Araştırma Makalesi
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Diz osteoartritli hastalarda 3-boyutlu yürüme analizi ile gözlemsel yürüme analizi sonuçlarının karşılaştırılması

Yıl 2015, , 151 - 159, 22.05.2015
https://doi.org/10.3944/AOTT.2015.14.0158

Öz

 

Amaç: Bu çalışmanın amacı, diz osteoartriti (OA) olan bireylerde, farklı klinik deneyimlere sahip fizyoterapistler tarafından yapılan gözlemsel yürüme analizinin (GYA), klinik kullanımda geçerlik, gözlemci içi ve gözlemciler arası güvenilirlik düzeylerinin araştırılmasıdır.

 

Çalışma planı: Çalışmaya, yaşları 46–81 arasında değişen, klinik ve radyografik incelemeler sonucunda bilateral diz OA’sı tanısı konulan 22 kadın 11 erkek, toplam 33 birey ve bu bireylerin yürüyüşünü gözlemsel olarak değerlendiren 4 fizyoterapist dahil edildi. Fizyoterapistler mesleki deneyimlerine göre 10 yıl üstü ve altı olmak üzere 2 gruba ayrıldı. Bireyler 3-Boyutlu Yürüme Analizi ile değerlendirilirken eş zamanlı olarak video kaydına alındı. Elde edilen video kayıtları klinik deneyimlerine göre 2 farklı gruba ayrılmış fizyoterapistler tarafından en az 6 hafta aralıklar ile iki kez gözlemsel olarak değerlendirildi. GYA 11 kinematik 5 zaman mesafe parametresinden oluşan bir form aracılığıyla yapıldı.

 

Bulgular: Topuk vuruşu fazında ayak bileği dorsifleksiyonu ve orta duruş fazında pelvis rotasyonu parametreleri en düşük geçerlik (r=0.06, p>0.05), gözlemciler arası (ICC:-0.12–0.06) ve gözlemci içi uyumun (ICC:0.30–0.45) kaydedildiği parametrelerdi. En yüksek gözlemci içi ve gözlemciler arası uyum zaman mesafe parametrelerinden adım genişliği, çift adım uzunluğu, tempo ve yürüme hızı parametrelerinde tespit edildi (ICC:0.61–0.80). En yüksek geçerlik duruş fazında pelvik tilt parametresinde bulunurken (r=0.74–0.78, p<0.001), duruş fazı dışında zaman mesafe parametrelerinde orta düzey veya kuvvetli uyum (r=0.52–0.69, p<0.05) olduğu bulundu.

 

Çıkarımlar: Bu çalışmanın sonucunda GYA ile değerlendirilen zaman mesafe parametrelerinin orta veya kuvvetli geçerlik ve güvenilirliğe, değerlendirilen kinematik parametrelerin birçoğunun ise düşük veya orta derecede geçerlik ve gözlemciler arası güvenilirliğe, orta veya kuvvetli gözlemci içi güvenilirliğe sahip olduğu bulundu.

 

Kaynakça

  • Felson DT. Epidemiology of hip and knee osteoarthritis. Epidemiol Rev 1988;10:1–28.
  • Astephen JL, Deluzio KJ, Caldwell GE, Dunbar MJ. Bio- mechanical changes at the hip, knee, and ankle joints dur- ing gait are associated with knee osteoarthritis severity. J Orthop Res 2008;26:332–41.
  • Nagano Y, Naito K, Saho Y, Torii S, Ogata T, Nakazawa K, et al. Association between in vivo knee kinematics during gait and the severity of knee osteoarthritis. Knee 2012;19:628–32.
  • Kopf A, Pawelka S, Kranzl A. Clinical gait analysis--meth- ods, limitations and possible applications. [Article in Ger- man] Acta Med Austriaca 1998;25:27–32. [Abstract]
  • McGinley JL, Goldie PA, Greenwood KM, Olney SJ. Ac- curacy and reliability of observational gait analysis data: judgments of push-off in gait after stroke. Phys Ther 2003;83:146–60.
  • Mackey AH, Lobb GL, Walt SE, Stott NS. Reliability and validity of the Observational Gait Scale in children with spastic diplegia. Dev Med Child Neurol 2003;45:4–11.
  • Toro B, Nester CJ, Farren PC. Inter- and intraobserver repeatability of the Salford Gait Tool: an observation- based clinical gait assessment tool. Arch Phys Med Rehabil 2007;88:328–32.
  • Viehweger E, Zürcher Pfund L, Hélix M, Rohon MA, Jacquemier M, Scavarda D, et al. Influence of clinical and gait analysis experience on reliability of observational gait analysis (Edinburgh Gait Score Reliability). Ann Phys Re- habil Med 2010;53:535–46.
  • Ong AM, Hillman SJ, Robb JE. Reliability and valid- ity of the Edinburgh Visual Gait Score for cerebral palsy when used by inexperienced observers. Gait Posture 2008;28:323–6.
  • Williams G, Morris ME, Schache A, McCrory P. Obser- vational gait analysis in traumatic brain injury: accuracy of clinical judgment. Gait Posture 2009;29:454–9.
  • Field-Fote EC, Fluet GG, Schafer SD, Schneider EM, Smith R, Downey PA, et al. The Spinal Cord Injury Func- tional Ambulation Inventory (SCI-FAI). J Rehabil Med 2001;33:177–81.
  • Brunnekreef JJ, van Uden CJ, van Moorsel S, Kooloos JG. Reliability of videotaped observational gait analysis in pa- tients with orthopedic impairments. BMC Musculoskelet Disord 2005;6:17.
  • Eastlack ME, Arvidson J, Snyder-Mackler L, Danoff JV, Mc- Garvey CL. Interrater reliability of videotaped observational gait-analysis assessments. Phys Ther 1991;71:465–72.
  • Kirtley C. Clinical gait analysis: theory and practice. Edin- burgh: Elsevier Churchill Livingstone; 2006.
  • Perry J. Gait analysis normal and pathological function. Thorofare, New Jersey: Slack; 1992.
  • Whitttle, M. Gait Analysis: an introduction. Edinburgh: Butterworth-Heinemann; 2007.
  • Kawamura CM, de Morais Filho MC, Barreto MM, de Paula Asa SK, Juliano Y, Novo NF. Comparison between visual and three-dimensional gait analysis in patients with spastic diplegic cerebral palsy. Gait Posture 2007;25:18–24.
  • Schmid S, Schweizer K, Romkes J, Lorenzetti S, Brunner R. Secondary gait deviations in patients with and without neurological involvement: a systematic review. Gait Posture 2013;37:480–93.
  • Opheim A, McGinley JL, Olsson E, Stanghelle JK, Jahnsen R. Walking deterioration and gait analysis in adults with spastic bilateral cerebral palsy. Gait Posture 2013;37:165–71.
  • Kiss RM. Effect of severity of knee osteoarthritis on the variability of gait parameters. J Electromyogr Kinesiol 2011;21:695–703.
  • Martin K, Hoover D, Wagoner E, Wingler T, Evans T, O’Brien J, et al. Development and reliability of an observa- tional gait analysis tool for children with Down syndrome. Pediatr Phys Ther 2009;21:261–8.
  • Brown CR, Hillman SJ, Richardson AM, Herman JL, Robb JE. Reliability and validity of the Visual Gait As- sessment Scale for children with hemiplegic cerebral palsy when used by experienced and inexperienced observers. Gait Posture 2008;27:648–52.

A comparison of results of 3-dimensional gait analysis and observational gait analysis in patients with knee osteoarthritis

Yıl 2015, , 151 - 159, 22.05.2015
https://doi.org/10.3944/AOTT.2015.14.0158

Öz

Objective: This study aimed to investigate levels of validity, and inter- and intra-observer reliability of observational gait analysis (OGA) in clinical usage, done by the physical therapists with varying clinical experience, in subjects with knee osteoarthritis.

Methods: The study included 33 subjects (22 female, 11 male; mean age: 58.24Å}9.14 years range: 46 to 81) clinically and radiographically diagnosed with bilateral knee osteoarthritis, and 4 physical therapists to observe the subjects’ gaits. The physical therapists were separated into two groups according to their professional experience: those with 10 or more years, and those with fewer than 10 years. Video recordings were made of the subjects undergoing three-dimensional gait analysis (3DGA). These recordings were then observationally assessed twice by the participating physical therapists with at least a 6-week interval between observations. OGA was done via a form comprising 11 kinematic and 5 temporo-spatial parameters.

Results: Lowest levels of agreement in both validity (r=0.06, p>0.05), and inter- (ICC:–0.12-0.06) and intra-observer (ICC:0.30–0.45) reliability were found in the parameters of ankle dorsiflexion in initial contact phase and pelvic rotation in midstance phase. Highest inter- and intra-observer agreement was found in the temporo-spatial parameters of step width, double step length, cadence and velocity (ICC:0.61–0.80). Highest validity was found in pelvic tilt in stance phase (r=0.74–0.78, p<0.001). With the exception of stance phase, moderate or good agreement (r=0.52–0.69, p<0.05) was found in the temporo-spatial parameters.

Conclusion: This study found that OGA assessment of temporo-spatial parameters had moderate or good validity and reliability. Assessment of the majority of kinematic parameters had fair or moderate validity and inter-observer reliabilty, and moderate or good intra-observer reliability.

Kaynakça

  • Felson DT. Epidemiology of hip and knee osteoarthritis. Epidemiol Rev 1988;10:1–28.
  • Astephen JL, Deluzio KJ, Caldwell GE, Dunbar MJ. Bio- mechanical changes at the hip, knee, and ankle joints dur- ing gait are associated with knee osteoarthritis severity. J Orthop Res 2008;26:332–41.
  • Nagano Y, Naito K, Saho Y, Torii S, Ogata T, Nakazawa K, et al. Association between in vivo knee kinematics during gait and the severity of knee osteoarthritis. Knee 2012;19:628–32.
  • Kopf A, Pawelka S, Kranzl A. Clinical gait analysis--meth- ods, limitations and possible applications. [Article in Ger- man] Acta Med Austriaca 1998;25:27–32. [Abstract]
  • McGinley JL, Goldie PA, Greenwood KM, Olney SJ. Ac- curacy and reliability of observational gait analysis data: judgments of push-off in gait after stroke. Phys Ther 2003;83:146–60.
  • Mackey AH, Lobb GL, Walt SE, Stott NS. Reliability and validity of the Observational Gait Scale in children with spastic diplegia. Dev Med Child Neurol 2003;45:4–11.
  • Toro B, Nester CJ, Farren PC. Inter- and intraobserver repeatability of the Salford Gait Tool: an observation- based clinical gait assessment tool. Arch Phys Med Rehabil 2007;88:328–32.
  • Viehweger E, Zürcher Pfund L, Hélix M, Rohon MA, Jacquemier M, Scavarda D, et al. Influence of clinical and gait analysis experience on reliability of observational gait analysis (Edinburgh Gait Score Reliability). Ann Phys Re- habil Med 2010;53:535–46.
  • Ong AM, Hillman SJ, Robb JE. Reliability and valid- ity of the Edinburgh Visual Gait Score for cerebral palsy when used by inexperienced observers. Gait Posture 2008;28:323–6.
  • Williams G, Morris ME, Schache A, McCrory P. Obser- vational gait analysis in traumatic brain injury: accuracy of clinical judgment. Gait Posture 2009;29:454–9.
  • Field-Fote EC, Fluet GG, Schafer SD, Schneider EM, Smith R, Downey PA, et al. The Spinal Cord Injury Func- tional Ambulation Inventory (SCI-FAI). J Rehabil Med 2001;33:177–81.
  • Brunnekreef JJ, van Uden CJ, van Moorsel S, Kooloos JG. Reliability of videotaped observational gait analysis in pa- tients with orthopedic impairments. BMC Musculoskelet Disord 2005;6:17.
  • Eastlack ME, Arvidson J, Snyder-Mackler L, Danoff JV, Mc- Garvey CL. Interrater reliability of videotaped observational gait-analysis assessments. Phys Ther 1991;71:465–72.
  • Kirtley C. Clinical gait analysis: theory and practice. Edin- burgh: Elsevier Churchill Livingstone; 2006.
  • Perry J. Gait analysis normal and pathological function. Thorofare, New Jersey: Slack; 1992.
  • Whitttle, M. Gait Analysis: an introduction. Edinburgh: Butterworth-Heinemann; 2007.
  • Kawamura CM, de Morais Filho MC, Barreto MM, de Paula Asa SK, Juliano Y, Novo NF. Comparison between visual and three-dimensional gait analysis in patients with spastic diplegic cerebral palsy. Gait Posture 2007;25:18–24.
  • Schmid S, Schweizer K, Romkes J, Lorenzetti S, Brunner R. Secondary gait deviations in patients with and without neurological involvement: a systematic review. Gait Posture 2013;37:480–93.
  • Opheim A, McGinley JL, Olsson E, Stanghelle JK, Jahnsen R. Walking deterioration and gait analysis in adults with spastic bilateral cerebral palsy. Gait Posture 2013;37:165–71.
  • Kiss RM. Effect of severity of knee osteoarthritis on the variability of gait parameters. J Electromyogr Kinesiol 2011;21:695–703.
  • Martin K, Hoover D, Wagoner E, Wingler T, Evans T, O’Brien J, et al. Development and reliability of an observa- tional gait analysis tool for children with Down syndrome. Pediatr Phys Ther 2009;21:261–8.
  • Brown CR, Hillman SJ, Richardson AM, Herman JL, Robb JE. Reliability and validity of the Visual Gait As- sessment Scale for children with hemiplegic cerebral palsy when used by experienced and inexperienced observers. Gait Posture 2008;27:648–52.
Toplam 22 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Orijinal Makale
Yazarlar

Serkan Tas Bu kişi benim

Sinem Guneri Bu kişi benim

Bayram Kaymak Bu kişi benim

Zafer Erden Bu kişi benim

Yayımlanma Tarihi 22 Mayıs 2015
Yayımlandığı Sayı Yıl 2015

Kaynak Göster

APA Tas, S., Guneri, S., Kaymak, B., Erden, Z. (2015). A comparison of results of 3-dimensional gait analysis and observational gait analysis in patients with knee osteoarthritis. Acta Orthopaedica Et Traumatologica Turcica, 49(2), 151-159. https://doi.org/10.3944/AOTT.2015.14.0158
AMA Tas S, Guneri S, Kaymak B, Erden Z. A comparison of results of 3-dimensional gait analysis and observational gait analysis in patients with knee osteoarthritis. Acta Orthopaedica et Traumatologica Turcica. Mayıs 2015;49(2):151-159. doi:10.3944/AOTT.2015.14.0158
Chicago Tas, Serkan, Sinem Guneri, Bayram Kaymak, ve Zafer Erden. “A Comparison of Results of 3-Dimensional Gait Analysis and Observational Gait Analysis in Patients With Knee Osteoarthritis”. Acta Orthopaedica Et Traumatologica Turcica 49, sy. 2 (Mayıs 2015): 151-59. https://doi.org/10.3944/AOTT.2015.14.0158.
EndNote Tas S, Guneri S, Kaymak B, Erden Z (01 Mayıs 2015) A comparison of results of 3-dimensional gait analysis and observational gait analysis in patients with knee osteoarthritis. Acta Orthopaedica et Traumatologica Turcica 49 2 151–159.
IEEE S. Tas, S. Guneri, B. Kaymak, ve Z. Erden, “A comparison of results of 3-dimensional gait analysis and observational gait analysis in patients with knee osteoarthritis”, Acta Orthopaedica et Traumatologica Turcica, c. 49, sy. 2, ss. 151–159, 2015, doi: 10.3944/AOTT.2015.14.0158.
ISNAD Tas, Serkan vd. “A Comparison of Results of 3-Dimensional Gait Analysis and Observational Gait Analysis in Patients With Knee Osteoarthritis”. Acta Orthopaedica et Traumatologica Turcica 49/2 (Mayıs 2015), 151-159. https://doi.org/10.3944/AOTT.2015.14.0158.
JAMA Tas S, Guneri S, Kaymak B, Erden Z. A comparison of results of 3-dimensional gait analysis and observational gait analysis in patients with knee osteoarthritis. Acta Orthopaedica et Traumatologica Turcica. 2015;49:151–159.
MLA Tas, Serkan vd. “A Comparison of Results of 3-Dimensional Gait Analysis and Observational Gait Analysis in Patients With Knee Osteoarthritis”. Acta Orthopaedica Et Traumatologica Turcica, c. 49, sy. 2, 2015, ss. 151-9, doi:10.3944/AOTT.2015.14.0158.
Vancouver Tas S, Guneri S, Kaymak B, Erden Z. A comparison of results of 3-dimensional gait analysis and observational gait analysis in patients with knee osteoarthritis. Acta Orthopaedica et Traumatologica Turcica. 2015;49(2):151-9.