Total Diz ve Kalça Eklem Replasman Cerrahisi Sonrası Taburculuk Gününde Fonksiyonel Mobilite
Amaç: Total diz ve kalça eklem replasman cerrahisi sonrası hastane post-akut bakımında taburculuk gününde fonksiyonel mobilite durumunu incelemektir.Yöntem: Total diz ve kalça replasman cerrahisi olan 80 hasta, taburculuk gününde mobiliteyle ilişkili aktivite ölçeklerinden De Morton Mobilite İndeksi (DEMMI), zamanlı kalk yürü testi (KYT), 5 tekrarlı sandalyeden ayağa kalkma testi ve Western Ontario McMaster Üniversitesi Osteoartrit Index (WOMAC) ile değerlendirildi. Demografik bilgiler,yaş, vücut kitle indeksi, cinsiyet, cerrahi tipi ve hastanede kalış süresidir. Veriler normal dağılım göstermediğinden nonparametrik testlerden Mann-Whitney U testi ile analiz edildi.Sonuçlar: Kırk hasta (yaş ort: 66.83±7.39 yıl) total diz replasmanı (TDR); 40 hasta (yaş ort: 62.63±11.95 yıl) total kalça replasmanı (TKR) cerrahisi geçirmişti. Yaş, vücut kitle indeksi ve hastanede kalış süresi açısından hastalar arasında istatistiksel farklılık yoktu (p>0.05). TDR hastalarının, ortalama WOMAC toplam ve WOMAC Fiziksel Fonksiyon skoru ile ortalama DEMMI total skoru TKR hastalarına göre daha iyiydi (p
Functional Mobility on Discharge Day After Total Knee and Hip Replacement Surgery
Purpose: To examine functional mobility status on discharge day after total knee and hip replacement surgery in post-acute care hospital setting.Methods: Eighty patients following total knee and hip replacement surgery were assessed with the de Morton Mobility Index (DEMMI), the Timed-Up-and-Go (TUG) and Five Times Sit to Stand Test, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) measurements of mobility-related activity on discharge day. Demographic information comprised age, body mass index, gender, type of surgery,length of hospital stay. Since the normality of distribution of the data was not confirmed, nonparametric Mann-Whitney-U test was used for analysis.Results: Forty patients (mean age: 66.83±7.39 years) underwent total knee replacement (TKR) and 40 patients (mean age: 62.63±11.95 years) underwent total hip replacement (THR). No statistical difference was found in age, body mass index and length of hospital stay between patients (p>0.05). TKR patients had better results in mean WOMAC total score, WOMAC Physical Functioning Score and mean DEMMI total score compared to THR patients (p
___
- Walsh MB, Herbold J. Outcome after rehabilitation for total joint replacement at IRF and SNF: a case-controlled comparison. Am J Phys MedRehabil. 2006;85(1):1-5.
- Mahomed NN, Davis AM, Hawker G, Badley E, Davey JR, Syed KA, et al. Inpatient compared with home-based rehabilitation fol- lowing primary unilateral total hip or knee replacement: a ran- domized controlled trial. J Bone Joint Surg Am. 2008;90(8):1673- 80.
- Tribe KL, Lapsley HM, Cross MJ, Courtenay BG, Brooks PM, Mar- ch LM. Selection of patients for inpatient rehabilitation or dire- ct home discharge following total joint replacement surgery: a comparison of health status and out-of-pocket expenditure of patients undergoing hip and knee arthroplasty for osteoarthritis. Chronic Illn. 2005;1(4):289-302.
- Kennedy DM, Stratford PW, Hanna SE, Wessel J, Gollish JD. Mo- deling early recovery of physical function following hip and knee arthroplasty. BMC Musculoskelet Disord. 2006;7(1):100.
- Nilsdotter A-K, Isaksson F. Patient relevant outcome 7 years af- ter total hip replacement for OA-a prospective study. BMC Mus- culoskelet Disord. 2010;11(1):47.
- Trudelle-Jackson E, Emerson R, Smith S. Outcomes of total hip arthroplasty: a study of patients one year postsurgery. J Orthop Sports Phys Ther. 2002;32(6):260-7.
- Rasch A, Dalén N, Berg HE. Muscle strength, gait, and balance in 20 patients with hip osteoarthritis followed for 2 years after THA. Acta Orthop. 2010;81(2):183-8.
- Sicard-Rosenbaum L, Light KE, Behrman AL. Gait, lower extre- mity strength, and self-assessed mobility after hip arthroplasty. J Gerontol A BiolSci Med Sci. 2002;57(1):47-51.
- de Morton NA, Davidson M, Keating JL. The de Morton Mobility Index (DEMMI): An essential health index for an ageing world. Health Qual Life Outcomes. 2008;6:63.
- Podsiadlo D, Richardson S. The timed” Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142-8.
- Kennedy DM, Stratford PW, Wessel J, Gollish JD, Penney D. As- sessing stability and change of four performance measures: a longitudinal study evaluating outcome following total hip and knee arthroplasty. BMC Musculoskelet Disord. 2005;6(1):3.
- Bohannon RW, Williams Andrews A. Normal walking speed: a descriptive meta-analysis. Physiotherapy. 2011;97(3):182-9.
- Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for me- asuring clinically important patient relevant outcomes to antir- heumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988;15(12):1833-40.
- Tüzün EH, Eker L, Aytar A, Daşkapan A, Bayramoğlu M. Accepta- bility, reliability, validity and responsiveness of the Turkish versi- on of WOMAC osteoarthritis index. Osteoarthritis and cartilage. 2005;13(1):28-33.
- Cohen J. Statistical power analysis for the behavioral scien- ces.2nd ed. New Jersey:Lawrence Erlbaum Associates, Publis- hers. 1988.
- Hayes JH, Cleary R, Gillespie W, Pinder I, Sher J. Are clinical and patient assessed outcomes affected by reducing length of hospi- tal stay for total hip arthroplasty. J Arthroplasty. 2000;15(4):448- 52.
- Dall GF, Ohly NE, Ballantyne JA, Brenkel IJ. The influence of pre-operative factors on the length of in-patient stay following primary total hip replacement for osteoarthritis a multivariate analysis of 2302 patients. J Bone Joint Surg Br. 2009;91(4):434- 40.
- Kreder HJ, Grosso P, Williams JI, Jaglal S, Axcell T, Wai EK, et al. Provider volume and other predictors of outcome after to- tal knee arthroplasty: a population study in Ontario. Can J Surg. 2003;46(1):15-22.
- Robbins SM, Rastogi R, McLaughlin TL. Predicting acute reco- very of physical function following total knee joint arthroplasty. J Arthroplasty. 2014;29(2):299-303.
- Jans MP, Slootweg VC, Boot CR, de Morton NA, van der Sluis G, van Meeteren NL. Reproducibility and validity of the Dutch translation of the de Morton Mobility Index (DEMMI) used by physiotherapists in older patients with knee or hip osteoarthri- tis. Arch Physl Med Rehabil. 2011;92(11):1892-9.
- de Morton NA, Lane K. Validity and reliability of the de Mor- ton Mobility Index in the subacute hospital setting in a Geri- atric Evaluation and Management population. J Rehabil Med. 2010;42(10):956-61.
- Judd DL, Dennis DA, Thomas AC, Wolfe P, Dayton MR, Ste- vens-Lapsley JE. Muscle strength and functional recovery during the first year after THA. Clin Orthop Relat Res. 2014;472(2):654- 64.
- Ouellet D, Moffet H. Locomotor deficits before and two months after knee arthroplasty. Arthritis Rheum. 2002;47(5):484-93.
- Itokazu M, Uemura S, Aoki T, Takatsu T. Analysis of rising from a chair after total knee arthroplasty. Bull Hosp Jt Dis. 1998;57(2):88-92.
- Bejek Z, Paróczai R, Illyés Á, Kiss RM. The influence of walking speed on gait parameters in healthy people and in patients with osteoarthritis. Knee Surg Sports Traumatol Arthrosc. 2006;14(7):612-22.
- Munton J, Ellis M, Chamberlain MA, Wright V. An investigation into the problems of easy chairs used by the arthritic and the elderly. Rheumatology. 1981;20(3):164-73.
- Miki H, Sugano N, Hagio K, Nishii T, Kawakami H, Kakimoto A, et al. Recovery of walking speed and symmetrical movement of the pelvis and lower extremity joints after unilateral THA. J Biomech. 2004;37(4):443-55.
- Foucher KC, Hurwitz DE, Wimmer MA. Preoperative gait adapta- tions persist one year after surgery in clinically well-functioning total hip replacement patients. J Biomech. 2007;40(15):3432-7.