Adölesan İdiyopatik Skolyozda İkili Görev Etkisi ve Spinal Deformite ile Korelasyonu

Öz

AMAÇ: Adölesan idiyopatik skolyozu (AIS) olan hastalar günlük aktivitelerinde bazı zorluklar yaşamaktadırlar. Bu aktivitelerin çoğu, eş zamanlı 
motor ve/veya bilişsel bileşenlerden oluşan çoklu görev yapmayı içerir. Bu çalışmanın amacı, AIS hastalarının yürüme performansını ve aynı 
anda iki görevi yerine getirme yeteneğini gerektiren çift görev etkisini (DTE) sağlıklı kontrol grubuyla karşılaştırmak ve bunların omurga 
deformitesiyle ilişkisini incelemektir.
GEREÇ ve YÖNTEM: Bu kesitsel vaka-kontrol çalışmasına 32 AIS hastası ve 34 sağlıklı kontrol dahil edildi. Fonksiyonel mobiliteyi değerlendirmek için Genişletilmiş Zamanlı Kalk ve Yürü (ETUG) Testi ve Tandem Yürüyüşü (TG) kullanıldı. Motor-motor ve bilişsel-motor çift görevli performansları kaydedilerek ilgili DTE’leri belirlendi. Skolyoz grubunun mevcut röntgen filmlerinden radyolojik parametreleri ölçüldü. Gövde rotasyon açısı skolyometre kullanılarak değerlendirildi. Spinal parametreler ile DTE’ler arasında korelasyon olup olmadığı analiz edildi. BULGULAR: AIS'li hastaların, sağlıklı kontrollere kıyasla, TG ile test edilen tek motor görevlerde daha yavaş oldukları, ancak ETUG ile böyle bir fark olmadığı bulundu (sırasıyla p=0,001, p=0,501). Hastaların hem bilişsel-motor hem de motor-motor DTE'lerinde artış görüldü (sırasıyla p<0,001, p=0,010). İncelenen spinal parametrelerden, lomber lordoz ölçümleri motor-motor DTE ile orta derecede korelasyon gösterirken 
(r=-0,48, p=0,005), gövde rotasyon açısı ve apikal vertebra translasyonu bilişsel-motor DTE ile zayıf korelasyon gösterdi (sırasıyla r=-0.35, p=0.05, r=-0,39, p=0,028).
SONUÇ: Bu bulgular, AIS hastalarının sağlıklı yaşıtlarına kıyasla çift görevli becerilerinde bozulma olduğunu ve hem biyomekanik değişikliklerin hem de ikili görev sırasında artan kortikal katkının fonksiyonel mobiliteyi etkileyebileceğini düşündürmektedir. Bu nedenle, rehabilitasyon protokollerine çift görevli yürüyüş ve sensörimotor entegrasyon eğitiminin dahil edilmesinin faydalı olabileceğine inanıyoruz. 

Anahtar Kelimeler

• Adölesan idiopatik skolyozu
• ikili görev
• tekli görev
• yürüyüş
• radyoloji

Destekleyen Kurum

Yok

Etik Beyan

Bu çalışma Karamanoğlu Mehmetbey Üniversitesi Etik Kurulu tarafından onaylanmıştır (tarih: 27.02.2024, sayı: 01-2024/06).

Teşekkür

Dil konusunda değerli yardımlarından dolayı Sayın Emre Basaran'a teşekkür ederiz.

Dual-Task Effect in Adolescent Idiopathic Scoliosis and Correlation with Spinal Deformity

Öz

OBJECTIVE: Patients with adolescent idiopathic scoliosis (AIS) experience various difficulties with daily activities. Many such activities involve 
multitasking that consists of simultaneous motor and/or cognitive components. The purpose of this study was to compare the walking 
performance and dual-task effect (DTE), which requires the ability to perform two tasks concurrently, of AIS patients with those of healthy 
controls and to investigate their correlation with spinal deformity. 
MATERIALS and METHODS: Thirty-two AIS patients and 34 healthy controls were included in this cross-sectional case-control study. The Expanded Timed Up and Go (ETUG) test and the Tandem Gait (TG) were used to assess functional mobility. The motor-motor and cognitive-motor dual-task performances were recorded to determine the corresponding DTEs. Radiological assessments of the scoliosis group were extracted from the radiographs, while the angle of trunk rotation was measured using a scoliometer. These spinal parameters were analyzed to identify any correlations with DTEs. 
RESULTS: We found that patients with AIS were slower with single motor tasks, by TG, but not by ETUG, compared to healthy controls (p=0.001, p=0.501, respectively). They exhibited an increase in both cognitive-motor and motor-motor DTEs (p<0.001, p=0.010, respectively). Among the spinal parameters examined, lumbar lordosis measurements were moderately correlated with motor-motor DTE (r=-0.48, p=0.005), while angle of trunk rotation and apical vertebral translation were weakly correlated with cognitive-motor DTE (r=-0.35, p=0.05, r=-0.39, p=0.028, respectively). 
CONCLUSION: These findings suggest impaired dual tasking among AIS patients compared to healthy peers, and both biomechanical changes and increased cortical contribution may influence functional mobility. Thus, we believe that including dual-task gait and sensorimotor integration training in management protocols may be beneficial for achieving better outcomes. 

Anahtar Kelimeler

• Adolescent idiopathic scoliosis
• dual task
• single task
• gait
• radiology

Destekleyen Kurum

Non

Etik Beyan

The study was approved by Karamanoğlu Mehmetbey University Ethics Committee (date: 27.02.2024, no: 01- 2024/06).

Teşekkür

We would like to thank M. Emre Basaran for his valuable help with language.

Kaynakça

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