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Duchenne Musküler Distrofi’de hamstring esnekliği ve ambulasyon ilişkili midir?

Yıl 2022, Cilt 15, Sayı 3, 425 - 431, 01.07.2022
https://doi.org/10.31362/patd.960882

Öz

Amaç: Bu çalışmanın amacı Duchenne Musküler Distrofi (DMD)’li çocuklarda hamstring esnekliği ile ambulasyon arasındaki ilişkiyi araştırmaktır.
Gereç ve yöntem: Çalışmaya yaşları 5 ile 13,5 arasında değişen fonksiyonel seviyeleri Brooke Alt Ekstremite Fonksiyonel Sınıflandırması (BAEFS)’na göre Seviye 1 ve 2 olan 60 DMD tanısı alan çocuk dahil edildi. Çocukların hamstring esnekliği popliteal açı testi, ambulasyonları ise North Star Ambulasyon Değerlendirme (NSAD) skalası ile değerlendirildi. Hamstring esnekliği ve NSAD’nin parametreleri arasındaki ilişki Spearmen korelasyon analizi ile değerlendirildi.
Bulgular: Çalışmaya dahil edilen çocukların hamstring esnekliği ortalamaları 53,78°±30,32° ve NSAD skalası ortalaması ise 24,93±6,44 puandı. Hamstring esnekliği ile NSAD skalası arasında negatif yönde, orta kuvvette ilişki bulundu (r=-0,544, p<0,001). NSAD alt parametreleri ile hamstring esnekliği arasındaki ilişkiler incelendiğinde ise esneklik ile birçok alt parametre arasında negatif yönde, zayıf-orta kuvvette anlamlı ilişki bulundu (p<0,05). Ayrıca, BAEFS’na göre Devre 1 ve 2’nin hamstring esnekliği ve NSAD skorunun farklı olduğu bulundu (p<0,001).
Sonuç: Hamstring esnekliğinin DMD’li çocukların ambulasyonu için önemli bir faktör olduğu belirlendi. Hamstring esnekliğini artırıcı/koruyucu yaklaşımların erken dönemden itibaren fizyoterapi ve rehabilitasyon programlarında yer almasının bu hasta grubunda ambulasyonun korunması/geliştirilmesi açısından önemli olduğu düşünüldü.

Kaynakça

  • 1. Chung J, Smith AL, Hughes SC, et al. Twenty‐year follow‐up of newborn screening for patients with muscular dystrophy. Muscle Nerve, 2016;53:570-578. https://doi.org/10.1002/mus.24880
  • 2. Pane, M, Scalise R, Berardinelli A, et al. Early neurodevelopmental assessment in duchenne muscular dystrophy. Neuromuscul Disord 2013;23:451-455. https://doi.org/10.1016/j.nmd.2013.02.012
  • 3. Parreira SLS, Resende MBD, Zanoteli E, Carvalho MS, Marie SK, Reed UC, Comparison of motor strength and function in patients with duchenne muscular dystrophy with or without steroid therapy. Arq Neuro-Psiquiatr 2010;68:683-688. https://doi.org/10.1590/s0004-282x2010000500002
  • 4. Lam T, Noonan VK, Eng JJ. A systematic review of functional ambulation outcome measures in spinal cord injury. Spinal Cord 2008;46:246-254. https://doi.org/10.1038/sj.sc.3102134
  • 5. Landfeldt E, Sejersen T, Tulinius M. A mini‐review and implementation model for using ataluren to treat nonsense mutation duchenne muscular dystrophy. Acta Paediatr 2019;108:224-230. https://doi.org/10.1111/apa.14568
  • 6. Kiefer M, Bonarrigo K, Quatman Yates K, Fowler A, Horn PS, Wong BL. Progression of ankle plantarflexion contractures and functional decline in duchenne muscular dystrophy: implications for physical therapy management. Pediatr Phys Ther 2019;31:61-66. https://doi.org/10.1097/PEP.0000000000000553
  • 7. Lerario A, Bonfiglio S, Sormani MP, et al. Quantitative muscle strength assessment in duchenne muscular dystrophy: longitudinal study and correlation with functional measures. BMC Neurol 2012;12:91. https://doi.org/10.1186/1471-2377-12-91
  • 8. Case LE, Apkon SD, Eagle M, et al. Rehabilitation management of the patient with duchenne muscular dystrophy. Pediatrics 2018;142:17-33. https://doi.org/10.1542/peds.2018-0333D
  • 9. Akkurt L, Alemdaroğlu Gürbüz İ, Karaduman A, Tunca Yilmaz Ö. Lower limb flexibility in children with duchenne muscular dystrophy: effects on functional performance. Pediatr Exerc Sci 2019;31:42-46. https://doi.org/10.1123/pes.2018-0115
  • 10. Akima H, Lott D, Senesac C, et al. Relationships of thigh muscle contractile and non-contractile tissue with function, strength, and age in boys with duchenne muscular dystrophy. Neuromuscul Disord 2012;22:16-25. https://doi.org/10.1016/j.nmd.2011.06.750
  • 11. Brooke MH, Griggs RC, Mendell JR, Fenichel GM, Shumate JB, Pellegrino RJ. Clinical trial in duchenne dystrophy. I. The design of the protocol. Muscle Nerve 1981;4:186-197. https://doi.org/10.1002/mus.880040304
  • 12. Winslow J. Treatment of lateral knee pain using soft tissue mobilization in four female triathletes. Int J Ther Massage Bodywork 2014;7:25-31
  • 13. Czaprowski D, Leszczewska J, Kolwicz A, et al. The comparison of the effects of three physiotherapy techniques on hamstring flexibility in children: a prospective, randomized, single-blind study. PloS One 2013;8:e72026. https://doi.org/10.1371/journal.pone.0072026
  • 14. Birnkrant DJ, Bushby K, Bann CM, et al. Diagnosis and management of duchenne muscular dystrophy, part 1: diagnosis, and neuromuscular, rehabilitation, endocrine, and gastrointestinal and nutritional management. Lancet Neurol 2018;17:251-267. https://doi.org/10.1016/S1474-4422(18)30024-3
  • 15. De Sanctis R, Pane M, Sivo S, et al. Suitability of north star ambulatory assessment in young boys with duchenne muscular dystrophy. Neuromuscul Disord 2015;25:14-18. https://doi.org/10.1016/j.nmd.2014.09.015
  • 16. Pane M, Mazzone ES, Sivo S, et al. Long term natural history data in ambulant boys with duchenne muscular dystrophy: 36-month changes. PloS One 2014;9:e108205. https://doi.org/10.1371/journal.pone.0108205
  • 17. Mercuri E, Coratti G, Messina S, et al. Revised north star ambulatory assessment for young boys with duchenne muscular dystrophy. PloS One 2016;11:e0160195. https://doi.org/10.1371/journal.pone.0160195
  • 18. Mazzone E, Martinelli D, Berardinelli A, et al. North star ambulatory assessment, 6-minute walk test and timed items in ambulant boys with duchenne muscular dystrophy. Neuromuscul Disord, 2010;20:712-716. https://doi.org/10.1016/j.nmd.2010.06.014
  • 19. Scott E, Eagle M, Mayhew A, et al. Development of a functional assessment scale for ambulatory boys with duchenne muscular dystrophy. Physiother Res Int 2012;17:101-109. https://doi.org/10.1002/pri.520
  • 20. Schober P, Boer C, Schwarte LA. Correlation coefficients: appropriate use and interpretation. Anesth Analg 2018;126:1763-1768. https://doi.org/10.1213/ANE.0000000000002864
  • 21. Hayran M. Sağlık araştırmaları için temel istatistik. 1.baskı. Ankara: Omega Araştırma, 2011;95-108.
  • 22. Mendell JR, Nathalie Goemans N, Lowes LP, et al. Longitudinal effect of eteplirsen versus historical control on ambulation in duchenne muscular dystrophy. Ann Neurol 2016;79:257-271. https://doi.org/10.1002/ana.24555.
  • 23. De Bruin M, Smeulders M, Kreulen M. Why is joint range of motion limited in patients with cerebral palsy? J Hand Surg (Eur Vol) 2013;38:8-13. https://doi.org/10.1177/1753193412444401
  • 24. Czaprowski D, Kędra A, Pawłowska P, Kolwicz Gańko A, Leszczewska J, Tyrakowski M. The examination of the musculoskeletal system based only on the evaluation of pelvic-hip complex muscle and trunk flexibility may lead to failure to screen children for generalized joint hypermobility. PloS One 2015;10:e0121360. https://doi.org/10.1371/journal.pone.0121360
  • 26. Henderson G, Barnes CA, Portas MD. Factors associated with increased propensity for hamstring injury in english premier league soccer players. J Sci Med Sport 2010;13:397-402. https://doi.org/10.1016/j.jsams.2009.08.003
  • 25. Choi YA, Chun SM, Kim Y, Shin HI, et al. Lower extremity joint contracture according to ambulatory status in children with duchenne muscular dystrophy. BMC Musculoskelet Disord 2018;19:287. https://doi.org/10.1186/s12891-018-2212-6

Importance of hamstring flexibility for ambulation in Duchenne Muscular Dystrophy?

Yıl 2022, Cilt 15, Sayı 3, 425 - 431, 01.07.2022
https://doi.org/10.31362/patd.960882

Öz

Purpose: The aim of this study was to investigate the relationship between hamstring flexibility and ambulation in children with Duchenne Muscular Dystrophy (DMD).
Materials and methods: Sixty children with a diagnosis of DMD between the ages of 5 and 13,5 and whose functional levels were Level 1 and 2 according to the Brooke Lower Extremity Functional Classification (BLEFC) were included in the study. The hamstring flexibility of the children was evaluated with the popliteal angle test and their ambulation with the North Star Ambulation Assessment (NSAA) scale. The relationship between hamstring flexibility and parameters of NSAA was evaluated with Spearman correlation analysis.
Results: The mean hamstring flexibility of the children included in the study was 53.78°±30.32° and the mean of the NSAA scale was 24.93±6.44 points. A negative, moderate correlation was found between the hamstring flexibility and NSAA (r=-0.544, p<0.001). When the relationships between NSAA sub-parameters and hamstring flexibility were examined a significant, negative, weak-medium strength, the relationship was found between flexibility and many sub-parameters (p<0.05). In addition, it was found that hamstring flexibility and NSAA score differ between Levels 1 and 2 according to BLEFC (p<0.001).
Conclusion: Hamstring flexibility was determined to be an important factor for ambulation of children with DMD. Inclusion of hamstring flexibility increasing/protective approaches in physiotherapy and rehabilitation programs from the early period was thought to be important in terms of preserving/developing ambulation in this patient group.

Kaynakça

  • 1. Chung J, Smith AL, Hughes SC, et al. Twenty‐year follow‐up of newborn screening for patients with muscular dystrophy. Muscle Nerve, 2016;53:570-578. https://doi.org/10.1002/mus.24880
  • 2. Pane, M, Scalise R, Berardinelli A, et al. Early neurodevelopmental assessment in duchenne muscular dystrophy. Neuromuscul Disord 2013;23:451-455. https://doi.org/10.1016/j.nmd.2013.02.012
  • 3. Parreira SLS, Resende MBD, Zanoteli E, Carvalho MS, Marie SK, Reed UC, Comparison of motor strength and function in patients with duchenne muscular dystrophy with or without steroid therapy. Arq Neuro-Psiquiatr 2010;68:683-688. https://doi.org/10.1590/s0004-282x2010000500002
  • 4. Lam T, Noonan VK, Eng JJ. A systematic review of functional ambulation outcome measures in spinal cord injury. Spinal Cord 2008;46:246-254. https://doi.org/10.1038/sj.sc.3102134
  • 5. Landfeldt E, Sejersen T, Tulinius M. A mini‐review and implementation model for using ataluren to treat nonsense mutation duchenne muscular dystrophy. Acta Paediatr 2019;108:224-230. https://doi.org/10.1111/apa.14568
  • 6. Kiefer M, Bonarrigo K, Quatman Yates K, Fowler A, Horn PS, Wong BL. Progression of ankle plantarflexion contractures and functional decline in duchenne muscular dystrophy: implications for physical therapy management. Pediatr Phys Ther 2019;31:61-66. https://doi.org/10.1097/PEP.0000000000000553
  • 7. Lerario A, Bonfiglio S, Sormani MP, et al. Quantitative muscle strength assessment in duchenne muscular dystrophy: longitudinal study and correlation with functional measures. BMC Neurol 2012;12:91. https://doi.org/10.1186/1471-2377-12-91
  • 8. Case LE, Apkon SD, Eagle M, et al. Rehabilitation management of the patient with duchenne muscular dystrophy. Pediatrics 2018;142:17-33. https://doi.org/10.1542/peds.2018-0333D
  • 9. Akkurt L, Alemdaroğlu Gürbüz İ, Karaduman A, Tunca Yilmaz Ö. Lower limb flexibility in children with duchenne muscular dystrophy: effects on functional performance. Pediatr Exerc Sci 2019;31:42-46. https://doi.org/10.1123/pes.2018-0115
  • 10. Akima H, Lott D, Senesac C, et al. Relationships of thigh muscle contractile and non-contractile tissue with function, strength, and age in boys with duchenne muscular dystrophy. Neuromuscul Disord 2012;22:16-25. https://doi.org/10.1016/j.nmd.2011.06.750
  • 11. Brooke MH, Griggs RC, Mendell JR, Fenichel GM, Shumate JB, Pellegrino RJ. Clinical trial in duchenne dystrophy. I. The design of the protocol. Muscle Nerve 1981;4:186-197. https://doi.org/10.1002/mus.880040304
  • 12. Winslow J. Treatment of lateral knee pain using soft tissue mobilization in four female triathletes. Int J Ther Massage Bodywork 2014;7:25-31
  • 13. Czaprowski D, Leszczewska J, Kolwicz A, et al. The comparison of the effects of three physiotherapy techniques on hamstring flexibility in children: a prospective, randomized, single-blind study. PloS One 2013;8:e72026. https://doi.org/10.1371/journal.pone.0072026
  • 14. Birnkrant DJ, Bushby K, Bann CM, et al. Diagnosis and management of duchenne muscular dystrophy, part 1: diagnosis, and neuromuscular, rehabilitation, endocrine, and gastrointestinal and nutritional management. Lancet Neurol 2018;17:251-267. https://doi.org/10.1016/S1474-4422(18)30024-3
  • 15. De Sanctis R, Pane M, Sivo S, et al. Suitability of north star ambulatory assessment in young boys with duchenne muscular dystrophy. Neuromuscul Disord 2015;25:14-18. https://doi.org/10.1016/j.nmd.2014.09.015
  • 16. Pane M, Mazzone ES, Sivo S, et al. Long term natural history data in ambulant boys with duchenne muscular dystrophy: 36-month changes. PloS One 2014;9:e108205. https://doi.org/10.1371/journal.pone.0108205
  • 17. Mercuri E, Coratti G, Messina S, et al. Revised north star ambulatory assessment for young boys with duchenne muscular dystrophy. PloS One 2016;11:e0160195. https://doi.org/10.1371/journal.pone.0160195
  • 18. Mazzone E, Martinelli D, Berardinelli A, et al. North star ambulatory assessment, 6-minute walk test and timed items in ambulant boys with duchenne muscular dystrophy. Neuromuscul Disord, 2010;20:712-716. https://doi.org/10.1016/j.nmd.2010.06.014
  • 19. Scott E, Eagle M, Mayhew A, et al. Development of a functional assessment scale for ambulatory boys with duchenne muscular dystrophy. Physiother Res Int 2012;17:101-109. https://doi.org/10.1002/pri.520
  • 20. Schober P, Boer C, Schwarte LA. Correlation coefficients: appropriate use and interpretation. Anesth Analg 2018;126:1763-1768. https://doi.org/10.1213/ANE.0000000000002864
  • 21. Hayran M. Sağlık araştırmaları için temel istatistik. 1.baskı. Ankara: Omega Araştırma, 2011;95-108.
  • 22. Mendell JR, Nathalie Goemans N, Lowes LP, et al. Longitudinal effect of eteplirsen versus historical control on ambulation in duchenne muscular dystrophy. Ann Neurol 2016;79:257-271. https://doi.org/10.1002/ana.24555.
  • 23. De Bruin M, Smeulders M, Kreulen M. Why is joint range of motion limited in patients with cerebral palsy? J Hand Surg (Eur Vol) 2013;38:8-13. https://doi.org/10.1177/1753193412444401
  • 24. Czaprowski D, Kędra A, Pawłowska P, Kolwicz Gańko A, Leszczewska J, Tyrakowski M. The examination of the musculoskeletal system based only on the evaluation of pelvic-hip complex muscle and trunk flexibility may lead to failure to screen children for generalized joint hypermobility. PloS One 2015;10:e0121360. https://doi.org/10.1371/journal.pone.0121360
  • 26. Henderson G, Barnes CA, Portas MD. Factors associated with increased propensity for hamstring injury in english premier league soccer players. J Sci Med Sport 2010;13:397-402. https://doi.org/10.1016/j.jsams.2009.08.003
  • 25. Choi YA, Chun SM, Kim Y, Shin HI, et al. Lower extremity joint contracture according to ambulatory status in children with duchenne muscular dystrophy. BMC Musculoskelet Disord 2018;19:287. https://doi.org/10.1186/s12891-018-2212-6

Ayrıntılar

Birincil Dil Türkçe
Konular Rehabilitasyon
Yayınlanma Tarihi Temmuz 2022
Bölüm Araştırma Makalesi
Yazarlar

Lütfiye AKKURT> (Sorumlu Yazar)
Kütahya Sağlık Bilimleri Üniversitesi, Sağlık Bilimleri Fakültesi, Fizyoterapi ve Rehabilitasyon Bölümü
0000-0003-3096-513X
Türkiye


Güllü AYDIN YAĞCIOĞLU>
HACETTEPE ÜNİVERSİTESİ, FİZİK TEDAVİ VE REHABİLİTASYON FAKÜLTESİ
0000-0003-1658-7697
Türkiye


Numan BULUT>
HACETTEPE ÜNİVERSİTESİ, FİZİK TEDAVİ VE REHABİLİTASYON FAKÜLTESİ
0000-0001-5427-1103
Türkiye


İpek GÜRBÜZ>
Hacettepe Üniversitesi, Fizik Tedavi ve Rehabilitasyon Fakültesi, Ankara
0000-0001-5556-6608
Türkiye


Aynur Ayşe KARADUMAN>
LOKMAN HEKİM ÜNİVERSİTESİ, SAĞLIK BİLİMLERİ FAKÜLTESİ, FİZYOTERAPİ VE REHABİLİTASYON BÖLÜMÜ
0000-0001-6252-1934
Türkiye


Öznur TUNCA YILMAZ>
Hacettepe Üniversitesi, Fizik Tedavi ve Rehabilitasyon Fakültesi, Ankara
0000-0002-0855-9541
Türkiye

Yayımlanma Tarihi 1 Temmuz 2022
Kabul Tarihi 10 Kasım 2021
Yayınlandığı Sayı Yıl 2022, Cilt 15, Sayı 3

Kaynak Göster

Bibtex @araştırma makalesi { patd960882, journal = {Pamukkale Tıp Dergisi}, eissn = {1308-0865}, address = {Pamukkale Üniversitesi Tıp Fakültesi Eğitim Blokları Kınıklı kampüsü 20070 Kınıklı, Denizli}, publisher = {Pamukkale Üniversitesi}, year = {2022}, volume = {15}, number = {3}, pages = {425 - 431}, doi = {10.31362/patd.960882}, title = {Duchenne Musküler Distrofi’de hamstring esnekliği ve ambulasyon ilişkili midir?}, key = {cite}, author = {Akkurt, Lütfiye and Aydın Yağcıoğlu, Güllü and Bulut, Numan and Gürbüz, İpek and Karaduman, Aynur Ayşe and Tunca Yılmaz, Öznur} }
APA Akkurt, L. , Aydın Yağcıoğlu, G. , Bulut, N. , Gürbüz, İ. , Karaduman, A. A. & Tunca Yılmaz, Ö. (2022). Duchenne Musküler Distrofi’de hamstring esnekliği ve ambulasyon ilişkili midir? . Pamukkale Tıp Dergisi , 15 (3) , 425-431 . DOI: 10.31362/patd.960882
MLA Akkurt, L. , Aydın Yağcıoğlu, G. , Bulut, N. , Gürbüz, İ. , Karaduman, A. A. , Tunca Yılmaz, Ö. "Duchenne Musküler Distrofi’de hamstring esnekliği ve ambulasyon ilişkili midir?" . Pamukkale Tıp Dergisi 15 (2022 ): 425-431 <https://dergipark.org.tr/tr/pub/patd/issue/68347/960882>
Chicago Akkurt, L. , Aydın Yağcıoğlu, G. , Bulut, N. , Gürbüz, İ. , Karaduman, A. A. , Tunca Yılmaz, Ö. "Duchenne Musküler Distrofi’de hamstring esnekliği ve ambulasyon ilişkili midir?". Pamukkale Tıp Dergisi 15 (2022 ): 425-431
RIS TY - JOUR T1 - Duchenne Musküler Distrofi’de hamstring esnekliği ve ambulasyon ilişkili midir? AU - Lütfiye Akkurt , Güllü Aydın Yağcıoğlu , Numan Bulut , İpek Gürbüz , Aynur Ayşe Karaduman , Öznur Tunca Yılmaz Y1 - 2022 PY - 2022 N1 - doi: 10.31362/patd.960882 DO - 10.31362/patd.960882 T2 - Pamukkale Tıp Dergisi JF - Journal JO - JOR SP - 425 EP - 431 VL - 15 IS - 3 SN - -1308-0865 M3 - doi: 10.31362/patd.960882 UR - https://doi.org/10.31362/patd.960882 Y2 - 2021 ER -
EndNote %0 Pamukkale Tıp Dergisi Duchenne Musküler Distrofi’de hamstring esnekliği ve ambulasyon ilişkili midir? %A Lütfiye Akkurt , Güllü Aydın Yağcıoğlu , Numan Bulut , İpek Gürbüz , Aynur Ayşe Karaduman , Öznur Tunca Yılmaz %T Duchenne Musküler Distrofi’de hamstring esnekliği ve ambulasyon ilişkili midir? %D 2022 %J Pamukkale Tıp Dergisi %P -1308-0865 %V 15 %N 3 %R doi: 10.31362/patd.960882 %U 10.31362/patd.960882
ISNAD Akkurt, Lütfiye , Aydın Yağcıoğlu, Güllü , Bulut, Numan , Gürbüz, İpek , Karaduman, Aynur Ayşe , Tunca Yılmaz, Öznur . "Duchenne Musküler Distrofi’de hamstring esnekliği ve ambulasyon ilişkili midir?". Pamukkale Tıp Dergisi 15 / 3 (Temmuz 2022): 425-431 . https://doi.org/10.31362/patd.960882
AMA Akkurt L. , Aydın Yağcıoğlu G. , Bulut N. , Gürbüz İ. , Karaduman A. A. , Tunca Yılmaz Ö. Duchenne Musküler Distrofi’de hamstring esnekliği ve ambulasyon ilişkili midir?. Pam Tıp Derg. 2022; 15(3): 425-431.
Vancouver Akkurt L. , Aydın Yağcıoğlu G. , Bulut N. , Gürbüz İ. , Karaduman A. A. , Tunca Yılmaz Ö. Duchenne Musküler Distrofi’de hamstring esnekliği ve ambulasyon ilişkili midir?. Pamukkale Tıp Dergisi. 2022; 15(3): 425-431.
IEEE L. Akkurt , G. Aydın Yağcıoğlu , N. Bulut , İ. Gürbüz , A. A. Karaduman ve Ö. Tunca Yılmaz , "Duchenne Musküler Distrofi’de hamstring esnekliği ve ambulasyon ilişkili midir?", Pamukkale Tıp Dergisi, c. 15, sayı. 3, ss. 425-431, Tem. 2022, doi:10.31362/patd.960882
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