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ORIJINAL ARAŞTIRMA

Nörolojik Hastalıklara Bağlı Engellilik Gelişmiş Bireylerde, Alt ve Üst Ekstremite Ortezlerine Uyumu Etkileyen Faktörler
Factors Affecting Compliance with Lower and Upper Extremity Orthoses in Patients with Disability Due to Neurological Diseases
Received Date : 01 Nov 2021
Accepted Date : 11 Feb 2022
Available Online : 28 Feb 2022
Doi: 10.31609/jpmrs.2021-86851 - Makale Dili: EN
J PMR Sci. 2022;25(2):240-7
ÖZET
Amaç: Nörolojik hastalıklara bağlı engellilik gelişmiş bireylerde ortez sıkça kullanılmaktadır. Bu bireylerde, orteze uyum göstermeme önemli bir sorundur. Bununla birlikte ortez uyumunu etkileyen faktörleri inceleyen çalışmalar sınırlıdır. Bu çalışmanın amacı, nörolojik hastalıklara bağlı engellilik gelişen bireylerde alt ve üst ekstremite ortezlerine uyumu etkileyen faktörleri incelemektir. Gereç ve Yöntemler: Nörolojik rehabilitasyon nedeniyle takip edilen daha önce alt ve/veya üst ekstemite ortezi önerilmiş 45 hastanın orteze uyumları sorgulandı. Ayrıca hastaların yaş, cinsiyet, boy, kilo, hastalık süresi, tanısı, meslek, eğitim durumu, yaşadığı yer, evinin kaçıncı kat olduğu, yaşadığı binada asansör olup olmadığı, yılda aldığı fizyoterapi seans sayısı, uyguladığı ev egzersizi süresi, kullandığı yürüme yardımcısı, reçetelenen ortezin tipi, ortezinin reçete edilme zamanı, etkilenen ekstremiteler, ambulasyon durumu, hastalığının klinik evresi, cihaza uyum göstermeme nedeni gibi faktörlerin ortez uyumu ile ilişkisi incelendi. Bulgular: Alt ekstremite ortezi önerilip de cihaza uyum göstermeyen hastaların cihazı aksatma nedenlerinden cihaz kaynaklı nedenler diğer nedenlere göre anlamlı olarak daha fazlaydı. Üst ekstremite ortez kullanım oranı ile hastalık süresi ve mevcut ortez reçetelenme süresi arasında negatif yönlü; yaş ile ise pozitif yönlü anlamlı bir ilişki saptanmıştır. Sonuç: Ortez kullanan hastaların ortez uyumunu etkileyen en önemli faktörlerin cihaza bağlı nedenler olduğu tespit edilmiştir. Ayrıca hastaların hastalık süresi, yaş ve ortez reçete süresi de ortez uyumu ile ilişkilidir. Bu sonuçlar ortez reçeteleme, ortez üretimi ve hasta takibi sırasında dikkate alınmalıdır.
ABSTRACT
Objective: Orthosis is frequently used in individuals with disability due to neurological diseases. Non-compliance with the orthosis is an important problem in these patients. However, studies examining the factors affecting orthotic compliance are limited. The aim of this study is to examine the factors affecting compliance with lower and upper extremity orthoses in individuals with disability due to neurological diseases. Material and Methods: Orthosis compliance of 45 patients who were previously recommended lower and/or upper extremity orthosis and followed up for neurological rehabilitation was questioned. In addition, the relationship of factors such as age, gender, height, weight, duration of disease, diagnosis, clinical stage of the disease, reasons for non-compliance with the device, occupation, education level, residence, what floor their house is on, whether there is an elevator in the building they live in, the number of physiotherapy sessions they receive per year, the duration of home exercise they use, the walking aid they use, the type of orthosis prescribed, the time their orthoses are prescribed, affected extremities, and ambulation status of patients with orthosis compliance were examined. Results: Device-related reasons were found to be significantly more common than other reasons, among the reasons for leaving the device in patients who were offered lower extremity orthosis and did not comply with the device. The rate of use of upper extremity orthosis was found to be negatively related to disease duration and orthosis prescription time, and positively related to age. Conclusion: It has been determined that the most important factors affecting the orthotic compliance of patients using orthoses are device-related reasons. In addition, patients' disease duration, age, and orthosis prescription duration are also associated with orthosis compliance. These results should be considered during prescribing, orthotic manufacture, and patient follow-up.
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