Total diz artroplastisinde quadriceps kas kuvveti, diz eklem propriosepsiyonu ve quadriceps kuvvet hissi: Sağlıklı kontrollerle karşılaştırmalı bir çalışma

Öz

Amaç: Bu çalışma eklem propriosepsiyonunun çoğunlukla ekstraartiküler proprioseptörler tarafından sağlandığı total diz artroplasti (TDA) cerrahisi geçiren bireyler ile sağlıklı kontroller arasında quadriceps kas kuvveti, diz eklemi propriosepsiyonu ve quadriceps kuvvet hissinin karşılaştırılması ve quadriceps kas kuvveti ile diz eklem propriosepsiyonu ve quadriceps kuvvet hissi arasındaki ilişkinin incelenmesi amacı ile planlandı. Yöntem: Bu çalışmaya en az dört ay önce TDA cerrahisi geçirmiş 46 birey (ortalama yaş: 67, %80,4 kadın) ve benzer yaş aralığında 46 sağlıklı kontrol (ortalama yaş: 63, %73,9 kadın) dahil edildi. Quadriceps kas kuvveti maksimal izometrik kasılma testi ile, diz eklemi pozisyon duyusu (aktif ve pasif olarak) yeniden konumlandırma hata testi ve quadriceps kası kuvvet hissi kuvvet hassasiyet testi ile değerlendirildi. Tüm değerlendirmelerde izokinetik dinamometre kullanıldı. Bulgular: Total diz artroplasti grubunda quadriceps kuvveti (p<0,001), aktif ve pasif eklem pozisyon hissi (tüm p<0,001) ve quadriceps kuvvet hissi (p=0,023) sağlıklı kontrollere göre anlamlı olarak az idi. TDA grubunda quadriceps kas kuvveti ile proprioseptif ölçümler arasında ve kontrol grubunda quadriceps kas kuvveti ile quadriceps kuvvet hissi arasında anlamlı bir ilişki bulunmazken (tüm p>0,05), kontrol grubunda quadriceps kas kuvveti ile quadriceps kuvvet hissi arasında düşük düzeyde negatif bir ilişki tespit edildi (p=0,007, rho=-0,391). Sonuç: Çalışmamızın sonuçları kuvvetli bir kasın aynı zamanda duyusal açıdan zengin olmayabileceğine ve bu yüzden bir kasın değerlendirilmesi ve tedavi süreçlerinde kuvvet bileşenine ek olarak kasın proprioseptif fonksiyonunun ayrıca ele alınması gerektiğine dair ipuçları sağlamaktadır.

Anahtar Kelimeler

• Total diz artroplastisi
• Propriosepsiyon
• Quadriceps kası
• Kas kuvveti

Quadriceps muscle strength, knee joint proprioception and quadriceps force sense in total knee arthroplasty: A comparative study with healthy controls

Öz

Purpose: This study was planned to compare the quadriceps muscle strength, knee joint proprioception, and quadriceps force sense between individuals with total knee arthroplasty (TKA) and healthy controls and investigate the relationship between quadriceps muscle strength, knee joint proprioception, and quadriceps force sense in individuals with TKA, in which joint proprioception is mostly provided by extra-articular proprioceptors. Methods: Forty-six individuals (mean age: 67, 80.4% female) who had undergone TKA surgery at least four months before and 46 age-matched healthy controls (mean age: 63, 73.9% female) were included in this study. Quadriceps muscle strength was assessed by maximal isometric contraction test, knee joint position sense (active and passive) with repositioning error test, and quadriceps force sense with force sensitivity test. An isokinetic dynamometer was used in all assessments. Results: In the total knee arthroplasty group, quadriceps strength (p<0.001), active and passive joint position sense (all p<0.001) and quadriceps muscle force sense (p=0.023) were significantly lower than in healthy controls. While there was no significant relationship between quadriceps muscle strength and proprioceptive measurements in the TKA group and quadriceps muscle strength and quadriceps force sensitivity in the control group (all p>0.05), a weak negative correlation was found between quadriceps muscle strength and quadriceps force sensitivity in the control group (p=0.007, rho=-0.391). Conclusion: Our findings provide clues that a muscle's strength is not always correlated with its sensory richness and therefore the proprioceptive function of the muscle should be considered separately in addition to the strength component in the evaluation and treatment processes of a muscle.

Anahtar Kelimeler

• Total knee arthroplasty
• Proprioception
• Quadriceps muscle
• Muscle strength

Kaynakça

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