Diz Osteoartritli Hastalarda 3-Boyutlu Bilgisayarlı Yürüme Analizi ile Gözlemsel Yürüme Analizi Sonuçlarının Karşılaştırılması
Özet
The purpose of this study was to compare the results of observational gait analysis (OGA) carried out by physiotherapists having different clinical experiences and the results of 3-dimentional gait analysis (3DGA) in patients with knee osteoarthritis (OA). The subjects were 22 woman 11 men, total 33, with an age range of 46-81 years who were diagnosed as having bilateral knee OA as a result of clinical and radiographic investigations and these subjects were observationally assessed by 4 physiotherapists. Physiotherapists were divided into 2 groups according to above and below 5 years of their professional experience. Diagnosed as having bilateral knee OA, 33 subject?s physical features, pain, stiffness and physical functions were assessed with gait parameters assessed by 3DGA in same day. When subjects were assessed by 3DGA, they were recorded simultaneously. These video records were observationally assessed two times with intervals of at least 6 weeks by physiotherapists divided into 2 groups according to their clinical experience. OGA were applied by a form we had developed. This form was composed of 21 parameters consisting of 15 angular and 6 temporo-spatial parameters. Prepared by us, a questionnaire about gait analysis was also applied to 147 physiotherapists. While pelvic tilt parameter in stance was the parameter in which the highest validity (r:0,74-0,77, p?0,001) recorded, interrater and intrarater agreement were moderate or substantial (ICC:0,55-0,82). It was found in other assessed pelvic parameters that interrater agreement was slight or fair (ICC:0,06-0,38), intrarater agreement was fair, moderate or substantial (ICC:0,25-0,67) and slight or fair correlation (r:0,06-0,40) was between OGA and 3DGA results. It was found in parameter of hip and knee joints that intrarater and interrater agreement was moderate or substantial (ICC:0,40-0,81) and slight or fair correlation (r:0,22-0,50) was found between OGA and 3DGA results. While intrarater and interrater was found slight (ICC:0,02-0,16) in angle dorsi flexion parameter in initial contact, in other angle parameters intrarater and interrater agreement was moderate or substantial (ICC:0,41-0,74). While in angle parameters, there was no correlation (r: 0,02-0,16, p>0,05) in angle dorsi flexion parameter in initial contact and terminal stance between OGA and 3DGA results, it was found fair and moderate correlation (r:0,49-0,71,p?0,001) in other parameters. It was identified in all temporo-spatial parameters except length of the stance phase that intrarater and interrater agreement was substantial (ICC:0,61-0,80) and moderate correlation (r:0,52-0,68, p?0,001) was between OGA and 3DGA results. A significant difference was not found among assessment results made by physiotherapists divided into 2 groups according to their professional experience. As a result of this study, it was found that OGA isn?t sufficiently reliable and valid method for the clinical use in the lots of assessed parameters. Sufficiently valid and reliable methods which are appropriate for the clinical use are needed. It was thought that this biomechanics study would be an advisor source for future researches.
