Gamze ERTÜRK, Çiçek GÜNDAY, Halenur EVRENDİLEK, İpek YELDAN

Diz Üstü Amputelerde Denge Değerlendirme Yöntemleri: Literatür Taraması

Amaç: Denge rehabilitasyonu, diz üstü amputasyonu bulunan bireylerde rehabilitasyon sürecinde önem taşımaktadır. Diz üstü ampute olan bireylerde denge değerlendirmesi için çeşitli yöntemler kullanılmaktadır ve literatürde en çok kullanılan yöntemlerin belirlenmesine ihtiyaç duyulmaktadır. Çalışmanın amacı, diz üstü amputasyonu bulunan bireylerde dinamik ve statik dengeyi değerlendirmek için sıklıkla kullanılan yöntemlerin gözden geçirilmesidir. Metot: PubMed/MEDLINE, Web of Science, Scopus ve Google Scholar veritabanları 2010 – 2021 (Mayıs ayına kadar) yılları arasında “(transfemoral amputasyon VEYA diz üstü ampütasyon VEYA kalça dezartikülasyonu) VE (statik denge VEYA dinamik denge VEYA postural salınım)” anahtar kelime grupları ile tarandı. Çalışmalar, Sistematik İncelemeler ve Meta-Analizler için Tercih Edilen Raporlama Öğeleri (PRISMA) çerçevesinde değerlendirildi. Çalışmaların kalitesini belirlemek için The Joanna Briggs Institute Critical Appraisal değerlendirme yöntemi kullanılmıştır. Sonuçlar: Derlemeye toplam 114 katılımcıyı içeren sekiz çalışma dahil edildi. Çalışmalardan 1'i randomize çapraz çalışma, 3'ü kesitsel çalışma, 2'si randomize olmayan çalışma, diğerleri ise kohort ve vaka kontrol çalışmalarıydı. İncelenen çalışmaların sonuçlarına göre, kuvvet platformu statik ve dinamik denge değerlendirmesinde yaygın olarak kullanılırken, statik değerlendirme için klinik testlerin de tercih edildiği görülmüştür. Tartışma: Alt ekstremite amputasyonu olan bireylerde kullanılan klinik denge ölçekleri özellikle amputasyon için geliştirilmemiştir. Ayrıca daha detaylı bir denge değerlendirmesi için teknolojik cihazlar kullanılmalıdır. Çalışmaların kalite düzeylerinin yüksek olmaması ve dahil edilen çalışma tasarımları farklı olması nedeniyle sonuçlar etkilenmiş olabilir. Gelecekteki çalışmaların yüksek popülasyonlu ve randomize kontrollü olarak tasarlanmasıyla daha doğru sonuçlara ulaşılabilir.

Anahtar Kelimeler:

Diz üstü amputasyonu, kuvvet platformu, posturografi, berg denge testi, süreli kalk ve yürü.

Measurement Methods of Balance Among Above-Knee Amputees: A Literature Review

Aim: Balance rehabilitation in individuals with above-knee amputees has importance during the rehabilitation process. Various methods are used for balance assessment in individuals with above-knee amputees and determination is needed to ways that were mostly used in the literature. The aim of the study was a review of the methods utilized often to assess dynamic and static balance for individuals with above-knee amputees. Method: PubMed/MEDLINE, Web of Science, Scopus, and Google Scholar were searched between 2010 – 2021 (up to May) years with “(transfemoral amputation OR above-knee amputation OR hip disarticulation) AND (static balance OR dynamic balance OR postural sway)” keywords groups. Studies read and analyzed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The Joanna Briggs Institute Critical Appraisal tools used to determine the quality of studies. Results: Eight studies that included a total of 114 participants were selected. Among the studies, 1 were randomized cross over study, 3 were cross-sectional studies, 2 were non-randomized studies and others were cohort, and case-control studies. According to results of reviewed studies, while force plate was widely used in static and dynamic balance evaluation, clinical tests were also preferred for static evaluation. Conclusion: Clinical balance scales used in individuals with lower limb amputation are not specifically developed for amputation. In addition, technological devices should be used for a more detailed balance assessment. The results may have been affected because the quality levels of the studies were not high, and the study designs included were varied. More accurate results can be achieved by designing future studies with a high population and randomized control.

Keywords:

Above-knee amputation, force platform, posturography, berg balance test, timed up go.,

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