Postural Disorders in Patients with Pectus Excavatum and Pectus Carinatum

Öz

Objective The most common anterior chest wall deformities; pectus excavatum (PE) and pectus carinatum (PC). Postural disorders are seen as an additional problem in these patients. In the present study, it is aimed to define the posture disorders of patients with PE and PC and to investigate the relationship of these posture disorders with clinical symptoms. Material and Methods: 526 patients [PE (n=346) and Pc (n=180)], aged 11-45 years, were included in the study. The patient's history/family history, back/chest pain, shortness of breath during rest/exercise were noted as clinical symptoms. Posture analyzes were performed with the help of the New York Posture Assessment Method (NYPDY) with anterior-posterior-laterally photographs. In addition, posture disorder markers were recorded as present/absent. p<0.05 was considered statistically significant. Results: Complaints of dyspnea were higher in patients with PE compared to patients with PC (p<0.001). In all patients, anterior tilt of the head [PE (93.3%) and PC (88.9%)] was the most common posture disorder. Thoracic kyphosis was more common in patients with PC than in patients with PE (p=0.007). NYPDY form results were lower in patients with PE (p<0.001). In patients with PC, dyspnea was significantly higher during rest (p=0.025) while, the rate of experiencing shortness of breath during exercise was higher (p<0.001) in the PE patients. Conclusion: Postural impairment rates significantly higher in patient with pectus deformities. For that reason patient who have pectus deformites should be assesed and for the prevention of further impairment, patient should be consulted to physiotherapy.

Anahtar Kelimeler

• Pectus carinatum
• Pectus excavatum
• Posture.

PEKTUS EKSKAVATUM VE PEKTUS KARİNATUMLU HASTALARDA GÖRÜLEN POSTÜR BOZUKLUKLARI

Öz

Giriş ve Amaç: En yaygın olarak görülen anterior göğüs duvarı deformiteleri, pektus ekskavatum (PE) ve pektus karinatum (PK)’dır. Hastalarda, ek sorun olarak postür bozuklukları görülebilmektedir. Mevcut çalışmada PE ve PK’lı hastaların postür bozukluklarını tanımlamak ve bu postür bozukluklarının klinik semptomlarla olan ilişkisini araştırmak amaçlanmaktadır. Gereç ve Yöntemler: Çalışmaya 11-45 yaş arası 526 hasta [PE (n=346) ve PK (n=180)] retrospektif olarak alınmıştır. Hastaların özgeçmişi, soy geçmişi, sırt ile göğüs ağrısı bulgusu, dinlenirken ve egzersiz sırasında nefes darlığı yaşayıp yaşamadığı gibi klinik semptomlar var/yok olarak not edilmiştir. Hastaların önden-yandan-arkadan çekilen fotoğraflarının yardımı ile New York Postür Değerlendirme Yöntemi (NYPDY) analizleri yapılmıştır. Ek olarak postür bozukluğu belirteçleri var/yok olarak kaydedilmiştir. İstatiksel olarak p<0,05 anlamlı olarak kabul edilmiştir. Bulgular: Hastaların kliniğe başvuru nedenlerinde PE’li hastalarda nefes darlığı şikayeti; PK’lı hastalara göre daha fazla görülmekte idi (p<0,001). Her iki hasta grubunda da, başın anterior tilti [PE (%93,3) ve PK (%88,9)] en fazla görülen postür bozukluğu idi. Torasik kifoz ise PK’lı hastalarda PE’li hastalara göre daha fazla görülmekteydi (p=0,007). NYPDY skorları PE’li hastalarda daha düşüktü (p<0,001). PK’lı hastalarda dinlenim sırasında nefes darlığı yaşama oranı istatiksel olarak anlamlı şekilde daha yüksek görülürken (p=0,025), PE’li hastalarda egzersiz sırasında nefes darlığı oluşma oranı daha fazla idi (p<0.001). Sonuç: Pektus deformitesine sahip hastalarda postür bozuklukları sıklığının fazla olması, hastaların bu yönden değerlendirilmesini ve önleme/tedavi için fizyoterapiye yönlendirilmesi gerektiğini bize göstermektedir.

Anahtar Kelimeler

• Pektus ekskavatum
• Pektus Karinatum
• Postür

Kaynakça

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