Turkiye Klinikleri Journal of Health Sciences

.: ORIGINAL RESEARCH
Nöropatisi Olan Tip 2 Diyabetiklerde Farklı Adım Sayılarıyla Yürüyüş Sonrası Plantar Sıcaklık Değişiminin İncelenmesi
Investigation of Plantar Temperature Changes After Walking with Different Step Counts in Type 2 Diabetics with Neuropathy
Yasin YURTa, Mehtap MERCANa, Cansu KOLTAKa
aDoğu Akdeniz Üniversitesi Sağlık Bilimleri Fakültesi, Fizyoterapi ve Rehabilitasyon Bölümü, Gazimağusa, KKTC
Turkiye Klinikleri J Health Sci. 2021;6(4):854-60
doi: 10.5336/healthsci.2020-80841
Article Language: TR
Full Text
ÖZET
 Amaç: Tip 2 diyabetin (T2D) tedavisi ve komplikasyonların önlenmesi için tempolu yürüyüş, önerilen orta şiddet egzersizlerden birisidir. Ayak ülseri riski olan T2D'li bireylerde ise bu egzersizin ayak sağlığı açısından güvenliği tartışmalıdır. Amacımız, nöropatisi olan T2D'li bireylerde farklı adım sayılarıyla yürüyüş sonrası plantar sıcaklık değişimlerini incelemekti. Gereç ve Yöntemler: Çalışmaya, en az 1 yıldır T2D tanısı olan, bağımsız yürüyebilen ve Michigan Nöropati Tarama Testi fiziksel değerlendirmesinden 2 ve üstü puan alan, 44 birey dâhil edildi. Katılımcıların cinsiyet, yaş, vücut ağırlığı, boy uzunluğu, beden kitle indeksi, HbA1c değerleri ve hastalık yılları sorgulandı. Bireylerin ayrı günlerde, 3 farklı adım sayısı (2.000, 4.000 ve 6.000 adım) ile koşu bandı üzerinde yürüyüşleri öncesi ve sonrasında plantar sıcaklıkları kızılötesi termometre ile değerlendirildi. Bulgular: İki bin adımla yürüyüş sonrasında sol ayak başparmak altı ve 1. metatars distali, her 2 ayak laterali ve sağ ayak topuk sıcaklık değerleri anlamlı olarak artış gösterdi (p<0,05). Dört bin ve 6.000 adım yürüyüşleri sonrasında ise her 2 ayağın ölçülen tüm bölgelerinde sıcaklık anlamlı olarak yükseldi (p<0,05). Farklı adım sayılarıyla yürüyüş sonrası sıcaklık artış değerleri karşılaştırıldığında, her 2 ayakta da 4.000 adım sonrası artışın 2.000 adımdan fazla, 6.000 adım sonrası artışın ise en fazla olduğu görüldü (p<0,05). Sonuç: Nöropatisi olan T2D'li bireylerde plantar sıcaklık, yürüyüş adım sayısının artmasıyla birlikte artış göstermektedir. Özellikle 2.000 adım üzerinde belirgin olan sıcaklık artışı, ülser riskini artırabileceği için tempolu yürüyüşe başlayan nöropatili bireylerin, tek seferde 2.000 adımdan fazla atmaması daha güvenli olabilir.

Anahtar Kelimeler: Diyabetik ayak; egzersiz; deri sıcaklığı
ABSTRACT
 Objective: Brisk walking is one of the moderate exercises which are advised in the type 2 diabetes (T2D) treatment and preventing complications. Safety of this exercise for T2D subjects with foot ulcer risk is controversial. Our aim was to investigate plantar temperature changes after walking with different step counts in T2D subjects with neuropathy. Material and Methods: Forty-four individuals with; T2D diagnoses for at least one year, ability to walk independently and more than two points from Michigan Neuropathy Screening Tool physical assessment participated in the study. Gender, age, body mass index, body length, HbA1c value and disease year of participants were questioned. Plantar temperatures of the subjects were measured before and after walking on treadmill, with three different step counts (2,000, 4,000 and 6,000 steps), on different days. Results: Temperature values increased significantly after 2000 steps under hallux, distal first metatarsal, lateral of both feet and right heel (p<0.05). After 4,000 and 6,000 steps of walking, temperature increased significantly at all measured cites of both feet (p<0.05). When temperature changes were compared, increase after 4,000 steps was higher than 2,000 and it was the highest after 6,000 steps (p<0.05). Conclusion: Plantar temperature shows an increase with increasing step count in T2D subjects. It could be safer to take no more than 2,000 steps when the neuropathic subjects start to do brisk walking. Because, the temperature increase which was prominent above 2,000 steps, might increase the ulcer risk.

Keywords: Diabetic foot; exercise; skin temperature
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