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ORIJINAL ARAŞTIRMA

Sarkopenisi Olan Diz Osteoartritli Yaşlılarda Dizliğin Diz Eklem Propriyosepsiyon Duyusuna ve Statik Dengeye Etkisi
The Effect of Knee Brace on Knee Joint Proprioception and Static Balance in Sarcopenic Elderly Patients with Knee Osteoarthritis
Received Date : 23 Mar 2022
Accepted Date : 22 May 2022
Available Online : 20 Jun 2022
Doi: 10.31609/jpmrs.2022-89896 - Makale Dili: TR
J PMR Sci. 2022;25(3):339-45
ÖZET
Amaç: Sarkopenik yaşlılarda ekstremite hareketlerinde farkındalığın artması ve dengenin iyileştirilmesi, düşmelerin ve düşme ile ilişkili fiziksel, ruhsal ya da sosyal problemlerin önüne geçebilir. Bu araştırmada amaç, sarkopenisi olan yaşlı diz osteoartritli bireylerde elastik neopren dizlik kullanımının diz eklem propriyosepsiyon duyusuna ve statik dengeye etkisini araştırmaktır. Gereç ve Yöntemler: Uluslararası Fiziksel Tıp ve Rehabilitasyon Derneği Sarkopeni Çalışma Grubu önerileri doğrultusunda el kavrama gücü, sandalyeden kalkma testi ve sonografik uyluk düzeltme oranına göre sarkopeni tanısı alan 61 yaşlı bilateral diz osteoartriti olan kadın hastanın dâhil edildiği bu kesitsel araştırmada, katılımcıların elastik neopren dizlikli ve dizliksiz statik denge ölçümü ve diz eklem propriyosepsiyon duyusu ölçümleri yapıldı. Diz eklem propriyosepsiyon duyusu, izokinetik dinamometre ile dominant ekstremiteden 45° fleksiyon açısı için modifiye bir reprodüksiyon yöntemi kullanılarak ölçüldü. Statik denge, bilgisayarlı denge sistemi kullanılarak genel stabilite indeksi, ön-arka stabilite indeksi ve medial- lateral stabilite indekslerine göre değerlendirildi. Dizliksiz ve dizlik giyilerek yapılan ölçümlerinin karşılaştırılmasında bağımlı gruplar t-testi kullanıldı. Bulgular: Ortalama yaşı 69,7 olan katılımcıların olduğu bu araştırmada, 6±1,2 olan diz fleksiyon sapma açısı dizlik giyilmesi sonrası 5,6±1,3’e istatistiksel anlamlı olarak geriledi (p=0,02). Sırasıyla 7,45±0,43, 6,78±0,29 ve 6,55±0,33 olan genel stabilite indeksi, ön-arka stabilite indeksi ve medial-lateral stabilite indeksi skorları dizlikli ölçümde sırasıyla 7,38±0,51, 6,64±0,43, 6,53±0,25 bulundu ancak değişim istatistiksel olarak anlamlı değildi (sırasıyla p=0,55, p=0,47, p=0,15). Sonuç: Elastik neopren dizlik kullanımı yaşlı sarkopenisi olan diz osteoartritli hastalarında diz eklem propriyoseptif duyusu keskinliğini artırır ancak statik dengeye etkisi yoktur. Dizlik kullanımı, diz ekleminin kinestetik farkındalığını artırarak olası yaralanmaların önüne geçilebilir.
ABSTRACT
Objective: Increasing awareness of extremity movements and improving balance in the sarcopenic elderly patients can prevent falls and the physical, mental, or social problems associated with falls. This study aims to investigate the effect of elastic neoprene knee brace on knee joint proprioception sense and static balance in sarcopenic elderly patients with knee osteoarthritis. Material and Methods: In this cross-sectional study, included 61 elderly female patients with bilateral knee osteoarthritis, who were diagnosed with sarcopenia according to the handgrip strength, chair stand test, and sonographic thigh adjustment ratio in line with the recommendations of the Special Interest Group on Sarcopenia of the International Society of Physical and Rehabilitation Medicine. Static balance and knee joint proprioception sense measurements were assessed with and without an elastic neoprene knee brace. Knee joint proprioception sense was measured with an isokinetic dynamometer using a modified reproduction method for a 45° flexion angle from the dominant extremity. The static balance was evaluated with a computerized balance system according to the general stability index, anterior-posterior stability index, and medial-lateral stability index. Dependent samples t-test was used to compare the measurements with and without knee braces. Results: Statistically significant decrease was found in knee joint flexion deviation angle after wearing knee braces (6±1.2 to 5.6±1.3, p=0.02), while no significant change was found in the general stability index, anterior-posterior stability index, and medial-lateral stability index scores (7.45±0.43 to 7.38±0.51 p=0.55, 6.78±0.29 to 6.64±0.43 p=0.47 and 6.55±0.33 to 6.53±0.25 p=0.15 respectively). Conclusion: The use of elastic neoprene knee brace increases knee joint proprioceptive acuity in sarcopenic elderly patients with knee osteoarthritis, but does not affect static balance. The use of knee braces can increase the kinesthetic awareness of the knee joint and prevent possible injuries.
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