VESTİBÜLER BOZUKLUĞU OLAN HASTALARDA KALÇA STRATEJİSİ KULLANIMI: RETROSPEKTİF BİR ÇALIŞMA

Yıl 2023, Cilt: 9 Sayı: 1, 43 - 54, 30.04.2023

Oğuz Yılmaz , Kerem Ersin , Şeyma Tuğba Öztürk , Mustafa Bülent Şerbetçioğlu

Öz

Duruş ve hareket için kullanılan üç ana postüral strateji ayak bileği, kalça ve adımlama stratejileridir. Ağırlık merkezi izdüşümü sınırları içindeyken ayak bileği ile denge sağlanırken ağırlık merkezi bu sınırların dışına çıktığında kalça stratejisi kullanılır.. Bu çalışmanın amacı, vestibüler sistem bozukluğu olan hastaların postürlerini ayarlarken hangi stratejiyi kullandıkları ve düştüklerinde hangi stratejiyi kullanamadıkları araştırmaktır. 2014-2021 yılları arasında vestibüler disfonksiyonu olan 40 kişi ve sağlık 40 kişi çalışmaya alınmıştır. Katılımcılar bilgisayarlı dinamik postürografi test ile değerlendirildi. Katılımcıların duyusal organizasyon testi (SOT) puanları için değerlendirildi. Ayak bileği stratejisi, SOT 5. ve 6. durumlarında vestibüler disfonksiyonlu hastalara göre anlamlı şekilde daha bir iyi çıktı (p<0.05). Hastaların düştükleri ve düşmedikleri durumlardaki strateji skorlarında da anlamlı fark gözlendi (p<0.05). 5. koşuldaki puanların düşme ve düşmeme karşılaştırılmasında anlamlı olarak bir fark gözlenirken, 6. koşulda önemli bir fark gözlenmedi. Kullanım için zorlu kullanımların yollarına yol vestibüler kullanılarak atılır. Vestibüler hipofonksiyonlu hastalarda düşmeyi azalmak için vestibüler rehabilitasyon planlanırken kalça stratejisi egzersizlerine önem verilmelidir.

Anahtar Kelimeler

POSTÜR, DÜŞME, HAREKET, KALÇA, AYAK BİLEĞİ

USE OF HIP STRATEGY IN PATIENTS WITH VESTIBULAR DISORDER: A RETROSPECTIVE STUDY

Öz

The three main postural strategies used to adjust posture and movement are ankle, hip and stepping strategies. While normal individuals use ankle strategy when center of gravity (COG) is within the limits of stability, they transition to hip strategy when COG approaches or exceeds the limits of stability. The aim of this study is to investigate which strategy is dominantly used by people with vestibular disorders whilst adjusting their posture and which strategy is used when they fall. Twenty patients with diagnosed vestibular dysfunction and nineteen healthy individuals evaluated between the years 2014-2019 were included in the study. The participants were assessed for balance with the computer dynamic posturography. Participants` sensory organization test (SOT) scores were collected for evaluation. The collected data were analyzed for normal distribution via One-Sample Kolmogorov-Smirnov test, while Mann Whitney U was used to determine significant difference. Use of ankle strategy was superior in normal individuals in comparison to individuals with vestibular disorders using SOT 5th and 6th conditions (p<0.05). Significant difference was observed between the strategies used by the participants in situations where they did and did not fall (p<0.05). While a statistically significant difference was observed in the comparison of falls within 5th condition, a significant difference was not observed in 6th condition. Due to the impairment of the vestibular system leading to the usage of the ankle strategy in challenging conditions, patients with vestibular defects fall more frequently. During the planning of vestibular rehabilitation for such patients, improving the hip strategy should be considered essential.

Anahtar Kelimeler

POSTURE, FALLS, MOVEMENT, HIP, ANKLE

Kaynakça

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