Egzersizin Yaşlı Yetişkinlerde Omuz ve Sırt Kas Ağrıları Üzerine Etkileri
Özet
Yaşlanma ve güçsüzlüğün, kronik ağrı gelişme olasılığını artırdığı, yaşlı yetişkinlerde boyun, omuz ve üst sırt bölgesi kas ağrılarının kendini iyi hissetme halini olumsuz etkilediği rapor edilmiştir. Omuz ekleminin geniş hareket açıklığını sağlayan ve eklem stabilitesini koruyan en kritik yapı, dört derin kastan olusan rotator manşet grubudur. Yaşlı yetişkinlerde bu kas gruplarındaki kuvvet kaybı ve esneklik azalması; omurga eğriliklerinin artmasına, skapular diskinestiye ve nihayetinde kronik omuz-sırt ağrılarına zemin hazırlar. Sırt kasları, gövdenin arka tarafında yer alan ve yüzeyel ile derin olmak üzere iki katmanda gruplanan önemli kas gruplarını içerir. Yüzeyel sırt kasları geniş ve yassı olup, çoğunlukla aksiyel iskelet oluşumlarından başlayarak scapula, clavicula, humerus ve kaburgalara tutunurlar. Derin sırt kasları ise miyotomların dorsal bölümlerinden köken alır ve otokton sırt kasları olarak adlandırılır. Bu kaslar, omurga ekstansiyonu, rotasyonu ve laterofleksiyonu gibi çeşitli hareketlerine katkıda bulunur ve omurganın dik durmasını sağlar. Bu bağlamda, işlevsellik döngüsünü kırmak için, fonksiyonel onarım veya en azından fonksiyonel gerilemenin azaltılmasının önemli olduğu, egzersizin ve rehabilitasyonun ağrıyla başa çıkmakta zorlanan yaşlı kişilerde sınırlamayı ve katılım kısıtlamasını azaltmada önemli bir işleve sahip oldukları görülmektedir. Bununla birlikte, yaşlı bireylerde egzersiz planlaması dikkatli ve bireyselleştirilmiş biçimde yapılmalıdır. Kas-iskelet sorunları, düzenli takip, metabolik güvenlik ve merkezi sinir sistemi işleyişi dikkate alınarak yönetilmelidir.
It has been reported that aging and frailty increase the likelihood of developing chronic pain, and that muscle pain in the neck, shoulder, and upper back regions negatively affects well-being in older adults. The most critical structure that provides a wide range of motion for the shoulder joint and maintains joint stability is the rotator cuff group, which consists of four deep muscles. In older adults, loss of strength and decreased flexibility in these muscle groups pave the way for increased spinal curvature, scapular dyskinesia, and ultimately chronic shoulder and back pain. The back muscles include important muscle groups located on the posterior side of the trunk and grouped into two layers: superficial and deep. The superficial back muscles are broad and flat, attaching primarily to the axial skeleton—specifically the scapula, clavicle, humerus, and ribs. The deep back muscles, on the other hand, originate from the dorsal portions of the myotomes and are referred to as autochthonous back muscles. These muscles contribute to various movements of the spine, such as extension, rotation, and lateral flexion, and help maintain the spine’s upright posture. In this context, it is evident that exercise and rehabilitation play a significant role in reducing limitations and participation restrictions in older adults who struggle with pain, as breaking the cycle of dysfunction requires functional restoration or, at the very least, a reduction in functional decline. However, exercise planning for older adults must be carried out carefully and in a personalized manner. Musculoskeletal issues must be managed with due consideration for regular follow-up, metabolic safety, and central nervous system function.
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