Turkiye Klinikleri Journal of Health Sciences

.: ORIGINAL RESEARCH
Total Diz Artroplastisi Sonrası Erken Dönemde Denge ve Yürüme Fonksiyonlarının İlişkisi: Kesitsel Araştırma
The Relationship of Balance and Walking Functions in the Early Period After Total Knee Arthroplasty: A Cross-Sectional Research
Mahmut BEŞLİa , Ayşe Neriman NARİNb
aAnkara Yıldırım Beyazıt Üniversitesi Sağlık Bilimleri Enstitüsü, Fizyoterapi ve Rehabilitasyon ABD, Ankara, Türkiye
bBolu Abant İzzet Baysal Üniversitesi Sağlık Bilimleri Fakültesi, Fizyoterapi ve Rehabilitasyon Bölümü, Bolu, Türkiye
Turkiye Klinikleri J Health Sci. 2023;8(4):623-9
doi: 10.5336/healthsci.2023-97770
Article Language: TR
Full Text
ÖZET
 Amaç: En sık karşılaşılan eklem hastalıklarından olan gonartrozun tedavisi için son dönem altın standart cerrahi kabul edilen total diz artroplastisi (TDA) sonrasında hastalar, denge ve yürüme kayıplarının da olduğu pek çok kısıtlılık yaşamaya devam etmektedir. Cerrahi sonrası kısıtlılıklar devam etse de hasta mobilizasyonu öncelikli olarak düşünülmekte; denge bozuklukları, düşme riski ve yürüme fonksiyonlarıyla olan ilişkisi göz ardı edilmektedir. Bu çalışma, cerrahi sonrası erken dönemde denge ve yürüme fonksiyonlarının ilişkisini incelemeyi amaçlar. Gereç ve Yöntemler: Çalışmaya TDA sonrası 1. ayında olan katılımcılar dâhil edildi. Katılımcılara tek ayak üstünde durma (TAÜD), zamanlı kalk ve yürü (ZKY), yürüme hızı (YH) ve merdiven çıkma (MÇ) testleri uygulandı ve süreler sn cinsinden kaydedildi. Bulgular: Çalışmaya 24'ü erkek, 11'i kadın toplam 35 katılımcı dâhil edildi. Dâhil edilen katılımcılar ortalama 65,54±6,37 yaşında ve ortalama 32,94±5,90 kg/m² beden kitle indeksi değerlerine sahiplerdi. Uygulanan denge ve yürüme testleri sonucu; ZKY ve YH testleri arasında pozitif korelasyon (p0,05). Sonuç: Yaşlanma ve osteoartrit ile beraber kayıplar görülen denge ve yürüme fonksiyonları, TDA sonrası cerrahiye bağlı teknikler nedeniyle etkilense de fonksiyonlar nispeten iyileşmektedir. Literatürde bu fonksiyonların cerrahi sonrası 1 yıl sonunda yaşıtlarıyla karşılaştırıldıklarında da yeterli olmadığı ileri sürülmektedir. Cerrahi sonrası mobilizasyon önem kazanmakta; asimetrik yürüyüş paternleri ve postüral salınımlar göz ardı edilebilmektektedir. Bu çalışma sonucunda önerimiz, denge kayıplarının azaltılması için rehabilitasyonda statik ve dinamik denge çalışmalarına ayrı ayrı yer verilmesi gerekmektedir.

Anahtar Kelimeler: Denge; total diz artroplastisi; yürüme
ABSTRACT
 Objective: After total knee arthroplasty (TKA), which is accepted as the latest gold standard surgery for the treatment of gonarthrosis, one of the most common joint diseases, patients continue to experience many limitations, including loss of balance and gait. Although limitations continue after surgery, patient mobilization is considered a priority; its relationship with balance disorders, the risk of falling, and walking functions are ignored. This study aims to examine the relationship between balance and gait functions in the early postoperative period. Material and Methods: Participants in the first month after TKA were included in the study. Single-leg stance (SLS), timed up and go (TUG), walking speed (WS), and stair climbing (SC) tests were applied to the participants, and the times were recorded in seconds. Results: A total of participants, 24 males and 11 females, were included in the study. The included participants were average age 65.54±6.37 and average body mass index 32.94±5.90 kg/m². Asa result of the balance and gait tests applied; positive correlation between TUG and WS tests (p0.05). Conclusion: Although balance and gait functions, which are lost with aging and osteoarthritis, are affected by techniques related to TKA, the functions are relatively improved. In the literature, it is suggested that these functions are not sufficient when compared to their peers at the end of one year after surgery. Mobilization after surgery is gaining importance; asymmetric gait patterns and postural sways are ignored. As a result of this study, we suggest: in order to reduce balance losses, static and dynamic balance exercises should be included separately in rehabilitation.

Keywords: Balance; total knee arthroplasty; gait
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