Diz osteoartritli hastalarda ağrı, fonksiyonel düzey ve yürüyüşün zaman mesafe parametreleri

Abstract

Amaç: Bu çalışmanın amacı, sağlıklı kadınlar ve diz osteoartritli (OA) kadınlarda ağrı, fonksiyonel durum ve yürüme ile ilişkili parametreleri karşılaştırmaktı.

Yöntem: Çalışmaya Amerikan Romatoloji Derneği’nin kriterlerine göre diz OA olan 27 kadın (yaş ortalaması 47,25±6,46 yıl) ve 34 sağlıklı kadın (yaş ortalaması 47,29±4,50 yıl) alındı. Bireylerin ağrı şiddeti vizüel analog skalası (VAS) ile sorgulandı. Q açısını değerlendirmek için gonyometrik ölçüm yapıldı. Fiziksel fonksiyonları Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Skalası kullanılarak değerlendirildi. Yürümenin zaman mesafe parametreleri ise Zebris™ FDM-2 cihazı ile ölçüldü.

Bulgular: Bu çalışmanın sonuçları diz OA’lı kadınların sağlıklı bireylere göre ağrı şiddetinin daha yüksek ve fonksiyonel düzeylerinin daha düşük olduğunu gösterdi (p<0,05). Yürüme ile ilişkili parametreler incelendiğinde OA’lı kadınlarda sağlıklı kadınlara göre adım uzunluğu (p<0,05), çift adım uzunluğu yüzdesi (p<0,05) ve yürüme hızının (p<0,05) daha düşük, adım genişliğinin daha yüksek (p<0,05) olduğu belirlendi.

Sonuç: Bu çalışma diz OA’lı kadınlarda ağrı şiddeti, fonksiyonel düzey ve yürümenin aynı yaştaki sağlıklı kadınlara göre olumsuz yönde etkilendiğini gösterdi.

Keywords

• Diz
• Osteoartrit
• Yürüme

Pain, functionality, and spatio-temporal gait parameters in patients with knee osteoarthritis

Abstract

Purpose: The aim of this study was to compare pain, functionality and walking related parameters in healthy women and women with knee osteoarthritis.

Methods: 27 women with knee osteoarthritis (with an average age of 47.25±6.46 years) and 34 healthy women (with an average age of 47.29±4.50 years) were included in the study according to the American College of Rheumatology (ACR) criteria. The magnitude of pain level was questioned via Visual Analogue Scale (VAS). Q angle was measured using a universal goniometer. Functional status was evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Time-distance parameters of walking was measured by Zebris™ FDM-2 equipment.

Results: The results of this study showed that pain level was higher and functionality was lower in women with knee osteoarthritis compared to healthy women (p<0.01). It is determined that step length (p <0.05), double step length percentage (p < 0.01) and walking speed measurements (p<0.05) were lower and step width measurements (p<0.05) were higher in women with knee osteoarthritis compared to healthy women.

Conclusion: This study showed that pain level, functional status and walking were negatively affected in women with knee osteoarthritis compared to age-matched healthy women.

Keywords

• Knee
• Osteoarthritis
• Gait

References

1. 1. Taş S, Baki A, Erdoğanoğlu Y, et al. Diz osteoartrit şiddetinin yürüyüşün kinematik parametreleri üzerine etkileri. Turk J Physiother Rehabil. 2014;25:1-7.
2. 2. Dıracoglu D, Aydın R, Baskent A, et al. Effect of kinesthesia and Balance exercises in knee osteoarthritis. J Rheumatol. 2005;11:303-310.
3. 3. Veldman MP, Item-Glatthorn JF, Visscher R, et al. Somatosensory Electrical Stimulation Does Not Improve Motor Coordination in Patients with Unilateral Knee Osteoarthritis. J Clinic Med.2019;8:259.
4. 4. Birmingham TB, Kramer JF, Kirkley A, et al. Association among neuromuscular and anatomic measures for patients with knee osteoarthritis. Arch Phys Med Rehabil.2001;82:1115-1118.
5. 5. Petersen KK, Siebuhr AS, Graven-Nielsen O, et al. Sensitization and serological biomarkers in knee osteoarthritis patients with Different degrees of synovitis. Clin J Pain. 2016;32:841-848.
6. 6. Hunt MA, McManus FJ, Hinman RS, et al. Predictors of single-leg standing balance in individuals with medial knee osteoarthritis. Arthritis Care Res. 2010;62:496-500.
7. 7. Bilgiç A, Kamiloğlu R, Tuncer S. Diz Osteoartritinde İzokinetik Egzersiz Programının Etkinliği. J PMR Sci.2007;3:70-75.
8. 8. Al-Zahrani KS, Bakheit AM. A study of gait characteristic of patients with chronic osteoarthritis of the knee. Disabil Rehabil. 2002;24:275-280.

9. 9. Baliunas AJ, Hurwitz DE, Ryals, AB, et al. Increased knee joint loads during walking are present in subjects with knee osteoarthritis. Osteoarthr Cartil. 2002;10:573-579.
10. 10. Hurwitz DE, Ryals AR, Block JA, et al. Knee pain and joint loading in subjects with osteoarthritis of the knee. J Orthop Res. 2000;18: 572-579.
11. 11. Gok H, Ergin S, Yavuzer G. Kinetic and kinematic characteristics of gait in patients with medial knee arthrosis. Acta Orthop Scan. 2002;73:647-652.
12. 12. Draper CE, Chew KTL, Wang R, et al. Comparison of Quadriceps Angle Measurements Using Short-Armand Long-Arm Goniometers: Correlation With MRI. PM R. 2011;3:111-116.
13. 13. Pritzker KPH. Pathology of Osteoarthritis. Osteoarthritis. New York: Oxford University Press. 2003; 49-58.
14. 14. Tüzün EH, Eker L, Aytar A, et al. Acceptability, reliability, validity and responsiveness of the Turkish version of WOMAC osteoarthritis index. Osteoart Cartil. 2005;13:28-33.
15. 15. Angst F, Aeschlimann A, Steiner W, et al. Responsiveness of the WOMAC osteoarthritis index as compared with the SF-36 in patients with osteoarthritis of the legs undergoing a comprehensive rehabilitation intervention. Ann Rheum Dis. 2001;60:834-840.
16. 16. Arık MI, Aras Ö, Akkan H, et al. Total Diz Artroplastisi Sonrası Erken Dönemde Plantar Basınç Dağılımı Nasıl Değişir? Pilot Çalışma. Osmangazi Tıp Dergisi. 2018.
17. 17. Bilgiç A, Kamiloğlu R, Tuncer S. Diz Osteoartritinde İzokinetik Egzersiz Programının Etkinliği. J PMR Sci. 2007;3:70-75.
18. 18. Kul-Panza E, Bekker N. Pedobarographic findings in patients with knee osteoarthritis. Am J Phys Med Rehabil. 2006;85:228-233.
19. 19. Sun SF, Hsu CW, Hwang CW, et al. Hyaluronate improves pain, physical function and balance in the geriatric osteoarthritic knee: a 6-month follow-up study using clinical tests. Osteoarthr Cartil. 2006;14:696-701.
20. 20. Clark, AL. Osteoarthritis: what we have been missing in the patellofemoral joint. Exerc Sport Sci Rev. 2008;36:30-37.
21. 21. Erduran M, Akseki D, Karaoğlan O, et al. Gonartrozlu hastalarda patellofemoral eklem dinamiği. Joint Dis Rel Surg. 2009;20:18-24.
22. 22. Clement, Nicholas D., et al. An Overview and Predictors of Achieving the Postoperative Ceiling Effect of the WOMAC Score Following Total Knee Arthroplasty. J Arthroplasty. 2019;34: 273-280.
23. 23. Woo J, Lau E, Lee P,et al. Impact of osteoarthritis on quality of life in Hong Kong Chinese population. J Rheumatol. 2004;31:2433-2468.
24. 24. Ünal N, Tosun B, Can N, et al. Diz Osteoartriti Olan Hastaların Yaşam Kalitesinin ve Etki Eden Parametrelerin Belirlenmesi. Düzce Med J.2016;18.
25. 25. Creamer P, Lethbridge-Cejku M, Hochberg MC. Factors associated with functional impairment in symptomatic knee osteoarthritis. Rheumatol. 2000;39:490-496.
26. 26. Rana P,Joshi S, Bodwal M. Quantitative Gait Analysis In Patients With Knee Osteoarthritis. Int J Physiother Res. 2016;4:1684-1688.
27. 27. Paquette MR, Klipple G, Zhang S. Greater step widths reduce internal knee abduction moments in medial compartment knee osteoarthritis patients during stair ascent. Appl Biomech. 2015;31:229-236.
28. 28. McAndrewYoung PM, Dingwell JB. Voluntary changes in step width and step length during human walking affect dynamic margins of stability. Gait Posture. 2012;36:219-224.
29. 29. Kiss RM. Effect of severity of knee osteoarthritis on the variability of gait parameters. Electromyogr Kinesiol. 2011;21:695-703.
30. 30. Huang SC, Wei IP, Chien HL, et al. Effects of severity of degeneration on gait patterns in patients with medial knee osteoarthritis. Med Eng Phys. 2008;30:997-1003.
31. 31. Kiliçoğlu O, Dönmez A, Karagülle Z, et al. Effect of balneotherapy on temporospatial gait characteristics of patients with osteoarthritis of the knee. Rheumatol Int. 2010;30:739-747.
32. 32. Harding GT, Hubley-Kozey CL, Dunbar MJ, et al. Body mass index affects knee joint mechanics during gait differently with and without moderate knee osteoarthritis. Osteoarthr Cartil. 2012;20:1234-1242.