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ORIJINAL ARAŞTIRMA

İnme Sonrası Hemipleji Gelişen Hastalarda Hemoglobin, Folat, Vitamin B12 ve 25 (OH) Vitamin D3 Düzeylerinin Fonksiyon, Disabilite, Ağrı ve Denge Üzerine Etkisi
The Effect of Hemoglobin, Folate, Vitamin B12, and 25 (OH) Vitamin D3 Levels on Function, Disability, Pain, and Balance in Patients with Post-Stroke Hemiplegia
Received Date : 05 Dec 2021
Accepted Date : 27 Apr 2022
Available Online : 09 May 2022
Doi: 10.31609/jpmrs.2021-87387 - Makale Dili: EN
J PMR Sci. 2022;25(3):286-92
ÖZET
Amaç: Hemoglobin, folat, 25 (OH) vitamin D3 ve vitamin B12 düzeylerinin inme riski ile ilişkili olduğu bildirilmiş olsa da bu düzeyler ile inme sonrası hemipleji gelişenlerin fonksiyonel durum, disabilite, ağrı veya denge durumları arasındaki ilişkisi ile ilgili veriler kısıtlıdır. Bu çalışmada, değişkenlerin düzeyleri ile inme sonrası hemipleji gelişen hastalardaki fonksiyonel durum, ağrı ve denge gibi parametreler arasındaki ilişkinin araştırılması amaçlandı. Gereç ve Yöntemler: Çalışmaya 39 hasta dâhil edildi. Brunnstrom iyileşme evreleri, Berg Denge Skalası, Fonksiyonel Ambülasyon Sınıflaması (FAS), Leeds Nöropatik Semptom ve Belirtilerin Değerlendirmesi ağrı skalası, Barthel İndeks skorları belirlendi. Ayrıca hastaların santral ağrıları ve hemiplejik omuz ağrıları nümerik derecelendirme ölçeği kullanılarak değerlendirildi. Katılımcıların hemoglobin, folat, vitamin B12 ve 25 (OH) vitamin D3 seviyeleri kaydedildi. Bulgular: Fonksiyonel ambülasyonu olan (FAS Evre 3-5) hastalarda, fonksiyonel ambülasyonu olmayan (FAS Evre 0-2) hastalara göre hemoglobin seviyeleri anlamlı olarak daha yüksekti (sırasıyla ortalama±standart sapma 13,77±2,38, 12,13±1,58) (p=0,019). Ayrıca hemoglobin seviyeleri Barthel İndeksi (r=0,496, p=0,002) ve Berg Denge Skalası (r=0,458, p=0,005) ile pozitif ilişkiliydi. Folat, vitamin B12 ve 25 (OH) vitamin D3 seviyeleri hiçbir skala ile ilişkili bulunmadı. Çok değişkenli lojistik regresyon analizi sonuçlarına göre hastaların hemoglobin değerlerindeki bir birimlik artış fonksiyonel ambulatuar grupta olma olasılığını 1.655 kat artırmaktadır (p=0,024). Sonuç: İnme sonrası hemiplejili hastalarda hemoglobin düzeyi ile disabilite, ambülasyon ve denge durumu ilişkili bulunmuştur. Daha iyi rehabilitasyon başarısı için hastaların hemoglobin düzeylerini değerlendirmek akılda tutulmalıdır.
ABSTRACT
Objective: Although hemoglobin, folate, 25 (OH) vitamin D3, and vitamin B12 levels have been reported to be associated with the risk of stroke, there are limited data on the relationship between these levels and functional status, disability, pain or balance in those who develop post-stroke hemiplegia. The present study aimed to investigate the relationship between parameters such as functional status, pain, balance, and hemoglobin, folate, 25 (OH) vitamin D3, and vitamin B12 levels in patients with post-stroke hemiplegia. Material and Methods: Thirty-nine patients were included in the study. Brunnstrom recovery stages, Berg Balance Scale, Functional Ambulation Category (FAC), Leeds Assessment of Neuropathic Symptoms and Signs pain scale, Barthel Index scores were determined. In addition, the patients’ central pain and hemiplegic shoulder pain were evaluated using numerical rating scales. The hemoglobin, folate, vitamin B12, and 25 (OH) vitamin D3 levels of the participants were noted. Results: Hemoglobin levels were significantly higher in functional ambulatory patients (FAC Stage 3-5) than in non-functional ambulatory (FAC Stage 0-2) patients (mean±standard deviation 13.77±2.38, 12.13±1.58, respectively) (p=0.019). In addition, hemoglobin levels were positively correlated with Barthel Index (r=0.496, p=0.002) and Berg Balance Scale (r=0.458, p=0.005). Folate, vitamin B12, and 25 (OH) vitamin D3 levels were not associated with any of the scales. According to the results of the multivariate logistic regression analysis, the increase in the hemoglobin values of the patients increases the probability of being in the functional ambulatory group 1,655 times (p=0.024). Conclusion: In this study, hemoglobin level was found to be associated with disability, ambulation and balance status in patients with post-stroke hemiplegia. For better rehabilitation success, it should be kept in mind to evaluate the hemoglobin levels of the patients.
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