Erişkin Nöromusküler Hastalarda Farklı Yürüme Yardımcılarının Enerji Harcama Düzeyi, Düşme Riski ve Yürüme Parametrelerine Etkisi

Abstract

This study was designed to investigate the effects of the different walk aides (single cane, bilateral forearm cructh and walker) on the energy expenditure, the risk of falling and gait parameters in patients with adult neuromuscular disease. The study was conducted self-control in 18 patients who are followed with neuromuscular disease diagnosis. Manual Muscle Test for muscle strength, the Rivermead Mobility Index for levels of mobility, Motor Function Assessment scale for motor function level, Trunk Control Test for trunk control of the cases were used as descriptive measurements. The 2-minute walk test for the functional capacity, Time up-go test and story of falling for the falls and risk of falling, four sensors Arm Band "Arm Band Bodysense Wear" Metabolic Holter for energy consumption, Modified Borg scale for fatigue, pulse oximetry for the oxygen saturation and heart rate and "BTS G-Walk" gait analysis system for the pelvis kinematic analysis and gait parameters were used as outcome measures. Outcome measures were performed firstly during normal gait (without walk aides), then during walking with single cane, bileteral forearm cructh and walker randomly. In this patients group, the proximal muscle weakness has been observed as the most important risk factor for falls. It was found that aproximately 90% of the patients are falling during walking, because of inability to stabilize the knee (50%) and tripping (33%) and mostly outside areas (55%). It was found that while walking with single cane per meter energy consumption unchanged compared with normal walking, 21% was increased with bileteral forearm cructh and 40% with a walker. It was observed that the walk aids decreased the walking speed, walking distance and cadence (the number of steps per minute). It was found that all walk aides increased the duration of the walking cycle. When the pelvis kinematic was analysed, there is only significant difference in extansion of pelvis between groups (p<0.05). The most useful (61%), most comfortable (44.4%) and the most preferred (61%) walk aid was determined as single cane by patients and the most safe (55%) was determined as walker. In the decision-making process for walk aid that the patient's biomechanical, physiological and psychosocial needs, expectations, satisfaction and level of independence should be considered to be provided to patients for walking