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MULTİPLE SKLEROZLU HASTALARDA AĞRI, DÜŞME VE YAŞAM KALİTESİNİN DEĞERLENDİRİLMESİ

Year 2018, Volume: 51 Issue: 3, 186 - 192, 26.12.2018

Abstract

Amaç



Çalışmamızda
Multiple Skleroz (MS)’lu hastalarda ağrılı bölgeler, ağrı tipleri, düşme
öyküsü, manyetik rezonans görüntüleme (MRG)’de tutulan santral sinir sistemi
(SSS) bölgeleri ve başlangıç semptomları ile bunların yaşam kalitesiyle olan
ilişkilerini değerlendirmeyi amaçladık.



Gereç ve Yöntemler



Çalışmaya 14 erkek ve 26 kadından oluşan
40 MS’li hasta dahil edildi. Yaş, medeni durum, eğitim durumu, meslek, vücut
kitle indexi (VKİ), başlangıç semptomu, tanı yaşı, hastalık süresi, hastalık
tipi, son bir yıldaki atak sayısı, en son i.v pulse steroid tedavisinden sonra
geçen süre, MS’ye yönelik ilaçlar, düşme öyküsü, ek hastalıklar, sigara ve alkol
kullanımı sorgulandı. Ağrı şiddeti Vizüel Analog Skala (VAS), ağrı tipleri ve
ağrılı bölgeler Hasta Ağrı Çizimi Ölçeği (HAÇ), yaşam kalitesi Multiple Skleroz
Yaşam Kalitesi Ölçeği-54 (MSYKÖ-54) değerlendirmesinin total, fiziksel, mental,
ağrı ile enerji skorları ve dizabilite Kurtzke’nin Genişletilmiş Dizabilite
Durum Skalası (GDDS) ile değerlendirildi.



 



Bulgular



Yaş
ortalaması 39,60 ±10,63,
GDSS skoru ortalaması 3,28±1,65 olan hastaların %52,5'inde düşme öyküsü
mevcuttu. MS hastalarının %47,5'inde hiç düşme öyküsü yokken, %10'ununda bir
kere düşme ve %42,5'inde iki ya da daha fazla düşme öyküsü vardı. Hastaların
%15'i yardımcı cihaz ve/veya ortez kullanıyordu. MS hastalarında en sık görülen
başlangıç semptomları sırasıyla; görsel (%57,5), duyusal (%35), motor
semptomlar (%30) ve denge bozukluğuydu (%10). Hastalarda MRG’de en sık tutulan
bölgeler sırasıyla; serebrum (%85), servikal spinal kord (%55), torakal spinal
kord (%42,5), beyin sapı (%20) ve serebellumdu (%17,5).
Alt ekstremite (%52,5), üst ekstremite (%27,5), bel (%15), sırt (%15),
boyun (%10) ve baş (%2,5) hastalarımızda en sık görülen ağrılı bölgelerdi.
Acıma (%47,5), batma (%27,5), iğnelenme (%15) ve yanma (%7,5) MS’li hastalarda
en sık görülen ağrı tipleriydi. MSQoL-54 total skoru meslek, eğitim durumu,
atak sayısı, VAS, düşme öyküsü, alt ekstremite ağrısı ve hastalık tipiyle
ilişkili bulundu.



 



Sonuç



MS’li
hastalarda en sık görülen semptomlar akılda tutulmalı ve bu semptomların bir ya
da bir kaçını bulunduran hastalar MS açısından gözden geçirilmeli ve ilgili
bölüme yönlendirilmelidir. MS’li hastaların üçte ikisinde görülen ağrı, MS’ye
spesifik semptomlar, atak sayısı, kas güçsüzlüğü, denge bozukluğu, eğitim
seviyesi düzeltilerek, düşme riski taşıyan hastalar önceden tespit edilerek ve
yorgunluk seviyesini azaltmayla ilgili önlemler alınarak hastaların yaşam
kalitesi arttırılabilir.

References

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  • 2. TUNALI G. Multipl Skleroz'da Tanı Kriterleri. Turkiye Klinikleri Journal of Neurology 2004; 2: 205-9.
  • 3. Trapp BD, Peterson J, Ransohoff RM, Rudick R, Mörk S, Bö L. Axonal transection in the lesions of multiple sclerosis. New England Journal of Medicine 1998; 338: 278-85.
  • 4. Hoang PD, Cameron MH, Gandevia SC, Lord SR. Neuropsychological, balance, and mobility risk factors for falls in people with multiple sclerosis: a prospective cohort study. Archives of physical medicine and rehabilitation 2014; 95: 480-6.
  • 5. Sosnoff JJ, Gappmaier E, Frame A, Motl RW. Influence of spasticity on mobility and balance in persons with multiple sclerosis. Journal of Neurologic Physical Therapy 2011; 35: 129-32.
  • 6. Svendsen KB, Jensen TS, Overvad K, Hansen HJ, Koch-Henriksen N, Bach FW. Pain in patients with multiple sclerosis: a population-based study. Archives of Neurology 2003; 60: 1089-94.
  • 7. O’Connor AB, Schwid SR, Herrmann DN, Markman JD, Dworkin RH. Pain associated with multiple sclerosis: systematic review and proposed classification. PAIN® 2008; 137: 96-111.
  • 8. Benito-León J, Martínez-Martín P, Frades B, Martínez-Ginés M, De Andrés C, Meca-Lallana J, et al. Impact of fatigue in multiple sclerosis: the Fatigue Impact Scale for Daily Use (D-FIS). Multiple Sclerosis Journal 2007; 13: 645-51.
  • 9. Sehanovic A, Dostovic Z, Smajlovic D, Avdibegovic E. Quality of life in patients suffering from Parkinson's disease and multiple sclerosis. Medical Archives 2011; 65: 291.
  • 10. Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology 1983; 33: 1444-.
  • 11. Idiman E, Uzunel F, Ozakbas S, Yozbatiran N, Oguz M, Callioglu B, et al. Cross-cultural adaptation and validation of multiple sclerosis quality of life questionnaire (MSQOL-54) in a Turkish multiple sclerosis sample. Journal of the neurological sciences 2006; 240: 77-80.
  • 12. Carlsson AM. Assessment of chronic pain. I. Aspects of the reliability and validity of the visual analogue scale. Pain 1983; 16: 87-101.
  • 13. Margolis RB, Chibnall JT, Tait RC. Test-retest reliability of the pain drawing instrument. Pain 1988; 33: 49-51.
  • 14. Cavenaghi VB, Dobrianskyj FM, Olival GSd, Carneiro RPCD, Tilbery CP. Characterization of the first symptoms of multiple sclerosis in a Brazilian center: cross-sectional study. Sao Paulo Medical Journal 2017; 135: 222-5.
  • 15. Barkhof F, Filippi M, Miller DH, Scheltens P, Campi A, Polman CH, et al. Comparison of MRI criteria at first presentation to predict conversion to clinically definite multiple sclerosis. Brain: a journal of neurology 1997; 120: 2059-69.
  • 16. Nijeholt G, Van Walderveen M, Castelijns J, Van Waesberghe J, Polman C, Scheltens P, et al. Brain and spinal cord abnormalities in multiple sclerosis. Correlation between MRI parameters, clinical subtypes and symptoms. Brain: a journal of neurology 1998; 121: 687-97.
  • 17. Seixas D, Sá MJ, Galhardo V, Guimarães J, Lima D. Pain in Portuguese patients with multiple sclerosis. Frontiers in neurology 2011; 2: 20.
  • 18. Svendsen KB, Jensen TS, Hansen HJ, Bach FW. Sensory function and quality of life in patients with multiple sclerosis and pain. Pain 2005; 114: 473-81.
  • 19. GHAJARZADEH M, JALILIAN R, SAHRAIAN MA, MOGHADASI AN, AZIMI A, MOHAMMADIFAR M, et al. Pain in Patients with Multiple Sclerosis. Maedica 2018; 13: 125.
  • 20. Güven ŞŞ, Özcan DS, Aras M, Köseoğlu BF, Ak F. Multipl sklerozlu hastalarda ağrının değerlendirilmesi ve yaşam kalitesi, yorgunluk ve depresyon ile ilişkisi. Turkish Journal of Physical Medicine & Rehabilitation/Turkiye Fiziksel Tip ve Rehabilitasyon Dergisi 2016; 62.
  • 21. Fisk JD, Pontefract A, Ritvo PG, Archibald CJ, Murray T. The impact of fatigue on patients with multiple sclerosis. Canadian Journal of Neurological Sciences 1994; 21: 9-14.
  • 22. Tabrizi FM, Radfar M. Fatigue, sleep quality, and disability in relation to quality of life in multiple sclerosis. International journal of MS care 2015; 17: 268-74.
  • 23. Nilsagård Y, Lundholm C, Denison E, Gunnarsson L-G. Predicting accidental falls in people with multiple sclerosis—a longitudinal study. Clinical rehabilitation 2009; 23: 259-69.
  • 24. Cattaneo D, De Nuzzo C, Fascia T, Macalli M, Pisoni I, Cardini R. Risks of falls in subjects with multiple sclerosis. Archives of physical medicine and rehabilitation 2002; 83: 864-7.
  • 25. Matsuda PN, Shumway-Cook A, Bamer AM, Johnson SL, Amtmann D, Kraft GH. Falls in multiple sclerosis. PM&R 2011; 3: 624-32.
  • 26. Finlayson ML, Peterson EW, Cho CC. Risk factors for falling among people aged 45 to 90 years with multiple sclerosis. Archives of physical medicine and rehabilitation 2006; 87: 1274-9.
Year 2018, Volume: 51 Issue: 3, 186 - 192, 26.12.2018

Abstract

References

  • 1. Goodin DS. The epidemiology of multiple sclerosis: insights to disease pathogenesis. In: Handbook of clinical neurology. Elsevier; 2014. p.231-66.
  • 2. TUNALI G. Multipl Skleroz'da Tanı Kriterleri. Turkiye Klinikleri Journal of Neurology 2004; 2: 205-9.
  • 3. Trapp BD, Peterson J, Ransohoff RM, Rudick R, Mörk S, Bö L. Axonal transection in the lesions of multiple sclerosis. New England Journal of Medicine 1998; 338: 278-85.
  • 4. Hoang PD, Cameron MH, Gandevia SC, Lord SR. Neuropsychological, balance, and mobility risk factors for falls in people with multiple sclerosis: a prospective cohort study. Archives of physical medicine and rehabilitation 2014; 95: 480-6.
  • 5. Sosnoff JJ, Gappmaier E, Frame A, Motl RW. Influence of spasticity on mobility and balance in persons with multiple sclerosis. Journal of Neurologic Physical Therapy 2011; 35: 129-32.
  • 6. Svendsen KB, Jensen TS, Overvad K, Hansen HJ, Koch-Henriksen N, Bach FW. Pain in patients with multiple sclerosis: a population-based study. Archives of Neurology 2003; 60: 1089-94.
  • 7. O’Connor AB, Schwid SR, Herrmann DN, Markman JD, Dworkin RH. Pain associated with multiple sclerosis: systematic review and proposed classification. PAIN® 2008; 137: 96-111.
  • 8. Benito-León J, Martínez-Martín P, Frades B, Martínez-Ginés M, De Andrés C, Meca-Lallana J, et al. Impact of fatigue in multiple sclerosis: the Fatigue Impact Scale for Daily Use (D-FIS). Multiple Sclerosis Journal 2007; 13: 645-51.
  • 9. Sehanovic A, Dostovic Z, Smajlovic D, Avdibegovic E. Quality of life in patients suffering from Parkinson's disease and multiple sclerosis. Medical Archives 2011; 65: 291.
  • 10. Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology 1983; 33: 1444-.
  • 11. Idiman E, Uzunel F, Ozakbas S, Yozbatiran N, Oguz M, Callioglu B, et al. Cross-cultural adaptation and validation of multiple sclerosis quality of life questionnaire (MSQOL-54) in a Turkish multiple sclerosis sample. Journal of the neurological sciences 2006; 240: 77-80.
  • 12. Carlsson AM. Assessment of chronic pain. I. Aspects of the reliability and validity of the visual analogue scale. Pain 1983; 16: 87-101.
  • 13. Margolis RB, Chibnall JT, Tait RC. Test-retest reliability of the pain drawing instrument. Pain 1988; 33: 49-51.
  • 14. Cavenaghi VB, Dobrianskyj FM, Olival GSd, Carneiro RPCD, Tilbery CP. Characterization of the first symptoms of multiple sclerosis in a Brazilian center: cross-sectional study. Sao Paulo Medical Journal 2017; 135: 222-5.
  • 15. Barkhof F, Filippi M, Miller DH, Scheltens P, Campi A, Polman CH, et al. Comparison of MRI criteria at first presentation to predict conversion to clinically definite multiple sclerosis. Brain: a journal of neurology 1997; 120: 2059-69.
  • 16. Nijeholt G, Van Walderveen M, Castelijns J, Van Waesberghe J, Polman C, Scheltens P, et al. Brain and spinal cord abnormalities in multiple sclerosis. Correlation between MRI parameters, clinical subtypes and symptoms. Brain: a journal of neurology 1998; 121: 687-97.
  • 17. Seixas D, Sá MJ, Galhardo V, Guimarães J, Lima D. Pain in Portuguese patients with multiple sclerosis. Frontiers in neurology 2011; 2: 20.
  • 18. Svendsen KB, Jensen TS, Hansen HJ, Bach FW. Sensory function and quality of life in patients with multiple sclerosis and pain. Pain 2005; 114: 473-81.
  • 19. GHAJARZADEH M, JALILIAN R, SAHRAIAN MA, MOGHADASI AN, AZIMI A, MOHAMMADIFAR M, et al. Pain in Patients with Multiple Sclerosis. Maedica 2018; 13: 125.
  • 20. Güven ŞŞ, Özcan DS, Aras M, Köseoğlu BF, Ak F. Multipl sklerozlu hastalarda ağrının değerlendirilmesi ve yaşam kalitesi, yorgunluk ve depresyon ile ilişkisi. Turkish Journal of Physical Medicine & Rehabilitation/Turkiye Fiziksel Tip ve Rehabilitasyon Dergisi 2016; 62.
  • 21. Fisk JD, Pontefract A, Ritvo PG, Archibald CJ, Murray T. The impact of fatigue on patients with multiple sclerosis. Canadian Journal of Neurological Sciences 1994; 21: 9-14.
  • 22. Tabrizi FM, Radfar M. Fatigue, sleep quality, and disability in relation to quality of life in multiple sclerosis. International journal of MS care 2015; 17: 268-74.
  • 23. Nilsagård Y, Lundholm C, Denison E, Gunnarsson L-G. Predicting accidental falls in people with multiple sclerosis—a longitudinal study. Clinical rehabilitation 2009; 23: 259-69.
  • 24. Cattaneo D, De Nuzzo C, Fascia T, Macalli M, Pisoni I, Cardini R. Risks of falls in subjects with multiple sclerosis. Archives of physical medicine and rehabilitation 2002; 83: 864-7.
  • 25. Matsuda PN, Shumway-Cook A, Bamer AM, Johnson SL, Amtmann D, Kraft GH. Falls in multiple sclerosis. PM&R 2011; 3: 624-32.
  • 26. Finlayson ML, Peterson EW, Cho CC. Risk factors for falling among people aged 45 to 90 years with multiple sclerosis. Archives of physical medicine and rehabilitation 2006; 87: 1274-9.
There are 26 citations in total.

Details

Primary Language Turkish
Journal Section Original research article
Authors

Melek Aykut Selçuk 0000-0002-9456-9155

Sühan Taşkın This is me

Mehmet Onat Çakıt This is me

Burcu Duyur Çakıt

Hakan Genç

Alper Gümüştepe This is me

Gökhan Yardımcı This is me

Publication Date December 26, 2018
Submission Date September 18, 2018
Published in Issue Year 2018 Volume: 51 Issue: 3

Cite

AMA Aykut Selçuk M, Taşkın S, Çakıt MO, Duyur Çakıt B, Genç H, Gümüştepe A, Yardımcı G. MULTİPLE SKLEROZLU HASTALARDA AĞRI, DÜŞME VE YAŞAM KALİTESİNİN DEĞERLENDİRİLMESİ. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. December 2018;51(3):186-192.