Alzheimer Hastalarında El Becerisi, Denge ve Gövde Kontrolü: Kesitsel Bir Araştırma

Yıl 2024, Cilt: 8 Sayı: 2, 160 - 167, 30.08.2024

Taşkın Özkan , Esra Erkoç Ataoğlu , Fatih Soke , Selda Karakoc , Süleyman Furkan Hangün , Mustafa Ertuğrul Yaşa , Çağrı Gülşen , Hatice Ayse Tokcaer Bora

https://doi.org/10.29058/mjwbs.1436898

Öz

Amaç: Çalışmanın amacı, Alzheimer hastalarında ve sağlıklı yaşlı yetişkinlerde el becerisini değerlendirmek ve Alzheimer hastalarında el becerisi ile denge ve gövde kontrolü arasındaki ilişkileri incelemekti.
Gereç ve Yöntemler: Çalışmaya 32 Alzheimer hastası ile cinsiyet ve yaş açısından eşleştirilmiş 32 sağlıklı yaşlı yetişkin katılmıştır. El becerisi Dokuz Delikli Peg Testi (DDPT) ile; denge Berg Denge Ölçeği (BDÖ), Dört Adım Kare Testi (DAKT) ve Tek Ayak Üzerinde Durma Testi (TADT) ile; gövde kontrolü Gövde Bozukluğu Ölçeği (GBÖ) ile değerlendirildi.
Bulgular: Dominant ve nondominant DDPT süreleri sağlıklı yaşlı yetişkinlere kıyasla Alzheimer hastalarında daha yüksekti (p<0.05). Alzheimer hastalarında dominant ve nondominat DDPT, BDÖ, DAKT, TADT ve GBÖ ile ilişkiliydi (r -0.375 ile -0.755 arasında; tümü için p<0.05).
Sonuç: Alzheimer hastalarında el becerisi sağlıklı yaşlı yetişkinlere kıyasla etkilenmiştir ve Alzheimer hastalarında el becerisi denge ve gövde kontrolü ile ilişkilidir. Alzheimer hastalarda bilateral el becerisi erken dönemden itibaren değerlendirilmeli, el rehabilitasyonu sırasında denge ve gövde kontrolünü geliştiren uygulamaların el fonksiyonları üzerinde olumlu etkileri olabileceği göz ardı edilmemelidir.

Anahtar Kelimeler

Alzheimer Hastalığı, el becerisi, denge, gövde kontrolü

Manual Dexterity, Balance, and Trunk Control in Patients with Alzheimer's Disease: A Cross-Sectional Study

Öz

Aim: The study's objectives were to assess manual dexterity in those with Alzheimer's Disease (AD) and healthy older adults, as well as to look into the relationships between manual dexterity and balance and trunk control in patients with AD.
Material and Methods: The study involved 32 patients with AD and 32 healthy older adults matched for gender and age. Manual dexterity was assessed with the Nine Hole Peg Test (NHPT); balance with The Berg Balance Scale (BBS), The Four Square Step Test (FSST) and The One Leg Standing Test (OLST); trunk control with the Trunk Impairment Scale (TIS).
Results: The dominant and nondominant NHPT times were higher in patients with AD compared to healthy older adults (p<0.05). The dominant and nondominat NHPT were associated with BBS, FSST, OLST, and TIS in patients with AD (r between -0.375 and -0.755; p<0.05 for all).
Conclusion: Manual dexterity was affected in patients with AD compared to healthy older adults and manual dexterity was related to balance and trunk control in patients with AD. In patients with AD, bilateral hand dexterity should be assessed from an early stage, and it should not be ignored that practices that improve balance and trunk control may have positive effects on hand functions during hand rehabilitation.

Anahtar Kelimeler

Alzheimer’s Disease, manual dexterity, balance, trunk control

Etik Beyan

Written ethical approval was obtained from Gazi University Clinical Research Ethics Committee on 16.05.2022. (Decision Number: 352).

Kaynakça

• 1. Anand R, Gill KD, Mahdi AA. Therapeutics of Alzheimer’s disease: Past, present and future. Neuropharmacology 2014;76:27-50.
• 2. Zucchella C, Bartolo M, Bernini S, Picascia M, Sinforiani E. Quality of life in Alzheimer disease: a comparison of patients’ and caregivers’ points of view. Alzheimer Dis Assoc Disord 2015;29:50-54.
• 3. Marshall GA, Fairbanks LA, Tekin S, Vinters HV, Cummings JL. Neuropathologic correlates of activities of daily living in Alzheimer disease. Alzheimer Dis Assoc Disord 2006;20:56-59.
• 4. Karagülmez AT, Külünkoğlu B. Yaşlı Bireylerde Düşük Yürüme Hızı ve Düşme Riski Faktörleri Arasındaki İlişki: Sistematik Derleme. “Med. J. West. Black Sea 2023;7(3):350-363.
• 5. Ott BR, Ellias SA, Lannon MC. Quantitative assessment of movement in Alzheimer’s disease. J Geriatr Psychiatry Neurol 1995;8:71-75.
• 6. Kluger A, Gianutsos JG, Golomb J, Ferris SH, George AE, Franssen E, Reisberg B. Patterns of motor impairment in normal aging, mild cognitive decline, and early Alzheimer’Disease. J Gerontol B Psychol Sci Soc Sci 1997;52:28-39.
• 7. Suzumura S, Osawa A, Nagahama T, Kondo I, Sano Y, Kandori A. Assessment of finger motor skills in individuals with mild cognitive impairment and patients with Alzheimer’s disease: Relationship between finger-to-thumb tapping and cognitive function. JJCRS 2016;7:19-28.
• 8. de Paula JJ, Albuquerque MR, Lage GM, Bicalho MA, Romano- Silva MA, Malloy-Diniz LF. Impairment of fine motor dexterity in mild cognitive impairment and Alzheimer’s disease dementia: association with activities of daily living. Braz J Psychiat 2016;38:235-8.
• 9. Raats J, Arntzen EC, Lamers I, Feys P, Normann B. What is the distribution of trunk impairments and its relationship with disability level in individuals with multiple sclerosis? Mult Scler Relat Disord 2022;57:103325.
• 10. Ozkan T, Ataoglu NEE, Soke F, Karakoc S, Bora HAT. Investigation of the relationship between trunk control and balance, gait, functional mobility, and fear of falling in people with Alzheimer’s disease. Ir J Med Sci 2023;192:2401-2408.
• 11. Pettersson AF, Engardt M, Wahlund L-O. Activity level and balance in subjects with mild Alzheimer’s disease. Dement Geriatr Cogn Disord 2002;13:213-216.
• 12. Tangen GG, Engedal K, Bergland A, Moger TA, Mengshoel AM. Relationships between balance and cognition in patients with subjective cognitive impairment, mild cognitive impairment, and Alzheimer disease. Phys Ther 2014;94:1123-1134.
• 13. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer’s disease: Report of the NINCDS‐ADRDA Work Group* under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology 1984;34:939-944.
• 14. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189-198.
• 15. Mathiowetz V, Weber K, Kashman N, Volland G. Adult norms for the nine hole peg test of finger dexterity.OTJR 1985;5:24-38.
• 16. Earhart GM, Cavanaugh JT, Ellis T, Ford MP, Foreman KB, Dibble L. The 9-hole PEG test of upper extremity function: average values, test-retest reliability, and factors contributing to performance in people with Parkinson disease. J Neurol Phys Ther 2011;35:157-163.
• 17. Telenius EW, Engedal K, Bergland A. Inter-rater reliability of the Berg Balance Scale, 30 s chair stand test and 6 m walking test, and construct validity of the Berg Balance Scale in nursing home residents with mild-to-moderate dementia. BMJ Open 2015;5:e008321.
• 18. Dite W, Temple VA. A clinical test of stepping and change of direction to identify multiple falling older adults. Arch Phys Med RehabiL 2002;83:1566-1571.
• 19. Suttanon P, Hill KD, Dodd KJ, Said CM. Retest reliability of balance and mobility measurements in people with mild to moderate Alzheimer’s disease. Int Psychogeriatr 2011;23:1152-1159.
• 20. Verheyden G, Vereeck L, Truijen S, Troch M, Herregodts I, Lafosse C, Nieuwboer A. Trunk performance after stroke and the relationship with balance, gait and functional ability. Clin Rehabil 2006;20:451-458.
• 21. Faul F, Erdfelder E, Lang A-G, Buchner A. G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007;39:175- 191.
• 22. Sakamoto M, Kikuchi E, Shigeta M. Relationship between hand dexterity and severity of dementia in alzheimer’s disease: changes in handedness superiority in the course of progression. JJRM 2007:391-397.
• 23. Sakamoto M, Kikuchi E, Shigeta M. The levels of recognition and hand functions of patients with Alzheimer’s disease: a pilot study based on the simple test for evaluating hand function. Nihon Ronen Igakkai zasshi Japanese Journal of Geriatrics 2006;43:616-621.
• 24. Yamada T, Yamada K, Yamaguchi M. Study on healthy elderly people and elderly people with alzheimer’s dementia by using subtest on simple test for evaluation hand function. Health Care 2003;45:921-927.
• 25. Hebert LE, Bienias JL, McCann JJ, Scherr PA, Wilson RS, Evans DA. Upper and lower extremity motor performance and functional impairment in Alzheimer’s disease. Am J Alzheimer’s Dis 2010;25:425-431.
• 26. Scherder E, Dekker W, Eggermont L. Higher-level hand motor function in aging and (preclinical) dementia: its relationship with (instrumental) activities of daily life–a mini-review. Gerontology 2008;54:333-341.
• 27. Kalkan AC, Kahraman T, Ugut BO, Colakoglu BD, Genc A. A comparison of the relationship between manual dexterity and postural control in young and older individuals with Parkinson’s disease. J Clin Neurosci 2020;75:89-93.
• 28. Söke F, Karaali HK, Ilgin D, Yüksel E, Özcan Ö, Arslan T. Relationship between postural control and hand function in the subjects aged 65 years and over. Turk J Physiother Rehabil 2018;29:33-38.
• 29. Korkmaz NC, Akman TC, Oren GK, Bir LS. Trunk control: The essence for upper limb functionality in patients with multiple sclerosis. Mult Scler Relat Disord 2018;24:101-106.
• 30. Özkul Ç, Gündüz AG, Esmer M, Yıldırım MŞ, Eldemir K, Irkec C. Mutual relationship between upper extremity function and core muscle endurance in patients with multiple sclerosis. Clin Exp Health Sci 2021;11:42-46.
• 31. Wee SK, Hughes A-M, Warner MB, et al. Effect of trunk support on upper extremity function in people with chronic stroke and people who are healthy. Phys Ther 2015;95:1163-1171.
• 32. Fujita T, Sato A, Togashi Y, Kasahara R, Ohashi T, Yamamoto Y. Contribution of abdominal muscle strength to various activities of daily living of stroke patients with mild paralysis. J Phys Ther Sci 2015;27:815-818.
• 33. Miyake Y, Kobayashi R, Kelepecz D, Nakajima M. Core exercises elevate trunk stability to facilitate skilled motor behavior of the upper extremities. J Bodyw Mov Ther 2013;17:259-265.
• 34. Lehman GJ, Story S, Mabee R. Influence of static lumbar flexion on the trunk muscles’ response to sudden arm movements. Chiropractic & Osteopathy 2005;13:1-5.
• 35. Rosenblum S, Josman N. The relationship between postural control and fine manual dexterity. Phys Occup Ther Pediatr 2003;23:47-60.
• 36. Kibler WB, Press J, Sciascia A. The role of core stability in athletic function. Sports Med 2006;36:189-198.
• 37. Davies PM. Steps to Follow: The Comprehensive Treatment of Patients with Hemiplegia. 2nd ed. Berlin-Heidelberg-New York: Springer Science & Business Media, 2000.
• 38. Gillen G, Boiangiu C, Neuman M, Reinstein R, Schaap Y. Trunk posture affects upper extremity function of adults. Percept Mot Skills 2007;104:371-80.
• 39. Tekin E, Küçük A, Kabay SC. Evaluation of Early diagnosis via some blood parameters in alzheimer type dementia and type 2 diabetes mellitus patients. Türkiye Diyabet ve Obezite Dergisi, 2023;7:206-213.