Yıl 2018, Cilt 18, Sayı 3, Sayfalar 402 - 409 2018-09-28

The Evaluation of Balance and Depression Status in Patients with Transtibial Amputations: Controlled Study
Diz Altı Ampute Hastalarda Denge ve Depresyon Durumlarının Değerlendirilmesi: Kontrollü Çalışma

Abdülkadir Aydın [1] , Sibel Çağlar Okur [2]

5 18

Objectives: Balance and coordination are more deteriorated in amputee elders, fear of falling and falling rates are higher than healthy elderly. Transtibial amputation (TTA) is an amputation happening due to vascular and non-vascular causes. The aim of our study is to investigate the risks of walking, balance and falling in patients with TTA and to compare patients with non-amputee control group (CG) of similar age group.
Materials and Methods: 72 patients (37 TTA, 35 CG) were included in the study. While the mean age of the patients was 61 ± 5.06 in the TTA group, 63 ± 5,12 in the CG. Demographic and clinical characteristics of both groups were recorded. In addition, the risk of falling and anxiety-depression were assessed using Tinetti walking and balance scores. Hypotheses were two-way, p <0.05 was considered statistically significant.
Results: There was no statistical difference between the two groups in terms of demographic data (p> 0.05). Balance, falls and the presence of fear of falls found a significant difference in favor of CG (p <0.001). The use of assistive device was found to be significant in favor of CG(p <0.05). Tinetti balance, Tinetti walking and Tinetti total and BECK anxiety-depression scores were found tobe  fairly significant in favor of CG(p <0.001), whereas Tinetti walking scores were found to be significant in CG(p <0.05).
Conclusion: TTA patients are highly exposed to walking and balance disorders and the incidence of anxiety-depression increases.

Amaç: Ampute yaşlılarda denge ve koordinasyon daha fazla bozulmakta, düşme ve düşme korkusu sağlıklı yaşlılara göre daha fazla olmaktadır. Diz altı amputasyonu (DAA) vasküler ve vasküler olmayan nedenlere bağlı olarak gelişen amputasyonlardır. Çalışmamızdaki amaç DAA’ lı hastalarda yürüme, denge ve düşme risklerini araştırmak ve benzer yaş grubundaki ampute olmayan kontrol grubu (KG) hastalarla karşılaştırmaktır.
Materyal ve Metot: Çalışmaya 72 hasta (37 DAA, 35 KG) dahil edildi. Hastaların yaş ortalaması DAA grubu 61±5,06 iken KG yaş ortalaması 63±5,12 idi. Her iki grubun demografik ve klinik özellikleri kaydedildi. Ayrıca denge ve yürümeyi değerlendirmek için tinetti yürüme ve denge skalası kullanılarak düşme riski ve anksiyete-depresyon değerlendirildi. Hipotezler çift yönlü olup, p≤0.05 ise istatistiksel olarak anlamlı kabul edildi.
Bulgular: Demografik veri açısından her iki grup arasında istatistiksel fark bulunmadı (p>0.05). Denge, düşme ve düşme korkusunun varlığı KG yaşlılar lehine anlamlı fark bulundu (p<0.001). Yardımcı cihaz kullanımı KG yaşlılar lehine anlamlı bulundu (p<0,05). Tinetti denge, tinetti yürüme ve tinetti total ve BECK anksiyete- depresyon skorlarında KG yaşlılar lehine oldukça anlamlı sonuçlar bulunurken (p<0.001), tinetti yürüme skorlarında KG yaşlılar lehine anlamlı bulundu(p<0.05).
Sonuç: DAA’lı hastalar yürüme ve denge bozukluklarına oldukça fazla maruz kalmakta ve anksiyete-depresyon sıklıkları artmaktadır. 

  • 1. Barnett D. Factors associated with falls in community dwelling individuals age 90 years or older. A Thesis Presented to the Department of Social Work California State University, Los Angeles; 2003.
  • 2. Ak L, Hoehler F. Visual perception of verticality and horizontality among elderly fallers. Archives of Physical Medicine and Rehabilitation 1981;62(12):619-22.
  • 3. Deans SA, McFadyen AK, Rowe PJ. Physical activity and quality of life: A study of a lower-limb amputee population. Prosthetics and Orthotics International 2008;32(2):186-200.
  • 4. Hale CA. Physiotherapy for people with major amputation. In: Tidy's Physiotherapy(Porter SB). 15th ed., China; Saunders, Elsevier; 2013:457.
  • 5. Ziegler-Graham K, MacKenzie EJ, Ephraim PL, Travison TG, Brookmeyer R. Estimating the prevalence of limb loss in the United States: 2005 to 2050. Archives of Physical Medicine and Rehabilitation 2008;89(3):422-9.
  • 6. Raya MA, Gailey RS, Fiebert IM, Roach KE. Impairment variables predicting activity limitation in individuals with lower limb amputation. Prosthet Orthot Int 2010;34(1):73-84.
  • 7. Dillingham TR, Pezzin LE, MacKenzie EJ. Limb amputation and limb deficiency: epidemiology and recent trends in the United States. South Medical Journal 2002;95(8):875-83.
  • 8. Myers AM, Powell LE, Maki BE, Holliday PJ, Brawley LR, Sherk W. Psychological indicators of balance confidence: relationship to actual and perceived abilities. Journal Gerontology A: Biological Sciences Medical Science 1996;51(1):37-43.
  • 9. Tennstedt S, Howland J, Lachman M, Peterson E, Kasten L, Jette A. A randomized, controlled trial of a group intervention to reduce fear of falling and associated activity restriction in older adults. Journal Gerontology B: Psychological Science and Social Science 1998;53(6):384-92.
  • 10. Miller WC, Deathe AB, Speechley M, Koval J. The influence of falling, fear of falling, and balance confidence on prosthetic mobility and social activity among individuals with a lower extremity amputation. Archives of Physical Medicine and Rehabilitation. 2001;82(9):1238-44.
  • 11. Ekşi Uymaz P, Nahcivan N. Yaşlılar için düşme davranışları ölçeği’nin geçerlik ve güvenirliği. F N Hem Derg 2013;21(1):22-32.
  • 12. Raîche M, Hébert R, Prince F, Corriveau H. Screening older adults at risk of falling with the Tinetti balance scale. The Lancet 2000;356(9234):1001-2.
  • 13. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An invent ory for measuring depression. Archives of General Psychiatry 1961;4:53-63.
  • 14. Hisli N. Beck depresyon envanterinin üniversite öğrencileri için geçerliği, güvenirliği. Psikoloji Dergisi 1989;7:13.
  • 15. Aydemir Ö, Köroğlu E: Psikiyatride kullanılan klinik ölçekler. Ankara: Hekimler Yayın Birliği; 2009:93-335.
  • 16. Beck AT, Steer RA, Garbin MG. Psychometric properties of the Beck Depression Inventory. Twenty-five years of evaluation. Clinical Psychology Review 1988;8:77-100.
  • 17.Vlahov D, Myers A, Al-Ibrahim M. Epidemiology of falls among patients in a rehabilitation hospital. Archives of Physical Medicine and Rehabilitation 1990;71(1):8-12.
  • 18.Thies SB, Richardson JK, Ashton-Miller JA. Effects of surface irregularity and lighting on step variability during gait: a study in healthy young and older women. Gait Posture 2005;22(1):26-31.
  • 19. Isakov E, Keren O, Benjuya N. Trans-tibial amputee gait: time-distance parameters and EMG activity. Prosthetics and Orthotics International 2000;24(3):216-20.
  • 20. Gates DH, Dingwell JB, Scott SJ, Sinitski EH, Wilken JM. Gait characteristics of individuals with transtibial amputations walking on a destabilizing rock surface. Gait & posture 2012;36(1):33-9.
  • 21. MacLellan MJ, Patla AE. Adaptations of walking pattern on a compliant surface to regulate dynamic stability. Experimental Brain Research 2006;173(3):521-30.
  • 22. Schmalz T, Blumentritt S, Marx B. Biomechanical analysis of stair ambulation in lower limb amputees. Gait & Posture 2007;25(2):267-78.
  • 23.Chartered Society of Physiotherapy- Agility’nin Egzersiz bukleti http:// balance.lifetips.com/cat/60981 /senior-exercise/ Erişim tarihi: 25.05.2018.
  • 24. Miller WC, Deathe AB, Speechley M. Psychometric properties of the Activities-specific Balance Confidence Scale among individuals with a lower-limb amputation. Archives of Physical Medicine and Rehabilitation 2003;84(5):656-61.
  • 25. Rajiv Singh, David Ripley, Brian Pentland, Iain Todd, John Hunter, Lynne Hutton, and Alistair Philip. Depression and anxiety symptoms after lower limb amputation: the rise and fall. Clinical Rehabilitation 2009;23(3):281-6.
  • 26. Desmond DM, MacLachlan M. Affective distress and amputation-related pain among older men with long-term traumatic limb amputations. Journal Pain Symptom Manage 2006;31:362–8.
  • 27. Ephraim PL, Wegener ST, MacKenzie EJ, Dillingham TR, Pezzin LE. Phantom pain, residual limb pain and back pain in amputees: results of a national survey. Archives of Physical Medicine and Rehabilitation 2005;86:1910–19.
  • 28. Atherton R, Robertson N. Psychological adjustment to lower limb amputation amongst prosthesis users. Disability and Rehabilitation 2006;28:1201–9.
  • 29. Fisher K, Hanspal R. Body image and patients with amputation: does the prosthesis maintain the balance? International Journal of Rehabilitation Research 1998;21:355–63.
  • 30. Hanley MA, Jensen MP, Ehde DM, Hoffman AJ, Patterson DR, Robinson LR. Psychosocial predictors of long-term adjustment to lower-limb amputation and phantom limb pain. Disability and Rehabilitation 2004;26:882–93.
  • 31. Whyte A, Niven C. Psychological distress in amputees with phantom limb pain. Journal Pain Symptom Manage 2001;22:938–46.
  • 32. Zijlstra GA, van Haastregt JC, van Rossum E, van Eijk JT, Yardley L, G.I. Kempen GI. Interventions to reduce fear of falling in community-living older people: a systematic review, Journal of the American Geriatrics Society 2007;55(4):603–15.
  • 33. Kendell C, Lemaire ED, Dudek NL, Kofman J. Indicators of dynamic stability in transtibial prosthesis users. Gait & Posture 2010;31(3):375-9.
Birincil Dil tr
Konular Sağlık Bilimleri
Dergi Bölümü Araştırmalar
Yazarlar

Yazar: Abdülkadir Aydın (Sorumlu Yazar)

Yazar: Sibel Çağlar Okur

Bibtex @araştırma makalesi { amj461395, journal = {Ankara Medical Journal}, issn = {}, eissn = {2148-4570}, address = {Ankara Yıldırım Beyazıt Üniversitesi}, year = {2018}, volume = {18}, pages = {402 - 409}, doi = {10.17098/amj.461395}, title = {Diz Altı Ampute Hastalarda Denge ve Depresyon Durumlarının Değerlendirilmesi: Kontrollü Çalışma}, key = {cite}, author = {Çağlar Okur, Sibel and Aydın, Abdülkadir} }
APA Aydın, A , Çağlar Okur, S . (2018). Diz Altı Ampute Hastalarda Denge ve Depresyon Durumlarının Değerlendirilmesi: Kontrollü Çalışma. Ankara Medical Journal, 18 (3), 402-409. DOI: 10.17098/amj.461395
MLA Aydın, A , Çağlar Okur, S . "Diz Altı Ampute Hastalarda Denge ve Depresyon Durumlarının Değerlendirilmesi: Kontrollü Çalışma". Ankara Medical Journal 18 (2018): 402-409 <http://www.ankaramedicaljournal.com/issue/39422/461395>
Chicago Aydın, A , Çağlar Okur, S . "Diz Altı Ampute Hastalarda Denge ve Depresyon Durumlarının Değerlendirilmesi: Kontrollü Çalışma". Ankara Medical Journal 18 (2018): 402-409
RIS TY - JOUR T1 - Diz Altı Ampute Hastalarda Denge ve Depresyon Durumlarının Değerlendirilmesi: Kontrollü Çalışma AU - Abdülkadir Aydın , Sibel Çağlar Okur Y1 - 2018 PY - 2018 N1 - doi: 10.17098/amj.461395 DO - 10.17098/amj.461395 T2 - Ankara Medical Journal JF - Journal JO - JOR SP - 402 EP - 409 VL - 18 IS - 3 SN - -2148-4570 M3 - doi: 10.17098/amj.461395 UR - http://dx.doi.org/10.17098/amj.461395 Y2 - 2018 ER -
EndNote %0 Ankara Medical Journal Diz Altı Ampute Hastalarda Denge ve Depresyon Durumlarının Değerlendirilmesi: Kontrollü Çalışma %A Abdülkadir Aydın , Sibel Çağlar Okur %T Diz Altı Ampute Hastalarda Denge ve Depresyon Durumlarının Değerlendirilmesi: Kontrollü Çalışma %D 2018 %J Ankara Medical Journal %P -2148-4570 %V 18 %N 3 %R doi: 10.17098/amj.461395 %U 10.17098/amj.461395
ISNAD Aydın, Abdülkadir , Çağlar Okur, Sibel . "Diz Altı Ampute Hastalarda Denge ve Depresyon Durumlarının Değerlendirilmesi: Kontrollü Çalışma". Ankara Medical Journal 18 / 3 (Eylül 2018): 402-409. http://dx.doi.org/10.17098/amj.461395