DİZ OSTEOARTRİTLİ HASTALARDA DÜŞME RİSKİNİ VE YARDIMCI YÜRÜME CİHAZI KULLANIMINI ETKİLEYEN FAKTÖRLER

Year 2022, , 179 - 186, 30.06.2022

Tuba Baykal , Esra Erdemir

https://doi.org/10.17343/sdutfd.993080

Abstract

Amaç
Bu çalışmada, ileri evre diz osteoartriti olan hastalarda
düşme riskini ve yardımcı yürüme cihazı kullanım
oranlarını ve bu hastalarda bu cihazların kullanımını
etkileyen faktörleri araştırmayı amaçladık.
Gereç ve Yöntem
Bu prospektif, kesitsel, gözlemsel çalışmaya Mart
2020 ile Eylül 2020 arasında polikliniğimize başvuran
ve ileri evre diz osteoartriti olan 79 hastayı (72 kadın,
7 erkek; medyan yaş 60; dağılım, 40-75) dahil
ettik. Hastaların denge durumunu Berg Denge Ölçeği
ile ağrı düzeylerini Sayısal Derecelendirme Ölçeği ile
kişi beyanına dayanan dizabilite skorlarını ise Western
Ontario and McMaster Universities Osteoarthritis
Index ile değerlendirdik. Birincil sonlanım noktası
hastaların denge durumu ve yardımcı yürüme cihazı
kullanım oranlarıydı. İkincil sonlanım noktaları ise
yaş, obezite, hastalık şiddeti, ağrı düzeyleri, sakatlık
skorları ve düşme öyküsüydü.
Bulgular
Berg Denge Skalasına göre 40 (% 50,6) hastada düşme
riski saptandı. Yardımcı yürüme cihazı kullanım
oranları tüm hastalarda ve düşme riski olan hastalarda
sırasıyla % 21.5 ve % 42.5 idi. Düşme riski olanlar
ile olmayanlar arasında yardımcı yürüme cihazı
kullanımı açısından istatistiksel olarak anlamlı fark
vardı (p<0,001). Artan düşme riski ile obezite, yüksek
hastalık şiddeti ve yüksek özürlülük skorları arasında
anlamlı bir ilişki bulundu. Ancak düşme riski olan kişilerde
yaş dışında (p<0,001) yardımcı yürüme cihazı
kullanımını etkileyen herhangi bir faktör bulamadık.
Sonuç
Çalışmamızın sonuçları ileri evre diz osteoartriti olan
hastalarda düşme riskinin arttığını ve bu hastalarda
yardımcı yürüme cihazı kullanımının düşme riski ile
ilişkili olduğunu göstermiştir.

Keywords

Diz osteoartriti, düşme riski, yardımcı yürüme cihazı

Thanks

We would like to thank Z. A. Kaymak (M.D., Asst. Prof.) for her support in the statistical analysis of the study data. Çalışma verilerinin istatistiksel analizinde destek veren Dr. Öğr. Üyesi Zümrüt Arda Kaymak'a teşekkür ederiz.

FACTORS AFFECTING THE FALL RISK AND ASSISTIVE WALKING DEVICE USE OF PATIENTS WITH KNEE OSTEOARTHRITIS

Abstract

Objective
In this study, we aimed to investigate the risk of falling
in patients with advanced-stage knee osteoarthritis and
the rates of assistive walking device use, and the factors
affecting the use of these devices in such patients.
Materials and Methods
In this prospective, cross-sectional, observational
study, we included 79 patients (72 females, 7 males;
median age 60 years; range, 40 to 75) with advancedstage
knee osteoarthritis. We assessed the balance
status of the patients with the Berg Balance Scale,
pain levels with the Numeric Rating Scale, selfreported
disability scores with the Western Ontario
and McMaster Universities Osteoarthritis Index.
Our primary outcome measurements were balance
status, and assistive walking device usage rates of
the patients. Secondary outcome measures were
age, obesity, disease severity, pain levels, disability
scores, and fall history.
Results
According to Berg Balance Scale, 40 (50.6 %)
patients had a risk of fall. Assistive walking device
usage rates were 21.5 % and 42.5 % for the total
of the patients and for the patients at risk of falling,
respectively. There was a statistically significant
difference in assistive walking device use between
those at risk of falling and those without (P<0.001). A
significant correlation was found between increased
risk of falling and obesity, high disease severity, and
high disability scores. However, we did not find any
factors other than age (P<0.001) that affect assistive
walking device use in people at risk of falling.
Conclusion
The results of our study showed that the risk of falling
is increased in patients with advanced-stage knee
osteoarthritis and that the use of an assistive walking
device is associated with the risk of falling in these
patients.

Keywords

Knee osteoarthritis, risk of falling, Assistive walking device

References

• Murphy L, Schwarz TA, Helmick CG, Renner JB, Tudor G, Koch G, et al. Lifetime risk of symptomatic knee osteoarthritis. Arthritis Rheum 2008;59(9): 1207–1213.
• Michael JW, Schlüter-Brust KU, Eysel P. The epidemiology, etiology, diagnosis, and treatment of osteoarthritis of the knee. Dtsch Arztebl Int 2010;107:152-62.
• Hatfield GL, Morrison A, Wenman M, Hammond CA, Hunt MA. Clinical Tests of Standing Balance in the Knee Osteoarthritis Population: Systematic Review and Meta-analysis. Phys Ther 2016;96(3):324-37.
• Levinger P, Dunn J, Bifera N, Butson M, Elias G, Hill KD. High-speed resistance training and balance training for people with knee osteoarthritis to reduce falls risk: study protocol for a pilot randomized controlled. Trials 2017 Aug 18;18(1):384.
• Arden NK, Perry TA, Bannuru RR, Bruyere O, Cooper C, Haugen IK, et al. Non-surgical management of knee osteoarthritis: comparison of ESCEO and OARSI 2019 guidelines. Nat Rev Rheumatol 2021;17(1):59-66.
• Kolasinski SL, Neogi T, Hochberg MC, Oatis C, Guyatt G, Block J, et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care Res (Hoboken) 2020;72(2):149-162.
• Manlapaz DG, Sole G, Jayakaran P, Chapple CM. Risk factors for falls in adults with knee osteoarthritis: A Systematic Review. PM R 2019;11(7):745-757.
• Salminen AL, Brandt A, Samuelsson K, Toytari O, Malmivaara A. Mobility devices to promote activity and participation: a systematic review. J Rehabil Med 2009;41:697-706.
• Carbone LD, Satterfield S, Liu C, Kwoh KC, Neogi T, Tolley E, et al. Assistive walking device use and knee osteoarthritis: Results from the health, aging and body composition study (Health ABC Study). Arch Phys Med Rehabil 2013;94(2):332-9.
• Kellgren JH, Lawrence JS: Radiological assessment of osteo-arthrosis. Ann Rheum Dis 1957;16:494-502.
• Scott J, Huskinson EC. Graphic representation of pain. Pain 1976;2(2):175-84 ).
• Bellamy N, Buchanan WW, Goldsmith CH, Campbel J, Stitt I. Validation study of WOMAC: A health status instrument for measuring clinically-important patient-relevant outcomes following hip or knee arthroplasty in osteoarthritis. J Rheumatol 1988 Dec;15(12):1833-40.
• Berg K, Wood-Dauphinee SL, Williams JI, Makki BE. Measuring balance in the elderly: validation of an instrument. Canadian Journal of Public Health 1992;83(12):7-11.
• Lusardi MM, Fritz S, Middleton A, Allison L, Wingood M, Phillips E. Determining risk of falls in community dwelling older adults: a systematic review and meta-analysis using posttest probability. J Geriatr Phys Ther 2017;40(1):1-36.
• Van der Esch M, Heijmans M, Dekker J. Factors contributing to possession and use of walking aids among persons with rheumatoid arthritis and osteoarthritis. Arthritis Rheum 2003;49:838-42.
• Shrier I, Feldman DE, Gaudet MC, Rossignol M, Zukor D, Tanzer M, et al. Conservative nonpharmacological treatment options are not frequently used in the management of hip osteoarthritis. J Sci Med Sport 2006;9:81-6.
• Hoops ML, Rosenblatt NJ, Hurt CP, Crenshaw J, Grabiner MD. Does lower extremity osteoarthritis exacerbate risk factors for falls in older adults? Womens Health 2012;8(6):685-698.
• Rubenstein LZ. Falls in older people: epidemiology, risk factors and strategies for prevention: a review. Age Ageing 2006;35-S2:ii37-ii41.
• Kim HS, Yun DH, Yoo SD, Kim DH, Jeong YS, Yun JS, et al. Balance control and knee osteoarthritis severity. Ann Rehabil Med 2011;35(5):701-9.
• Adegoke BOA, Babatunde FO, Oyeyemi AL. Pain, balance, self-reported function and physical function in individuals with knee osteoarthritis. Physiother Theory Pract 2012;28(1):32-40.
• Maffiuletti NA, Agosti F, Proietti M, Resnik M, Lafortuna CL, Sartorio A. Postural instability of extremely obese individuals improves after a body weight reduction program entailing specific balance training. J Endocrinol Invest 2005;28(1):2–7.
• Handrigan G, Hue O, Simoneau M, Corbeil P, Marceau P, Marceau S, et al. Weight loss and muscular strength affect static balance control. Int J Obes 2010;34(5):936–942.
• Akinbo SRA, Sokunbi O, Ogunbameru T. Factors contributing to possession of walking aids among persons with osteoarthritis of the knee. Nig Q J Hosp Med 2008;18(2):64-8.
• Van Hook FW, Demonbreun D, Weiss BD. Ambulatory devices for chronic gait disorders in the elderly: a review. Am Fam Physician 2003;67(8):1717-24.
• McAlindon TE, Bannuru RR, Sullivan MC, Arden NK, Berenbaum F, Bierma-Zeinstra SM, et al. OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthritis Cartilage 2014;22(3):363-88.
• Fillingim RB, King CD, Riberio-Dasilva MC, Rahim-Williams B, Riley JL 3rd. Sex, gender, and pain: a review of recent clinical and experimental findings. J Pain 2009;10(5):447-85.