Turkiye Klinikleri Physiotherapy and Rehabilitation - Special Topics

Kadın Sağlığında Fizyoterapi ve Rehabilitasyon Özel Sayısı
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Kadınlarda Görülen Ortopedik Problemler: Fizyoterapi ve Rehabilitasyon
Orthopedic Problems Seen in Women: Physiotherapy and Rehabilitation
Filiz CANa
aFizyoterapi ve Rehabilitasyon Bölümü, Hacettepe Üniversitesi Sağlık Bilimleri Fakültesi, Ankara
Turkiye Klinikleri J Physiother Rehabil-Special Topics. 2017;3(3):245-57
Article Language: TR
ÖZET
Kadınlarda patellofemoral ağrı sendromu, ön çapraz bağ yaralanması, osteoartrit, osteoporoz ve kırıklar gibi bazı kas-iskelet sistem problemleri erkeklere göre daha sık görülür. Fizyolojik ve anatomik olmak üzere cinsler arasındaki yapısal farklılıklar nedeniyle ortaya çıkan bu problemler, kadınlarda farklı özellikte ve şiddette olabilir. Hormonal faktörler ve nöromusküler faktörler, cinsler arasında fizyolojik farklılıkları oluşturan en önemli faktörlerdir. Kadınlarda Q açısının büyük olması, patellofemoral disfonksiyon için hazırlayıcı bir faktör olarak kabul edilir ve özellikle aktif bayanlarda patellofemoral ağrı sendromu yaygın olarak görülür. Kadınlardaki yüksek ön çapraz bağ (ÖÇB) yaralanma insidansı için de anatomik, hormonal ve nöromusküler faktörler söz konusudur. Osteoartritin prevalansı, insidansı ve tutulum şiddeti kadınlarda daha yüksektir ve özellikle diz ekleminde daha belirgindir. Hem ÖÇB, hem de osteoartritin rehabilitasyonunda, önleme programları çok önemli yer tutar. Özellikle, kadınlarda daha yüksek oranda görülen osteoporoz ve düşmeler nedeniyle kırıklara daha fazla raslanır. En sık olarak görülen kırıklar; kalça kırıkları, vertebra ve radius distal uç kırıklarıdır. Kırıkların tedavisi, kırığın bulunduğu yere, kırığın tipine ve kemiğin beslenme durumuna göre konservatif veya cerrahi olarak yapılır ve rehabilitasyonu da buna bağlı olarak değişir. Ayak ağrısı ve ayak problemleri de kadınlarda özellikle yüksek topuklu veya uygun olmayan ayakkabı kullanımı nedeniyle yaygın olarak görülür. Ayak problemlerinin tedavisinde, ayak bakımı, eğitimi ve uygun ayakkabı önerisi oldukça önemlidir.

Anahtar Kelimeler: Kadınlarda kas-iskelet problemleri; patellofemoral ağrı sendromu; ön çapraz bağ yaralanması; osteoartrit; kırıklar; ayak sorunları
ABSTRACT
Patellofemoral pain syndrome, anterior cruciate ligament injuries, osteoarthritis, osteoporosis and fractures are more frequently seen in females than in males. These problems resulted from anatomical and physiological type of structural differences between genders may have different charecteristics and intensity level. Hormonal and neuromuscular factors are the most important factors included in physiological differences. Larger Q angle found in females is considered as a predisposing factor to patellofemoral dysfunction and patellofemoral pain syndrome is commonly seen in active females. High incidence of anterior cruciate ligament (ACL) injuries in females is contributed to anatomical, hormonal and neuromuscular factors. Prevalance, incidence and intensity of involvement are higher in females and it is more accentuated in knee joint. In rehabilitation of both ACL and osteoarthritis, prevention programs take important place. Fractures are more commonly seen in females due to high rate of osteoporosis and falls. Hip fractures, vertebral fractures and distal radius fractures are frequently seen fractures. The fractures will be treated concervatively of surgically depended upon localization and type of fracture, and vascularization, and rehabilitation may differ following to the treatment options. Foot problems can be commonly seen in females, especially due to using high heels or unappropriate footwear. To educate the individuals for foot care and to give advise for appropriate footwear are very important in treatment of foot problems.

Keywords: Musculoskeletal problems in females; patellofemoral pain syndrome; anterior pain syndrome; osteoarthritis; fracture; foot problems

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