The Effect of Submaximal Exercises on Static Postural Adaptations and Back Pain: Comparison of Transtibial and Transfemoral Amputees

Abstract

Objective: To evaluate and compare static postural adaptations and the effect of submaximal exercise on posture and back pain in Transtibial (TTA) and Transfemoral (TFA) amputees.
Materials and Methods: In prospective study, male participants with unilateral transtibial (n: 14; age: 36.36±12.15 years) and transfemoral (n:15; age:27.36±7.60 years) amputation were included. Postural parameters were measured by analyzing images taken from ADIBAS Posture (Physical TECH, Spain) in free standing and standing where the body weight was evenly distributed to extremities. 6-Minute Walk Test was performed as submaximal exercise; all evaluations were repeated after exercise. Back pain was assessed by Wong-Baker Pain Scale.
Results: In TTA group, before submaximal exercise, in free standing, the difference between intact and amputated side lordosis angle was found significant (p: 0.019). Following the submaximal exercise, the plane angle of Spina Iliaca Posterior Superior differed significantly between standing positions (p: 0.041). In TFA group, the shoulder plane angle showed significant difference between the stance positions before the submaximal exercise (p: 0.015) and this situation continued after the exercise (p: 0.003). The distance covered in submaximal exercise is higher in favor of TTAs (p<0.001). Pain increased significantly following submaximal exercise in both groups (p<0.05)
Conclusion: The results of the study showed the level of amputation does not have a distinctive effect on the development of static postural adaptations. Similarly, it was determined the effect of submaximal exercise on posture and back pain are not affected by the level of amputation. With early rehabilitation program, adaptations and back pain can be reduced, even prevented.

Keywords

• amputation
• asymmetry
• posture
• submaximal exercises

Submaksimal Egzersizin Statik Postural Adaptasyonlar ve Bel Ağrısı Üzerine Etkisi: Transtibial ve Transfemoral Amputelerin Karşılaştırılması

Abstract

Amaç: Transtibial (TTA) ve Transfemoral (TFA) amputelerde görülen statik postural adaptasyonları ve submaksimal egzersizin postür ile bel ağrısı üzerine etkisini değerlendirmek ve karşılaştırmaktır.
Gereç ve Yöntem: Prospektif olarak yapılan araştırmaya, tek taraflı transtibial (n:14; yaş:36,36±12,15 yıl) ve transfemoral (n:15; yaş:27,36±7,60 yıl) ampütasyona sahip erkek olgular dahil edilmiştir. Postüral parametrelerin ölçümü ayakta serbest duruş ile her iki ekstremiteye eşit ağırlık verilmiş duruş pozisyonunda, ADIBAS Posture (Physical TECH, Barselona, İspanya) ile elde edilen görüntülerin analizi yoluyla gerçekleştirilmiştir. Submaksimal egzersiz amacıyla 6 Dakika Yürüme Testi yapılmış; tüm değerlendirmeler submaksimal egzersiz sonrasında tekrar edilmiştir. Bel bölgesi ağrısı Wong-Baker Ağrı Skalası ile değerlendirilmiştir.
Bulgular: TTA grupta, submaksimal egzersiz öncesinde, serbest duruşta elde edilen sağlıklı ve ampute taraf lordoz açısı arasındaki fark anlamlı bulunmuştur (p:0,019). Submaksimal egzersizi takiben Spina İliaca Posterior Superior düzlem açısı iki duruş pozisyonu arasında anlamlı düzeyde farklılık göstermiştir (p:0,041). TFA grupta, submaksimal egzersiz öncesinde, omuz düzlem açısı duruş pozisyonları arasında anlamlı fark göstermiştir (p:0,015) ve bu durum egzersizi takiben devam etmiştir (p:0,003). Egzersiz sırasında katedilen mesafe TTA’lar lehine yüksek bulunmuştur (p<0,001). Ağrı submaksimal egzersizi takiben her iki grupta da anlamlı düzeyde artmıştır (p<0.05).
Sonuç: Çalışmanın sonuçları amputasyon seviyesinin statik postural adaptasyonların gelişiminde ayırt edici bir etkiye sahip olmadığını göstermiştir. Benzer şekilde, submaksimal egzersizin postür ve bel ağrısı üzerine etkisinin amputasyon seviyesinden etkilenmediği tespit edilmiştir. Erken dönem rehabilitasyon uygulamaları ile postüral adaptasyonların ve bel ağrısının semptom şiddeti düşürülebilir hatta önlenebilir.

Keywords

• amputasyon
• asimetri
• postür
• submaksimal egzersiz

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