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Postmenopozal Osteoporozu Olan Kadınlarda Diz Ekstansör ve Fleksör Kas Zayıflığı DüÅŸme Ä°çin Risk Faktörü Olabilir mi?
Can Knee Extensor and Flexor Muscle Weakness be a Risk Factor for Falls in Women with Postmenopausal Osteoporosis?
Received Date : 14 Jun 2019
Accepted Date : 17 Sep 2019
Available Online : 11 Oct 2019
Özet PDF Benzer Makaleler
Dilek EKER BÜYÜKŞİRECİa, Belgin KARAOĞLANb
aFiziksel Tıp ve Rehabilitasyon ABD, Hitit Üniversitesi Erol Olçok Eğitim ve Araştırma Hastanesi, Çorum, TÜRKİYE bFiziksel Tıp ve Rehabilitasyon ABD, Gazi Üniversitesi Tıp Fakültesi, Ankara, TÜRKİYE
Doi: 10.31609/jpmrs.2019-70170 - Makale Dili: TR
J PMR Sci. 2019;22(3):108-13
ÖZET
Amaç: Postmenopozal osteoporozlu kadınlarda diz ekstansör ve fleksör kas kuvvetinin düşme üzerine etkisini araştırmaktır. Gereç ve Yöntemler: Çalışmaya 32 postmenopozal osteoporozlu kadın dâhil edildi (Grup 1: Son 1 yılda düşme öyküsü olan postmenopozal osteoporozlu kadınlar, Grup 2: Son 1 yılda düşme öyküsü olmayan postmenopozal kadınlar). Eşlik eden romatizmal hastalığı, alt ekstremiteden geçirilmiş cerrahi, osteoartriti olanlar çalışmadan dışlandı. Katılımcıların demografik ve klinik özellikleri kaydedildi. Katılımcıların düşme değerlendirmesi Düşme Etkinlik Ölçeği, denge değerlendirmesi ise Tinetti Denge Testi ile yapıldı. İzokinetik diz kas kuvveti testleri 60 ve 180°/s’de, kalibre edilmiş standart bir izokinetik test cihazı ile bilateral olarak yapıldı. Bulgular: Son 1 yılda düşme öyküsü olan postmenopozal kadınlarda (Grup 1) yaş ortalaması, son 1 yılda düşme öyküsü olmayan kadınlara (Grup 2) göre anlamlı derecede yüksek saptandı (p=0,015). Boy, kilo, beden kitle indeksi, kalsiyum, vitamin D, lomber total ve femur boyun kemik mineral yoğunluğu ölçümleri her iki grupta benzer bulundu. Grup 1’de Düşme Etkinlik Ölçeği skoru, Grup 2’ye göre anlamlı derecede yüksek saptandı (p<0,001). Ayrıca, Grup 1’de Tinetti Denge Testi skoru, Grup 2’ye göre anlamlı derecede düşük saptandı (p=0,037). Grup 1 ve Grup 2 arasında 60 ve 180°/s’de izokinetik diz kas kuvvetleri açısından anlamlı fark saptanmadı. Sonuç: Son 1 yılda düşme öyküsü olan postmenopozal osteoporozlu kadınların diz ekstansör ve fleksör kas kuvvetlerinin son 1 yılda düşme öyküsü olmayan postmenopozal kadınlarla benzer olduğu saptandı.
Anahtar Kelimeler: Postmenopozal osteoporoz; kas kuvveti; düşme
ABSTRACT
Objective: The aim of this study was to investigate the effect of knee extensor and flexor muscle strength on falling in women with postmenopausal osteoporosis. Material and Methods: Study included 32 women with postmenopausal osteoporosis (Group 1: women with postmenopausal osteoporosis with a history of fall in the last 1 year, Group 2: women with postmenopausal osteoporosis without a history of falling in the last 1 year). Patients with associated rheumatic disease, lower extremity surgery, and osteoarthritis were excluded from the study. Demographic and clinical characteristics of the participants were recorded. The fall assessment of the participants was done by the Falls Efficacy Scale, and the balance was evaluated by Tinetti Balance test. Isokinetic knee muscle strength tests were performed bilaterally at 60 and 180°/s with a standard calibrated isokinetic test device. Results: The mean age of women with postmenopausal osteoporosis with a history of fall in the last 1 year (Group 1) was significantly higher than women with postmenopausal osteoporosis without a history of fall in the last 1 year (Group 2) (p=0.015). Height, weight, body-mass index, calcium-vitamine D level, lumbar total and femoral neck bone mineral density measurements were similar in both groups. The Fall Efficacy Scale score was significantly higher in Group 1 than in Group 2 (p<0.001). Tinetti Balance Test score was significantly lower in Group 1 than in Group 2 (p=0.037). There was no significant isokinetic knee muscle strength difference was found between Group 1 and Group 2 participants. Conclusion: Postmenopausal osteoporosis women who had a history of falling in the last 1 year had similar knee extensor and flexor muscle strengths in postmenopausal osteoporosis women who had no history of falling in the last year.
Keywords: Postmenopausal osteoporosis; muscle strength; fall
REFERENCES
  1. World Health Organization (WHO). WHO Scientific Group on the Assessment of Osteoporosis at the Primary Health Care Level. Geneva: WHO Press; 2004. p.13. (Last accessed January, 2013). Available at:www.who.int/chp/topics/Osteoporosis.pdf.
  2. Looker AC, Borrud LG, Dawson-Hughes B, et al. Osteoporosis or low bone mass at the femur neck or lumbar spine in older adults: United States, 2005-2008. NCHS Data Brief. 2012;93:1-8.
  3. Tuzun S, Eskiyurt N, Akarirmak U, et al; Turkish Osteoporosis Society. Incidence of hip fracture and prevalence of osteoporosis in Turkey: the FRACTURK study. Osteoporos Int. 2012;23:949-55. [Crossref]  [PubMed] 
  4. Mohd-Tahir NA, Li SC. Economic burden of osteoporosis-related hip fracture in Asia: a systematic review. Osteoporos Int. 2017;28:2035-44. [Crossref]  [PubMed] 
  5. Center JR, Nguyen TV, Schneider D, et al. Mortality after all major types of osteoporotic fracture in men and women: an observational study. Lancet. 1999;353:878-82. [Crossref] 
  6. Cree M, Soskolne CL, Belseck E, et al. Mortality and institutionalisation following hip fracture. J Am Geriatr Soc. 2000;48:283-8. [Crossref]  [PubMed] 
  7. Cheong HW, Peh WC, Guglielmi G. Imaging of diseases of the axial and peripheral skeleton. Radiol Clin North Am. 2008;46:703-33. [Crossref]  [PubMed] 
  8. Hausdorff JM, Rios DA, Edelberg HK. Gait variability and fall risk in community-living older adults: a 1-year prospective study. Arch Phys Med Rehabil. 2001;82:1050-6. [Crossref]  [PubMed] 
  9. Owens PL, Russo CA, Spector W, et al. Emergency Department Visits for Injurious Falls among the Elderly, 2006. Healthcare Cost and Utilization Project Brief. Statistical Brief #802009. p.11. Available at: http://www.hcup-us.ahrq.gov/reports/statbriefs/sb80.pdf.
  10. Arnold CM, Busch AJ, Schachter CL, et al. The relationship of intrinsic fall risk factors to a recent history of falling in older women with osteoporosis. J Orthop Sports Phys Ther. 2005;35:452-60. [Crossref]  [PubMed] 
  11. Kanis JA, McCloskey EV, Johansson H, et al; Scientific Advisory Board of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) and the Committee of Scientific Advisors of the International Osteoporosis Foundation (IOF). European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int. 2013;24:23-57. [Crossref]  [PubMed]  [PMC] 
  12. Henderson NK, White CP, Eisman JA. The roles of exercise and fall risk reduction in the prevention of osteoporosis. Endocrinol Metab Clin North Am. 1998;27:369-87. [Crossref] 
  13. Moreland JD, Richardson JA, Goldsmith CH, et al. Muscle weakness and falls in older adults: a systematic review and meta-analysis. J Am Geriatr Soc. 2004;52:1121-9. [Crossref]  [PubMed] 
  14. Abreu HC, Reiners AA, Azevedo RC, et al. Incidence and predicting factors of falls of older inpatients. Rev Saude Publica. 2015;49:37. [Crossref] 
  15. Ungar A, Rafanelli M, Iacomelli I, et al. Fall prevention in the elderly. Clin Cases Miner Bone Metab. 2013;10:91-5.
  16. World Health Organization (WHO). WHO Global Report on Falls Prevention in Older Age. Geneva: WHO Press; 2007. p.47. Available From: http://www.who.int/ageing/publications/Falls_prevention7March.pdf. (Last accessed on 2016 Jun 15).
  17. Huang CH, Cheng CK, Lee YT, et al. Muscle strength after successful total knee replacement: a 6- to 13-year followup. Clin Orthop Relat Res. 1996;328:147-54. [Crossref]  [PubMed] 
  18. Knapik JJ, Wright JE, Mawdsley RH, et al. Isokinetic, isometric and isotonic strength relationships. Arch Phys Med Rehabil. 1983;64:77-80.
  19. Tan J, Cubukcu S, Sepici V. Relationship between bone mineral density of the proximal femur and strength of hip muscles in postmenopausal women. Am J Phys Med Rehabil. 1998;77:477-82. [Crossref]  [PubMed] 
  20. Eickhoff JA, Molczyk L, Gallagher JC, et al. Influence of isotonic, isometric and isokinetic muscle strength on bone mineral density of the spine and femur in young women. Bone Miner. 1993;20:201-9. [Crossref] 
  21. Dretakis OE, Tsatsanis C, Fyrgadis A, et al. Correlation between serum 25-hydroxyvitamin D levels and quadriceps muscle strength in elderly cretans. J Int Med Res. 2010;38:1824-34. [Crossref]  [PubMed] 
  22. Rinaldi I, Setiati S, Oemardi M, et al. Correlation between serum vitamin D (25(OH)D) concentration and quadriceps femoris muscle strength in Indonesian elderly women living in three nursing homes. Acta Med Indones. 2007;39:107-11.
  23. Civelek GM, Pekyavas NO, Cetin N, et al. Association of vitamin D deficiency with muscle strength and quality of life in postmenopausal women. Climacteric. 2014;17:472-7. [Crossref]  [PubMed] 
  24. Gunendi Z, Eker D, Tecer D, et al. Is the word "osteoporosis" a reason for kinesiophobia? Eur J Phys Rehabil Med. 2018;54:671-5. [Crossref]  [PubMed] 
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