DİZ OSTEOARTRİTİNİN EVRELERİNE GÖRE AĞRI, STATİK VE DİNAMİK DENGE İLE EKLEM HAREKET AÇIKLIĞI İLİŞKİLERİ

Öz

Osteoartrit (OA), dünyada en sık görülen artrit türü olup diz eklemi en sık etkilenen eklemdir. Yük taşıyan eklemlerde ilerleyen, kıkırdak yıkımı, osteofit oluşumu ve subkondral skleroz ile karakterize kronik dejeneratif bir hastalıktır. Bu çalışmada erken ve ileri evre diz OA’lı bireylerde ağrı, denge ve eklem hareket açıklığı (EHA) parametrelerinin incelenmesi, bu parametreler arasındaki ilişkilerin değerlendirilmesi ve gruplar arası farklılıkların karşılaştırılması amaçlanmıştır. Çalışmaya, Amerikan Romatoloji Derneği (ACR) kriterleri doğrultusunda diz OA tanısı alan ve Kellgren-Lawrence evrelendirmesine göre sınıflandırılan, 40–65 yaş aralığında 128 hasta dahil edildi. Hastalar erken evre (1–2) ve ileri evre (3–4) olmak üzere iki gruba ayrıldı. Diz eklemi hareket açıklığı gonyometri ile, ağrı Görsel Analog Skala (VAS) ile, statik ve dinamik denge ise Kinesthetic Ability Trainer 3000 (KAT3000) cihazı ile değerlendirildi. OA evresi ilerledikçe diz fleksiyon açıları ile statik ve dinamik denge puanları azalırken ağrı şiddeti arttı (p<0,001). Erken evrede istirahat VAS puanı ile statik denge arasında pozitif yönde zayıf korelasyon bulundu (p<0,05, r=0,252). İleri evrede VAS puanı ile hem statik hem de dinamik denge arasında pozitif yönde zayıf korelasyon vardı (p<0,05, r=0,360 ve r=0,363). EHA ile denge arasında erken evrede negatif yönde zayıf, ileri evrede ise orta düzeyde korelasyon saptandı. Diz OA şiddeti arttıkça EHA azalmakta, denge bozulmakta ve ağrı artmaktadır. Bulgular, EHA ve ağrı parametrelerinin denge bozuklukları ve fonksiyonel kısıtlılıklar açısından öngörücü olabileceğini göstermektedir.

Anahtar Kelimeler

• Diz osteoartriti
• ağrı
• denge
• eklem hareket açıklığı
• fonksiyonel değerlendirme

RELATIONSHIPS BETWEEN PAIN, STATIC AND DYNAMIC BALANCE, AND RANGE OF MOTION ACCORDING TO THE STAGES OF KNEE OSTEOARTHRITIS

Abstract

Osteoarthritis (OA) is the most common type of arthritis worldwide, and the knee joint is the most frequently affected site. It is a chronic degenerative disease of weight-bearing joints characterized by cartilage destruction, osteophyte formation, and subchondral sclerosis. This study aimed to examine pain, range of motion (ROM), and balance parameters in individuals with early and advanced stage knee OA, to evaluate the relationships among these variables, and to compare differences between the groups. A total of 128 patients aged 40–65 years who were diagnosed with knee OA according to the American College of Rheumatology (ACR) criteria and classified using the Kellgren–Lawrence grading system were included. Patients were divided into early-stage (grades 1–2; mean age: 57.5±0.83 years; BMI: 30.8±0.53 kg/m²) and advanced-stage (grades 3–4; mean age: 59.05±0.74 years; BMI: 31.07±0.57 kg/m²) groups. Knee ROM was assessed by goniometric measurement, pain level at rest and during activity by Visual Analog Scale (VAS), and static and dynamic balance by the Kinesthetic Ability Trainer 3000 (KAT3000). Significant differences were found between the early and advanced OA groups: the advanced OA group exhibited lower knee flexion angles, static balance scores, and dynamic balance scores, and higher pain severity (p<0.001). In early-stage patients, a weak positive correlation was found between resting VAS scores and static balance (p<0.05, r=0.252). In advanced stages, weak positive correlations were observed between resting VAS scores and static balance (p<0.05, r=0.360) and dynamic balance (p<0.05, r=0.363). The relationship between ROM and balance was weakly negative in early stages (static: r = -0.348, p = 0.005; dynamic: r = –0.337, p = 0.006) and moderately negative in advanced stages (static: r = -0.548, p < 0.001; dynamic: r = -0.652, p < 0.001). With increasing OA severity, ROM decreases, balance deteriorates, and pain intensity rises. These findings suggest that ROM and pain parameters may serve as predictors of balance impairments in knee OA.

Keywords

• Knee osteoarthritis
• pain
• range of motion
• balance
• functional assessment

Kaynakça

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