Diz osteoartritli hastalarda ağrı, fonksiyonel düzey ve yürüyüşün zaman mesafe parametreleri

Yıl 2019, Cilt: 6 Sayı: 2, 86 - 92, 23.08.2019

Cansu Şahbaz Pirinççi Meltem Işıntaş Arık Emine Aslan Telci

Öz

Amaç: Bu
çalışmanın amacı, sağlıklı kadınlar ve diz osteoartritli (OA) kadınlarda ağrı, fonksiyonel
durum ve yürüme ile ilişkili parametreleri karşılaştırmaktı.

Yöntem: Çalışmaya
Amerikan Romatoloji Derneği’nin kriterlerine göre diz OA olan 27 kadın (yaş ortalaması
47,25±6,46 yıl) ve 34 sağlıklı kadın (yaş ortalaması 47,29±4,50 yıl) alındı. Bireylerin
ağrı şiddeti vizüel analog skalası (VAS) ile sorgulandı. Q açısını değerlendirmek
için gonyometrik ölçüm yapıldı. Fiziksel fonksiyonları Western Ontario and McMaster
Universities Osteoarthritis Index (WOMAC) Skalası kullanılarak değerlendirildi.
Yürümenin zaman mesafe parametreleri ise Zebris™ FDM-2 cihazı ile ölçüldü.

Bulgular: Bu
çalışmanın sonuçları diz OA’lı kadınların sağlıklı bireylere göre ağrı şiddetinin
daha yüksek ve fonksiyonel düzeylerinin daha düşük olduğunu gösterdi (p<0,05).
Yürüme ile ilişkili parametreler incelendiğinde OA’lı kadınlarda sağlıklı kadınlara
göre adım uzunluğu (p<0,05), çift adım uzunluğu yüzdesi (p<0,05) ve yürüme
hızının (p<0,05) daha düşük, adım genişliğinin daha yüksek (p<0,05) olduğu
belirlendi.

Sonuç: Bu çalışma
diz OA’lı kadınlarda ağrı şiddeti, fonksiyonel düzey ve yürümenin aynı yaştaki sağlıklı
kadınlara göre olumsuz yönde etkilendiğini gösterdi.

Anahtar Kelimeler

Diz, Osteoartrit, Yürüme

Pain, functionality, and spatio-temporal gait parameters in patients with knee osteoarthritis

Öz

Purpose: The aim of this study was to compare pain,
functionality and walking related parameters in healthy women and women with
knee osteoarthritis.

Methods: 27 women with knee osteoarthritis (with an average age of 47.25±6.46
years) and 34 healthy women (with an average age of 47.29±4.50 years) were
included in the study according to the American College of Rheumatology (ACR) criteria.
The magnitude of pain level was questioned via Visual Analogue Scale (VAS). Q
angle was measured using a universal goniometer. Functional status was
evaluated using the Western Ontario and McMaster Universities Osteoarthritis
Index (WOMAC). Time-distance parameters of walking was measured by Zebris™
FDM-2 equipment.

Results: The
results of this study showed that pain level was higher and functionality was
lower in women with knee osteoarthritis compared to healthy women (p<0.01).
It is determined that step length (p <0.05), double step length percentage
(p < 0.01) and walking speed measurements (p<0.05) were lower and step width
measurements (p<0.05) were higher in women with knee osteoarthritis compared
to healthy women.

Conclusion: This study showed that pain level, functional status
and walking were negatively affected in women with knee osteoarthritis compared
to age-matched healthy women.

Anahtar Kelimeler

Knee, Osteoarthritis, Gait

Kaynakça

• 1. Taş S, Baki A, Erdoğanoğlu Y, et al. Diz osteoartrit şiddetinin yürüyüşün kinematik parametreleri üzerine etkileri. Turk J Physiother Rehabil. 2014;25:1-7.
• 2. Dıracoglu D, Aydın R, Baskent A, et al. Effect of kinesthesia and Balance exercises in knee osteoarthritis. J Rheumatol. 2005;11:303-310.
• 3. Veldman MP, Item-Glatthorn JF, Visscher R, et al. Somatosensory Electrical Stimulation Does Not Improve Motor Coordination in Patients with Unilateral Knee Osteoarthritis. J Clinic Med.2019;8:259.
• 4. Birmingham TB, Kramer JF, Kirkley A, et al. Association among neuromuscular and anatomic measures for patients with knee osteoarthritis. Arch Phys Med Rehabil.2001;82:1115-1118.
• 5. Petersen KK, Siebuhr AS, Graven-Nielsen O, et al. Sensitization and serological biomarkers in knee osteoarthritis patients with Different degrees of synovitis. Clin J Pain. 2016;32:841-848.
• 6. Hunt MA, McManus FJ, Hinman RS, et al. Predictors of single-leg standing balance in individuals with medial knee osteoarthritis. Arthritis Care Res. 2010;62:496-500.
• 7. Bilgiç A, Kamiloğlu R, Tuncer S. Diz Osteoartritinde İzokinetik Egzersiz Programının Etkinliği. J PMR Sci.2007;3:70-75.
• 8. Al-Zahrani KS, Bakheit AM. A study of gait characteristic of patients with chronic osteoarthritis of the knee. Disabil Rehabil. 2002;24:275-280.
• 9. Baliunas AJ, Hurwitz DE, Ryals, AB, et al. Increased knee joint loads during walking are present in subjects with knee osteoarthritis. Osteoarthr Cartil. 2002;10:573-579.
• 10. Hurwitz DE, Ryals AR, Block JA, et al. Knee pain and joint loading in subjects with osteoarthritis of the knee. J Orthop Res. 2000;18: 572-579.
• 11. Gok H, Ergin S, Yavuzer G. Kinetic and kinematic characteristics of gait in patients with medial knee arthrosis. Acta Orthop Scan. 2002;73:647-652.
• 12. Draper CE, Chew KTL, Wang R, et al. Comparison of Quadriceps Angle Measurements Using Short-Armand Long-Arm Goniometers: Correlation With MRI. PM R. 2011;3:111-116.
• 13. Pritzker KPH. Pathology of Osteoarthritis. Osteoarthritis. New York: Oxford University Press. 2003; 49-58.
• 14. Tüzün EH, Eker L, Aytar A, et al. Acceptability, reliability, validity and responsiveness of the Turkish version of WOMAC osteoarthritis index. Osteoart Cartil. 2005;13:28-33.
• 15. Angst F, Aeschlimann A, Steiner W, et al. Responsiveness of the WOMAC osteoarthritis index as compared with the SF-36 in patients with osteoarthritis of the legs undergoing a comprehensive rehabilitation intervention. Ann Rheum Dis. 2001;60:834-840.
• 16. Arık MI, Aras Ö, Akkan H, et al. Total Diz Artroplastisi Sonrası Erken Dönemde Plantar Basınç Dağılımı Nasıl Değişir? Pilot Çalışma. Osmangazi Tıp Dergisi. 2018.
• 17. Bilgiç A, Kamiloğlu R, Tuncer S. Diz Osteoartritinde İzokinetik Egzersiz Programının Etkinliği. J PMR Sci. 2007;3:70-75.
• 18. Kul-Panza E, Bekker N. Pedobarographic findings in patients with knee osteoarthritis. Am J Phys Med Rehabil. 2006;85:228-233.
• 19. Sun SF, Hsu CW, Hwang CW, et al. Hyaluronate improves pain, physical function and balance in the geriatric osteoarthritic knee: a 6-month follow-up study using clinical tests. Osteoarthr Cartil. 2006;14:696-701.
• 20. Clark, AL. Osteoarthritis: what we have been missing in the patellofemoral joint. Exerc Sport Sci Rev. 2008;36:30-37.
• 21. Erduran M, Akseki D, Karaoğlan O, et al. Gonartrozlu hastalarda patellofemoral eklem dinamiği. Joint Dis Rel Surg. 2009;20:18-24.
• 22. Clement, Nicholas D., et al. An Overview and Predictors of Achieving the Postoperative Ceiling Effect of the WOMAC Score Following Total Knee Arthroplasty. J Arthroplasty. 2019;34: 273-280.
• 23. Woo J, Lau E, Lee P,et al. Impact of osteoarthritis on quality of life in Hong Kong Chinese population. J Rheumatol. 2004;31:2433-2468.
• 24. Ünal N, Tosun B, Can N, et al. Diz Osteoartriti Olan Hastaların Yaşam Kalitesinin ve Etki Eden Parametrelerin Belirlenmesi. Düzce Med J.2016;18.
• 25. Creamer P, Lethbridge-Cejku M, Hochberg MC. Factors associated with functional impairment in symptomatic knee osteoarthritis. Rheumatol. 2000;39:490-496.
• 26. Rana P,Joshi S, Bodwal M. Quantitative Gait Analysis In Patients With Knee Osteoarthritis. Int J Physiother Res. 2016;4:1684-1688.
• 27. Paquette MR, Klipple G, Zhang S. Greater step widths reduce internal knee abduction moments in medial compartment knee osteoarthritis patients during stair ascent. Appl Biomech. 2015;31:229-236.
• 28. McAndrewYoung PM, Dingwell JB. Voluntary changes in step width and step length during human walking affect dynamic margins of stability. Gait Posture. 2012;36:219-224.
• 29. Kiss RM. Effect of severity of knee osteoarthritis on the variability of gait parameters. Electromyogr Kinesiol. 2011;21:695-703.
• 30. Huang SC, Wei IP, Chien HL, et al. Effects of severity of degeneration on gait patterns in patients with medial knee osteoarthritis. Med Eng Phys. 2008;30:997-1003.
• 31. Kiliçoğlu O, Dönmez A, Karagülle Z, et al. Effect of balneotherapy on temporospatial gait characteristics of patients with osteoarthritis of the knee. Rheumatol Int. 2010;30:739-747.
• 32. Harding GT, Hubley-Kozey CL, Dunbar MJ, et al. Body mass index affects knee joint mechanics during gait differently with and without moderate knee osteoarthritis. Osteoarthr Cartil. 2012;20:1234-1242.