Total kalça artroplastili hastalarda egzersiz yapma süresinin yapay eklemi unutma becerisi, ağrı ve fonksiyonel durum üzerine etkisi

Yıl 2016, Cilt: 3 Sayı: 1, 30 - 35, 01.04.2016

Sercan Önal Gizem İrem Kınıklı Hande Güney Ceyda Sarıal Ömür Çağlar Bülent Atilla İnci Yüksel

Öz

Amaç: Bu çalışmanın amacı, kalça osteoartriti nedeniyle total kalça artroplastisi (TKA) cerrahisi geçiren hastaların egzersiz yapma süresinin yapay eklemi unutma yeteneği, ağrı ve fonksiyonel durum üzerine etkisini araştırmaktı.

Yöntem: Çalışmaya tek taraflı TKA cerrahisi geçirmiş toplam 42 hasta (26’sı kadın, 16’sı erkek) dahil edildi. Hastalar egzersiz yapma sürelerine göre 6 aydan kısa egzersiz yapan grup (Yaş ortalaması: 53,9±15,1 yıl, vücut kütle indeksi: 27,2±1,5 kg/cm2, N=24) ve 6 aydan uzun süre egzersiz yapan grup (57,5±13,3 yıl, Vücut kütle indeksi: 27,2±5,2 kg/cm2, N=18) olmak üzere iki gruba ayrıldı. TKA cerrahisi sonrası hastaların yapay kalça eklemlerini unutma yeteneğini belirlemek amacıyla Unutulan Eklem Ölçeği-12 (UEÖ-12) uygulandı. Fonksiyonel durumu belirlemek amacıyla, Western Ontario ve McMaster Osteoartrit İndeksi (WOMAC) kullanıldı.

Bulgular: Gruplar arasında WOMAC tutukluk puanında fark yoktu (p>0,05). WOMAC ağrı ve WOMAC fonksiyon puanları, uzun süreli egzersiz yapan grupta, kısa süreli egzersiz yapan gruptan daha iyi bulundu (p<0,05). UEÖ-12 skorları gruplar arasında karşılaştırıldığında, uzun süre yapan grubun lehine fark vardı (p<0,05).

Sonuç: TKA’yı takiben yapılan 6 aydan fazla egzersiz eğitiminin, hastaların yapay eklemlerini unutabilme yeteneğini geliştirmenin yanı sıra ağrı ve fonksiyonlar üzerine de olumlu etkileri vardır.

Anahtar Kelimeler

Artroplasti, Kalça, Farkındalık, Egzersiz

Kaynakça

• 1. Williams SJ. OPCS Surveys of Disability in Great Britain, Report 1: The Prevalence of Disability Among Adults (Book). Sociology of Health & Illness. 1989;11(2):187-189.
• 2. Dougados M, Gueguen A, Nguyen M, et al. Radiological progression of hip osteoarthritis: definition, risk factors and correlations with clinical status. Ann Rheum Dis. 1996;55(6):356-362.
• 3. Lowe CJM, Barker KL, Dewey ME, et al. Effectiveness of physiotherapy exercise following hip arthroplasty for osteoarthritis: a systematic review of clinical trials. BMC Musculoskelet Dis.2009;10:1.
• 4. Matsumoto M, Baba T, Homma Y, et al. Validation study of the Forgotten Joint Score-12 as a universal patient-reported outcome measure. Eur J Orthop Surg Tr. 2015;25:1141-1145.
• 5. Learmonth ID, Young C, Rorabeck C. The operation of the century: total hip replacement. Lancet. 2007;370(9597):1508-1519.
• 6. Trudelle-Jackson E, Emerson R, Smith S. Outcomes of total hip arthroplasty: a study of patients one year postsurgery. J Orthop Sport Phys. 2002;32:260-267.
• 7. Vissers MM, Bussmann JB, Verhaar JA, et al. Recovery of physical functioning after total hip arthroplasty: systematic review and metaanalysis of the literature. Phys Ther. 2011;91:615-629.
• 8. Ritter MA, Albohm MJ, Keating EM, et al. Life expectancy after total hip arthroplasty. J Arthroplasty. 1998;13:874-875.
• 9. Berry DJ, Harmsen WS, Cabanela ME, et al. Twenty-five-year survivorship of two thousand consecutive primary Charnley total hip replacements: factors affecting survivorship of acetabular and femoral components. J Bone Joint Surg Am. 2002;84:171-177.
• 10. Jones CA, Beaupre LA, Johnston D, et al. Total joint arthroplasties: current concepts of patient outcomes after surgery. Rheum Dis Clin N Am. 2007;33:71-86.
• 11. Montin L, Leino‐Kilpi H, Suominen T, et al. A systematic review of empirical studies between 1966 and 2005 of patient outcomes of total hip arthroplasty and related factors. J Clin Nurs. 2008;17:40-45.
• 12. Ethgen O, Bruyere O, Richy F, et al. Healthrelated quality of life in total hip and total knee arthroplasty. J Bone Joint Surg Am. 2004;86:963-974.
• 13. Wright RW. Knee injury outcomes measures. J Am Acad Orthop Sur. 2009;17:31-39.
• 14. Suk M, Norvell DC, Hanson B, et al. Evidence‐based orthopaedic surgery: what ıs evidence without the outcomes? J Am Acad Orthop Sur. 2008;16:123-129.
• 15. Pollard B, Johnston M, Dixon D. Theoretical framework and methodological development of common subjective health outcome measures ın osteoarthritis: a critical review. Health Qual Life Out. 2007;5:1.
• 16. Trudelle-Jackson E. Balance and postoperative lower extremity joint replacement. Orthop Clin N Am. 2002;11:101-110.
• 17. Roos EM. Effectiveness and practice variation of rehabilitation after joint replacement. Curr Opin Rheumatol. 2003;15(2):160-2.
• 18. Westby MD, Brittain A, Backman CL. Expert consensus on best practices for post–acute rehabilitation after total hip and knee arthroplasty: a Canada and United States Delphi Study. Arthrit Care Res. 2014;66:411-423.
• 19. Thienpont E, Opsomer G, Koninckx A, et al. Joint awareness in different types of knee arthroplasty evaluated with the forgotten joint score. J Arthroplasty. 2014;29:48-51.
• 20. Hamilton DF, Giesinger JM, MacDonald DJ, et al. Responsiveness and ceiling effects of the Forgotten Joint Score-12 following total hip arthroplasty. Bone Joint Res. 2016;5:87-91.
• 21. Giesinger JM, Kuster MS, Holzner B, et al. Development of a computer-adaptive version of the Forgotten Joint Score. J Arthroplasty. 2013;28:418-422.
• 22. Kinikli Gİ, Güney H, Karaman A, et al. Functional mobility on discharge day after total knee and hip replacement surgery. Turk J Physiother Rehabil. 2014;25:1-7.
• 23. Behrend H, Giesinger K, Giesinger JM, et al. The “Forgotten Joint” as the ultimate goal ın joint arthroplasty: validation of a new patientreported outcome measure. J Arthroplasty. 2012;27:430-6.e1.
• 24. Bellamy N. Validation study of WOMAC: A health status instrument for measuring clinically-important patient-relevant outcomes following total hip or knee arthroplasty in osteoarthritis. J Orthop Rheumatol. 1988;1:95-108.
• 25. Tüzün E, Eker L, Aytar A, et al. Acceptability, reliability, validity and responsiveness of the Turkish Version of WOMAC Osteoarthritis Index. Osteoarthr Cartilage. 2005;13:28-33.
• 26. Giesinger K, Hamilton D, Jost B, et al. comparative responsiveness of outcome measures for total knee arthroplasty. Osteoarthr Cartilage. 2014;22:184-189.
• 27. Thienpont E, Berghe AV, Schwab P, et al. Joint awareness in osteoarthritis of the hip and knee evaluated with the ‘Forgotten Joint’ score before and after joint replacement. Knee Surg Sports Traumatol Arthrosc. 2016 Jan 6.