Total diz protezi sonrası denge egzersizlerinin klinik sonuçlar ve fonksiyonellik üzerine etkisi
Abstract
Amaç: Çalışmanın amacı, primer diz osteoartriti tanısı ile tek taraflı total diz artroplastisi ameliyatı uygulanan kadın hastalarda standart fizyoterapi programına ek olarak uygulanan denge egzersizlerinin fonksiyonel performans, denge ve fonkiyonellik üzerindeki etkisini incelemekti. Yöntem: Prospektif randomize tek kör kontrollü olarak tasarlanan araştırmaya 38 kadın hasta (yaş ortalaması 68.98 ± 5.07) dahil edildi. Hastalar denge grubu (DG) ve kontrol grubuna (KG) randomizasyon ile ayrıldı. Denge grubu, standart fizyoterapi programına ek olarak denge egzersizlerini gerçekleştirdi. İyileşme düzeyi tayininde eklem hareket açıklığı değerlendirmesi, fonksiyonel performansın incelenmesinde 50 Adım Yürüme Testi ve Merdiven İnip Çıkma Testi, düşme riski değerlendirmesinde Berg Denge Ölçeği, statik denge değerlendirmesinde Tek Ayak Üzerinde Durma Testi, dinamik denge incelenmesinde ise Zamanlı Kalk Yürü Testi kullanıldı. Hastaların fonksiyonellik düzeyi WOMAC ölçeği ile incelendi. Tüm değerlendirmeler ameliyattan sonraki 6. haftada yapıldı. Bulgular: Aktif diz eklemi fleksiyon, ekstansiyon hareket açıklığı ortalama skorları ile 50 Adım Yürüme Testi ortalama skorlarında iki grup arasında istatistiksel olarak anlamlı fark saptanmadı (p>0.05). Merdiven İnip Çıkma Testi (d=1.92, p<0.001), Tek Ayak Üzerinde Durma Testi (d=2.63, p<0.001), Zamanlı Kalk Yürü Testi (d=1.88, p<0.001) ve Berg Denge Ölçeği (d=1.41, p<0.001) ortalama skorlarının DG'de anlamlı olarak iyileştiği kaydedildi. WOMAC ağrı ve sertlik skoru açısından anlamlı fark saptanmadı (p>0.05). Ancak WOMAC fonksiyon skoru sonuçlarında DG'nin skoru ortalama 21.53 (19.95 - 23.00) kontrol grubunun skoru ortalama 30,58 (27.76 - 33.73) olarak bulundu (p<0.001). Sonuç: Denge egzersizleri standart fizyoterapi programına eklenince, TDA ameliyatı uygulanan kadın hastaların fonksiyonel performansı, statik dengesi ve fonksiyonellikleri erken dönem sonuçlarnın daha iyi düzeye geldiği, düşme risklerinin azaldığı gözlendi. Anahtar Kelimeler: Total Diz Protezi, Fizyoterapi, Rehabilitasyon, Denge, Egzersiz
Objective: The aim of the study was to examine the effect of balance exercises applied in addition to the standard physiotherapy program on functional performance, balance and functionality in female patients who underwent unilateral total knee arthroplasty surgery with the diagnosis of primary knee osteoarthritis. Methods: 38 female patients (mean age 68.98 ± 5.07) were included in the prospective randomized single-blind controlled study. Patients were divided into balance group (BG) and control group (CG) by randomization. The balance group performed balance exercises in addition to the standard physiotherapy program. Joint range of motion was used to assess the level of improvement, 50-Step Walk Test and Stair Climbing Test were used to assess functional performance, Berg Balance Scale was used to assess fall risk, One Foot Standing Test was used for static balance assessment, and Timed Up-Go Test was used to assess dynamic balance. The functionality level of the patients was evaluated with the WOMAC scale. All assessments were made at 6 weeks post-surgery. Results: There was no statistically significant difference between the two groups in the mean scores of active knee joint flexion, extension range of motion and 50-Step Walk Test mean scores (p>0.05). Stair Climbing Test (d= 1.92, p<0.001), Standing on One Leg Test (d= 2.63, p<0.001), Timed Up and Go Test (d= 1.88, p<0.001) and Berg Balance Scale (d= 1.41, p<0.001) improved significantly in BG. There was no significant difference in terms of WOMAC pain and stiffness scores (p>0.05). However, in the WOMAC function score results, the mean score of BG was 21.53 (19.95 - 23.00) and the mean score of the control group was 30.58 (27.76 - 33.73) (p<0.001). Conclusion: When balance exercises were added to the conventional physiotherapy program, it was observed that the functional performance, static balance and functionality of female patients who underwent TKA surgery improved in short-term results, and the risk of falling was reduced. Keywords: Total Knee Replacement, Physiotherapy, Rehabilitation, Balance, Exercise
Objective: The aim of the study was to examine the effect of balance exercises applied in addition to the standard physiotherapy program on functional performance, balance and functionality in female patients who underwent unilateral total knee arthroplasty surgery with the diagnosis of primary knee osteoarthritis. Methods: 38 female patients (mean age 68.98 ± 5.07) were included in the prospective randomized single-blind controlled study. Patients were divided into balance group (BG) and control group (CG) by randomization. The balance group performed balance exercises in addition to the standard physiotherapy program. Joint range of motion was used to assess the level of improvement, 50-Step Walk Test and Stair Climbing Test were used to assess functional performance, Berg Balance Scale was used to assess fall risk, One Foot Standing Test was used for static balance assessment, and Timed Up-Go Test was used to assess dynamic balance. The functionality level of the patients was evaluated with the WOMAC scale. All assessments were made at 6 weeks post-surgery. Results: There was no statistically significant difference between the two groups in the mean scores of active knee joint flexion, extension range of motion and 50-Step Walk Test mean scores (p>0.05). Stair Climbing Test (d= 1.92, p<0.001), Standing on One Leg Test (d= 2.63, p<0.001), Timed Up and Go Test (d= 1.88, p<0.001) and Berg Balance Scale (d= 1.41, p<0.001) improved significantly in BG. There was no significant difference in terms of WOMAC pain and stiffness scores (p>0.05). However, in the WOMAC function score results, the mean score of BG was 21.53 (19.95 - 23.00) and the mean score of the control group was 30.58 (27.76 - 33.73) (p<0.001). Conclusion: When balance exercises were added to the conventional physiotherapy program, it was observed that the functional performance, static balance and functionality of female patients who underwent TKA surgery improved in short-term results, and the risk of falling was reduced. Keywords: Total Knee Replacement, Physiotherapy, Rehabilitation, Balance, Exercise
Description
Keywords
Fizyoterapi ve Rehabilitasyon, Denge, Diz, Diz eklemi, Physiotherapy and Rehabilitation, Diz protezi, Equilibrium, Knee, Egzersiz, Knee joint, Knee prosthesis, Egzersiz tedavisi, Exercise, Fonksiyonel yetkinlik, Exercise therapy, Functional competency, Postural denge, Postural balance