.: ORİJİNAL ARAŞTIRMA
Erken Evre ve Geç Evre Gonartrozlu Hastalarda Ağrı, Tibial Eğim, Fiziksel Performans, Dinamik Denge ve İşlevsel Seviyenin Karşılaştırılması
Comparison of Pain, Tibial Slope, Physical Performance, Dynamic Balance and Functional Level in Early and Late Stage Gonartrosis Patients
Turkiye Klinikleri J Health Sci. 2021;6(4):779-86
doi: 10.5336/healthsci.2020-79174
Makale Dili: TR
Tam Metin
ÖZET
Amaç: Bu çalışma, erken evre ve geç evre gonartrozlu hastalarda ağrı, tibial eğim, fiziksel performans, dinamik denge ve işlevsel seviyenin karşılaştırılması amacıyla yapıldı. Gereç ve Yöntemler: Çalışmaya, Amerikan Romatoloji Derneği ölçütlerine göre gonartroz tanısı konulmuş 56 hasta dâhil edildi. Hastalar, Kellgren-Lawrence ölçütleri esas alınarak erken evre (erken evre 1, erken evre 2) 28 kişi, geç evre (geç evre 3, geç evre 4) 28 kişi olmak üzere 2 gruba ayrıldı. Hastaların demografik bilgileri alındıktan sonra Numerik Ağrı Skalası ile ağrı şiddetleri; tibia proksimal anatomik aks ile tibial eğimleri; 30 sn kalk otur testi, merdiven inip çıkma testi ve 6 Dakika Yürüme Testi mesafesi ile fiziksel performansları; Y Denge Testi ile dinamik dengeleri ve Diz İncinme ve Osteoartrit Sonuç Skoru ile işlevsel seviyeleri değerlendirildi. Bulgular: Erken evre ve geç evre gonartrozu olan hastalar, demografik özellikler (yaş, boy, vücut ağırlığı, beden kitle indeksi) açısından karşılaştırıldığında grupların homojen dağıldığı görüldü (p>0,05). Erken evre gonartrozlu hastaların, geç evre gonartroz hastalarına göre ağrı şiddetlerinin daha düşük, fiziksel performans, dinamik denge ve işlevsel seviyelerinin ise daha iyi olduğu bulundu (p0,05). Sonuç: Sonuç olarak gonartrozun ilerleyen evrelerinde, hastaların ağrı şiddetinin arttığı, fiziksel performans, dinamik denge ve işlevsel seviyenin azaldığı, ancak tibial eğimin ise değişmediği görüldü. Gonartrozlu hastalarda, erken evreden itibaren uygulanacak fizyoterapi ve rehabilitasyon programlarının, bu hasta grubunda ileride ortaya çıkabilecek olumsuz klinik sonuçlara karşı koruyucu olabileceği düşünüldü.
Anahtar Kelimeler: Osteoartrit; diz; artralji; postüral denge; fiziksel fonksiyonel performans
Amaç: Bu çalışma, erken evre ve geç evre gonartrozlu hastalarda ağrı, tibial eğim, fiziksel performans, dinamik denge ve işlevsel seviyenin karşılaştırılması amacıyla yapıldı. Gereç ve Yöntemler: Çalışmaya, Amerikan Romatoloji Derneği ölçütlerine göre gonartroz tanısı konulmuş 56 hasta dâhil edildi. Hastalar, Kellgren-Lawrence ölçütleri esas alınarak erken evre (erken evre 1, erken evre 2) 28 kişi, geç evre (geç evre 3, geç evre 4) 28 kişi olmak üzere 2 gruba ayrıldı. Hastaların demografik bilgileri alındıktan sonra Numerik Ağrı Skalası ile ağrı şiddetleri; tibia proksimal anatomik aks ile tibial eğimleri; 30 sn kalk otur testi, merdiven inip çıkma testi ve 6 Dakika Yürüme Testi mesafesi ile fiziksel performansları; Y Denge Testi ile dinamik dengeleri ve Diz İncinme ve Osteoartrit Sonuç Skoru ile işlevsel seviyeleri değerlendirildi. Bulgular: Erken evre ve geç evre gonartrozu olan hastalar, demografik özellikler (yaş, boy, vücut ağırlığı, beden kitle indeksi) açısından karşılaştırıldığında grupların homojen dağıldığı görüldü (p>0,05). Erken evre gonartrozlu hastaların, geç evre gonartroz hastalarına göre ağrı şiddetlerinin daha düşük, fiziksel performans, dinamik denge ve işlevsel seviyelerinin ise daha iyi olduğu bulundu (p0,05). Sonuç: Sonuç olarak gonartrozun ilerleyen evrelerinde, hastaların ağrı şiddetinin arttığı, fiziksel performans, dinamik denge ve işlevsel seviyenin azaldığı, ancak tibial eğimin ise değişmediği görüldü. Gonartrozlu hastalarda, erken evreden itibaren uygulanacak fizyoterapi ve rehabilitasyon programlarının, bu hasta grubunda ileride ortaya çıkabilecek olumsuz klinik sonuçlara karşı koruyucu olabileceği düşünüldü.
Anahtar Kelimeler: Osteoartrit; diz; artralji; postüral denge; fiziksel fonksiyonel performans
ABSTRACT
Objective: This study was conducted to compare pain, tibial slope, physical performance, dynamic balance, and functional level in patients with early and late-stage gonarthrosis. Material and Methods: Fifty-six patients diagnosed with gonarthrosis according to American Rheumatology Association criteria were included in the study. The patients were divided into 2 groups, based on KellgrenLawrence criteria, as 28 patients in early-stage (early stage 1, early stage 2), and 28 patients in late-stage (late stage 3, late-stage 4). After obtaining the demographic information of the patients, pain intensity was determined with Numeric Pain Scale, tibial slopes with Tibia Proximal Anatomic Axis, physical performances with the 30-second standup test, stair up and down test, and 6 Minute Walking Test distance, the dynamic balance was evaluated with Y Balance Test and functional levels were evaluated with Knee Injury and Osteoarthritis Outcome Score. Results: When the patients with early and late-stage gonarthrosis were compared in terms of demographic characteristics (age, height, body weight, body mass index), it was observed that the groups were homogeneously distributed (p>0.05). It was found that early-stage gonarthrosis patients had lower pain intensity and better physical performance, dynamic balance, and functional levels compared to late-stage gonarthrosis patients (p0.05). Conclusion: As a result, it was observed that in the advanced stages of gonarthrosis, the pain intensity of the patients increased, physical performance, dynamic balance, and functional level decreased, but the tibial slope did not change. It was thought that physiotherapy and rehabilitation programs to be applied from the early stage in patients with gonarthrosis may be protective against future negative clinical consequences in this patient group.
Keywords: Osteoarthritis; knee; arthralgia; postural balance; physical functional performance
Objective: This study was conducted to compare pain, tibial slope, physical performance, dynamic balance, and functional level in patients with early and late-stage gonarthrosis. Material and Methods: Fifty-six patients diagnosed with gonarthrosis according to American Rheumatology Association criteria were included in the study. The patients were divided into 2 groups, based on KellgrenLawrence criteria, as 28 patients in early-stage (early stage 1, early stage 2), and 28 patients in late-stage (late stage 3, late-stage 4). After obtaining the demographic information of the patients, pain intensity was determined with Numeric Pain Scale, tibial slopes with Tibia Proximal Anatomic Axis, physical performances with the 30-second standup test, stair up and down test, and 6 Minute Walking Test distance, the dynamic balance was evaluated with Y Balance Test and functional levels were evaluated with Knee Injury and Osteoarthritis Outcome Score. Results: When the patients with early and late-stage gonarthrosis were compared in terms of demographic characteristics (age, height, body weight, body mass index), it was observed that the groups were homogeneously distributed (p>0.05). It was found that early-stage gonarthrosis patients had lower pain intensity and better physical performance, dynamic balance, and functional levels compared to late-stage gonarthrosis patients (p0.05). Conclusion: As a result, it was observed that in the advanced stages of gonarthrosis, the pain intensity of the patients increased, physical performance, dynamic balance, and functional level decreased, but the tibial slope did not change. It was thought that physiotherapy and rehabilitation programs to be applied from the early stage in patients with gonarthrosis may be protective against future negative clinical consequences in this patient group.
Keywords: Osteoarthritis; knee; arthralgia; postural balance; physical functional performance
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