therapy on anxiety, depression and quality of life in patients with fibromyalgia. Evid Based Complement Alternat Med. 2011; 1:178769. Doi:10.1093/ecam/nep125
Castejón-Castejón M, Murcia-González MA, Martínez Gil JL, et al. Effectiveness of craniosacral therapy in the treatment of infantile colic: A randomized controlled trial. Complement Ther Med. 2019; 47:102164. doi: 10.1016/j.ctim.2019.07.023
Lee FH, Raja SN. Complementary and alternative medicine in chronic pain. Pain. 2011;152(1):28-30. doi: 10.1016/j.pain.2010.09.023
Sposato NS, Bjerså K. Osteopathic manipulative treatment in surgical care: Short review of research publications in osteopathic journals during the period 1990 to 2017. J Evid Based Integr Med. 2018; 23:2515690X18767671. doi:10.1177/2515690X18767671
Baer HA. Osteopathy in Australasia: From marginality to a fully professionalised system of health care. Int J Osteopath Med. 2009; 12:25-31. doi: 10.1016/j.ijosm.2008.05.002
Henwood L, Le Donne ME, Vaughn A, et al. The effects of osteopathic manipulative treatment (OMT) on postoperative length of stay: A meta-analysis. Cureus. 2024;16(5): e59983. doi:10.7759/cureus.59983
Von Heymann W, Locher H. Manüel tıp ve ortopedi. Bilimsel Tamamlayıcı Tıp Regülasyon ve Nöral Terapi Dergisi. 2015;9(1):10-15.
Talhaoğlu D. Geleneksel ve tamamlayıcı tedavi uygulamaları. Bütünleyici ve Anadolu Tıbbı Dergisi. 2021;3(1):16-29. doi: 10.53445/batd.945893
Mete O, Özkan Yıldız B, Balaban M, et al. Kronik boyun ağrılı bireylerde manuel terapinin servikal kas sertliği üzerine etkisinin incelenmesi: pilot çalışma. Journal of Physical Medicine & Rehabilitation Sciences. 2021;24(1). doi: 10.31609/jpmrs.2020-78176
Bialosky JE, Bishop MD, Price DD, et al. The mechanisms of manual therapy in the treatment of musculoskeletal pain: A comprehensive model. Manual Therapy. 2009; 14(5): 531-538. doi: 10.1016/j.math.2008.09.001
Groeneweg R, van Assen L, Kropman H, et al. Manual therapy compared with physical therapy in patients with non-specific neck pain: A randomized controlled trial. Chiropr Man Therap. 2017;25(1):1-12. doi: 10.1186/s12998-017-0141-3
Revolve Physical Therapy. 5 benefits of manual therapy for pain relief and improved mobility. Available from: https://revolvephysicaltherapy.com/5-benefits-of-manual-therapy-for-pain-relief-and-improved-mobility/?utm_source=chatgpt.com (Accessed 11th May 2025).
Vining R, Minkalis A, Long CR, et al. Assessment of chiropractic care on strength, balance, and endurance in active-duty U.S. military personnel with low back pain: A protocol for a randomized controlled trial. Trials. 2018;19(1):671. doi:10.1186/s13063-018-3041-5
Colombi A, Testa M. The effects induced by spinal manipulative therapy on the immune and endocrine systems. Medicina (Kaunas). 2019;55(8):448. doi:10.3390/medicina55080448
Bonanno M, Papa GA, Calabrò RS. The neurophysiological impact of touch-based therapy: Insights and clinical benefits. J Integr Neurosci. 2024;23(12):214. doi:10.31083/j.jin2312214
Resilience Physiotherapy. What is the role of manual physiotherapy in post-operative care? Available from: https://www.resiliencephysiotherapy.com/blog/what-is-the-role-of-manual-physiotherapy-in-post-operative-care/ (Accessed 14th January 2025).
Flynn S., Lucas B. The team approach and nursing roles in orthopaedic and musculoskeletal trauma care 2016. Available from: https://clinicalgate.com/the-team-approach-and-nursing-roles-in-orthopaedic-and-musculoskeletal-trauma-care/ (Accessed 14th January 2025).
Bizzarri P, Foglia A. Manual therapy: Art or science. In Bernardo-Filho M, Sá-Caputo D, Taiar R Furlong MJ (eds.) Physical therapy effectiveness. London: IntechOpen; 2020. p.275-300. doi: 10.5772/intechopen.90730
Sağlık Bakanlığı Tepecik Eğitim ve Araştırma Hastanesi, Cerrahi Gerektiren Hastalıklar Hemşirelik Bakım Rehberi 2011. 6 Şubat 2025 tarihinde https://www.researchgate.net/publication/278244006 adresinden ulaşılmıştır.
Referanslar
Nazlıkul H, Nazlıkul FGU, Okur SÇ, et al. Lokomotor sistem hastalıklarında kayropraktik yaklaşımlar. Bilimsel Tamamlayıcı Tıp Regülasyon ve Nöral Terapi Dergisi. 2020;14(2):47-52.
Çiftci MM, Çiftci N. Bir manuel tedavi yöntemi: Osteopati. Anadolu Tıbbı Dergisi. 2023;2(1):10-14. doi:10.5505/anadolutd.2023.57966
Bergman TF, Peterson DH. Principles of adjustive technique. In: Bergman TF, Peterson DH (eds.) Chiropractic technique. 4th ed. St. Louis, MO: Mosby Elsevier; 2011. p.85.
Özkan G. Kronik boyun ağrılı kadınlarda aletli klinik pilates egzersizlerinin ve manuel terapi uygulamalarının etkinliğinin karşılaştırılması: Randomize kontrollü tek kör çalışma. 2024. [Yayınlanmamış Yüksek Lisans Tezi]. 2024. Pamukkale Üniversitesi.
Marcon AR, Murdoch B, Caulfield T. The "subluxation" issue: An analysis of chiropractic clinic websites. Arch Physiother. 2019; 9:11. doi:10.1186/s40945-019-0064-5
Akalın B, İrban A, Özargun G. Türkiye’de geleneksel ve tamamlayıcı tıp uygulamalarının mevcut standartları ve iyileştirme önerileri. Sağlık Profesyonelleri Araştırma Dergisi. 2023;5(1):49-69.
Hofstetter L, Fontana M, Tomlinson GA, et al. A Bayesian analysis integrating expert beliefs to better understand how new evidence ought to update what we believe: A use case of chiropractic care and acute lumbar disc herniation with early surgery. BMC Med Res Methodol. 2024;24(1):281. doi:10.1186/s12874-024-02359-3
Upledger JE, Vredevoogd JD. Craniosacral therapy. Vol. 236. Seattle: Eastland Press; 1983. p.1-5.
Green C, Martin CW, Bassett K, et al. A systematic review of craniosacral therapy: Biological plausibility, assessment reliability and clinical effectiveness. Complement Ther Med. 1999;7(4):201-207. doi:10.1016/s0965-2299(99)80002-8
Matarán-Peñarrocha GA, Castro-Sánchez AM, García GC, et al. Influence of craniosacral therapy on anxiety, depression and quality of life in patients with fibromyalgia. Evid Based Complement Alternat Med. 2011; 1:178769. Doi:10.1093/ecam/nep125
Castejón-Castejón M, Murcia-González MA, Martínez Gil JL, et al. Effectiveness of craniosacral therapy in the treatment of infantile colic: A randomized controlled trial. Complement Ther Med. 2019; 47:102164. doi: 10.1016/j.ctim.2019.07.023
Lee FH, Raja SN. Complementary and alternative medicine in chronic pain. Pain. 2011;152(1):28-30. doi: 10.1016/j.pain.2010.09.023
Sposato NS, Bjerså K. Osteopathic manipulative treatment in surgical care: Short review of research publications in osteopathic journals during the period 1990 to 2017. J Evid Based Integr Med. 2018; 23:2515690X18767671. doi:10.1177/2515690X18767671
Baer HA. Osteopathy in Australasia: From marginality to a fully professionalised system of health care. Int J Osteopath Med. 2009; 12:25-31. doi: 10.1016/j.ijosm.2008.05.002
Henwood L, Le Donne ME, Vaughn A, et al. The effects of osteopathic manipulative treatment (OMT) on postoperative length of stay: A meta-analysis. Cureus. 2024;16(5): e59983. doi:10.7759/cureus.59983
Von Heymann W, Locher H. Manüel tıp ve ortopedi. Bilimsel Tamamlayıcı Tıp Regülasyon ve Nöral Terapi Dergisi. 2015;9(1):10-15.
Talhaoğlu D. Geleneksel ve tamamlayıcı tedavi uygulamaları. Bütünleyici ve Anadolu Tıbbı Dergisi. 2021;3(1):16-29. doi: 10.53445/batd.945893
Mete O, Özkan Yıldız B, Balaban M, et al. Kronik boyun ağrılı bireylerde manuel terapinin servikal kas sertliği üzerine etkisinin incelenmesi: pilot çalışma. Journal of Physical Medicine & Rehabilitation Sciences. 2021;24(1). doi: 10.31609/jpmrs.2020-78176
Bialosky JE, Bishop MD, Price DD, et al. The mechanisms of manual therapy in the treatment of musculoskeletal pain: A comprehensive model. Manual Therapy. 2009; 14(5): 531-538. doi: 10.1016/j.math.2008.09.001
Groeneweg R, van Assen L, Kropman H, et al. Manual therapy compared with physical therapy in patients with non-specific neck pain: A randomized controlled trial. Chiropr Man Therap. 2017;25(1):1-12. doi: 10.1186/s12998-017-0141-3
Revolve Physical Therapy. 5 benefits of manual therapy for pain relief and improved mobility. Available from: https://revolvephysicaltherapy.com/5-benefits-of-manual-therapy-for-pain-relief-and-improved-mobility/?utm_source=chatgpt.com (Accessed 11th May 2025).
Vining R, Minkalis A, Long CR, et al. Assessment of chiropractic care on strength, balance, and endurance in active-duty U.S. military personnel with low back pain: A protocol for a randomized controlled trial. Trials. 2018;19(1):671. doi:10.1186/s13063-018-3041-5
Colombi A, Testa M. The effects induced by spinal manipulative therapy on the immune and endocrine systems. Medicina (Kaunas). 2019;55(8):448. doi:10.3390/medicina55080448
Bonanno M, Papa GA, Calabrò RS. The neurophysiological impact of touch-based therapy: Insights and clinical benefits. J Integr Neurosci. 2024;23(12):214. doi:10.31083/j.jin2312214
Resilience Physiotherapy. What is the role of manual physiotherapy in post-operative care? Available from: https://www.resiliencephysiotherapy.com/blog/what-is-the-role-of-manual-physiotherapy-in-post-operative-care/ (Accessed 14th January 2025).
Flynn S., Lucas B. The team approach and nursing roles in orthopaedic and musculoskeletal trauma care 2016. Available from: https://clinicalgate.com/the-team-approach-and-nursing-roles-in-orthopaedic-and-musculoskeletal-trauma-care/ (Accessed 14th January 2025).
Bizzarri P, Foglia A. Manual therapy: Art or science. In Bernardo-Filho M, Sá-Caputo D, Taiar R Furlong MJ (eds.) Physical therapy effectiveness. London: IntechOpen; 2020. p.275-300. doi: 10.5772/intechopen.90730
Sağlık Bakanlığı Tepecik Eğitim ve Araştırma Hastanesi, Cerrahi Gerektiren Hastalıklar Hemşirelik Bakım Rehberi 2011. 6 Şubat 2025 tarihinde https://www.researchgate.net/publication/278244006 adresinden ulaşılmıştır.
