Üniversite Çağındaki Türk Popülasyonunda Normal Lumbal Omurga Hareket Kapasitesinin Ultrason Tabanlı Üç Boyutlu Hareket Analiz Sistemi Kullanılarak Ölçümü
Amaç: Bu çalışmanın amacı Türk toplumunda üç boyutlu hareket analiz metodunu kullanarak lumbal omurga hareket kapasitesi değerlerini tespit etmektir. Hastalar ve Yöntemler: Ölçümlere 100 gönüllü denek (50 erkek, 50 kadın; dağılım 18-22) alındı. Hareket ölçümleri için “Zebris© 3D Motion Analysis System” kullanıldı. Ölçümlerde lateral fleksiyon, fleksiyon, ekstansiyon, pelvik tilt hareketleri değerlendirildi. Bulgular: Lumbal bölge total lateral fleksiyon erkeklerde 51.3°±7.5, kadınlarda 52.7°±9.9 olarak bulundu. Total fleksiyon ekstansiyon hareketi erkeklerde 81.0°±11.1, kadınlarda 80.2°±10.2 idi. L4-L5 fleksiyon, L5-S1 ekstansiyon değerleri istatistiksel olarak kadınlar için daha yüksek iken (p
Measurement of Normal Lumbar Spine Range of Motion in the College-Aged Turkish Population Using a 3D Ultrasound-Based Motion Analysis System
Objectives: The aim of this study was to determine range of motion values of lumbar spine in Turkish people by using 3D motion analysis method. Patients and Methods: The study included 100 subjects (50 males, 50 females; range 18 to 22 years). The Zebris® 3D Motion Analysis System was used for the measurement. Lateral bending, flexion, extension, pelvic tilt were evaluated in the measurements. Results: The average value for total lateral flexion at lumbar spine was found to be 51.3°±7.5 in males and 52.7°±9.9 in females. Total flexion-extension was 81.0°±11.1 in males and 80.2°±10.2 in females. L4-L5 flexion, L5-S1 extension values were statistically high in women (p<0.05) while L3-L4 total flexion- extension and L1-L2 total lateral flexion values were statistically high in men (p<0.05). The support of pelvic tilt to total lumbosacral flexion was 46.6% in males and 42.1% in females. The support was 36.8% in males and 26.2% in females during extension. Flexion and extension of pelvic tilt values in men were found to be significantly higher than that in women (p<0.05). Conclusion: The normal values of movements of lumbar spine in Turkish people have been determined with 3D motion analysis system Turkish Başlık: Üniversite Çağındaki Türk Popülasyonunda Normal Lumbal Omurga Hareket Kapasitesinin Ultrason Tabanlı Üç Boyutlu Hareket Analiz Sistemi Kullanılarak Ölçümü Anahtar Kelimeler: Hareket kapasitesi; pelvik salınım; lumbal omurga; Türkiye Amaç: Bu çalışmanın amacı Türk toplumunda üç boyutlu hareket analiz metodunu kullanarak lumbal omurga hareket kapasitesi değerlerini tespit etmektir. Hastalar ve Yöntemler: Ölçümlere 100 gönüllü denek (50 erkek, 50 kadın; dağılım 18-22) alındı. Hareket ölçümleri için “Zebris© 3D Motion Analysis System” kullanıldı. Ölçümlerde lateral fleksiyon, fleksiyon, ekstansiyon, pelvik tilt hareketleri değerlendirildi. Bulgular: Lumbal bölge total lateral fleksiyon erkeklerde 51.3°±7.5, kadınlarda 52.7°±9.9 olarak bulundu. Total fleksiyon ekstansiyon hareketi erkeklerde 81.0°±11.1, kadınlarda 80.2°±10.2 idi. L4-L5 fleksiyon, L5-S1 ekstansiyon değerleri istatistiksel olarak kadınlar için daha yüksek iken (p<0.05), L3-L4 total fleksiyonekstansiyon ve L1-L2 total lateral fleksiyon değerleri istatistiksel olarak erkeklerde daha yüksekti. Pelvik tiltin total lumbosakral fleksiyon hareketine katkısı erkeklerde %46.6, kadınlarda %42.1 idi. Ekstansiyon hareketi esnasında katkısı erkeklerde %36.8, kadınlarda %26.2 olarak bulundu. Pelvik tilt fleksiyon ve ekstansiyon değerleri erkeklerde kadınlara göre anlamlı olarak daha yüksek bulundu (p<0.05). Sonuç: Türk toplumunda lumbal omurganın hareketlerinin normal değerleri üç boyutlu hareket analiz sistemi ile tespit edilmiştir.
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- Ensink FB, Saur PM, Frese K, Seeger D, Hildebrandt J. Lumbar range of motion: influence of time of day and individual factors on measurements. Spine 1996;21:1339-43.
- Fathallah FA, Marras WS, Wright PL. Diurnal varia- tion in trunk kinematics during a typical work shift. J Spinal Disord 1995;8:20-5.
- Cigali BS, Ulucam E, Yilmaz A, Cakiroglu M. Comparison of asymmetries in ground reaction force patterns between normal human gait and football players. Biol Sport 2004;21:241-8.
- Mellin G, Kiiski R, Weckström A. Effects of subject position on measurements of flexion, extension, and lateral flexion of the spine. Spine 1991;16:1108-10.
- White AA, Panjabi MM, editors. Clinical biomechan- ics of the spine. 2nd ed. Philadelphia: Lippincott; 1990.
- Humphreys SC, Hodges SD, Lumpkin KJ, Eck JC, Wurster R, Hagen J, et al. Assessing lumbar sagittal motion using videography in an in vivo pilot study. Int J Ind Ergon 2007;37:653-6.
- Al-Eisa E, Egan D, Deluzio K, Wassersug R. Effects of pelvic asymmetry and low back pain on trunk kine- matics during sitting: a comparison with standing. Spine 2006;31:E135-43.
- Coates JE, McGregor AH, Beith ID, Hughes SP. The influence of initial resting posture on range of motion of the lumbar spine. Man Ther 2001;6:139-44.
- Pearcy M, Portek I, Shepherd J. The effect of low-back pain on lumbar spinal movements measured by three- dimensional X-ray analysis. Spine 1985;10:150-3.
- Pearcy MJ, Tibrewal SB. Axial rotation and lateral bending in the normal lumbar spine measured by three-dimensional radiography. Spine 1984;9:582-7.
- Dvorák J, Panjabi MM, Chang DG, Theiler R, Grob D. Functional radiographic diagnosis of the lumbar spine. Flexion-extension and lateral bending. Spine 1991;16:562-71.
- Fitzgerald GK, Wynveen KJ, Rheault W, Rothschild B. Objective assessment with establishment of nor- mal values for lumbar spinal range of motion. Phys Ther 1983;63:1776-81.
- Dillard J, Trafimow J, Andersson GB, Cronin K. Motion of the lumbar spine. Reliability of two mea- surement techniques. Spine 1991;16:321-4.
- Ng JK, Kippers V, Richardson CA, Parnianpour M. Range of motion and lordosis of the lumbar spine: reliability of measurement and normative values. Spine 2001;26:53-60.
- Bell JA, Stigant M. Development of a fibre optic goni- ometer system to measure lumbar and hip move- ment to detect activities and their lumbar postures. J Med Eng Technol 2007;31:361-6.
- Wong KW, Luk KD, Leong JC, Wong SF, Wong KK. Continuous dynamic spinal motion analysis. Spine 2006;31:414-9.
- Gajdosik RL, Albert CR, Mitman JJ. Influence of hamstring length on the standing position and flex- ion range of motion of the pelvic angle, lumbar angle, and thoracic angle. J Orthop Sports Phys Ther 1994;20:213-9.
- Hayes MA, Howard TC, Gruel CR, Kopta JA. Roentgenographic evaluation of lumbar spine flex- ion-extension in asymptomatic individuals. Spine 1989;14:327-31.
- Alaranta H, Hurri H, Heliövaara M, Soukka A, Harju R. Flexibility of the spine: normative values of gonio- metric and tape measurements. Scand J Rehabil Med 1994;26:147-54.
- Petersen CM, Johnson RD, Schuit D, Hayes KW. Intraobserver and interobserver reliability of asymp- tomatic subjects' thoracolumbar range of motion using the OSI CA 6000 Spine Motion Analyzer. J Orthop Sports Phys Ther 1994;20:207-12.
- Putto E, Tallroth K. Extension-flexion radiographs for motion studies of the lumbar spine. A compari- son of two methods. Spine 1990;15:107-10.
- Robinson ME, O'Connor PD, Shirley FR, Mac Millan M. Intrasubject reliability of spinal range of motion and velocity determined by video motion analysis. Phys Ther 1993;73:626-31.
- Russell P, Pearcy MJ, Unsworth A. Measurement of the range and coupled movements observed in the lumbar spine. Br J Rheumatol 1993;32:490-7.
- Littlewood C, May S. Measurement of range of move- ment in the lumbar spine-what methods are valid? A systematic review. Physiotherapy 2007;93:201-11.
- Teyhen DS, Flynn TW, Bovik AC, Abraham LD. A new technique for digital fluoroscopic video assess- ment of sagittal plane lumbar spine motion. Spine 2005;30:E406-13.
- Kılınçer C, Cigali BS, Hamamcıoğlu MK, Çobanoğlu S. Omurgada hareket ölçümleri. Türk Nöroşirürji Derg 2002:12;119-24.
- Schreiber TU, Anders C, Uhlemann C, Bak P, Smolenski U, Scholle H.C. Mobility of lumbar spine recorder by three-dimensional motion analysis in patients with low back pain and controls. In: Vleeming A, Mooney V, Tilscher H, Dorman T, Snijders C, editors. Proceedings of the 3rd interdisci- plinary world congress on low back and pelvic pain; 1998 Nov 19-21; Vienna: Austria; 1998. p. 446-50.
- Wang SF, Teng CC, Lin KH. Measurement of cervical range of motion pattern during cyclic neck move- ment by an ultrasound-based motion system. Man Ther 2005;10:68-72.
- Dvir Z, Prushansky T. Reproducibility and instru- ment validity of a new ultrasonography-based sys- tem for measuring cervical spine kinematics. Clin Biomech 2000;15:658-64.
- Lee RY, Wong TK. Relationship between the move- ments of the lumbar spine and hip. Hum Mov Sci 2002;21:481-94.