Buket BÜYÜKTURAN, Caner KARARTI, Alperen KILIÇ, Öznur BÜYÜKTURAN

Şizofrenik Bireylerde Semptom Şiddeti İle Plantar Duyu, Postüral Denge, Düşme Riski ve Yürüme Arasındaki İlişkinin İncelenmesi

Amaç: Şizofrenik bireylerde semptom şiddetinin plantar duyuyla ilişkili olup olmadığı ile ilgili objektif bir veriye rastlanılmamıştır. Ayrıca semptom şiddeti ile postüral denge, düşme riski ve yürüme arasındaki ilişkiyi inceleyen çalışmalar da yetersizdir. Bu sebeple, incelenen parametreler açısından semptom şiddeti ile plantar duyu, postüral denge, düşme riski ve yürüme arasındaki ilişkinin incelenmesi amaçlanmıştır. Materyal ve Metot: Bu çalışmaya 45 şizofrenik birey dahil edildi. Psikiyatrist tarafından, [Diagnostic and Statistical Manual of Mental Disorders-V] (DSM-V)’e ve klinik değerlendirmeye göre şizofreni tanısı alan bireyler deneyimli bir fizyoterapist tarafından değerlendirildi. Katılımcıların değerlendirilmesinde Pozitif ve Negatif Sendrom Ölçeği (PANSS), Semmes-Weinstein Monofilamentleri (SWM), Berg Denge Skalası (BDS), Tinetti Düşme Etkinlik Ölçeği (TDEÖ), Walk-aLine Ataxia Battery (WLAB) ve Süreli Kalk Yürü Testi (TUG) kullanıldı. Olguların semptom şiddeti ile plantar duyu, postüral denge, düşme riski ve yürüme arasındaki ilişkinin değerlendirilmesinde Pearson Korelasyon Analizi kullanıldı. Bulgular: Katılımcılarda SWM skorları ile PANSS pozitif sendrom ve toplam skor alt başlıkları arasında düşük orta-orta şiddette (r=0,35- 0,52) pozitif yönde ilişki olduğu saptandı (p=0,001-0,025). PANSS tüm alt skorlar ile BDS skorları arasında düşük orta-orta şiddette (r=-0,33/- 0.41) negatif yönde ilişki bulundu (p=0,011-0,030). PANSS tüm alt skorlar ile TUG (r=0,33-0,42; p=0,009-0,030) ve TDEÖ (r=0,36-0,41; p= 0,011-0,023) skorları arasında da düşük orta-orta şiddette pozitif yönde ilişki bulundu. PANSS skorları ile WLAB testinin gözler kapalı şekilde yapılan test alt başlıkları arasında düşük orta-orta şiddette pozitif yönde istatistiksel olarak anlamlı ilişki bulundu (r= 0,33-0,42; p=0,015-0,043). Sonuç: Şizofrenide semptom şiddetinin artması, plantar duyu, postüral denge ve yürümedeki kötüleşmelerle ve düşme riskindeki artış ile ilişkilidir. Semptom şiddetinin artmasına bağlı olarak meydana gelebilecek sekonder problemlerin, klinisyen tarafından akılda tutulması gerektiği düşünülmektedir

Anahtar Kelimeler:

şizofreni, plantar duyu, postüral denge, düşme riski, yürüme

Investigation of the Relationship Between Plantar Sensation, Postural Balance, Falling Risk and Gait in Patients with Schizophrenia

Aim: There is no objective data about whether symptom severityis associated with plantar sensation in schizophrenic individuals. Inaddition, the studies examining relationship between symptom severity and postural balance, falling risk, and gait are also inadequate.Therefore, it was aimed to investigate the relationship between symptom severity and plantar sensation, postural balance, falling risk andgait in terms of parameters examined.Material and Method: A total of 45 healthy schizophrenic individuals were included in the study. Individuals who were diagnosed withschizophrenia by a psychiatrist according to [Diagnostic and StatisticalManual of Mental Disorders-V] (DSM-V) and clinical assessment wereassessed by an experienced physiotherapist. In the assessment ofthe participants, the Positive and Negative Syndrome Scale (PANSS),Semmes-Weinstein Monofilament (SWM), Berg Balance Scale (BBS),Tinetti Falls Efficacy Scale (TFES), Walk-a-Line Ataxia Battery (WLAB),and Timed Up and Go Test (TUG) were used. Pearson CorrelationAnalysis was used to evaluate the relationship between symptom severity of the cases and plantar sensory, postural balance, falling riskand gait.Results: There was a low-moderate and positive (r=0.35-0.52) correlation between SWM scores and PANSS positive syndrome andtotal score subscales (p=0.001-0.025). There was a low-to-moderate(r = -0.33 / -0.41) and negative relationship between PANSS all subscales and BBS scores (p = 0.011-0.030). It has been found that therewere low-moderate and positive correlations between all subscalesof PANSS and TUG (r=0.33-0.42; p=0.009-0.030) and TFES (r=0.36-0.41;p=0.011-0.023) scores. Also, there was a significant low-tomoderate and positive correlation between PANSS scores and WLABtest performed with closed eyes (r= 0.33-0.42; p=0.015-0.043).Conclusion: The increase in the symptom severity of schizophreniais associated with deterioration in plantar sensation, postural balance,gait and increase in the risk of falling. Secondary problems that mayocur due to increased symptom severity should be kept in mind bythe clinician.

Keywords:

schizophrenia, plantar sensation, postural balance, falling risk, gait,

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