Türk toplumunda kalça, diz ve ayak bileğinin normal eklem hareket açıklığı

Öz

Amaç: Bu çalışmanın amacı, cinsiyetin ve kültürel alışkanlıkların kalça, diz ve ayak bileği eklem hareket açıklığına (EHA) olan etkisini ve alt ekstremitenin sağ ve sol taraf simetrik eklemlerinin EHA’ları arasında fark olup olmadığını belirlemekti. Çalışma planı: Çalışmaya 987 (513 erkek ve 474 kadın) gönüllü alındı. Alt ekstremite eklemlerinden herhangi birisiyle ilgili hastalık öyküsü bulunan, ameliyat veya travma geçirmiş olanlar çalışmaya dahil edilmedi. Terminoloji ve ölçüm tekniklerinde Amerikan Ortopedik Cerrahlar Akademisi’nin yönergeleri temel alındı. Bulgular: Sol taraf kalça pasif fleksiyonu ve aktif iç rotasyonu sağ tarafa göre daha yüksek olarak ölçüldü. Kalça ekleminde; pasif fleksiyon erkeklerde daha yüksek olduğu halde, iç ve dış rotasyon kadınlarda daha yüksekti. Dizde; pasif ekstansiyon erkeklerde daha yüksekti. Ayak bileğinde; plantarfleksiyon ve inversiyon erkeklerde daha fazla iken, dorsifleksiyon ve eversiyonun kadınlarda daha fazla olduğu görüldü. Ölçülen farklılıkların hiçbiri üç dereceden fazla olmadığı için klinik olarak anlamlı değildi. Çıkarımlar: Kalça diz ve ayak bileği EHA’larında sağ ve sol taraf arasında klinik olarak anlamlı bir fark olmadığı, cinsiyet ve kültürel alışkanlıkların alt ekstremite eklemlerindeki EHA’yı klinik olarak anlamlı bir şekilde etkilemediği saptandı.

Anahtar Kelimeler

• Ayak bileği eklem hareket açıklığı; diz eklem hareket açıklığı; kalça eklem hareket açıklığı; Türk toplumu.

Normal hip, knee and ankle range of motion in the Turkish population

Öz

Objective: The aim of this study was to ascertain the effect of gender and cultural habits on hip, knee and ankle range of motion (ROM) and to determine the differences between the ROM of right and left side symmetric joints of the lower extremities.
Methods: The study included 987 (513 males and 474 females) healthy volunteers. Individuals with a history of illness, prior surgery or trauma involving any joint of either lower extremity wereexcluded from the study. The terminology and techniques of measurements used were those suggested by the American Academy of Orthopedic Surgeons.
Results: Left side passive hip flexion and active internal rotation was higher than the right side. Passive flexion of the hip joint was higher in male subjects and internal and external rotation was higher in female subjects. In the knee joint, passive extension was higher in males. Plantarflexion and inversion of the ankle joint were higher in male subjects and dorsiflexion and eversion were higher in female subjects. The differences were considered insignificant in clinical terms as all were less than 3 degrees.
Conclusion: There is no clinically significantly difference between right and left side hip, knee and ankle joints ROM. Gender and cultural habits do not appear to have clinically significantly effects on lower extremity joint ROM.

Anahtar Kelimeler

• Ankle range of motion
• hip range of motion
• knee range of motion
• Turkish population

Kaynakça

1. American Academy of Orthopaedic Surgeons. Joint motion: methods of measuring and recording. 6th ed. Edinburgh: Churchill Livingstone; 1972.
2. Macedo LG, Magee DJ. Differences in range of motion between dominant and nondominant sides of upper and lower extremities. J Manipulative Physiol Ther 2008;31:577-82. CrossRef
3. Ahlberg A, Moussa M, Al-Nahdi M. On geographical variations in the normal range of joint motion. Clin Orthop Relat Res 1988;234:229-31.
4. James B, Parker AW. Active and passive mobility of lower limb joints in elderly men and women. Am J Phys Med Rehabil. 1989;68:162-7. CrossRef
5. Roach KE, Miles TP. Normal hip and knee active range of motion: the relationship to age. Phys Ther 1991;71:656
6. Bergström G, Aniansson A, Bjelle A, Grimby G, LundgrenLindquist B, Svanborg A. Functional consequences of joint impairment at age 79. Scand J Rehabil Med 1985;17:183
7. Svenningsen S, Terjesen T, Auflem M, Berg V. Hip motion related to age and sex. Acta Orthop Scand 1989;60:97 CrossRef
8. Boone DC, Azen SP. Normal range of motion of joints in male subjects. J Bone Joint Surg Am 1979;61:756-9.

9. Roaas A, Andersson GB. Normal range of motion of the hip, knee and ankle joints in male subjects, 30-40 years of age. Acta Orthop Scand 1982;53:205-8. CrossRef
10. Kouyoumdjian P, Coulomb R, Sanchez T, Asencio G. Clinical evaluation of hip joint rotation range of motion in adults. Orthop Traumatol Surg Res 2012;98:17-23. CrossRef Kumar S, Sharma R, Gulati D, Dhammi IK, Aggarwal AN. Normal range of motion of hip and ankle in Indian population. Acta Orthop Traumatol Turc 2011;45:421 CrossRef
11. Al-Rawi ZS, Al-Aszawi AJ, Al-Chalabi T. Joint mobility among university students in Iraq. Br J Rheumatol 1985;24:326-31. CrossRef
12. Gûnal I, Köse N, Erdogan O, Göktürk E, Seber S. Normal range of motion of the joints of the upper extremity in male subjects, with special reference to side. J Bone Joint Surg Am 1996;78:1401-4.
13. Kendall HO, Kendall FP, Wadsworth GE. Muscles, testing and function. 2nd ed. Baltimore, MD: Williams & Wilkins; 19 Daniels L Worthingam C. Muscle testing – techniques of manual examination. 3rd ed. Philadelphia: W.B. Saunders Co; 1972.
14. Kolber MJ, Hanney WJ. The reliability and concurrent validity of shoulder mobility measurements using a digital inclinometer and goniometer: a technical report. Int J Sports Phys Ther 2012;7:306-13.
15. Gajdosik RL, Bohannon RW. Clinical measurement of range of motion. Review of goniometry emphasizing reliability and validity. Phys Ther 1987;67:1867-72.
16. Stefanyshyn DJ, Engsberg JR. Right to left differences in the ankle joint complex range of motion. Med Sci Sports Exerc 1994;26:551-5. CrossRef