Özge VERGİLİ, Birhan OKTAŞ, Hülya DEVECİ, Fatma Cansu AKTAŞ, Halime ARIKAN

KALKANEAL EPİN HASTALARINDA FİZİKSEL AKTİVİTE DÜZEYİNİN AYAK AĞRISI VE FONKSİYONEL PERFORMANS ÜZERİNDEKİ ETKİSİ

AMAÇ: Kalkaneal epin, hastalara ciddi anlamda rahatsızlık vererek günlük yaşam aktivitelerini kısıtlar. Çalışmamızın amacı bu bireylerde fiziksel aktivite düzeyinin ağrı ve fonksiyonellik yanıtları üzerindeki etkisini araştırmaktı. GEREÇ VE YÖNTEM: Çalışma kalkaneal epin tanısı konmuş 41 birey ile yapıldı. Bireylerin yaş, cinsiyet, boy, kilo, beden kütle indeksi (BKİ) ve topuk ağrılarına ilişkin niteliksel ve niceliksel özellikleri sorgulandı. Bireylerin fiziksel aktivite düzeylerini değerlendirmek için Uluslararası Fiziksel Aktivite Anketi (UFAA) kullanıldı. Ayak ağrısını değerlendirmek için algometre, fonksiyonel performanslarını belirlemek için 6 dakika yürüme testi ve topuk yükseltme testi kullanıldı. BULGULAR: Bireylerin 8’i (%19,5) düşük düzeyde aktivite, 26’sı (%63,4) orta düzeyde aktivite ve 7’si (%17,1) yüksek düzeyde aktiviteye sahipti. Fiziksel aktivite düzeylerine göre sınıflandırılan bireylerde ayak ağrısı ve fonksiyonel performans parametreleri açısından anlamlı bir fark görülmedi. SONUÇ: Farklı fiziksel aktivite düzeyine sahip gruplar arasında ağrı ve fonksiyonel performans açısından farklılık çıkmamış olsa da çok yüksek düzeyde fiziksel aktivitenin topuk ağrısı / plantar fasit / kalkaneal epin gelişimi için önemli bir risk faktörü olduğu, bunun özellikle de yüksek BKİ’ye sahip kişilerde daha sık görüldüğü bilinmektedir. Aktif bir yaşamın ve egzersiz alışkanlığının sistemik endokrin yanıtlar, kas iskelet sistemi ve vücut kompozisyonu üzerindeki olumlu etkileri ile söz konusu şikayetlerin görülme sıklığını azaltabileceği unutulmamalıdır.

THE EFFECT OF PHYSICAL ACTIVITY LEVEL ON FOOT PAIN AND FUNCTIONAL PERFORMANCE IN PATIENTS WITH CALCANEAL SPUR

AIM: Calcaneal epin limits the activities of daily living by causing serious discomfort to patients. The aim of our study was to investigate the effect of physical activity level on pain and functionality responses in these individuals. MATERIAL AND METHOD: The study was performed with 41 individuals diagnosed with the calcaneal spur. Related to the heel pain of individuals, qualitative and quantitative characteristics age, gender, height, weight, body mass index (BMI) were questioned. The International Physical Activity Questionnaire (IPAQ) was used to evaluate the physical activity levels of the individuals. Respectively, algometer and 6-minute walk test and a heel lift test were used to determine the foot pain and functional performance. RESULTS: Of the individuals, 8 (19.5%) had low-level activity, 26 (63.4%) had moderate activity and 7 (17.1%) had a high level of activity. There was no significant difference in terms of foot pain and functional performance parameters in the individuals classified according to physical activity levels. CONCLUSION: Although there was no difference in pain and functional performance between groups with different physical activity levels, it is known that very high level of physical activity is an important risk factor for the development of heel pain / plantar fasciitis / calcaneal epin, especially in people with high BMI. It should be kept in mind that an active life and exercise habit can reduce the incidence of these complaints with positive effects on systemic endocrine responses, musculoskeletal system, and body composition.

PDF

___

1.)Yalçın E, Akca AK, Selcuk B, et al. Effects of extra corporal shock wave therapy on symptomatic heelspurs: a correlation between clinical outcome and radiologic changes. Rheumatol Int. 2012; 32: 343–347.
2.) Selth CA, Francis BE. Review of non-functional plantar heel pain. The Foot. 2000;10: 97- 104.
3.)Kuyucu E, Kocyigit F, Erdil M. The association of calcaneal spur length and clinical and functional parameters in plantar fasciitis. Int J Surg. 2015; 21: 28-31.
4.)Johal KS, Milner SA. Plantar fasciitis and the calcaneal spur: factor fiction? Foot Ankle Surg. 2012; 18: 39-41.
5.)Riberio AP, Sacco IC, Dinato RC, et al. Relationships between static foot alignment and dynamic plantar loads in runners with acute and chronic stages of plantar fasciitis: a cross-sectional study. Braz J Phys Ther. 2016; 20: 87-95.
6.) Lareau CR, Sawyer GA, Wang JH, et al. Plantar and medial heel pain: diagnosis and management. J Am Acad Orthop Surg. 2014; 22: 372-80.
7.) Shimojo G, Joseph B, Shah R, et al. Exercise activates vagal induction of dopamine and atttenuates systemic inflammation. Brain Behav Immun. 2019; 75: 181-191.
8.) Sluka KA, O’Donnell JM, Danielson J, et al. Regular physical activity prevents development of chronic pain and activation of central neurons. J Appl Physiol. 2013; 114: 725-733.
9.) Ylinen J, Nykanen M, Kautiainen H, et al. Evaluation of repeatability of pressure algometry on the neck muscles for clinical use. Man Ther. 2007; 12: 192-197.
10.) Visscher C, Lobbezoo F, Naeije M. Comparison of algometry and palpation in the recognition of temporomandibular disorder pain complaints. J. Oral Facial Pain Headache. 2004; 18: 214-219.
11.) Fischer AA. Pressure algometry over normal muscles. Standard values, validity and reproducibility of pressure threshold. Pain. 1987; 30: 115-126.
12.) Savcı S, İnal İnce D, Arıkan H, et al. Six minute walk test as a measure of functional exercise capacity in multiple sclerosis. Disabil Rehabil. 2005; 27: 1365-1371.
13.) Ünver B, Karatosun V, Kahraman T, et al. Reliability of the six minute walk test after total hip arthroplasty. Hip Int. 2013; 23: 541-545.
14.) Page MG, Katz J, Escobar EMR, et al. Distinguishing problematic from nonproblematic postsurgical pain: a pain trajectory analysis after total knee arthroplasty. Pain. 2015; 156: 460–468.
15.) Hébert-Losier K, Newsham-West RJ, Schneiders AG, et al. Raising the standards of the calf-raise test: A systematic review. J Sci Med Sport. 2009; 12:594-602.
16.) Ross MD, Fontenot EG. Test-retest reliability of the standing heel rise test. J Sport Rehabil. 2000: 9; 117-123.
17.) Sağlam M, Arikan H, Savci S, et al. International physical activity questionnaire: reliability and validity of the Turkish version. Percept Mot Skills. 2010; 111: 278-284.
18.) Kuyucu E, Koçyiğit F, Erdil M. The association of calcaneal spur length and clinical and functional parameters in plantar fasciitis. Int J Surg. 2015; 21: 28-31.
19.) Akkaya S, Akkaya N, Yıldız N, et al. The association of physical examination findings and functional status with radiological and clinical variables in plantar heel pain. Romatol Tıp Rehab. 2011; 21: 1-5.
20.) Irving DB, Cook JL, Young MA, et al. Obesity and pronated foot type may increase the risk of chronic plantar heel pain: a matched case-control study. BMC Musculoskelet Disord. 2007; 17: 8:41.
21.) Valizadeh MA, Afshar A, Hassani E, et al. Relationship between anthropometric findings and results of corticosteroid injections treatment in chronic plantar heel pain. Anesth Pain Med. 2018; 8: e64357, doi: 10.5812/aapm.64357.
22.) Irving DB, Cook JL, Menz HB. Factors associated with chronic plantar heel pain: a systematic review. J Sci Med Sport. 2006; 9: 11–22.
23.) Van Leeuwen KD, Rogers J, Winzenberg T, et al. Higher body mass index is associated with plantar fasciopathy/’plantar fasciitis’: systematic review and meta-analysis of various clinical and imaging risk factors. Br J Sports Med. 2016; 50: 972–81.
24.) Pais SR, Palma M, Roque A, et al. Physical activity can influence pain intensity in community living elderly subjects with osteoarthritis. Abstracts / Osteoarthritis and Cartilage. 2018; 26: 60-474.
25.) Heneweer H, Vanhees L, Picavet HS. Physical activity and low back pain: A u-shaped relation? Pain. 2009; 143: 21–25.
26.) Riddle DL, Pulisic M, Pidcoe P, et al. Risk factors for plantar fasciitis: a matched case-control study. J Bone Joint Surg. 2003; 85: 872-877.
27.) Büyükturan Ö, Sezgin H, Yetis M, et al. Relationship between ankle muscle strength and pain and calcaneal spur length in individuals with exercise habit: a pilot study. Ann Yoga Phys Ther. 2017; 2: 1020.