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PEKTUS EKSKAVATUM VE PEKTUS KARİNATUMLU HASTALARDA GÖRÜLEN POSTÜR BOZUKLUKLARI

Yıl 2021, Cilt: 8 Sayı: 2, 270 - 276, 30.06.2021
https://doi.org/10.34087/cbusbed.805585

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.

Destekleyen Kurum

Yoktur

Proje Numarası

Yoktur

Teşekkür

yoktur

Kaynakça

  • 1- Prasad SA. Growth and development of the cardiorespiratory system. In: Prasad SA, Hussey J (ed) Pediatric Respiratory Care. 1nd edn. Chapman&Hall, Atlanta,1995. pp 1-12.
  • 2- Moriggl B. Deformities of the anterior thoracic wall; Functional anatomy of the thoracic cage. In: Schwabegger AH (ed) Congenital thoracic wall deformities: diagnosis, therapy and current developments. Springer-Verlog Wien, 2011, pp 3-13.
  • 3- Blanco FC, Elliott ST, Sandler AD. Management of congenital chest wall deformities. Seminars in Plastic Surgery, 2011, 25, 107-16
  • 4- Shamberger RC. Chest Wall Deformities. In: Shields TW (ed) General Thoracic Surgery. Williams&Wilkins, Baltimore/ Philadelphia, 1994, pp 529- 557.
  • 5- Kuhn MA, Nuss D. Pectus deformities. In: Mattei P (ed), Fundamentals of Pediatric Surgery. Springer, New York, 2011, pp 313-322.
  • 6- Welch KJ. Satisfactory Surgical Correction of Pectus Excavatum Deformity in Childhood. The Journal of Thoracic Surgery, 1958, 36, 697-713.
  • 7- Quigley PM, Haller JA Jr, Jelus KL, Loughin GM, Marcus CL. Cardiorespiratory Function Before and After Corrective Surgery in Pectus Excavatum. Journal Pediatry, 1996, 128, 638-643
  • 8- Gürkök S. Pektus ekskavatum deformitelerinde açık cerrahi tedavi yöntemleri. Journal of Clinical and Analytical Medicine, 2011, 60-9.
  • 9- Shneerson JM. Rehabilitation in thoracic wall deformities. In: Donner CF, Ambrossino N, Goldstein RS (ed), Pulmonary rehabilitation. 1nd ed. Edward Arnold, New York, 2005, pp 266-277.
  • 10- Kelly RE, Shamberger RC. Congenital wall deformities. In: Coran AG, Adzick NS, Krummel TM, Laberge JM (ed) Pediatric Surgery. 7nd ed. Elsevier Saunders, Philadelphia, 2012. Pp 779-808
  • 11- Roberts J, Hayashi A, Anderson JO, Martin JM, Maxwell LL. Quality of life of patients who have undergone the Nuss procedure for pectus excavatum: preliminary findings. Journal Pediatric Surgery, 2003, 38, 779—83
  • 12- Morhuis WJ, Mulder H, Wapperom G, et al. Pectus Excavatum. A clinical Study with Longterm Postoperative Follow-up. European Journal of Cardio-Thoracic Surgery, 1992, 6, 318-328.
  • 13- Culham EG, Jimenez HA, King CE. Thoracic kyphosis, rib mobility, and lung volumes in normal women and women with osteoporosis. Spine, 1994,19(11),1250-1255.
  • 14- Steinmann C, Krille S, Mueller A, Weber P, Reingruber B, Martin A. Pectus excavatum and pectus carinatum patients suffer from lower quality of life and impaired body image: a control group comparison of psychological characteristics prior to surgical correction. European Journal of Cardio-Thoracic Surgery, 2011, 40(5), 1138-1145.
  • 15- Croitoru D, Nuss D. Chest wall anomalies: pectus excavatum and pectus carinatum. Adolescent Medicine, 2014, 15, 455-471.
  • 16- Nuss D, Kuhn MA, Obermeyer RJ. Our approach: MIS repair of pectus excavatum. Contemporary surgery, 2007, 63(9), 444.
  • 17- Hebra A. Minimally invasive repair of pectus excavatum. Semin Thoracic Cardiovascular Surgery, 2009, 21(1), 76-84.
  • 18- Akkaş Y, Peri NG, Koçer B, Gülbahar G, Aksakal FNB. The prevalence of chest wall deformity in Turkish children. Turkish Journal Medical Science, 2018, 48(6),1200-1206.
  • 19- Magee DJ. Orthopedic Physical Assessment. Gait Assessment. W.B.Saunders Company, Toronto, 1997. pp 362-376.
  • 20- Shamberger RC, Welch, KJ. Surgical correction of pectus carinatum. Journal Pediatric Surgery, 1987, 22(1), 48-53.
  • 21- Pilegaard, H. K. Growth and pectus excavatum: is there a relation?. European Journal of Cardio-Thoracic Surgery, 2016, 50(6), 1110
  • 22- Park HJ, Sung SW, Park JK, Kim JJ, Jeon HW, Wang YP. How early can we repair pectus excavatum: the earlier the better?. European Journal of Cardio-Thoracic Surgery, 2012, 42(4), 667-672.
  • 23- Chen C, Zeng Q, Li Z, Zhang N, Yu J. Force required for correcting the deformity of pectus carinatum and related multivariate analysis. Journal Pediatric Surgery, 2018, 53(9), 1855-1857.
  • 24- Nuss D, Kelly RE, Croitoru DP, et al. A 10-year review of a minimally invasive technique for the correction of pectus excavatum. Journal Pediatric Surgery ,1998, 33, 545-52
  • 25- Creswick HA, Stacey MW, Kelly RE Jr, et al. Family study of the inheritance of pectus excavatum. Journal Pediatric Surgery, 2006, 41, 1699-703.
  • 26- Snyder LH, Curtis GM. An inherited “hollow chest”, koilosternia, a new character dependent upon a dominant autosomal gene. Journal of Heredity, 1934, 25, 445-7.
  • 27- Koumbourlis, AC. Pectus excavatum: pathophysiology and clinical characteristics. Paedıatric Respıratuar Reviews, 2009, 10(1), 3-6.
  • 28- Williams AM, Crabbe DCG. Pectus deformities of the anterior chest wall. Paedıatric Respıratuar Reviews, 2003, 4(3), 237-242.
  • 29- Saxena AK. Pectus excavatum, pectus carinatum and other forms of thoracic deformities. Journal of Indian Association of Pediatric Surgeons, 2005, 10(3), 14.

Postural Disorders in Patients with Pectus Excavatum and Pectus Carinatum

Yıl 2021, Cilt: 8 Sayı: 2, 270 - 276, 30.06.2021
https://doi.org/10.34087/cbusbed.805585

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.

Proje Numarası

Yoktur

Kaynakça

  • 1- Prasad SA. Growth and development of the cardiorespiratory system. In: Prasad SA, Hussey J (ed) Pediatric Respiratory Care. 1nd edn. Chapman&Hall, Atlanta,1995. pp 1-12.
  • 2- Moriggl B. Deformities of the anterior thoracic wall; Functional anatomy of the thoracic cage. In: Schwabegger AH (ed) Congenital thoracic wall deformities: diagnosis, therapy and current developments. Springer-Verlog Wien, 2011, pp 3-13.
  • 3- Blanco FC, Elliott ST, Sandler AD. Management of congenital chest wall deformities. Seminars in Plastic Surgery, 2011, 25, 107-16
  • 4- Shamberger RC. Chest Wall Deformities. In: Shields TW (ed) General Thoracic Surgery. Williams&Wilkins, Baltimore/ Philadelphia, 1994, pp 529- 557.
  • 5- Kuhn MA, Nuss D. Pectus deformities. In: Mattei P (ed), Fundamentals of Pediatric Surgery. Springer, New York, 2011, pp 313-322.
  • 6- Welch KJ. Satisfactory Surgical Correction of Pectus Excavatum Deformity in Childhood. The Journal of Thoracic Surgery, 1958, 36, 697-713.
  • 7- Quigley PM, Haller JA Jr, Jelus KL, Loughin GM, Marcus CL. Cardiorespiratory Function Before and After Corrective Surgery in Pectus Excavatum. Journal Pediatry, 1996, 128, 638-643
  • 8- Gürkök S. Pektus ekskavatum deformitelerinde açık cerrahi tedavi yöntemleri. Journal of Clinical and Analytical Medicine, 2011, 60-9.
  • 9- Shneerson JM. Rehabilitation in thoracic wall deformities. In: Donner CF, Ambrossino N, Goldstein RS (ed), Pulmonary rehabilitation. 1nd ed. Edward Arnold, New York, 2005, pp 266-277.
  • 10- Kelly RE, Shamberger RC. Congenital wall deformities. In: Coran AG, Adzick NS, Krummel TM, Laberge JM (ed) Pediatric Surgery. 7nd ed. Elsevier Saunders, Philadelphia, 2012. Pp 779-808
  • 11- Roberts J, Hayashi A, Anderson JO, Martin JM, Maxwell LL. Quality of life of patients who have undergone the Nuss procedure for pectus excavatum: preliminary findings. Journal Pediatric Surgery, 2003, 38, 779—83
  • 12- Morhuis WJ, Mulder H, Wapperom G, et al. Pectus Excavatum. A clinical Study with Longterm Postoperative Follow-up. European Journal of Cardio-Thoracic Surgery, 1992, 6, 318-328.
  • 13- Culham EG, Jimenez HA, King CE. Thoracic kyphosis, rib mobility, and lung volumes in normal women and women with osteoporosis. Spine, 1994,19(11),1250-1255.
  • 14- Steinmann C, Krille S, Mueller A, Weber P, Reingruber B, Martin A. Pectus excavatum and pectus carinatum patients suffer from lower quality of life and impaired body image: a control group comparison of psychological characteristics prior to surgical correction. European Journal of Cardio-Thoracic Surgery, 2011, 40(5), 1138-1145.
  • 15- Croitoru D, Nuss D. Chest wall anomalies: pectus excavatum and pectus carinatum. Adolescent Medicine, 2014, 15, 455-471.
  • 16- Nuss D, Kuhn MA, Obermeyer RJ. Our approach: MIS repair of pectus excavatum. Contemporary surgery, 2007, 63(9), 444.
  • 17- Hebra A. Minimally invasive repair of pectus excavatum. Semin Thoracic Cardiovascular Surgery, 2009, 21(1), 76-84.
  • 18- Akkaş Y, Peri NG, Koçer B, Gülbahar G, Aksakal FNB. The prevalence of chest wall deformity in Turkish children. Turkish Journal Medical Science, 2018, 48(6),1200-1206.
  • 19- Magee DJ. Orthopedic Physical Assessment. Gait Assessment. W.B.Saunders Company, Toronto, 1997. pp 362-376.
  • 20- Shamberger RC, Welch, KJ. Surgical correction of pectus carinatum. Journal Pediatric Surgery, 1987, 22(1), 48-53.
  • 21- Pilegaard, H. K. Growth and pectus excavatum: is there a relation?. European Journal of Cardio-Thoracic Surgery, 2016, 50(6), 1110
  • 22- Park HJ, Sung SW, Park JK, Kim JJ, Jeon HW, Wang YP. How early can we repair pectus excavatum: the earlier the better?. European Journal of Cardio-Thoracic Surgery, 2012, 42(4), 667-672.
  • 23- Chen C, Zeng Q, Li Z, Zhang N, Yu J. Force required for correcting the deformity of pectus carinatum and related multivariate analysis. Journal Pediatric Surgery, 2018, 53(9), 1855-1857.
  • 24- Nuss D, Kelly RE, Croitoru DP, et al. A 10-year review of a minimally invasive technique for the correction of pectus excavatum. Journal Pediatric Surgery ,1998, 33, 545-52
  • 25- Creswick HA, Stacey MW, Kelly RE Jr, et al. Family study of the inheritance of pectus excavatum. Journal Pediatric Surgery, 2006, 41, 1699-703.
  • 26- Snyder LH, Curtis GM. An inherited “hollow chest”, koilosternia, a new character dependent upon a dominant autosomal gene. Journal of Heredity, 1934, 25, 445-7.
  • 27- Koumbourlis, AC. Pectus excavatum: pathophysiology and clinical characteristics. Paedıatric Respıratuar Reviews, 2009, 10(1), 3-6.
  • 28- Williams AM, Crabbe DCG. Pectus deformities of the anterior chest wall. Paedıatric Respıratuar Reviews, 2003, 4(3), 237-242.
  • 29- Saxena AK. Pectus excavatum, pectus carinatum and other forms of thoracic deformities. Journal of Indian Association of Pediatric Surgeons, 2005, 10(3), 14.
Toplam 29 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makalesi
Yazarlar

Nuray Alaca 0000-0003-3034-9388

İhsan Alaca 0000-0002-0848-923X

Atılay Morgül 0000-0001-5809-1855

Mustafa Yüksel 0000-0001-9493-4194

Proje Numarası Yoktur
Yayımlanma Tarihi 30 Haziran 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 8 Sayı: 2

Kaynak Göster

APA Alaca, N., Alaca, İ., Morgül, A., Yüksel, M. (2021). PEKTUS EKSKAVATUM VE PEKTUS KARİNATUMLU HASTALARDA GÖRÜLEN POSTÜR BOZUKLUKLARI. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 8(2), 270-276. https://doi.org/10.34087/cbusbed.805585
AMA Alaca N, Alaca İ, Morgül A, Yüksel M. PEKTUS EKSKAVATUM VE PEKTUS KARİNATUMLU HASTALARDA GÖRÜLEN POSTÜR BOZUKLUKLARI. CBU-SBED. Haziran 2021;8(2):270-276. doi:10.34087/cbusbed.805585
Chicago Alaca, Nuray, İhsan Alaca, Atılay Morgül, ve Mustafa Yüksel. “PEKTUS EKSKAVATUM VE PEKTUS KARİNATUMLU HASTALARDA GÖRÜLEN POSTÜR BOZUKLUKLARI”. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 8, sy. 2 (Haziran 2021): 270-76. https://doi.org/10.34087/cbusbed.805585.
EndNote Alaca N, Alaca İ, Morgül A, Yüksel M (01 Haziran 2021) PEKTUS EKSKAVATUM VE PEKTUS KARİNATUMLU HASTALARDA GÖRÜLEN POSTÜR BOZUKLUKLARI. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 8 2 270–276.
IEEE N. Alaca, İ. Alaca, A. Morgül, ve M. Yüksel, “PEKTUS EKSKAVATUM VE PEKTUS KARİNATUMLU HASTALARDA GÖRÜLEN POSTÜR BOZUKLUKLARI”, CBU-SBED, c. 8, sy. 2, ss. 270–276, 2021, doi: 10.34087/cbusbed.805585.
ISNAD Alaca, Nuray vd. “PEKTUS EKSKAVATUM VE PEKTUS KARİNATUMLU HASTALARDA GÖRÜLEN POSTÜR BOZUKLUKLARI”. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 8/2 (Haziran 2021), 270-276. https://doi.org/10.34087/cbusbed.805585.
JAMA Alaca N, Alaca İ, Morgül A, Yüksel M. PEKTUS EKSKAVATUM VE PEKTUS KARİNATUMLU HASTALARDA GÖRÜLEN POSTÜR BOZUKLUKLARI. CBU-SBED. 2021;8:270–276.
MLA Alaca, Nuray vd. “PEKTUS EKSKAVATUM VE PEKTUS KARİNATUMLU HASTALARDA GÖRÜLEN POSTÜR BOZUKLUKLARI”. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, c. 8, sy. 2, 2021, ss. 270-6, doi:10.34087/cbusbed.805585.
Vancouver Alaca N, Alaca İ, Morgül A, Yüksel M. PEKTUS EKSKAVATUM VE PEKTUS KARİNATUMLU HASTALARDA GÖRÜLEN POSTÜR BOZUKLUKLARI. CBU-SBED. 2021;8(2):270-6.