Postmenopozal osteoporozlu hastalarda denge-koordinasyon, kuvvetlendirme ve aerobik egzersizlerin düşmeye etkisi
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Date
2012
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Uludağ Üniversitesi
Abstract
Çalışmamız, postmenopozal osteoporoz'lu (OP) hastalarda denge-koordinasyon, kuvvetlendirme ve aerobik egzersizlerinin statik ve dinamik denge fonksiyonlarına, yaşam kalitesine ve düşme sıklığına etkisini değerlendirmek ve birbirlerine üstünlükleri olup olmadığını belirlemek amacıyla planlanmıştır.Çalışmaya Dünya Sağlık Örgütü OP Tanı Kriterlerine göre primer OP tanısı konan 75 hasta alınmıştır. Hastalar 3 gruba eşit olarak randomize edilerek 1.gruba denge-koordinasyon, 2.gruba kuvvetlendirme ve 3. gruba aerobik egzersizler verildi. Egzersiz programı 12 hafta boyunca haftada 3 gün, 1 saat süre ile eğitmen eşliğinde uygulandı. Değerlendirme egzersiz öncesi (0. hafta) ve sonrası (12. ve 24. haftada) uygulanan tedaviden habersiz bir araştırmacı tarafından yapıldı. Statik denge TeknoBody PK stabilometri denge platformu, dinamik denge Berg Denge Skalası (BDS) ve Zamanlı Ayağa Kalkma ve Yürüme Testi (ZAKY), yaşam kalitesi Quality Of Life Quetionnarie Of The Europen Foundation For Osteoporosis (QUALEFFO-41) ve ağrı Vizüel Anolog Skala (VAS) ile değerlendirildi.Tedavi sonrası her 3 egzersiz grubu ile total QUALEFFO-41, VAS ve ZAKY parametrelerinde anlamlı düzelmeler saptandı. ZAKY ile BDS'deki düzelmenin birlikteliği sadece denge-koordinasyon grubunda gözlendi. VAS'daki düzelmenin kuvvetlendirme grubunda 24. haftada da devam ettiği belirlendi. BDS ve göz kapalı çevre parametresinde denge-koordinasyon grup lehine, zihinsel fonksiyon ve göz açık Y (24.hafta) parametresinde kuvvetlendirme grup lehine ve sosyal fonksiyonda (24.hafta) aerobik grup lehine anlamlı düzelmeler tespit edildi. Her 3 egzersiz grubu ile takip süresince düşme gözlenmedi.Sonuç olarak OP'li hastalarda egzersizlerin erken dönemde ağrı, dinamik denge fonksiyonları, yaşam kalitesi ve düşme sıklığını azaltmada etkili olduğu söylenebilir. Ayrıca denge-koordinasyon egzersizlerinin diğer egzersizlere nazaran statik ve dinamik dengede ve düşmelerin önlenmesinde daha etkili olduğu tespit edildi.
The aim of this study is to evaluate effect of balance-coordination, strengthening and aerobic exercises to static and dynamic balance functions, quality of life and frequency of falling, and to determine if it is superior to the other in postmenopausal patients with osteoporosis. Our study was included 75 patients who are diagnosed primary osteoporosis according to World Health Organization osteoporosis diagnostic criteria. Patients were randomized equally to three groups and balancecoordination (group 1), strengthening (group 2) and aerobic exercises (group 3) were given these groups. Exercise programs were administered during 12 weeks as 3 days a week for 1 hour accompanied by an instructor. Assessment, pre- (week 0) and post-treatment (week 12 and week 24), was made by an investigator who unaware of the administered treatment. Static balance, dynamic balance, quality of life and pain were assessed by Technobody PK Stabilometry Balance Platform, Berg Balance Scale (BBS) and Time „‟Up & Go‟‟ Test (TUGT), Quality Of Life Questionnaire Of The European Foundation For Osteoporosis (QUALEFFO-41) and Visual Analog Scale (VAS), consecutively. After treatment, significant improvements in total TUGT, VAS and QUALEFFO-41 parameters were achieved in every exercise group. Combination of improvement in TUGT and BBS were observed in only balance-coordination group. Improvement in the VAS was also continued at the 24th week in strengthening group. Significantly improvements were determined in parameters of BBS and eyes-closed perimeter in balancecoordination group, parameters of mental function and eyes-open Y (24th week) in strengthening group and social function (24th week) in aerobic group. Falling was not observed in all three exercise groups during follow-up. In conclusion ıt can be say that exercises are more effective in reducing pain, frequency of falling and improving dynamic balance functions and quality of life in patients with osteoporosis. Furthermore balancecoordination exercises were found to be more effective in static and dynamic balance functions and prevention of falls than other exercises.
The aim of this study is to evaluate effect of balance-coordination, strengthening and aerobic exercises to static and dynamic balance functions, quality of life and frequency of falling, and to determine if it is superior to the other in postmenopausal patients with osteoporosis. Our study was included 75 patients who are diagnosed primary osteoporosis according to World Health Organization osteoporosis diagnostic criteria. Patients were randomized equally to three groups and balancecoordination (group 1), strengthening (group 2) and aerobic exercises (group 3) were given these groups. Exercise programs were administered during 12 weeks as 3 days a week for 1 hour accompanied by an instructor. Assessment, pre- (week 0) and post-treatment (week 12 and week 24), was made by an investigator who unaware of the administered treatment. Static balance, dynamic balance, quality of life and pain were assessed by Technobody PK Stabilometry Balance Platform, Berg Balance Scale (BBS) and Time „‟Up & Go‟‟ Test (TUGT), Quality Of Life Questionnaire Of The European Foundation For Osteoporosis (QUALEFFO-41) and Visual Analog Scale (VAS), consecutively. After treatment, significant improvements in total TUGT, VAS and QUALEFFO-41 parameters were achieved in every exercise group. Combination of improvement in TUGT and BBS were observed in only balance-coordination group. Improvement in the VAS was also continued at the 24th week in strengthening group. Significantly improvements were determined in parameters of BBS and eyes-closed perimeter in balancecoordination group, parameters of mental function and eyes-open Y (24th week) in strengthening group and social function (24th week) in aerobic group. Falling was not observed in all three exercise groups during follow-up. In conclusion ıt can be say that exercises are more effective in reducing pain, frequency of falling and improving dynamic balance functions and quality of life in patients with osteoporosis. Furthermore balancecoordination exercises were found to be more effective in static and dynamic balance functions and prevention of falls than other exercises.
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Keywords
Osteoporoz, Denge, Egzersiz, Düşme, Osteoporosis, Balance, Exercise, Falling
Citation
Dizdar, M. (2012). Postmenopozal osteoporozlu hastalarda denge-koordinasyon, kuvvetlendirme ve aerobik egzersizlerin düşmeye etkisi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.