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VESTİBÜLER BOZUKLUĞU OLAN HASTALARDA KALÇA STRATEJİSİ KULLANIMI: RETROSPEKTİF BİR ÇALIŞMA

Yıl 2023, Cilt: 9 Sayı: 1, 43 - 54, 30.04.2023

Öz

Duruş ve hareket için kullanılan üç ana postüral strateji ayak bileği, kalça ve adımlama stratejileridir. Ağırlık merkezi izdüşümü sınırları içindeyken ayak bileği ile denge sağlanırken ağırlık merkezi bu sınırların dışına çıktığında kalça stratejisi kullanılır.. Bu çalışmanın amacı, vestibüler sistem bozukluğu olan hastaların postürlerini ayarlarken hangi stratejiyi kullandıkları ve düştüklerinde hangi stratejiyi kullanamadıkları araştırmaktır. 2014-2021 yılları arasında vestibüler disfonksiyonu olan 40 kişi ve sağlık 40 kişi çalışmaya alınmıştır. Katılımcılar bilgisayarlı dinamik postürografi test ile değerlendirildi. Katılımcıların duyusal organizasyon testi (SOT) puanları için değerlendirildi. Ayak bileği stratejisi, SOT 5. ve 6. durumlarında vestibüler disfonksiyonlu hastalara göre anlamlı şekilde daha bir iyi çıktı (p<0.05). Hastaların düştükleri ve düşmedikleri durumlardaki strateji skorlarında da anlamlı fark gözlendi (p<0.05). 5. koşuldaki puanların düşme ve düşmeme karşılaştırılmasında anlamlı olarak bir fark gözlenirken, 6. koşulda önemli bir fark gözlenmedi. Kullanım için zorlu kullanımların yollarına yol vestibüler kullanılarak atılır. Vestibüler hipofonksiyonlu hastalarda düşmeyi azalmak için vestibüler rehabilitasyon planlanırken kalça stratejisi egzersizlerine önem verilmelidir.

Kaynakça

  • 1. Horak F, Shupert CL. Role of the vestibular system in postural control. In: Herdman SJ, ed. Vestibular Rehabilitation. Davis; 1994:22-46.
  • 2. Appiah-Kubi KO, Wright WG. Vestibular training promotes adaptation of multisensory integration in postural control. Gait Posture. Published online 2019.
  • 3. Cooksey FS. Rehabilitation in Vestibular Injuries. J R Soc Med. 1946;39(5):273-278. doi:10.1177/003591574603900523
  • 4. Alghwiri AA, Whitney SL. Balance and Falls in Older Adults. In: Dale A, Rita W, eds. Guccıone’s Gerıatrıc Physıcal Therapy. 4th ed. Mosby; 2020:220-239.
  • 5. Chander H, Garner JC, Wade C, et al. An analysis of postural control strategies in various types of footwear with varying workloads. Footwear Sci. 2021;13(2):181-189. doi:10.1080/19424280.2021.1899297/SUPPL_FILE/TFWS_A_1899297_SM4232.PDF
  • 6. Runge CF, Shupert CL, Horak FB, Zajac FE. Role of vestibular information in initiation of rapid postural responses. Exp Brain Res. 1998;122(4):403-412. doi:10.1007/s002210050528
  • 7. McCollum G, Horak FB, Nashner LM. Parsimony in Neural Calculations for Postural Movements. In: ; 1984:52-66. doi:10.1007/978-3-642-69980-1_4
  • 8. Tsang WWN, Hui-Chan CWY. Effects of Tai Chi on Joint Proprioception and Stability Limits in Elderly Subjects. Med Sci Sports Exerc. 2003;35(12):1962-1971. doi:10.1249/01.MSS.0000099110.17311.A2
  • 9. Black FO, Shupert CL, Horak FB, Nashner LM. Abnormal postural control associated with peripheral vestibular disorders. Prog Brain Res. 1988;76(C):263-275. doi:10.1016/S0079-6123(08)64513-6
  • 10. Horak FB, Shumway‐Cook A, Crowe TK, Black FO. Vestibular Function and Motor Proficiency of Children With Impaired Hearing, or With Learning Dısability and Motor Impairments. Dev Med Child Neurol. 1988;30(1):64-79. doi:10.1111/j.1469-8749.1988.tb04727.x
  • 11. Nashner LM, Black FO, Wall C. Adaptation to altered support and visual conditions during stance: patients with vestibular deficits. J Neurosci. 1982;2(5):536-544. doi:10.1523/jneurosci.02-05-00536.1982
  • 12. Aksoy S. Dengesi̇zli̇k şi̇kayeti̇ olan 65 yaş ve üzeri̇ yaşli bi̇reyleri̇n bi̇lgi̇sayarli di̇nami̇k postürografi̇ sonuçlari: Retrospekti̇f anali̇z. Turk Geriatr Derg. 2012;15(3):279-283.
  • 13. Rosengren KS, Rajendran K, Contakos J, et al. Changing control strategies during standard assessment using computerized dynamic posturography with older women. Gait Posture. 2007;25(2). doi:10.1016/j.gaitpost.2006.03.009
  • 14. Horak FB, Nashner LM. Central programming of postural movements: Adaptation to altered support-surface configurations. J Neurophysiol. 1986;55(6):1369-1381. doi:10.1152/jn.1986.55.6.1369
  • 15. Neurocom International Inc. Clinical Interpretetion Guide Computerized Dynamic Posturography. Published online 2008.
  • 16. Nashner LM. Adapting reflexes controlling the human posture. Exp brain Res. 1976;26(1):59-72. doi:10.1007/BF00235249
  • 17. Nashner LM, Woollacott M, Tuma G. Organization of rapid responses to postural and locomotor-like perturbations of standing man. Exp brain Res. 1979;36(3):463-476. doi:10.1007/BF00238516
  • 18. Diener HC, Horak FB, Nashner LM. Influence of stimulus parameters on human postural responses. J Neurophysiol. 1988;59(6):1888-1905. doi:10.1152/JN.1988.59.6.1888
  • 19. Horak FB, Nashner LM, Diener HC. Postural strategies associated with somatosensory and vestibular loss. Exp Brain Res. 1990;82(1):167-177. doi:10.1007/BF00230848
  • 20. Błażkiewicz M, Wiszomirska I, Kaczmarczyk K, Wit A. Types of falls and strategies for maintaining stability on an unstable surface. Med Pr. 2018;69(3):245-252. doi:10.13075/mp.5893.00639
  • 21. Nashner LM, Shupert CL, Horak FB, Black FO. Organization of posture controls: an analysis of sensory and mechanical constraints. Prog Brain Res. 1989;80(C):411-418. doi:10.1016/S0079-6123(08)62237-2
  • 22. Keshner EA, Galgon AK. Postural Abnormalities in Vestibular Disorders. In: Herdman SJ, Clendaniel RA, eds. Vestibular Rehabilitation. Fourth. F. A. Davis Company; 2015:85-109.
  • 23. Hain TC, Helminski JO. Anatomy and Physiology of the Normal Vestibular System. In: Susan J. Herdman, ed. Vestibular Rehabilitation. 3rd ed. F. A. Davis Company; 2007:2-18.
  • 24. Mitsutake T, Taniguchi T, Nakazono H, Yoshizuka H, Sakamoto M. Effects of Noisy Galvanic Vestibular Stimulation on the Muscle Activity and Joint Movements in Different Standing Postures Conditions. Front Hum Neurosci. 2022;16. doi:10.3389/FNHUM.2022.891669
  • 25. Mitsutake T, Sakamoto M, Horikawa E. Comparing activated brain regions between noisy and conventional galvanic vestibular stimulation using functional magnetic resonance imaging. Neuroreport. 2021;32(7):583-587. doi:10.1097/WNR.0000000000001629

USE OF HIP STRATEGY IN PATIENTS WITH VESTIBULAR DISORDER: A RETROSPECTIVE STUDY

Yıl 2023, Cilt: 9 Sayı: 1, 43 - 54, 30.04.2023

Öz

The three main postural strategies used to adjust posture and movement are ankle, hip and stepping strategies. While normal individuals use ankle strategy when center of gravity (COG) is within the limits of stability, they transition to hip strategy when COG approaches or exceeds the limits of stability. The aim of this study is to investigate which strategy is dominantly used by people with vestibular disorders whilst adjusting their posture and which strategy is used when they fall. Twenty patients with diagnosed vestibular dysfunction and nineteen healthy individuals evaluated between the years 2014-2019 were included in the study. The participants were assessed for balance with the computer dynamic posturography. Participants` sensory organization test (SOT) scores were collected for evaluation. The collected data were analyzed for normal distribution via One-Sample Kolmogorov-Smirnov test, while Mann Whitney U was used to determine significant difference. Use of ankle strategy was superior in normal individuals in comparison to individuals with vestibular disorders using SOT 5th and 6th conditions (p<0.05). Significant difference was observed between the strategies used by the participants in situations where they did and did not fall (p<0.05). While a statistically significant difference was observed in the comparison of falls within 5th condition, a significant difference was not observed in 6th condition. Due to the impairment of the vestibular system leading to the usage of the ankle strategy in challenging conditions, patients with vestibular defects fall more frequently. During the planning of vestibular rehabilitation for such patients, improving the hip strategy should be considered essential.

Kaynakça

  • 1. Horak F, Shupert CL. Role of the vestibular system in postural control. In: Herdman SJ, ed. Vestibular Rehabilitation. Davis; 1994:22-46.
  • 2. Appiah-Kubi KO, Wright WG. Vestibular training promotes adaptation of multisensory integration in postural control. Gait Posture. Published online 2019.
  • 3. Cooksey FS. Rehabilitation in Vestibular Injuries. J R Soc Med. 1946;39(5):273-278. doi:10.1177/003591574603900523
  • 4. Alghwiri AA, Whitney SL. Balance and Falls in Older Adults. In: Dale A, Rita W, eds. Guccıone’s Gerıatrıc Physıcal Therapy. 4th ed. Mosby; 2020:220-239.
  • 5. Chander H, Garner JC, Wade C, et al. An analysis of postural control strategies in various types of footwear with varying workloads. Footwear Sci. 2021;13(2):181-189. doi:10.1080/19424280.2021.1899297/SUPPL_FILE/TFWS_A_1899297_SM4232.PDF
  • 6. Runge CF, Shupert CL, Horak FB, Zajac FE. Role of vestibular information in initiation of rapid postural responses. Exp Brain Res. 1998;122(4):403-412. doi:10.1007/s002210050528
  • 7. McCollum G, Horak FB, Nashner LM. Parsimony in Neural Calculations for Postural Movements. In: ; 1984:52-66. doi:10.1007/978-3-642-69980-1_4
  • 8. Tsang WWN, Hui-Chan CWY. Effects of Tai Chi on Joint Proprioception and Stability Limits in Elderly Subjects. Med Sci Sports Exerc. 2003;35(12):1962-1971. doi:10.1249/01.MSS.0000099110.17311.A2
  • 9. Black FO, Shupert CL, Horak FB, Nashner LM. Abnormal postural control associated with peripheral vestibular disorders. Prog Brain Res. 1988;76(C):263-275. doi:10.1016/S0079-6123(08)64513-6
  • 10. Horak FB, Shumway‐Cook A, Crowe TK, Black FO. Vestibular Function and Motor Proficiency of Children With Impaired Hearing, or With Learning Dısability and Motor Impairments. Dev Med Child Neurol. 1988;30(1):64-79. doi:10.1111/j.1469-8749.1988.tb04727.x
  • 11. Nashner LM, Black FO, Wall C. Adaptation to altered support and visual conditions during stance: patients with vestibular deficits. J Neurosci. 1982;2(5):536-544. doi:10.1523/jneurosci.02-05-00536.1982
  • 12. Aksoy S. Dengesi̇zli̇k şi̇kayeti̇ olan 65 yaş ve üzeri̇ yaşli bi̇reyleri̇n bi̇lgi̇sayarli di̇nami̇k postürografi̇ sonuçlari: Retrospekti̇f anali̇z. Turk Geriatr Derg. 2012;15(3):279-283.
  • 13. Rosengren KS, Rajendran K, Contakos J, et al. Changing control strategies during standard assessment using computerized dynamic posturography with older women. Gait Posture. 2007;25(2). doi:10.1016/j.gaitpost.2006.03.009
  • 14. Horak FB, Nashner LM. Central programming of postural movements: Adaptation to altered support-surface configurations. J Neurophysiol. 1986;55(6):1369-1381. doi:10.1152/jn.1986.55.6.1369
  • 15. Neurocom International Inc. Clinical Interpretetion Guide Computerized Dynamic Posturography. Published online 2008.
  • 16. Nashner LM. Adapting reflexes controlling the human posture. Exp brain Res. 1976;26(1):59-72. doi:10.1007/BF00235249
  • 17. Nashner LM, Woollacott M, Tuma G. Organization of rapid responses to postural and locomotor-like perturbations of standing man. Exp brain Res. 1979;36(3):463-476. doi:10.1007/BF00238516
  • 18. Diener HC, Horak FB, Nashner LM. Influence of stimulus parameters on human postural responses. J Neurophysiol. 1988;59(6):1888-1905. doi:10.1152/JN.1988.59.6.1888
  • 19. Horak FB, Nashner LM, Diener HC. Postural strategies associated with somatosensory and vestibular loss. Exp Brain Res. 1990;82(1):167-177. doi:10.1007/BF00230848
  • 20. Błażkiewicz M, Wiszomirska I, Kaczmarczyk K, Wit A. Types of falls and strategies for maintaining stability on an unstable surface. Med Pr. 2018;69(3):245-252. doi:10.13075/mp.5893.00639
  • 21. Nashner LM, Shupert CL, Horak FB, Black FO. Organization of posture controls: an analysis of sensory and mechanical constraints. Prog Brain Res. 1989;80(C):411-418. doi:10.1016/S0079-6123(08)62237-2
  • 22. Keshner EA, Galgon AK. Postural Abnormalities in Vestibular Disorders. In: Herdman SJ, Clendaniel RA, eds. Vestibular Rehabilitation. Fourth. F. A. Davis Company; 2015:85-109.
  • 23. Hain TC, Helminski JO. Anatomy and Physiology of the Normal Vestibular System. In: Susan J. Herdman, ed. Vestibular Rehabilitation. 3rd ed. F. A. Davis Company; 2007:2-18.
  • 24. Mitsutake T, Taniguchi T, Nakazono H, Yoshizuka H, Sakamoto M. Effects of Noisy Galvanic Vestibular Stimulation on the Muscle Activity and Joint Movements in Different Standing Postures Conditions. Front Hum Neurosci. 2022;16. doi:10.3389/FNHUM.2022.891669
  • 25. Mitsutake T, Sakamoto M, Horikawa E. Comparing activated brain regions between noisy and conventional galvanic vestibular stimulation using functional magnetic resonance imaging. Neuroreport. 2021;32(7):583-587. doi:10.1097/WNR.0000000000001629
Toplam 25 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makalesi
Yazarlar

Oğuz Yılmaz 0000-0003-1884-0246

Kerem Ersin 0000-0002-9666-7867

Şeyma Tuğba Öztürk 0000-0002-3619-0139

Mustafa Bülent Şerbetçioğlu 0000-0002-5985-097X

Erken Görünüm Tarihi 30 Nisan 2023
Yayımlanma Tarihi 30 Nisan 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 9 Sayı: 1

Kaynak Göster

APA Yılmaz, O., Ersin, K., Öztürk, Ş. T., Şerbetçioğlu, M. B. (2023). USE OF HIP STRATEGY IN PATIENTS WITH VESTIBULAR DISORDER: A RETROSPECTIVE STUDY. International Anatolia Academic Online Journal Health Sciences, 9(1), 43-54.

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