Diz osteoartriti hastalarında radyografik ve ultrasonografik değişikliklerin denge bozukluğu ve kinezyofobi üzerine etkisinin araştırılması
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Tarih
2024
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Kırıkkale Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada diz osteoartriti hastalarında radyografik ve ultrasonografik değişikliklerin denge bozukluğu ve kinezyofobi üzerine etkisinin araştırılması amaçlanmıştır. Gereç ve Yöntem: Klinik ve radyografik olarak diz OA tanısı konulan 68 hasta ve diz yakınması olmayan 60 sag?lıklı go?nu?llu? birey çalıs?maya dahil edildi. Bireylerin fonksiyonel du?zeyi Western Ontario ve McMaster Üniversitesi Osteoartrit İndeksi (WOMAC) skoru ile, statik ve dinamik denge; Berg denge ölçeği ile, kinezyofobi; Tampa kinezyofobi ölçeği ile deg?erlendirildi. Gec?en yıl ic?indeki du?s?melerin sayısı ve düşme sonrası alt ekstremite kırık öyküsü sorgulandı. Ag?rı s?iddeti; visual analog skala (VAS) ile deg?erlendirildi ve istirahat, aktivite sırasında, gece, şimdiki VAS değerleri olarak ayrı not edildi. Hasta grubunda diz osteoartritinin radyografik evrelemesi ic?in Kellgren Lawrence (KL) skalası kullanıldı. Ultrasonografi ile rektus femoris (RF) kas kalınlıg?ı ve femoral kartilaj (FK) kalınlıg?ı; medial, lateral, interkondiler olarak değerlendirildi. Bulgular: Çalışmamız sonucunda diz OA grubunda kontrol grubuna kıyasla WOMAC ve Berg denge ölçeği puanları daha düşük, Tampa kinezyofobi ölçeği puanı daha yüksek saptandı (p<0.001). Hasta grubunda kontrol grubuna kıyasla femoral kartilaj medial, lateral ve interkondiler kalınlığı, rektus femoris kas kalınlığı daha düşük saptandı (p<0.001). Berg Denge Ölçeği ile negatif yönlü korelasyon gösteren bulgular; yaş, VKI, şimdiki VAS, gece VAS, aktivite VAS, Kellgren Lawrence evrelemesi, WOMAC ve Tampa Kinezyofobi ölçeği puanları iken pozitif yönde korelasyon gösteren bulgular; eğitim düzeyi, rektus femoris kas kalınlığı, FKM-FKİ-FKL kalınlıkları idi (p<0,05). Tampa Kinezyofobi Ölçeği ile negatif yönlü korelasyon gösteren bulgular; eğitim düzeyi, rektus femoris kas kalınlığı ve FKM- FKİ-FKL kalınlıkları iken pozitif yönlü korelasyon gösteren bulgular; şimdiki VAS, gece VAS, istirahat VAS, aktivite VAS, Kellgren Lawrence evrelemesi, WOMAC skoru idi (p<0,05). Regresyon analizinde Tampa Kinezofobi Ölçeği için kadın cinsiyet, WOMAC ve FKL kalınlığı; Berg Denge Ölçeği için ise yaş, VKİ, WOMAC, RF kas kalınlığı ve FKL kalınlığı daha fazla öneme sahip bulundu. Sonuç: Çalışmamız diz OA hastalarında ağrı artışı, dengede bozulma, fonksiyonellikte azalma ve kinezyofobide artış olduğunu göstermiştir. Yine çalışmamız göstermiştir ki rektus femoris kas kalınlığı, femoral kartilaj kalınlığı ve KL evrelemesi hem denge bozukluğu hem de kinezyofobi ile ilişkilidir. Yaygın görülen bir hastalık olan diz OA'sında saptadığımız bu ilişki denge bozukluğu ve kinezyofobinin nedeninin anlamada ve etkin bir tedavi planı oluşturmamızda yol göstereceğini düşünmekteyiz. İlerleyici diz OA' sında lateral kompartman etkilenmesiyle diz stabilitesinde ve propriosepsiyonda daha fazla azalma gözlendiği kanaatindeyiz. Çalışmamızda da Berg denge ölçeği ve Tampa kinezyofobi ölçeğinin regresyon analizinde FKL kalınlığı ile daha ilişkili saptanması bu görüşümüzü destekler niteliktedir. Sonuç olarak hastalar erken evrede teşhis edilmeli, uygun tedavi ve egzersiz programı ile hastalık progresyonunun önüne geçilmelidir. Anahtar Kelimeler: Diz osteooartriti, radyografi, ultrasonografi, kinezyofobi, denge bozukluğu
Objective: This study aimed to investigate the effects of radiographic and ultrasonographic changes on balance disorders and kinesiophobia in knee osteoarthritis patients. Materials and Methods: 68 patients diagnosed with knee OA clinically and radiographically and 60 healthy volunteers without knee complaints were included in the study. Functional level of individuals is determined by the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) score, static and dynamic balance; With the Berg balance scale, kinesiophobia; Evaluated with Tampa kinesiophobia scale. The number of falls in the past year and history of lower extremity fractures following falls were questioned. Pain intensity; It was evaluated with the visual analog scale (VAS) and recorded separately as resting, activity, night and current VAS values. Kellgren Lawrence (KL) scale was used for radiographic staging of knee osteoarthritis in the patient group. Rectus femoris (RF) muscle thickness and femoral cartilage (FK) thickness by ultrasonography; It was evaluated as medial, lateral and intercondylar. Results: As a result of our study, WOMAC and Berg balance scale scores were found to be lower and Tampa kinesiophobia scale scores were higher in the knee OA group compared to the control group (p<0.001). Medial, lateral and intercondylar thickness of the femoral cartilage and rectus femoris muscle thickness were found to be lower in the patient group compared to the control group (p<0.001). Findings showing a negative correlation with the Berg Balance Scale; age, BMI, current VAS, night VAS, activity VAS, Kellgren-Lawrence staging, WOMAC and Tampa Kinesiophobia scale scores, the findings showing positive correlation were; education level, rectus femoris muscle thickness, FKM-FKİ-FKL thicknesses (p<0.05). Findings showing a negative correlation with the Tampa Kinesiophobia Scale; Education level, rectus femoris muscle thickness and FKM-FKİ-FKL thicknesses showed positive correlation; current VAS, night VAS, resting VAS, activity VAS, Kellgren-Lawrence staging, WOMAC score (p<0.05). In regression analysis, female gender, WOMAC and FKL thickness for Tampa Kinesophobia Scale; For the Berg Balance Scale; age, BMI, WOMAC, RF muscle thickness and FKL thickness were found to be more important. Conclusion: Our study showed that there was increased pain, impaired balance, decreased functionality, and increased kinesiophobia in knee OA patients. Again, our study showed that rectus femoris muscle thickness, femoral cartilage thickness and CL staging are associated with both balance disorder and kinesiophobia. We think that this relationship we found in knee OA, a common disease, will guide us in understanding the cause of balance disorder and kinesiophobia and in creating an effective treatment plan. We believe that in progressive knee OA, a further decrease in knee stability and proprioception is observed as the lateral compartment is affected. In our study, the Berg balance scale and Tampa kinesiophobia scale were found to be more related to FKL thickness in the regression analysis, which supports our view. As a result, patients should be diagnosed at an early stage and disease progression should be prevented with appropriate treatment and exercise program. Key Words: Knee osteoarthritis, radiography, ultrasonography, kinesiophobia, balance disorder
Objective: This study aimed to investigate the effects of radiographic and ultrasonographic changes on balance disorders and kinesiophobia in knee osteoarthritis patients. Materials and Methods: 68 patients diagnosed with knee OA clinically and radiographically and 60 healthy volunteers without knee complaints were included in the study. Functional level of individuals is determined by the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) score, static and dynamic balance; With the Berg balance scale, kinesiophobia; Evaluated with Tampa kinesiophobia scale. The number of falls in the past year and history of lower extremity fractures following falls were questioned. Pain intensity; It was evaluated with the visual analog scale (VAS) and recorded separately as resting, activity, night and current VAS values. Kellgren Lawrence (KL) scale was used for radiographic staging of knee osteoarthritis in the patient group. Rectus femoris (RF) muscle thickness and femoral cartilage (FK) thickness by ultrasonography; It was evaluated as medial, lateral and intercondylar. Results: As a result of our study, WOMAC and Berg balance scale scores were found to be lower and Tampa kinesiophobia scale scores were higher in the knee OA group compared to the control group (p<0.001). Medial, lateral and intercondylar thickness of the femoral cartilage and rectus femoris muscle thickness were found to be lower in the patient group compared to the control group (p<0.001). Findings showing a negative correlation with the Berg Balance Scale; age, BMI, current VAS, night VAS, activity VAS, Kellgren-Lawrence staging, WOMAC and Tampa Kinesiophobia scale scores, the findings showing positive correlation were; education level, rectus femoris muscle thickness, FKM-FKİ-FKL thicknesses (p<0.05). Findings showing a negative correlation with the Tampa Kinesiophobia Scale; Education level, rectus femoris muscle thickness and FKM-FKİ-FKL thicknesses showed positive correlation; current VAS, night VAS, resting VAS, activity VAS, Kellgren-Lawrence staging, WOMAC score (p<0.05). In regression analysis, female gender, WOMAC and FKL thickness for Tampa Kinesophobia Scale; For the Berg Balance Scale; age, BMI, WOMAC, RF muscle thickness and FKL thickness were found to be more important. Conclusion: Our study showed that there was increased pain, impaired balance, decreased functionality, and increased kinesiophobia in knee OA patients. Again, our study showed that rectus femoris muscle thickness, femoral cartilage thickness and CL staging are associated with both balance disorder and kinesiophobia. We think that this relationship we found in knee OA, a common disease, will guide us in understanding the cause of balance disorder and kinesiophobia and in creating an effective treatment plan. We believe that in progressive knee OA, a further decrease in knee stability and proprioception is observed as the lateral compartment is affected. In our study, the Berg balance scale and Tampa kinesiophobia scale were found to be more related to FKL thickness in the regression analysis, which supports our view. As a result, patients should be diagnosed at an early stage and disease progression should be prevented with appropriate treatment and exercise program. Key Words: Knee osteoarthritis, radiography, ultrasonography, kinesiophobia, balance disorder
Açıklama
Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Ana Bilim Dalı, Fiziksel Tıp ve Rehabilitasyon Bilim Dalı
Anahtar Kelimeler
Fiziksel Tıp ve Rehabilitasyon, Physical Medicine and Rehabilitation
