Statik pelvik tilt varyasyonlarının transfemoral protez kullanıcılarında analizi: farklı soket tasarımlarının sağlıklı kontrollerle karşılaştırılması

Abstract

Amaçlar: Bu çalışmanın amacı, transfemoral protez kullanan hastalarda pelvik tilt açılarını farklı soket tasarımlarına göre incelemek ve sağlıklı bireylerle karşılaştırmaktı. Yöntemler: Bu kesitsel çalışmaya, 14 tek taraflı transfemoral protez kullanıcısı (protez grubu) ve 14 demografik olarak benzer sağlıklı birey (kontrol grubu) olmak üzere 28 erkek katılımcı dahil edildi. Sagittal ve frontal düzlemlerdeki pelvik tilt açıları, iki kollu bir kumpas üzerine monte edilen dijital inklinometre ile ölçüldü. Bulgular: Tüm katılımcılarda anterior pelvik tilt vardı. Protez grubunda, protezli taraf ile kontralateral taraf arasında anterior pelvik tilt ve lateral pelvik tilt açılarında anlamlı bir fark yoktu (sırasıyla p=0.106, Etki Büyüklüğü (EB)=0.464; p=0.055, EB=-0.564). Hem quadrilateral soket tasarımı hem de ischial containment soket tasarımı kullanan katılımcıların protezli tarafları ile kontralateral tarafları arasında anterior pelvik tilt ve lateral pelvik tilt açılarında anlamlı bir fark yoktu (sırasıyla p=0.499, EB=-0.256; p=0.128, EB=-0.575; p=0.063, EB=-0.703; p=0.612, EB=-0.192). Bununla birlikte, protez grubu ile kontrol grubu arasında hem sağ ve sol anterior pelvik tilt açılarında hem de lateral pelvik tilt açılarında anlamlı bir fark bulundu (sırasıyla p=0.001, EB=-0.582; p<0.001, EB=-0.635; p<0.001, EB=-0.797). Sonuç: Bulgular, anterior pelvik tiltin tüm katılımcılarda mevcut olmasına rağmen, protez kullanıcıları ile sağlıklı bireyler arasında hem anterior hem de lateral pelvik tilt açılarında önemli farklılıklar olduğunu ortaya koymaktadır. Bu sonuçlar, protezlerin tasarımında ve takılmasında pelvik hizalamanın dikkate alınmasının önemini vurgulamakta ve transfemoral protez kullanıcılarının konforunu ve işlevselliğini artırmak için klinik uygulamaları potansiyel olarak bilgilendirmektedir.

Keywords

• Transfemoral protezler
• pelvik tilt açısı
• anterior pelvik tilt
• lateral pelvik tilt

Analysis of static pelvic tilt variations in transfemoral prosthesis users: comparison of different socket designs with healthy controls

Abstract

Aims: The aim of this study was to investigate pelvic tilt angles in patients with transfemoral prosthesis, considering different socket designs, and to compare them with healthy controls. Methods: In this cross-sectional study, 28 male participants were enrolled, including 14 unilateral transfemoral prosthesis users (prosthesis group) and 14 demographically similar healthy subjects (control group). Pelvic tilt angles in both sagittal and frontal planes were measured using a digital inclinometer mounted on a two-arm caliper. Results: All participants had anterior pelvic tilt. Within the prosthesis group, there was no significant difference in anterior pelvic tilt and lateral pelvic tilt angles between the prosthetic side and the contralateral side (p=0.106, effect size (ES)=0.464; p=0.055, ES=-0.564, respectively). There was no significant difference in anterior pelvic tilt and lateral pelvic tilt angles between the prosthetic side and the contralateral side of the participants using both quadrilateral socket design and ischial containment socket designs (p=0.499, ES=-0.256; p=0.128, ES=-0.575; p=0.063, ES=-0.703; p=0.612, ES=-0.192, respectively). However, a significant difference was found in both the right and left anterior pelvic tilt angles and the lateral pelvic tilt angles between the prosthesis group and the control group (p=0.001, ES=-0.582; p<0.001, ES=-0.635; p<0.001, ES=-0.797, respectively). Conclusion: The findings reveal that while anterior pelvic tilt is present in all participants, significant differences exist between prosthesis users and healthy individuals in both anterior and lateral pelvic tilt angles. These results underscore the importance of considering pelvic alignment in the design and fitting of prostheses, potentially in forming clinical practices to enhance the comfort and functionality for transfemoral prosthesis users.

Keywords

• Transfemoral prostheses
• pelvic tilt angle
• anterior pelvic tilt
• lateral pelvic tilt

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