The evaluation of postural stability and fall risk in morbidly obese preoperative bariatric patients: A cross-sectional study

Yıl 2021, Cilt: 11 Sayı: 5, 715 - 720, 17.09.2021

Nurdan Yılmaz , Ertan Bulbuloglu

https://doi.org/10.16899/jcm.976662

Cited By: 2

Öz

Amaç: Obez bireylerin, obez olmayan bireylere göre daha fazla postural instabilite ve düşme riskinde artış gösterdiği bilinmektedir. Morbid obez preoperatif bariatrik hastalarda postural stabiliteyi, düşme riskini ve postural stabiliteye katkıda bulunan faktörleri değerlendirmeyi amaçladık.
Gereç ve Yöntemler: Çalışmamıza bariatrik cerrahi öncesi değerlendirilen morbid obez 38 hasta (vücut kitle indeksi (VKI)≥40) ve 52 obez olmayan (BMI <30) sağlıklı birey dahil edildi. Katılımcıların postural stabilite indeksleri (PSI) ve düşme riski indeksi (FRI) Biodex stabilite sistemi kullanılarak değerlendirildi. Düşme korkusunu (FOF) değerlendirmek için Falls Efficacy Scale-International (FES-I) kullanıldı.
Bulgular: Çalışma grubundaki 18 hasta (%47.4) ev hanımı ve sedanterdi. Ayrıca 15 hastaya (%39.5) Diabetes Mellitus Tip 2 tanısı konuldu. Gruplar arasında FOF, düşme öyküsü varlığı ve son bir yıl içinde düşme sayısı açısından istatistiksel olarak anlamlı fark yoktu (p:0.831, p:0.558, p:0.596 sırasıyla). Ancak FES-I ve FRI skorları çalışma grubunda istatistiksel olarak anlamlı derecede yüksekti (p:0,006, p<0,001). FRI ile ağırlık, VKİ, bel ve kalça çevresi arasında istatistiksel olarak anlamlı pozitif korelasyon bulundu (r:0.708, p<0.001; r:0.697, p<0.001; r:0.699, p<0.001; r:0.715, p<0.001 sırasıyla).
Sonuç: Morbid obezite, önemli bir dinamik stabilite göstergesi olan FRI'yi olumsuz etkilemektedir. Morbid obez hastalarda bariatrik cerrahi öncesi ve sonrası postural denge eğitimi için dinamik görevlere odaklanan rehabilitasyon programlarının uygulanmasını önermekteyiz.
Anahtar Kelimeler: Obezite; Vücut kitle indeksi; Morbid obezite; Postural stabilite; düşme riski.

Anahtar Kelimeler

Obesity, Body Mass Index, Morbid Obesity, Postural stability, fall risk

Proje Numarası

--

Kaynakça

• 1. Hrysomallis C. Balance ability and athletic performance. Sports Med 2011;41(3):221-32.
• 2. Ünlüsoy D, Aydoğ E, Tuncay R, Eryüksel R, Ünlüsoy İ,Çakçı A. Postural Balance in Women with Osteoporosis and Effective Factors. Turkish Journal of Osteoporosis 2011;17:37-43.
• 3. Humphriss R, Hall A, May M, Macleod J. Balance ability of 7 and 10 year old children in the population: results from a large UK birth cohort study. Int J Pediatr Otorhinolaryngol 2011;75(1):106-13. 4. Horak FB. Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls? Age Ageing 2006;35(Suppl 2):ii7-ii11.
• 5. Teasdale N, Hue O, Marcotte J, et al. Reducing weight increases postural stability in obese and morbid obese men. Int J Obes (Lond) 2007;31(1):153-60.
• 6. Matrangola SL, Madigan ML. The effects of obesity on balance recovery using an ankle strategy. Hum Mov Sci 2011;30(3):584-95.
• 7. Miller EM, Matrangola SL, Madigan ML. Effects of obesity on balance recovery from small postural perturbations. Ergonomics 2011;54(6):547-554.
• 8. Błaszczyk JW, Cieślinska-Swider J, Plewa M, Zahorska-Markiewicz B, Markiewicz A. Effects of excessive body weight on postural control. J Biomech 2009;42(9):1295-300.
• 9. Corbeil P, Simoneau M, Rancourt D, Tremblay A, Teasdale N. Increased risk for falling associated with obesity: mathematical modeling of postural control. IEEE Trans Neural Syst Rehabil Eng 2001;9(2):126-36. 10. Dreber H, Thorell A, Torgerson J, Reynisdottir S, Hemmingsson E. Weight loss, adverse events, and loss to follow-up after gastric bypass in young versus older adults: A Scandinavian Obesity Surgery Registry study. Surg Obes Relat Dis 2018;14(9):1319-1326.
• 11. Ulus Y, Durmus D, Akyol Y, Terzi Y, Bilgici A, Kuru O. Reliability and validity of the Turkish version of the Falls Efficacy Scale International (FES-I) in community-dwelling older persons. Arch Gerontol Geriatr 2012;54(3):429-33.
• 12. Lohman TG, Roche AF, Martorerell R. Skinfold thicknesses and measurement technique. In: LohmanTG, Roche AF, Martello R, editors. Anthropometric Standardization Reference Manual, Champlain: Human kinetics books; 1988. p. 55–80.
• 13. Ibrahim MS, Mattar AG, Elhafez SM. Efficacy of virtual reality-based balance training versus the Biodex balance system training on the body balance of adults. J Phys Ther Sci 2016; 28(1):20-6.
• 14. Vaz MM, Costa GC, Reis JG, Junior WM, Albuquerque de Paula FJ, Abreu DC. Postural control and functional strength in patients with type 2 diabetes mellitus with and without peripheral neuropathy. Arch Phys Med Rehabil 2013;94(12):2465-2470.
• 15. Del Din S, Godfrey A, Galna B, Lord S, Rochester L. Free-living gait characteristics in ageing and Parkinson's disease: impact of environment and ambulatory bout length. J Neuroeng Rehabil. 2016;13(1):46.
• 16. Nodehi Moghadam A, Goudarzian M, Azadi F et al. Falls and postural control in older adults with cataracts. Med J Islam Repub Iran 2015;27(29):311.
• 17. Alfieri FM, Riberto M, Lopes JA, Filippo TR, Imamura M, Battistella LR. Postural Control of Healthy Elderly Individuals Compared to Elderly Individuals with Stroke Sequelae. Open Neurol J 2016;15(10):1-8.
• 18. Sedaghati P, Daneshmandi H, Karimi N, Barati AH. A Selective Corrective Exercise to Decrease Falling and Improve Functional Balance in Idiopathic Parkinson's Disease. Trauma Mon 2016;21(1):e23573.
• 19. Mignardot JB, Olivier I, Promayon E, Nougier V. Origins of balance disorders during a daily living movement in obese: can biomechanical factors explain everything? PLoS One 2013;8(4):e60491.
• 20. Hergenroeder AL, Wert DM, Hile ES, Studenski SA, Brach JS. Association of body mass index with self-report and performance-based measures of balance and mobility. Phys Ther 2011;91(8):1223-34.
• 21. Ku PX, Abu Osman NA, Yusof A, Wan Abas WA. Biomechanical evaluation of the relationship between postural control and body mass index. J Biomech 2012;45(9):1638-42.
• 22. Cau N, Cimolin V, Galli M et al. Center of pressure displacements during gait initiation in individuals with obesity. J Neuroeng Rehabil 2014;7(11):82.
• 23. Rossi-Izquierdo M, Santos-Pérez S, Faraldo-García A et al. Impact of obesity in elderly patients with postural instability. Aging Clin Exp Res 2016;28(3):423-8.
• 24. Mainenti MR, Rodrigues Ede C, Oliveira JF, Ferreira Ade S, Dias CM, Silva AL. Adiposity and postural balance control: correlations between bioelectrical impedance and stabilometric signals in elderly Brazilian women. Clinics (Sao Paulo) 2011;66(9):1513-8.
• 25. Alonso AC, Luna NM, Mochizuki L, Barbieri F, Santos S, Greve JM. The influence of anthropometric factors on postural balance: the relationship between body composition and posturographic measurements in young adults. Clinics (Sao Paulo) 2012;67(12):1433-41.
• 26. Owusu W, Willett W, Ascherio A et al. Body anthropometry and the risk of hip and wrist fractures in men: results from a prospective study. Obes Res 1998;6(1):12-9.