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TRANSTİBİAL VE TRANSFEMORAL AMPUTELERİN DENGE VE DÜŞME DÜZEYLERİNİN KARŞILAŞTIRILMASI Comparison of Balance and Falling Levels of Transtibial and Transfemoral Amputees

Year 2019, Volume: 9 Issue: 1, 64 - 70, 26.03.2019

Abstract

ÖZET
Amaç: Yaşlılıkta denge ve koordinasyonun bozulmasına bağlı olarak düşmeler meydana gelir. Ampute yaşlılarda
denge ve koordinasyon daha fazla bozulur. Düşme ve düşme korkusu sağlıklı yaşlılara göre daha fazladır. Bu
çalışmadaki amacımız, Transtibial (TT) ve Transfemoral (TF) yaşlı amputasyonlularda denge, yürüme, düşme ve
depresyon-anksite durumlarını karşılaştırmaktır.
Gereç ve Yöntem: Çalışmaya, TT ve TF protez kullanan 60 yaş üzeri 52 hasta 26 TT (17 erkek, 9 kadın) ve 26 TF
(15 erkek, 11 kadın) yaşlı ampute alındı. Yaş ortalamaları 69±6,69 olan TT ve 67±6,12 olan TF ampute dahil
edildi. Tüm hastaların demografik özellikleri ve 1 yıl içinde düşme öyküsü, amputasyona adaptasyon, proteze
adaptasyon, düşme korkusunun varlığı, yardımcı cihaz kullanımı ve amputasyon rehabilitasyonu almaları gibi
klinik özellikler sorgulandı. Ayrıca her iki gruba Tinetti denge ve yürüme testi ile total BECK anksiyete-depresyon
anketi uygulandı. Hipotezler çift yönlü olup, p≤0.05 ise istatistiksel olarak anlamlı sonuç kabul edildi.
Bulgular: Demografik özelliklerde her grup açısından fark yoktu (p>0.05). Klinik özelliklerde düşme öyküsü,
düşme korkusunun varlığı, yardımcı cihaz kullanımı ve rehabilitasyon alma parametrelerinde TT amputeler
lehine istatistiksel olarak anlamlı sonuçlar bulundu (p<0.05). Tinetti denge ve yürüme parametrelerinde TT
amputeler lehine anlamlı sonuçlar bulundu (p<0.05). Ancak BECK depresyon-anksiyete skorların iki grup
arasında bir fark bulunmadı (p>0.05).
Sonuç: Çalışmamızın sonuçlarına göre TT amputelerin düşme riski orta, TF amputelerin düşme riskinin yüksek
derecede olduğu bulundu. Bunun nedeni TT amputelerde sağlam kalan ekstremite miktarı TF amputelere göre
daha fazla, diz ekleminin varlığı ve denge merkezinin yere daha yakın olması düşünülebilir.
Anahtar Kelimler: Denge; Düşme; Alt ekstremite ampütasyonları; Rehabilitasyon
ABSTRACT
Purpose: Falling occurs due to the impairment of balance and coordination in old age. Balance and coordination
further deteriorate in elderly amputee. Falling and fear of falling is more in the elderly amputee than the
healthy ones. Our aim of this study was to compare the balance, walking, falling and depression-anxiety status
in Transtibial (TT) and Transfemoral (TF) aged amputations.
Material and Methods: The study included 52 amputated patients 26 TT (17 males, 9 females) and 26 TF (15
males, 11 females) over 60 years of age. TT amputees with a mean age of 69 ± 6,69 and TF amputees with
a mean age of 67 ± 6,12 were included in the study. Clinical characteristics of all patients were questioned
such as demographic characteristics and falling narrative within 1 year, adaptation to amputation, prosthetic
adaptation, presence of fear of falling, use of assistive device and amputation rehabilitation. In addition, the
total BECK anxiety-depression questionnaire was applied with Tinetti balance and walking test in both groups.
Results: Hypotheses were bidirectional and p <0.05 was considered as statistically significant. There was no
difference in demographic characteristics of each group (p> 0.05).
Clinical features statistically significant results were found in favor of TT amputees in falling parameters,
presence of falling fear, use of assistive device and rehabilitation parameters (p <0.05). Significant results were
found in favor of TT amputers in Tinetti balance and walking parameters (p <0.05). However, BECK depressionanxiety
scores did not differ between the two groups (p> 0.05).
Discussion: According to the results of our study, TT amputees had a low risk of falling and TF amputees had
a high risk of falling. The reason for this is thought to be the amount of limb that remains in the TT amputees
is more than TF amputees, the presence of knee joint and being close of equilibrium center to the ground.
Keywords: Balance; falling; lower extremity amputations; rehabilitation

References

  • 1. Lord S, Ward J, Williams P, Anstey K. Physiological factors associated with falls in older community-dwelling women. J Am Geriatr Soc. 1994;42: 1110-7. 2. Aile ve Sosyal Politikalar Bakanlığı, 2013: 2. 3. Dajpratham P, Tantiniramai S, Lukkapichonchut P, Kaewnaree S. Factors Associated with Vocational Reintegration Among the Thai Lower Limb Amputees. Journal of the Medical Association of Thailand. 2008;91 (2): 234-39. 4. Deans SA, Mcfadyen AK, Rowe PJ. Physical Activity and quality of life: A study of a lower-limb amputee population. Prosthetics and Orthotics International. 2008; 32 (2): 186-200. 5. Raya MA, Gailey RS, Fiebert IM, Roach EM. Impairment variables predicting activity limitation in individuals with lower limb amputation. Prosthetics and Orthotics International. 2010; 34(1): 73–84. 6. Dillingham TR, Pezzin LE, MacKenzie EJ. Limb amputation and limb deficiency: Epidemiology and recent trends in the United States. South Med J. 2002;95(8):875–83. 7. Powell LE, Myers AM. The Activities-specific Confidence (ABC) Scale. J Gerontol A Biol Sci Med Sci. 1995;50: 28–34. 8. Myers AM, Powell LE, Maki BE, Holliday PJ, Brawley LR, Sherk W. Psychological indicators of balance confidence: relationship to actual and perceived abilities. J Gerontol A Biol Sci Med Sci. 1996;51: 37–43. 9. Tennstedt S, Howland J, Lachman M, Peterson E, Kasten L, Jette A. A randomized, controlled trial of a group intervention to reduce fear of falling and associated activity restriction in older adults. J Gerontol B Psychol Sci Soc Sci. 1998;53: 384–92. 10. Tinetti ME, Powell L. Fear of falling and low self-efficacy: a cause of dependence in elderly persons. Gerontology. 1993;48: 35–8.
Year 2019, Volume: 9 Issue: 1, 64 - 70, 26.03.2019

Abstract

References

  • 1. Lord S, Ward J, Williams P, Anstey K. Physiological factors associated with falls in older community-dwelling women. J Am Geriatr Soc. 1994;42: 1110-7. 2. Aile ve Sosyal Politikalar Bakanlığı, 2013: 2. 3. Dajpratham P, Tantiniramai S, Lukkapichonchut P, Kaewnaree S. Factors Associated with Vocational Reintegration Among the Thai Lower Limb Amputees. Journal of the Medical Association of Thailand. 2008;91 (2): 234-39. 4. Deans SA, Mcfadyen AK, Rowe PJ. Physical Activity and quality of life: A study of a lower-limb amputee population. Prosthetics and Orthotics International. 2008; 32 (2): 186-200. 5. Raya MA, Gailey RS, Fiebert IM, Roach EM. Impairment variables predicting activity limitation in individuals with lower limb amputation. Prosthetics and Orthotics International. 2010; 34(1): 73–84. 6. Dillingham TR, Pezzin LE, MacKenzie EJ. Limb amputation and limb deficiency: Epidemiology and recent trends in the United States. South Med J. 2002;95(8):875–83. 7. Powell LE, Myers AM. The Activities-specific Confidence (ABC) Scale. J Gerontol A Biol Sci Med Sci. 1995;50: 28–34. 8. Myers AM, Powell LE, Maki BE, Holliday PJ, Brawley LR, Sherk W. Psychological indicators of balance confidence: relationship to actual and perceived abilities. J Gerontol A Biol Sci Med Sci. 1996;51: 37–43. 9. Tennstedt S, Howland J, Lachman M, Peterson E, Kasten L, Jette A. A randomized, controlled trial of a group intervention to reduce fear of falling and associated activity restriction in older adults. J Gerontol B Psychol Sci Soc Sci. 1998;53: 384–92. 10. Tinetti ME, Powell L. Fear of falling and low self-efficacy: a cause of dependence in elderly persons. Gerontology. 1993;48: 35–8.
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Details

Primary Language Turkish
Journal Section Original Research
Authors

Abdulkadir Aydın This is me

Ramazan Atiç This is me

Publication Date March 26, 2019
Published in Issue Year 2019 Volume: 9 Issue: 1

Cite

APA Aydın, A., & Atiç, R. (2019). TRANSTİBİAL VE TRANSFEMORAL AMPUTELERİN DENGE VE DÜŞME DÜZEYLERİNİN KARŞILAŞTIRILMASI Comparison of Balance and Falling Levels of Transtibial and Transfemoral Amputees. Bozok Tıp Dergisi, 9(1), 64-70.
AMA Aydın A, Atiç R. TRANSTİBİAL VE TRANSFEMORAL AMPUTELERİN DENGE VE DÜŞME DÜZEYLERİNİN KARŞILAŞTIRILMASI Comparison of Balance and Falling Levels of Transtibial and Transfemoral Amputees. Bozok Tıp Dergisi. March 2019;9(1):64-70.
Chicago Aydın, Abdulkadir, and Ramazan Atiç. “TRANSTİBİAL VE TRANSFEMORAL AMPUTELERİN DENGE VE DÜŞME DÜZEYLERİNİN KARŞILAŞTIRILMASI Comparison of Balance and Falling Levels of Transtibial and Transfemoral Amputees”. Bozok Tıp Dergisi 9, no. 1 (March 2019): 64-70.
EndNote Aydın A, Atiç R (March 1, 2019) TRANSTİBİAL VE TRANSFEMORAL AMPUTELERİN DENGE VE DÜŞME DÜZEYLERİNİN KARŞILAŞTIRILMASI Comparison of Balance and Falling Levels of Transtibial and Transfemoral Amputees. Bozok Tıp Dergisi 9 1 64–70.
IEEE A. Aydın and R. Atiç, “TRANSTİBİAL VE TRANSFEMORAL AMPUTELERİN DENGE VE DÜŞME DÜZEYLERİNİN KARŞILAŞTIRILMASI Comparison of Balance and Falling Levels of Transtibial and Transfemoral Amputees”, Bozok Tıp Dergisi, vol. 9, no. 1, pp. 64–70, 2019.
ISNAD Aydın, Abdulkadir - Atiç, Ramazan. “TRANSTİBİAL VE TRANSFEMORAL AMPUTELERİN DENGE VE DÜŞME DÜZEYLERİNİN KARŞILAŞTIRILMASI Comparison of Balance and Falling Levels of Transtibial and Transfemoral Amputees”. Bozok Tıp Dergisi 9/1 (March 2019), 64-70.
JAMA Aydın A, Atiç R. TRANSTİBİAL VE TRANSFEMORAL AMPUTELERİN DENGE VE DÜŞME DÜZEYLERİNİN KARŞILAŞTIRILMASI Comparison of Balance and Falling Levels of Transtibial and Transfemoral Amputees. Bozok Tıp Dergisi. 2019;9:64–70.
MLA Aydın, Abdulkadir and Ramazan Atiç. “TRANSTİBİAL VE TRANSFEMORAL AMPUTELERİN DENGE VE DÜŞME DÜZEYLERİNİN KARŞILAŞTIRILMASI Comparison of Balance and Falling Levels of Transtibial and Transfemoral Amputees”. Bozok Tıp Dergisi, vol. 9, no. 1, 2019, pp. 64-70.
Vancouver Aydın A, Atiç R. TRANSTİBİAL VE TRANSFEMORAL AMPUTELERİN DENGE VE DÜŞME DÜZEYLERİNİN KARŞILAŞTIRILMASI Comparison of Balance and Falling Levels of Transtibial and Transfemoral Amputees. Bozok Tıp Dergisi. 2019;9(1):64-70.
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