Hitit Sağlık Dergisi 3023-7297 Hitit Üniversitesi 10.69563/hititsaglikderg.1433564 Physiotherapy Fizyoterapi Alt Ekstremite Amputelerinde Enerji Tüketimi: Derleme Makale Energy Consumption in Lower Extremity Amputees: Review Article https://orcid.org/0000-0003-3567-3531 Samut Cem ONDOKUZ MAYIS ÜNİVERSİTESİ https://orcid.org/0000-0001-5215-5125 Çalık Kütükcü Ebru HACETTEPE ÜNİVERSİTESİ, FİZİK TEDAVİ VE REHABİLİTASYON FAKÜLTESİ https://orcid.org/0000-0002-9090-3937 Topuz Semra HACETTEPE ÜNİVERSİTESİ, FİZİK TEDAVİ VE REHABİLİTASYON FAKÜLTESİ 09 30 2024 3 21 29 02 07 2024 05 31 2024 Copyright © 2023, Hitit Sağlık Dergisi 2023 Hitit Sağlık Dergisi

Amaç: Bu derlemenin amacı; alt ekstremite amputasyonu olan bireylerin enerji tüketimini araştıran çalışmaları özetlemek ve sonuçlarını bildirmektir. Yöntem: Çalışmamızın amacına uygun olarak seçilmiş olan anahtar kelimeleri kullanarak enerji tüketiminin değerlendirilmesinde kullanılan yöntemlerin, enerji tüketimine etki eden faktörlerin, sağlıklı ve alt ekstremite amputasyonu olan bireylerin enerji tüketimi açısından farklılıkların ortaya konulması açısından alt ekstremite amputelerinde enerji tüketimi ile ilgili yapılmış bilimsel çalışmalar belirlenerek incelendi.Sonuçlar: Amputasyonu takiben protez kullanımı ile birlikte vücut, amputasyon seviyesine göre biyomekaniksel değişiklikler göstermekte ve bunun sonucunda hem sağlıklı hem ampute tarafta adaptasyon mekanizmaları geliştirmektedir. Temel amacı kaybedilen eklem, kas ve sensorimotor girdiyi kompanse etmek olan bu adaptasyonlar, özellikle alt ekstremite amputasyonlarını takiben gerçekleşmekte ve uzun vadede tüm kinetik zinciri etkileyen sekonder patolojilerin ortaya çıkmasına neden olmaktadır. Alt ekstremite amputasyonu olan bireyler yürüyüş sırasında biyomekanik değişiklikler ve fiziksel uygunluktaki yetersizlikler ile dinamik dengenin azalmasına bağlı olarak gelişen fonksiyonel yetersizliklerini kompanse edebilmek amacıyla aşırı enerji harcamaktadırlar.Tartışma: Değişen fiziksel parametreler ağırlık merkezini, yürüyebilme yeteneğini ve yürüyüşün doğal kinematiğini olumsuz yönde etkilemektedir. Bu değişikler bireylerin fiziksel kapasitesine, günlük yaşam aktivitelerine katılımına, hangi tip protez veya yardımcı cihaz kullandıklarına ve hangi hızda yürüdüklerine bağlı olarak değişen oranlarda enerji tüketiminde artışa neden olabilmektedir. Enerji tüketimi açısından protez kullanan bireyler sağlıklı bireylerle karşılaştırıldığında, protez kullanan bireylerin daha düşük hızda yürürken daha yüksek enerji harcadıkları tespit edilmiştir. Amputasyonlu kişilerin kendi seçtikleri yürüyüş hızlarındaki azalmanın, artmış metabolik harcamaların önüne geçmek için geliştirdikleri bir kompansasyon yöntemi olduğu belirtilmiştir.

Purpose: The aim of this review is to summarise and report the results of studies investigating the energy consumption of individuals with lower limb amputation.Methods: Using the keywords selected in accordance with the purpose of our study, scientific studies on energy consumption in lower extremity amputees were identified and analysed in order to reveal the methods used in the evaluation of energy consumption, the factors affecting energy consumption, and the differences between healthy individuals and individuals with lower extremity amputation in terms of energy consumption.Results: The use of prostheses after amputation may show some biomechanical changes in the body depending on the level of the existing amputation and as a result, adaptation mechanisms develop at varying rates on both healthy and amputee sides. These adaptations, whose main purpose is to compensate for the lost joint, muscle and sensorimotor inputs, occur especially following lower limb amputations and cause secondary pathologies that affect the entire kinetic chain in the long term. Individuals with lower limb amputation expend excessive energy during walking in order to compensate for biomechanical changes and functional inadequacies due to inadequacies in physical fitness and decreased dynamic balance.Conclusions: Changing physical parameters negatively affect the centre of gravity, the ability to walk and the natural kinematics of gait. These changes may cause an increase in energy consumption at varying rates depending on the physical capacity of the individuals, their participation in activities of daily living, the type of prosthesis or assistive device they use and the speed at which they walk. When individuals using prostheses were compared with healthy individuals in terms of energy consumption, it was found that individuals using prostheses spent more energy while walking at a lower speed. It has been stated that the decrease in self-selected walking speeds of people with amputation is a compensation method developed to prevent increased metabolic expenditure.

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