YAŞLI BİREYLERDE NON-SPESİFİK BEL AĞRISININ POSTÜRAL KONTROL, DENGE, DÜŞME, MOBİLİTE VE FİZİKSEL AKTİVİTE ÜZERİNE ETKİSİ: KARŞILAŞTIRMALI BİR ÇALIŞMA

Yıl 2021, Cilt: 32 Sayı: 1, 67 - 73, 10.04.2021

Gülşah Özsoy , Nursen İlçin

https://doi.org/10.21653/tjpr.716260

Cited By: 2

Öz

Amaç: Çalışmamızın amacı non-spesifik bel ağrısı (NSBA) olan ve olmayan yaşlı bireylerde denge, postüral kontrol ve ilgili faktörleri karşılaştırmaktı.
Yöntem: Bu çalışma kesitsel çalışma olarak tasarlandı. Çalışmaya toplam 67 yaşlı birey (NSBA grubu, n = 33; kontrol grubu, n = 34) dahil edildi. Hastaların ağrı şiddeti ve özürlülük düzeyleri sırasıyla Görsel Analog Skala (VAS) ve Oswestry Özürlülük İndeksi (ODI) ile değerlendirildi. Postural kontrol ve düşme riski Biodex Denge Sistemi ile ölçüldü. Katılımcıların denge performansı, mobilite, düşme korkusu ve fiziksel aktivite düzeyleri sırasıyla Fonksiyonel Uzanma Testi (FUT), Zamanlı Kalk Yürü Testi (TUG), Uluslararası Düşme Etkinlik Skalası (UDES) ve Uluslararası Fiziksel Aktivite Anketi (IPAQ) -kısa form ile değerlendirildi.
Sonuçlar: Statik postural stabilite testinin tüm parametrelerinde iki grup arasında anlamlı fark bulunurken (p <0,05), dinamik postural stabilite ve modifiye klinik duyu entegrasyon testinde fark yoktu (p> 0,05). Her iki grup düşme riski indeksi açısından benzerdi (p> 0,05). UDES skoru (p = 0.003) ve TUG süresi (p = 0.001) NSBA grubunda kontrol grubuna göre anlamlı olarak daha yüksekti. Ek olarak, FUT mesafesi (p = 0,001) ve IPAQ skoru (p = 0,029), NSBA grubunda kontrol grubuna göre anlamlı olarak daha düşüktü.
Tartışma: Bu çalışma, NSBA’lı yaşlı bireylerde statik postural kontrol, denge, mobilite ve fiziksel aktivitenin bozulmakta olduğunu düşündürmektedir. Ek olarak, NSBA’lı yaşlı bireylerde düşme korkusu artmaktadır.

Anahtar Kelimeler

Denge, Yaşlı, Non-spesifik bel ağrısı, Postural kontrol

THE IMPACT OF NON-SPECIFIC LOW BACK PAIN ON POSTURAL CONTROL, BALANCE, FALL, MOBILITY AND PHYSICAL ACTIVITY IN ELDERLY INDIVIDUALS: A COMPARATIVE STUDY

Öz

Purpose: Studies investigating the effects of non-specific low back pain (NSLBP) on elderly individuals are limited in the literature. The study aimed to compare postural control, balance, physical activity and related factors in elderly individuals with and without the NSLBP.
Methods: The study was designed as a cross-sectional. A total of 67 elderly individuals (NSLBP group n=33 and control group n=34) were included in the study. Patients' pain intensity and disability levels were evaluated using Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI), respectively. Postural control and fall risk were measured using the Biodex Balance System. Participants' balance performance, mobility, fear of falling and physical activity levels were evaluated using functional reach test (FRT), timed up and go test (TUG), Falls Efficacy Scale International (FES-I) and International Physical Activity Questionnaire (IPAQ)-Short Form, respectively.
Results: While there was a significant difference between the two groups in all parameters of static postural stability test (p<0.05), no difference was found in dynamic postural stability, modified clinical sensory integration test, and fall risk index (p>0.05). The FES-I score (p=0.003) and the TUG time (p=0.001) were significantly higher in the NSLBP group than in the control group. The FRT distance (p=0.001) and the IPAQ score (p=0.029) were significantly lower in the NSLBP group than in the control group.
Conclusion: This study suggests that static postural control, balance, mobility, and physical activity are impaired in elderly individuals with NSLBP. Clinicians should take into account these disadvantages in planning rehabilitation programs in elderly individuals with the NSLBP.

Anahtar Kelimeler

Elderly, Low Back Pain, Postural Control

Kaynakça

• Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML, Genevay S, et al. What low back pain is and why we need to pay attention. Lancet (London, England). 2018;391(10137):2356-67.
• Balagué F, Mannion AF, Pellisé F, Cedraschi C. Non-specific low back pain. Lancet (London, England). 2012;379(9814):482-91.
• Jones LD, Pandit H, Lavy C. Back pain in the elderly: a review. Maturitas. 2014;78(4):258-62.
• Grabovac I, Dorner TE. Association between low back pain and various everyday performances : Activities of daily living, ability to work and sexual function. Wien Klin Wochenschr. 2019;131(21-22):541-9.
• Di Iorio A, Abate M, Guralnik JM, Bandinelli S, Cecchi F, Cherubini A, et al. From chronic low back pain to disability, a multifactorial mediated pathway: the InCHIANTI study. Spine. 2007;32(26):E809-15.
• Hodges PW, Richardson CA. Inefficient muscular stabilization of the lumbar spine associated with low back pain. A motor control evaluation of transversus abdominis. Spine. 1996;21(22):2640-50.
• Hodges PW. Changes in motor planning of feedforward postural responses of the trunk muscles in low back pain. Exp Brain Res. 2001;141(2):261-6.
• Lin J, Halaki M, Rajan P, Leaver A. Relationship Between Proprioception and Pain and Disability in People With Non-Specific Low Back Pain: A Systematic Review With Meta-Analysis. Spine. 2019;44(10):E606-e17.
• Caffaro RR, França FJ, Burke TN, Magalhães MO, Ramos LA, Marques AP. Postural control in individuals with and without non-specific chronic low back pain: a preliminary case-control study. Eur Spine J : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 2014;23(4):807-13.
• Berenshteyn Y, Gibson K, Hackett GC, Trem AB, Wilhelm M. Is standing balance altered in individuals with chronic low back pain? A systematic review. Disabil Rehabil. 2019;41(13):1514-23.
• Wong AY, Karppinen J, Samartzis D. Low back pain in older adults: risk factors, management options and future directions. Scoliosis Spinal Disord. 2017;12:14.
• Todd KH, Funk JP. The minimum clinically important difference in physician–assigned visual analog pain scores. Acad Emerg Med. 1996;3(2):142-6.
• Yakut E, Düger T, Öksüz Ç, Yörükan S, Üreten K, Turan D, et al. Validation of the Turkish version of the Oswestry Disability Index for patients with low back pain. Spine. 2004;29(5):581-5.
• Karimi N, Ebrahimi I, Kharizi S, Torkaman G. Reliability of postural balance evaluation using the biodex balance system in subjects with and without low back pain. J. Postgrad. Med. Inst. (Peshawar-Pakistan). 2011;22(2).
• Cohen H, Blatchly CA, Gombash LL. A study of the clinical test of sensory interaction and balance. Physical Therapy. 1993;73(6):346-51.
• Arnold BL, Schmitz RJ. Examination of balance measures produced by the biodex stability system. J Athl Train. 1998;33(4):323-7.
• Delbaere K, Close JC, Mikolaizak AS, Sachdev PS, Brodaty H, Lord SR. The Falls Efficacy Scale International (FES-I). A comprehensive longitudinal validation study. Age ageing. 2010;39(2):210-6.
• Duncan PW, Weiner DK, Chandler J, Studenski S. Functional reach: a new clinical measure of balance. J Gerontol. 1990;45(6):M192-M7.
• Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142-8.
• Lee PH, Macfarlane DJ, Lam T, Stewart SM. Validity of the international physical activity questionnaire short form (IPAQ-SF): A systematic. Int J Behav Nutr Phys Act. 2011;8:115.
• Xie B, Luo C, Wang R, Wang. Balance control comparison between subjects with and without non-specific low back pain. Chinese Journal of Rehabilitation Medicine. 2009;24(5):394-8.
• Ruhe A, Fejer R, Walker B. Center of pressure excursion as a measure of balance performance in patients with non-specific low back pain compared to healthy controls: a systematic review of the literature. Eur Spine J. 2011;20(3):358-68.
• Karimi N, Ebrahimi I, Kahrizi S, Torkaman G. Evaluation of postural balance using the biodex balance system in subjects with and without low back pain. Pak J Med Sci. 2008;24(3):372.
• Lihavainen K, Sipilä S, Rantanen T, Sihvonen S, Sulkava R, Hartikainen S. Contribution of musculoskeletal pain to postural balance in community-dwelling people aged 75 years and older. J Gerontol A Biol Sci Med Sci. 2010;65(9):990-6.
• Champagne A, Prince F, Bouffard V, Lafond D. Balance, falls-related self-efficacy, and psychological factors amongst older women with chronic low back pain: A preliminary case-control study. Rehabil Res Pract. 2012.
• Cetin N, Bayramoglu M, Aytar A, Surenkok O, Yemisci. Effects of lower-extremity and trunk muscle fatigue on balance. Open Sports Med J. 2008;2(1).
• Duncan PW, Weiner DK, Chandler J, Studenski S. Functional reach: a new clinical measure of balance. J Gerontol. 1990;45(6):M192-7.
• Rudy TE, Weiner DK, Lieber SJ, Slaboda J, Boston JR. The impact of chronic low back pain on older adults: a comparative study of patients and controls. Pain. 2007;131(3):293-301.
• Queiroz BZ, Pereira DS, de Britto RN, Lopes RA, Felício DC, Pereira DG, et al. Functional performance and plasma cytokine levels in elderly women with and without low back pain. J Back Musculoskelet Rehabil. 2015;28(2):343-9.
• Campbell AJ, Spears GF, Borrie MJ. Examination by logistic regression modelling of the variables which increase the relative risk of elderly women falling compared to elderly men. J Clin Epidemiol. 1990;43(12):1415-20.
• Berková M, Berka Z. Falls: a significant cause of morbidity and mortality in elderly people. Vnitrni lekarstvi. 2018;64(11):1076-83.
• Marshall LM, Litwack-Harrison S, Makris UE, Kado DM, Cawthon PM, Deyo RA, et al. A Prospective Study of Back Pain and Risk of Falls Among Older Community-dwelling Men. J Gerontol A Biol Sci Med Sci. 2017;72(9):1264-9.
• Verma S, Pal BP. Correlation Between Pain, Fear of Falling and Disability in Low Back Pain. Ann Rehabil Med. 2015;39(5):816-20.
• Lin C-WC, McAuley JH, Macedo L, Barnett DC, Smeets RJ, Verbunt JA. Relationship between physical activity and disability in low back pain: a systematic review and meta-analysis. PAIN®. 2011;152(3):607-13.