ORIJINAL ARAŞTIRMA
İnme Sonrası Hemipleji Gelişen Hastalarda Hemoglobin, Folat, Vitamin B12 ve 25 (OH) Vitamin D3 Düzeylerinin Fonksiyon, Disabilite, Ağrı ve Denge Üzerine Etkisi
The Effect of Hemoglobin, Folate, Vitamin B12, and 25 (OH) Vitamin D3 Levels on Function, Disability, Pain, and Balance in Patients with Post-Stroke Hemiplegia
Received Date : 05 Dec 2021
Accepted Date : 27 Apr 2022
Available Online : 09 May 2022
Mehmet OKÇUa, Figen TUNCAYb, Fatmanur Aybala KOÇAKb, Yıldız Gonca DOĞRUb,
Zeynep KARAKUZU GÜNGÖRc, Samet Sancar KAYAb
aDepartment of Physical Medicine and Rehabilitation, Marmara University Faculty of Medicine, İstanbul, Türkiye
bDepartment of Physical Medicine and Rehabilitation, Kırşehir Ahi Evran University Faculty of Medicine, Kırşehir, Türkiye
cClinic of Physical Medicine and Rehabilitation, Batman Training and Research Hospital, Batman, Türkiye
Doi: 10.31609/jpmrs.2021-87387 - Makale Dili: EN
J PMR Sci. 2022;25(3):286-92
ÖZET
Amaç: Hemoglobin, folat, 25 (OH) vitamin D3 ve vitamin B12 düzeylerinin
inme riski ile ilişkili olduğu bildirilmiş olsa da bu düzeyler ile inme sonrası
hemipleji gelişenlerin fonksiyonel durum, disabilite, ağrı veya denge durumları
arasındaki ilişkisi ile ilgili veriler kısıtlıdır. Bu çalışmada, değişkenlerin düzeyleri
ile inme sonrası hemipleji gelişen hastalardaki fonksiyonel durum, ağrı ve
denge gibi parametreler arasındaki ilişkinin araştırılması amaçlandı. Gereç ve
Yöntemler: Çalışmaya 39 hasta dâhil edildi. Brunnstrom iyileşme evreleri, Berg
Denge Skalası, Fonksiyonel Ambülasyon Sınıflaması (FAS), Leeds Nöropatik
Semptom ve Belirtilerin Değerlendirmesi ağrı skalası, Barthel İndeks skorları belirlendi.
Ayrıca hastaların santral ağrıları ve hemiplejik omuz ağrıları nümerik
derecelendirme ölçeği kullanılarak değerlendirildi. Katılımcıların hemoglobin,
folat, vitamin B12 ve 25 (OH) vitamin D3 seviyeleri kaydedildi. Bulgular: Fonksiyonel
ambülasyonu olan (FAS Evre 3-5) hastalarda, fonksiyonel ambülasyonu
olmayan (FAS Evre 0-2) hastalara göre hemoglobin seviyeleri anlamlı olarak
daha yüksekti (sırasıyla ortalama±standart sapma 13,77±2,38, 12,13±1,58)
(p=0,019). Ayrıca hemoglobin seviyeleri Barthel İndeksi (r=0,496, p=0,002) ve
Berg Denge Skalası (r=0,458, p=0,005) ile pozitif ilişkiliydi. Folat, vitamin B12
ve 25 (OH) vitamin D3 seviyeleri hiçbir skala ile ilişkili bulunmadı. Çok değişkenli
lojistik regresyon analizi sonuçlarına göre hastaların hemoglobin değerlerindeki
bir birimlik artış fonksiyonel ambulatuar grupta olma olasılığını 1.655 kat
artırmaktadır (p=0,024). Sonuç: İnme sonrası hemiplejili hastalarda hemoglobin
düzeyi ile disabilite, ambülasyon ve denge durumu ilişkili bulunmuştur. Daha iyi
rehabilitasyon başarısı için hastaların hemoglobin düzeylerini değerlendirmek
akılda tutulmalıdır.
Anahtar Kelimeler: Hemipleji; hemoglobin; denge; ambülasyon; disabilite
ABSTRACT
Objective: Although hemoglobin, folate, 25 (OH) vitamin D3, and
vitamin B12 levels have been reported to be associated with the risk of stroke,
there are limited data on the relationship between these levels and functional status,
disability, pain or balance in those who develop post-stroke hemiplegia. The
present study aimed to investigate the relationship between parameters such as
functional status, pain, balance, and hemoglobin, folate, 25 (OH) vitamin D3, and
vitamin B12 levels in patients with post-stroke hemiplegia. Material and Methods:
Thirty-nine patients were included in the study. Brunnstrom recovery stages,
Berg Balance Scale, Functional Ambulation Category (FAC), Leeds Assessment
of Neuropathic Symptoms and Signs pain scale, Barthel Index scores were determined.
In addition, the patients’ central pain and hemiplegic shoulder pain
were evaluated using numerical rating scales. The hemoglobin, folate, vitamin
B12, and 25 (OH) vitamin D3 levels of the participants were noted. Results:
Hemoglobin levels were significantly higher in functional ambulatory patients
(FAC Stage 3-5) than in non-functional ambulatory (FAC Stage 0-2) patients
(mean±standard deviation 13.77±2.38, 12.13±1.58, respectively) (p=0.019). In addition,
hemoglobin levels were positively correlated with Barthel Index (r=0.496,
p=0.002) and Berg Balance Scale (r=0.458, p=0.005). Folate, vitamin B12, and 25
(OH) vitamin D3 levels were not associated with any of the scales. According to the
results of the multivariate logistic regression analysis, the increase in the hemoglobin
values of the patients increases the probability of being in the functional ambulatory
group 1,655 times (p=0.024). Conclusion: In this study, hemoglobin level was
found to be associated with disability, ambulation and balance status in patients with
post-stroke hemiplegia. For better rehabilitation success, it should be kept in mind
to evaluate the hemoglobin levels of the patients.
Keywords: Hemiplegia; hemoglobin; balance; ambulation; disability
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