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Sağlıklı sedanter bireylerde vücut ağırlığı artışının ayak postürü ve diz ağrısı üzerine etkisi

Yıl 2016, Cilt: 3 Sayı: 2, 66 - 71, 01.08.2016

Öz

Amaç: Bu çalışmanın amacı, vücut ağırlığı artışının her hangi bir alt ekstremite patolojisine sahip olmayan orta yaş sağlıklı sedanter bireylerin ayak biyomekaniği ve diz ağrısı üzerine etkisiyle ilgili bilgi edinmekti.


Yöntem: Çalışmaya 45-55 yaşları arasında 75 kadın, 18 erkek toplam 93 birey alındı. Bireylerin vücut kütle indeksi (VKİ), medial longitudinal arkları (MLA) ve subtalar açıları (SA) ölçüldü. Pes planusun MLA değerlendirilmesinde Harris tabakası, diğer açısal ölçümlerde ise universal gonyometre kullanıldı. Harris tabakası ile bulunan ayak tabanı grafisini yorumlamak için Staheli indeksi kullanıldı. Vizüel analog skala ile diz ağrısı değerlendirildi. Bütün ölçümler saat 16:00 ile 18:00 arasında ve bireyler 30 dk dinlendikten sonra yapıldı. Ölçümler standart tekniklerle yapıldı ve üç kez tekrarlandı.


Bulgular: Değerlendirmelerin sonucuna göre, VKİ ile Sİ, Sİ ile SA arasındaki ilişki anlamlıydı (p< 0,05). VKİ ile SA arasında anlamlı ilişki olmadığı görüldü (p>0,05). Sİ ve SA ile ağrı arasında anlamlı ilişki bulundu (p<0,05). VKİ ile diz ağrısı arasında ise zayıf anlamlı ilişki olduğu belirlendi (p=0,049).


Tartışma: Bu çalışma, pes planus’un VKİ’den doğrudan etkilendiğini, SA’nın ise VKİ’den ayak arkının değişmesiyle dolaylı olarak etkilendiğini gösterdi. VKİ artışı ile birlikte ayak arkındaki değişikliklerin hatalı alt ekstremite dizilimi ve dizde ağrı oluşmasına neden olabileceği, bu durumun da uzun vadede alt ekstremiteye bağlı ortopedik sorunların birincil nedeni olabileceği sonucuna varıldı.

Kaynakça

  • 1. Burton BT, Foster WR, Hirsch J, et al. Health implications of obesity: an NIH Consensus Development Conference. Int J Obes. 1985;9:155-169.
  • 2. Tukker A, Visscher TL, Picavet HS. Overweight and health problems of the lower extremities: osteoarthritis, pain and disability. Public Health Nutr. 2009;12:359-368
  • 3. Chan G, Chen CT. Musculoskeletal effects of obesity. Curr Opin Pediatr. 2009;21(1):65-70.
  • 4. Palastanga N, Soames RW. Anatomy and human movement: Structure and function. Churchill living stone Elsevier 6th ed; 2011.
  • 5. Nigg BM, Herzog W. Biomechanics of the Musculo-skeletal System. 3rd ed. Wiley. 2007.
  • 6. Shih YF, Chen CY, Chen WY, et al. Lower extremity kinematics in children with and without flexible flatfoot: a comparative study. BMC Musculoskelet Disord. 2012;13:31.
  • 7. Gross KD, Felson DT, Niu J, et al. Association of flat feet with knee pain and cartilage damage in older adults. Arthritis Care Res (Hoboken). 2011;63:937-944.
  • 8. Barry JR, Scranton PE Jr. Flat feet in children. Clin Orthop Rel Res. 1983;181(12):69-75.
  • 9. Rodgers MM. Dynamic biomechanics of the normal foot and ankle during walking and running. Phys Ther. 1988;68:1822-1830.
  • 10. Morris JM. Biomechanics of the foot and ankle. Clin Orthop Rel Res. 1977;122(1-2):10-17.
  • 11. Mann R. Biomechanics of the foot. In Atlas of Orthotics, American Academy of Orthopedic Surgeon 2nd ed. CV Mosby Company, St. Louis. 1985:112-125.
  • 12. Bernhardt DB. Prenatal and postnatal growth and development of the foot and ankle. Phys. Ther. 1988;68(12):1831-1839.
  • 13. Salathe EP, Arangio GA. The Foot as a shock absorber. J Biomech. 1990;23(7):655-659.
  • 14. Stolzman S, Irby MB, Callahan AB, Skelton JA. Pes planus and paediatric obesity: a systematic review of the literature. Clin Obes. 2015;5(2):52-59.
  • 15. Coughlin MJ, Kaz A. Correlation of Harris mats, physical exam, pictures, and radiographic measurements in adult flatfoot deformity. Foot Ankle Int. 2009;30(7):604-612.
  • 16. Messier SP, Davies AB, Moore DT, Davis SE, Pack RJ, Kazmar SC. Severe obesity: effects on foot mechanics during walking. Foot Ankle Int. 1994;15(1):29-34.
  • 17. Hills AP, Henning EM, McDonald M, et al. Plantar pressure differences between obese and non-obese adults: a biomechanical analysis. Int J Obes Relat Metab Disord. 2001 Nov;25(11):1674-1679.
  • 18. Aurichio TR, Rebelatto JR. The relationship between the body mass index (BMI) and foot posture in elderly people. Arch Gerontol Geriatr. 2011;52(2):89-92.
  • 19. Dowling AM, Steele JR, Baur LA. Does obesity influence foot structure and plantar pressure patterns in prepubescent children? Int J Obes Relat Metab Disord. 2001;25(6):845-852.
  • 20. Chuckpaiwong B, Nunley JA 2nd, Queen RM. Correlation between static foot type measurements and clinical assessments. Foot Ankle Int. 2009;30(3):205-12. 21. Hunt AE, Fahey AJ, Smith RM. Static measures of calcaneal deviation and arch angle as predictors of rearfoot motion during walking. Aust J Physiother. 2000;46(1):9-16.
  • 22. Tachdijian MO. Pediatric orthopedics 2nd ed. W.B. Saunders Company. Philadelphia. 1990:2717-2728.
  • 23. Gould N. Evaluation of Hyperpronation and pes planus in Adults. Clin Orthop Rel Res. 1983;181(12):37-45.
  • 24. Bernhardt DB. Prenatal and Postnatal Growth and Development of the Foot and Ankle. Phys Ther. 1988;68(12):1831-1839.
  • 25. Janke EA, Collins A, Kozak AT. Overview of the relationship between pain and obesity: What do we know? Where do we go next? J Rehabil Res Dev. 2007;44(2):245-62.
  • 26. Tenenbaum S, Hershkovich O, Gordon B, et al. Flexible pes planus in adolescents: body mass index, body height, and gender--an epidemiological study. Foot Ankle Int. 2013;34(6):811-7.
  • 27. Hatfield GL, Cochrane CK, Takacs J, et al. Knee and ankle biomechanics with lateral wedges with and without a custom arch support in those with medial knee osteoarthritis and flat feet. J Orthop Res. 2016 Jan 22. doi:10.1002/jor.23174.
  • 28. Sadeghi-Demneh E, Azadinia F, Jafarian F, et al. Flatfoot and obesity in school-age children: a cross-sectional study. Clin Obes. 2016;6(1):42-50.

Effects of increased body mass index on foot posture and knee pain in healthy sedentaries

Yıl 2016, Cilt: 3 Sayı: 2, 66 - 71, 01.08.2016

Öz

Purpose: The aim of this study was to obtain information regarding the effect of body weight gain on the biomechanics of foot and the knee pain in middle aged healthy sedentary individuals without any lower extremity pathology. 


Methods: Seventy-five women and 18 men a total of 93 cases between the ages of 45-55 years were included in the study. Body mass index (BMI), medial longitudinal arch (MLA), and subtalar angles (SA) of participants were measured. To evaluate pes planus (medial longitudinal arch), Harris Mat was used and universal goniometer was used for angular measurements. The Staheli Index (SI) was used to interpret the graph of foot arch found using the Harris Mat. Knee pain was evaluated by Visual Analog Scale. All assessments were performed at a standard time line between 16:00 and 18.00 after resting for 30 minutes. Measurements were performed with standard techniques, and repeated for three times.


Results: According to the results of the evaluations, there were significant correlations between SI and BMI and SA (p<0.05). There was no significant difference between BMI and SA (p>0.05). There were significant correlations between the SI and SA with pain (p<0.05). There was a weak significant correlation between BMI and the knee pain (p=0.049). 


Conclusion: This study showed that foot arch (pes planus) was directly affected from BMI and SA was indirectly affected. Changes in foot arch with the increase of BMI may cause incorrect alignment of lower extremity and formation of the knee pain. It was concluded that this situation may be the primary reason for the orthopedic problems due to the lower extremities in long term.

Kaynakça

  • 1. Burton BT, Foster WR, Hirsch J, et al. Health implications of obesity: an NIH Consensus Development Conference. Int J Obes. 1985;9:155-169.
  • 2. Tukker A, Visscher TL, Picavet HS. Overweight and health problems of the lower extremities: osteoarthritis, pain and disability. Public Health Nutr. 2009;12:359-368
  • 3. Chan G, Chen CT. Musculoskeletal effects of obesity. Curr Opin Pediatr. 2009;21(1):65-70.
  • 4. Palastanga N, Soames RW. Anatomy and human movement: Structure and function. Churchill living stone Elsevier 6th ed; 2011.
  • 5. Nigg BM, Herzog W. Biomechanics of the Musculo-skeletal System. 3rd ed. Wiley. 2007.
  • 6. Shih YF, Chen CY, Chen WY, et al. Lower extremity kinematics in children with and without flexible flatfoot: a comparative study. BMC Musculoskelet Disord. 2012;13:31.
  • 7. Gross KD, Felson DT, Niu J, et al. Association of flat feet with knee pain and cartilage damage in older adults. Arthritis Care Res (Hoboken). 2011;63:937-944.
  • 8. Barry JR, Scranton PE Jr. Flat feet in children. Clin Orthop Rel Res. 1983;181(12):69-75.
  • 9. Rodgers MM. Dynamic biomechanics of the normal foot and ankle during walking and running. Phys Ther. 1988;68:1822-1830.
  • 10. Morris JM. Biomechanics of the foot and ankle. Clin Orthop Rel Res. 1977;122(1-2):10-17.
  • 11. Mann R. Biomechanics of the foot. In Atlas of Orthotics, American Academy of Orthopedic Surgeon 2nd ed. CV Mosby Company, St. Louis. 1985:112-125.
  • 12. Bernhardt DB. Prenatal and postnatal growth and development of the foot and ankle. Phys. Ther. 1988;68(12):1831-1839.
  • 13. Salathe EP, Arangio GA. The Foot as a shock absorber. J Biomech. 1990;23(7):655-659.
  • 14. Stolzman S, Irby MB, Callahan AB, Skelton JA. Pes planus and paediatric obesity: a systematic review of the literature. Clin Obes. 2015;5(2):52-59.
  • 15. Coughlin MJ, Kaz A. Correlation of Harris mats, physical exam, pictures, and radiographic measurements in adult flatfoot deformity. Foot Ankle Int. 2009;30(7):604-612.
  • 16. Messier SP, Davies AB, Moore DT, Davis SE, Pack RJ, Kazmar SC. Severe obesity: effects on foot mechanics during walking. Foot Ankle Int. 1994;15(1):29-34.
  • 17. Hills AP, Henning EM, McDonald M, et al. Plantar pressure differences between obese and non-obese adults: a biomechanical analysis. Int J Obes Relat Metab Disord. 2001 Nov;25(11):1674-1679.
  • 18. Aurichio TR, Rebelatto JR. The relationship between the body mass index (BMI) and foot posture in elderly people. Arch Gerontol Geriatr. 2011;52(2):89-92.
  • 19. Dowling AM, Steele JR, Baur LA. Does obesity influence foot structure and plantar pressure patterns in prepubescent children? Int J Obes Relat Metab Disord. 2001;25(6):845-852.
  • 20. Chuckpaiwong B, Nunley JA 2nd, Queen RM. Correlation between static foot type measurements and clinical assessments. Foot Ankle Int. 2009;30(3):205-12. 21. Hunt AE, Fahey AJ, Smith RM. Static measures of calcaneal deviation and arch angle as predictors of rearfoot motion during walking. Aust J Physiother. 2000;46(1):9-16.
  • 22. Tachdijian MO. Pediatric orthopedics 2nd ed. W.B. Saunders Company. Philadelphia. 1990:2717-2728.
  • 23. Gould N. Evaluation of Hyperpronation and pes planus in Adults. Clin Orthop Rel Res. 1983;181(12):37-45.
  • 24. Bernhardt DB. Prenatal and Postnatal Growth and Development of the Foot and Ankle. Phys Ther. 1988;68(12):1831-1839.
  • 25. Janke EA, Collins A, Kozak AT. Overview of the relationship between pain and obesity: What do we know? Where do we go next? J Rehabil Res Dev. 2007;44(2):245-62.
  • 26. Tenenbaum S, Hershkovich O, Gordon B, et al. Flexible pes planus in adolescents: body mass index, body height, and gender--an epidemiological study. Foot Ankle Int. 2013;34(6):811-7.
  • 27. Hatfield GL, Cochrane CK, Takacs J, et al. Knee and ankle biomechanics with lateral wedges with and without a custom arch support in those with medial knee osteoarthritis and flat feet. J Orthop Res. 2016 Jan 22. doi:10.1002/jor.23174.
  • 28. Sadeghi-Demneh E, Azadinia F, Jafarian F, et al. Flatfoot and obesity in school-age children: a cross-sectional study. Clin Obes. 2016;6(1):42-50.
Toplam 27 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Ebrar Atak Bu kişi benim

Hanefi Özbek Bu kişi benim

Zehra Candan Algun Bu kişi benim

Yayımlanma Tarihi 1 Ağustos 2016
Gönderilme Tarihi 17 Mayıs 2016
Yayımlandığı Sayı Yıl 2016 Cilt: 3 Sayı: 2

Kaynak Göster

Vancouver Atak E, Özbek H, Algun ZC. Sağlıklı sedanter bireylerde vücut ağırlığı artışının ayak postürü ve diz ağrısı üzerine etkisi. JETR. 2016;3(2):66-71.