YÜRÜYÜŞ PARAMETRELERİ FONKSİYONEL PERFORMANS DENGE AĞIRLIK AKTARMA VE YAŞAM KALİTESİ AÇISINDAN TRAVMA VE DİYABET NEDENLİ TRANSTİBİAL AMPUTELERİN KARŞILAŞTIRILMASI

Abstract

Tosun N., Comparison of Trauma and Diabetes Induced Transtibial Amputees in Terms of Gait Parameters Functional Performance Balance Weight Bearing and Quality of Life, Hacettepe University, Graduate School of Health Sciences, Prosthesis-Orthesis and Biomechanics Program, PhD Thesis, Ankara, 2025. This study was planned to compare the results of gait parameters, balance, weight transfer symmetry, functional capacity, functional mobility, quality of life and prosthesis satisfaction in diabetes and trauma induced transtibial amputees (TTA). Ten trauma and 10 diabetes-induced TTA subjects aged 18-65 years were included in the study. All amputees in the trauma and diabetes groups were wearing a transtibial prosthesis with vacuum assisted suspension system and carbon composite foot. Gait analysis and weight transfer symmetry were evaluated by computerised gait analysis system, balance by Biodex Balance System, functional capacity by Six Minute Walk Test, functional mobility by Timed Up and Go Test and Stair Climb and Descent Test, prosthesis satisfaction by Trinity Amputation and Prosthesis Experience Scale and quality of life by Short Form-36. When the results of the trauma and diabetes groups were compared, a significant difference was found in favor of the trauma group among the gait parameters of stride length (p<0.05), amputated limb step length (p<0.05), non-affected limb step length (p<0.05), balance assessment parameters of general postural stability (p<0.001), anterio-posterior postural stability (p<0.001), medio lateral postural stability (p<0.05), Stair Climbing and Descent Test (p<0.001), activity restriction subsection of Trinity Amputation and Prosthesis Experience Scale (p<0.05). No significant difference was found between the parameters of velocity, cadence, step width, amputee and non-affected limb weight bearing percentages, Timed Up and Go Test, Short Form-36 and Trinity Amputation and Prosthesis Experience Scale (Psycho social Adjustment, Prosthesis Satisfaction, Daily Prosthesis Use Time subsections). There was a correlation between functional performance and gait parameters (stride stride length, amputee limb step length, non-affected limb step length, speed), postural stability (general, anterio-posterior, medio-lateral), Trinity Amputation and Prosthesis Experience Scale (physical function, energy/vitality/, social function, general health perception) assessments (p<0.05). When the results of diabetic and traumatic amputees were evaluated in our study, it was seen that the difference in favor of traumatic amputees became evident, especially in activity-related measurements and when the difficulty level of the activity increased. In other parameters, the use of vacuum assisted suspension system prosthesis by the participants had a positive effect on the results of the diabetes group and contributed to the emergence of results close to the trauma group. The fact that diabetic amputees use their prostheses as long as traumatic amputees during the day and the choice of prosthesis and suspension system can be counted as factors in favour of diabetic amputees. It is thought that these factors will provide a different perspective to the relevant health professionals in terms of the success of rehabilitation and will guide future studies on a larger number of amputees, including different levels of amputation and different suspension systems. Key words: Trauma, Diabetes, Transtibial, Amputee, Gait, Balance