Ýdiyopatik Skolyozda Denge ve Yürümenin Deðerlendirilmesi

GÝRÝÞ ve AMAÇ: Ýdiyopatik skolyoz (ÝS), koronal düzlemde 10 dereceden fazla lateral sapma olarak radyografik olarak tanýmlanan, sagital ve transvers düzlem deðiþiklikleriyle kendini gösteren, omurganýn üç boyutlu bir deformitesidir. Denge ve yürüme günlük yaþamýn en yaygýn aktiviteleridir. Çalýþmamýzda, ilerleme riski azalmýþ ve eðrilikleri genellikle stabil olan ÝS bireylerinde eðriliðin denge ve yürüyüþ üzerindeki etkisini analiz etmeyi amaçladýk.
YÖNTEM ve GEREÇLER: Çalýþmaya 34 ÝS hastasý ve 34 saðlýklý birey alýndý. Tüm katýlýmcýlara sosyo-demografik ve fiziksel özellikleri soruldu. Denge parametreleri, yerleþik kuvvet sensörleri ve tutacaklarý olan Huber 360 adlý çok eksenli, motorlu bir platform sistemi kullanýlarak kaydedildi. Katýlýmcýlarýn yürüme analizi, Zebris FDM tip 3 (Zebris Medical GmbH, Almanya) yürüme platformu kullanýlarak gerçekleþtirildi.
BULGULAR: Yürüme parametreleri incelendiðinde, adým atma süresi ve yürüme döngüsü süresi ÝS grubunda kontrol grubuna göre anlamlý olarak yüksekti (sýrasýyla, p=0.007 ve p=0.008). Buna karþýn, kontrol grubunun sað ayak yükleme yanýtý ve yürüme hýzý skolyoz grubuna göre anlamlý olarak yüksekti (sýrasýyla, p=0.006 ve p=0.0003). Gözler kapalýyken stabilite hýzý ÝS grubunda kontrol grubuna göre anlamlý olarak yüksekti (sýrasýyla, 14.55±3.5 mm/s ve 12.6±4.6 mm/s, p=0.012). Diðer denge ve yürüyüþ özellikleri açýsýndan gruplar arasýnda anlamlý bir fark gözlenmedi.
TARTIÞMA ve SONUÇ: Bu çalýþma, ÝS hastalarýnda denge ve yürüyüþün etkilendiðini ve skolyozlu bireylerin saðlýklý bireylere göre zayýf denge ve yürüme becerilerine sahip olduðunu ortaya koymuþtur. Bu nedenle skolyoz rehabilitasyonunda omurga eðriliklerinden kaynaklanabilecek denge ve yürüyüþ sorunlarýnýn mutlaka dikkate alýnmasý gerekmektedir.

Evaluation of Balance and Gait in Idiopathic Scoliosis

INTRODUCTION: Idiopathic scoliosis (IS) is a three-dimensional deformity of the spine, defined radiographically as a lateral deviation of more than 10 degrees in the coronal plane, characterized by sagittal and transverse plane changes. Balance and walking are the most common activities of daily living. In our study, we aimed to analyze the effect of the curvature on balance and walking in IS individuals, who have a reduced risk of progression and whose curvatures are generally stable, by analyzing quantitative data.
METHODS: The study included 34 patients with IS and 34 healthy individuals. All participants were questioned about their socio-demographic and physical characteristics. Balance parameters were recorded using a multi-axis, motorized platform system called Huber 360 with built-in force sensors and handles. The participants’ gait analysis was performed using a Zebris FDM type 3 (Zebris Medical GmbH, Germany) walking platform.
RESULTS: When gait parameters were examined, step time and walking cycle duration were significantly higher in the IS group compared to the control group (p=0.007 and p=0.008, respectively). On the contrary, right-foot loading response and walking speed of the control group were significantly higher than the scoliosis group (p=0.006 and p=0.0003, respectively). Stability speed with eyes closed was significantly higher in the IS group compared to controls (14.55±3.5 mm/s and 12.6±4.6 mm/s, respectively, p=0.012). No significant differences were observed between the groups in terms of other balance and gait characteristics.
DISCUSSION AND CONCLUSION: This study revealed that balance and gait were affected in patients with IS, and individuals with scoliosis had poor balance and walking skills compared to healthy individuals. Therefore, in scoliosis rehabilitation, balance and walking problems that may be caused by spinal curvatures should definitely be taken into consideration.