CHEVRON OSTEOTOMİSİ GEÇİREN HALLUKS VALGUSLU KADINLARDA FONKSİYONEL DURUM, DENGE VE KİNEZYOFOBİNİN İNCELENMESİ: PİLOT ÇALIŞMA

Yıl 2022, Cilt: 33 Sayı: 1, 48 - 55, 20.04.2022

Meltem Meran , Gizem İrem Kınıklı , Ömür Çağlar

https://doi.org/10.21653/tjpr.941641

Öz

Amaç: Bu çalışmanın amacı, Halluks Valgus’lu (HV) kadınların Chevron osteotomisi sonrası fonksiyonel durumunu, dengesini ve kinezyofobisini HV tanılı cerrahi geçirmemiş kadınlarla karşılaştırmalı olarak incelemekti.
Yöntem: Çalışmaya 20-70 yaşları arasında, cerrahi sonrası ortalama 28 ay süre geçmiş 19 HV’li kadın ve cerrahi geçirmemiş HV tanılı 19 kadın olmak üzere toplam 38 birey dahil edildi. Bireylerin ağrı şiddeti (Vizüel Analog Skalası), başparmak eklem hareket açıklığı (universal gonyometre), statik dengesi (Tek Bacak Üzerinde Durma Testi), dinamik dengesi (Zamanlı Kalk Yürü Testi), fonksiyonel durumu ve kozmetik kaygısı (Çok Boyutlu Nil Halluks Valgus Ölçeği), kinezyofobisi (Tampa Kinezyofobi Ölçeği) değerlendirildi. Sonuçlar: Cerrahi geçiren HV’li kadınların ağrı şiddeti, kozmetik kaygısı, başparmak toplam eklem hareket açıklığı ve HV açısı cerrahi geçirmeyen HV’li kadınlara oranla daha düşüktü (p<0,001); fonksiyonel skorları ise cerrahi geçirmeyen HV’li kadınlara göre daha iyi durumdaydı (p<0,05). Denge ve kinezyofobi skorları her iki grupta benzerdi (p>0,05). Ancak her iki grubun da ortalama kinezyofobi puanları (cerrahi olan: 36,20 ± 5,35; cerrahi olmayan: 36,44 ± 5,40), ölçeğin ortalama puanının üstündeydi. Cerrahi grubunun HV ve 1-2 intermetatarsal açısı, cerrahi öncesindeki değerlere göre anlamlı iyileşme gösterdi (p<0,001).
Tartışma: Bu çalışmanın sonuçları, HV’li kadınlarda cerrahi sonrası uzun dönemde başparmak toplam eklem hareket açıklığının kısıtlandığını ve kinezyofobinin varlığını göstermektedir. Bu bireylerde kapsamlı bir değerlendirme için, cerrahi öncesinde ve sonrasında eklem hareketlerinin ve kinezyofobi değerlendirmelerinin de fizyoterapi ve rehabilitasyon programlarına eklenmesinin gerektiği göz önünde bulundurulmalıdır.

Anahtar Kelimeler

Ayak, Halluks Valgus, Kinezyofobi, Postüral Denge

Proje Numarası

Nil.

INVESTIGATION OF FUNCTIONAL STATUS, BALANCE AND KINESIOPHOBIA IN WOMEN WITH HALLUX VALGUS UNDERWENT CHEVRON OSTEOTOMY, A PILOT STUDY

Öz

Purpose: The aim of this study, was to investigate functional status, balance and kinesiophobia after Chevron osteotomy in women with Hallux Valgus (HV) in comparison to non-surgical women with HV.
Methods: A total of 38 individuals were included in the study, including those aged 20-70 years 19 women with an average of 28 months after surgery, and 19 HV women diagnosed with non-surgical. Individuals' pain intensity (Visual Analogue Scale), thumb joint range of motion (ROM) (universal goniometer), static balance (Single-Leg-Stance Test), dynamic balance (Timed Up and Go Test), functional status, and cosmetic concern (Multidimensional Nil Hallux Valgus Scale), kinesiophobia (Tampa Kinesiophobia Scale) was evaluated.
Results: Pain severity, cosmetic concern, range of motion of the thumb, and HV angle (HVA) were lower in women with HV following surgery than non-surgical HV women (p<0.001); functional scores were better than women with non-surgical HV (p<0.05). Balance and kinesiophobia scores were similar in both groups (p> 0.05). However, the average kinesiophobia scores in both groups (surgical: 36.20 ± 5.35; non-surgical: 36.44 ± 5.40) were above the mean score of the scale. HVA and 1-2 intermetatarsal angle (IMA) of the surgical group showed significant improvement compared to the values before surgery (p <0.001).
Conclusion: The results of this study showed that the total ROM of thumb is limited and the presence of kinesiophobia in the long-term postoperative period in women with HV. For a comprehensive evaluation of these individuals, it should be taken into consideration that joint movements and kinesiophobia evaluations should be added to physiotherapy and rehabilitation programs before and after surgery.

Anahtar Kelimeler

Foot, Hallux Valgus, Kinesiophobia, Postural Balance

Destekleyen Kurum

Nil.

Proje Numarası

Nil.

Teşekkür

Nil.

Kaynakça

• 1. Kuhn J, Alvi F. Hallux Valgus. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2020 Jan.
• 2. Nguyen US, Hillstrom HJ, Li W, Dufour AB, Kiel DP, Procter-Gray E, et al. Factors associated with hallux valgus in a population-based study of older women and men: the Mobilize Boston Study. Osteoarthritis Cartilage. 2010;18(1):41-6.
• 3. Nix SE, Vicenzino BT, Collins NJ, Smith MD. Characteristics of foot structure and footwear associated with hallux valgus: a systematic review. Osteoarthritis Cartilage. 2012;20(10):1059-74.
• 4. Abhishek A, Roddy E, Zhang W, Doherty M. Are hallux valgus and big toe pain associated with impaired quality of life? A cross-sectional study. Osteoarthritis Cartilage. 2010 Jul;18(7):923-6.
• 5. Kawakami W, Takahashi M, Iwamoto Y, Shinakoda K. Coordination among shank, rearfoot, midfoot and forefoot kinematic movement during gait in individuals with hallux valgus. J Appl Biomech. 2018:1-23.
• 6. Kelly LA, Kuitunen S, Racinais S, Cresswell AG. Recruitment of the plantar intrinsic foot muscles with increasing postural demand. Clin Biomech (Bristol, Avon). 2012;27(1):46-51.
• 7. Nishimura A, Ito N, Nakazora S, Kato K, Ogura T, Sudo A. Does hallux valgus impair physical function? BMC Musculoskelet Disord. 2018;19(1):174.
• 8. Chopra S, Moerenhout K, Crevoisier X. Characterization of gait in female patients with moderate to severe hallux valgus deformity. Clin Biomech (Bristol, Avon). 2015;30(6):629-35.
• 9. Lentz TA, Sutton Z, Greenberg S, Bishop MD. Pain-related fear contributes to self-reported disability in patients with foot and ankle pathology. Arch Phys Med Rehabil. 2010;91(4):557-61.
• 10. Kocic M, Stankovic A, Lazovic M, Dimitrijevic L, Stankovic I, Spalevic M, et al. Influence of fear of movement on total knee arthroplasty outcome. Ann Ital Chir. 2015;86(2):148-55.
• 11. Padovan AM, Kuvacic G, Gulotta F, Sellami M, Bruno C, Isoardi M, et al. A new integrative approach to increase quality of life by reducing pain and fear of movement in patients undergoing total hip arthroplasty: the IARA model. Psychol Health Med. 2018;23(10):1223-30.
• 12. Dogar F, Ozan F, Gurbuz K, Ekincl Y, Bilal O, Oncel ES, et al. Distal metatarsal osteotomy in hallux valgus surgery: Chevron osteotomy. JCAM. 2015;6:752-5.
• 13. Van Groningen B, Van der Steen MC, Reijman M, Bos J, Hendriks JG. Outcomes in chevron osteotomy for Hallux Valgus in a large cohort. Foot (Edinb). 2016 Dec;29:18-24.
• 14. Sadra S, Fleischer A, Klein E, Grewal GS, Knight J, Weil LS, Sr., et al. Hallux valgus surgery may produce early improvements in balance control: results of a cross-sectional pilot study. J Am Podiatr Med Assoc. 2013;103(6):489-97.
• 15. Polastri M. Postoperative rehabilitation after hallux valgus surgery: a literature review. Foot Ankle Int. 2011;4(6):13-4.
• 16. Bek N, Coskun G, Kinikli GI, Karahan S. Development of Multidimensional Nil Hallux Valgus Scale: a reliability and validity study. Acta Orthop Traumatol Turc. 2016;50(3):269-76.
• 17. Vellas BJ, Wayne SJ, Romero L, Baumgartner RN, Rubenstein LZ, Garry PJ. One-leg balance is an important predictor of injurious falls in older persons. J Am Geriatr Soc. 1997;45(6):735-8.
• 18. Yoshimoto Y, Oyama Y, Tanaka M, Sakamoto A. Toe functions have little effect on dynamic balance ability in elderly people. J Phys Ther Sci. 2017;29(1):158-162.
• 19. Yilmaz ÖT, Yakut Y, Uygur F, ULUĞ N. Tampa Kinezyofobi Ölçeği’nin Türkçe versiyonu ve test-tekrar test güvenirliği. Fizyoterapi Rehabilitasyon. 2011;22(1):44-9.
• 20. Srivastava S, Chockalingam N, El Fakhri T. Radiographic measurements of hallux angles: a review of current techniques. Foot. 2010;20(1):27-31
• 21. MacMahon A, Karbassi J, Burket JC, Elliott AJ, Levine DS, Roberts MM, et al. Return to sports and physical activities after the Modified Lapidus Procedure for hallux valgus in young patients. Foot Ankle Int. 2016;37(4):378-85.
• 22. Lai SWH, Tang CQY, Graetz AEK, Thevendran G. Preoperative mental health score and postoperative outcome after hallux valgus surgery. Foot Ankle Int. 2018;39(12):1403-9.
• 23. Choi GW, Kim HJ, Kim TW, Lee JW, Park SB, Kim JK. Sex-related differences in outcomes after hallux valgus surgery. Yonsei Med J. 2015;56(2):466-73.
• 24. Schrier JC, Palmen LN, Verheyen CC, Jansen J, Koeter S. Patient-reported outcome measures in hallux valgus surgery. A review of literature. Foot Ankle Surg. 2015;21(1):11-5.
• 25. Ozkurt B, Aktekin CN, Altay M, Belhan O, Tabak Y. Range of motion of the first metatarsophalangeal joint after chevron procedure reinforced by a modified capsuloperiosteal flap. Foot Ankle Int. 2008;29(9):903-9.
• 26. Park HW, Lee KB, Chung JY, Kim MS. Comparison of outcomes between proximal and distal chevron osteotomy, both with supplementary lateral soft-tissue release, for severe hallux valgus deformity: A prospective randomised controlled trial. Bone Joint J. 2013;95(4):510-6.
• 27. Takao M, Komatsu F, Oae K, Miyamoto W, Uchio Y, Ochi M, et al. Proximal oblique-domed osteotomy of the first metatarsal for the treatment of hallux valgus associate with flat foot: effect to the correction of the longitudinal arch of the foot. Arch Orthop Trauma Surg. 2007;127(8):685-90.
• 28. Jeuken RM, Schotanus MG, Kort NP, Deenik A, Jong B, Hendrickx RP. Long-term Follow-up of a Randomized Controlled Trial Comparing Scarf to Chevron Osteotomy in Hallux Valgus Correction. Foot Ankle Int. 2016;37(7):687-95.
• 29. Hawson ST. Physical therapy post-hallux abducto valgus correction. Clin Podiatr Med Surg. 2014 Apr;31(2):309-22.
• 30. Kaufmann G, Sinz S, Giesinger JM, Braito M, Biedermann R, Dammerer D. Loss of correction after Chevron Osteotomy for hallux valgus as a function of preoperative deformity. Foot Ankle Int. 2019;40(3):287-96.