Bu çalışmada, Türkiye’de çocuklarda fiziksel aktivite ile ilgili araştırmaların çeşitli değişkenlere göre eğilimlerinin belirlenmesi hedeflenmiştir. Araştırmada betimsel tarama modeli ve içerik analiz yöntemi kullanılmıştır. Araştırmanın örneklemini Yüksek Öğretim Kurumu Ulusal Tez Merkezi internet sitesinden ulaşılan 90 yüksek lisans, doktora ve tıpta uzmanlık tezi oluşturmaktadır. Araştırmadan elde edilen bulgulara göre çocuklarda fiziksel aktiviteye ilişkin lisansüstü tezlerin çoğunlukla 2017-2022 yılları arasında yapıldığı, tez sayılarının yıllara göre artma eğiliminde olduğu ve tezlerin çoğunluğunun yüksek lisans türünde olduğu saptanmıştır. Çocuklarda fiziksel aktiviteye ilişkin yapılan araştırmalarda yıllara göre çoğalma saptanmıştır. Bununla birlikte bu konuda yayınlanan tezlerin genelinin kanıt düzeyinin düşük olduğu, betimsel ve karşılaştırmalı çalışmaların daha fazla olduğu, fiziksel aktivite miktar ve şiddetini artırmaya yönelik uygulamalı çalışmaların sınırlı kaldığı görülmüştür. Bundan sonra yapılacak olan çalışmaların mevcut durumu ortaya koymanın yanı sıra, problemleri çözme, bireyler ve ebeveynlerini eğitme, programlarını geliştirme ve toplumun bilincini artırmaya yönelik olması önerilmektedir.
BackgroundTotal knee arthroplasty (TKA) is the gold-standard procedure for end-stage knee osteoarthritis, however, some residual problems may still continue and cause a variety of dysfunctions, such as pain, impaired strength, proprioception, postural instability, dynamic balance, and gait deficiencies [1]. Falls are the most frequent cause of injuries in elderly people, accounting for 90% of hip and wrist fractures and 60% of head injuries [2] requiring expensive and difficult procedures such as fracture surgeries and arthroplasties [3].The most frequent cause of falling was transfer activities while shifting body weight which accounted for 41% of falls [2] especially getting up from bed and walking to the bathroom [2,4,5]. Additionally, the three major classes of activities—walking, sitting down, and standing—were the most common precipitants of falls. These findings emphasize the need to target each of these activities in fall risk assessment and prevention strategies [2,5]. The Lie-to-Sit-to-Stand-to-Walk Transfer Test (LSSWT) incorporates a multitask approach to measure complicated transfer abilities in older people. However, there is no study investigating the reliability and validity of the LSSWT in TKA patients.ObjectivesThe aim of the study is to determine the reliability, validity, and minimal clinically important difference (MCID) of the LSSWT in patients with TKA.MethodsTwenty-one patients with TKA were included in the study. The LSSWT, the Timed Up and Go Test (TUG), and the Hospital for Special Surgery (HSS) were administered to the patients. Patients rested between the tests for an hour to prevent fatigue.ResultsThe mean age was 68.1 ± 2.59 years and the mean HSS Knee Score was 85.43± 3.47. The relative (ICC coefficient) and absolute (SEM and SRD95) reliability values were 0.88, 1.21, and 3.33 respectively. The Spearman correlation coefficient of the LSSWT with the TUG was 0.63.ConclusionThe LSSWT has excellent reliability and high validity in evaluating fall risk and complex dynamic balance and mobility for the activities of daily living in patients with TKA. The low MCID value (3.33) shows that it is sensitive and identifies little alterations in a patient’s condition over time or management strategies. Therefore, it is advisable to use the LSSWT for assessing the fall risk, dynamic balance, and mobility for living in the community, discharging, or admitting to a facility.References[1] Huber EO, Roos EM, Meichtry A, de Bie RA, Bischoff-Ferrari HA. Effect of preoperative neuromuscular training (NEMEX-TJR) on functional outcome after total knee replacement: An assessor-blinded randomized controlled trial. BMC Musculoskelet Disord [Internet]. 2015 Apr 25 [cited 2023 Jan 15];16(1):1–14. Available from:https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-015-0556-8[2] Robinovitch SN, Feldman F, Yang Y, Schonnop R, Leung PM, Sarraf T, et al. Video capture of the circumstances of falls in elderly people residing in long-term care: an observational study. Lancet [Internet]. 2013 Jan 1 [cited 2022 Nov 19];381(9860):47. Available from:/pmc/articles/PMC3540102/[3] Total Hip Arthroplasty or Hemiarthroplasty for Hip Fracture. New England Journal of Medicine [Internet]. 2019 Dec 5 [cited 2023 Jan 15];381(23):2199–208. Available from:https://www.nejm.org/doi/full/10.1056/NEJMoa1906190[4] Rice LA, Ousley C, Sosnoff JJ. A systematic review of risk factors associated with accidental falls, outcome measures and interventions to manage fall risk in non-ambulatory adults.https://doi.org/103109/096382882014976718[Internet]. 2015 Sep 1 [cited 2023 Jan 15];37(19):1697–705. Available from:https://www.tandfonline.com/doi/abs/10.3109/09638288.2014.976718[5] Yang Y, van Schooten KS, Sims-Gould J, McKay HA, Feldman F, Robinovitch SN. Sex Differences in the Circumstances Leading to Falls: Evidence From Real-Life Falls Captured on Video in Long-Term Care. J Am Med Dir Assoc. 2018 Feb 1;19(2):130-135.e1.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
BackgroundKnee osteoarthritis (OA) can cause a variety of dysfunctions leading to limitations in mobility, gait, and balance that predisposes them to increased fall risk [1,2]. Falls are the leading cause of injury and fracture [3], putting a significant financial burden on the healthcare system. The fall risk is even higher in people with knee OA with a prevalence between 23 and 63% [4]. Another study reported that almost 50% of patients with knee OA experienced falls [5]. Therefore, the identification of fall predictors is essential to minimize fall incidence [6]. The Cone Evasion Walk Test (CEW) evaluates fall risk by the ability to evade obstacles and walking, which provides a versatile assessment including attentional, perceptual, seeing, and several neuromusculoskeletal and movement-related functions and can be performed with or without a walking aid [7].ObjectivesThe study aimed to investigate the reliability, validity, and minimal clinically important difference (MCID) of the CEW in people with knee OA.MethodsThirty-three patients with knee OA were included. Patients performed trials for the CEW and the Timed up and Go Test on the same day. Between the trials, patients waited for an hour in a sitting position to prevent fatigue.ResultsThe CEW was shown to have excellent test-retest reliability and moderate validity (p<0.001). The relative (ICC coefficient) and absolute (SEM and SRD95) reliability of the CEW were 0.97, 0.73, and 2.02 respectively. The Pearson correlation coefficient between the CEW and the TUG was 0.72.ConclusionThe measurements support the use of the CEW to evaluate dynamic balance and obstacle avoidance of knee OA patients. The analysis demonstrated excellent reliability and moderate validity. The low MCID value (2.02) indicated that it is a responsive test to identicate small changes in a patient’s status. The CEW can be used for a global evaluation of the function and mobility of knee OA patients with little space and equipment, easily and quickly.References[1]Khalaj N, Abu Osman NA, Mokhtar AH, Mehdikhani M, Wan Abas WAB. Balance and Risk of Fall in Individuals with Bilateral Mild and Moderate Knee Osteoarthritis. PLoS One. 2014 Mar 18;9(3):e92270.[2]Arnold CM, Gyurcsik NC. Risk Factors for Falls in Older Adults with Lower Extremity Arthritis: A Conceptual Framework of Current Knowledge and Future Directions. Physiotherapy Canada. 2012 Jul;64(3):302–14.[3]Cai G, Li X, Zhang Y, Wang Y, Ma Y, Xu S, et al. Knee symptom but not radiographic knee osteoarthritis increases the risk of falls and fractures: results from the Osteoarthritis Initiative. Osteoarthritis Cartilage. 2022 Mar 1;30(3):436–42.[4]Blasco JM, Pérez-Maletzki J, Díaz-Díaz B, Silvestre-Muñoz A, Martínez-Garrido I, Roig-Casasús S. Fall classification, incidence and circumstances in patients undergoing total knee replacement. Sci Rep [Internet]. 2022 Dec 1 [cited 2023 Jan 14];12(1):19839. Available from:/pmc/articles/PMC9674575/[5]Thompson DP, Moula K, Woby SR. Are fear of movement, self-efficacy beliefs and fear of falling associated with levels of disability in people with osteoarthritis of the knee? A cross sectional study. Musculoskeletal Care [Internet]. 2017 Sep 1 [cited 2023 Jan 14];15(3):257–62. Available from:https://pubmed.ncbi.nlm.nih.gov/27925419/[6]Rosadi R, Jankaew A, Wu PT, Kuo LC, Lin CF. Factors associated with falls in patients with knee osteoarthritis: A cross-sectional study. Medicine [Internet]. 2022 Dec 12 [cited 2023 Jan 14];101(48):e32146. Available from:/pmc/articles/PMC9726291/[7]Sjöholm H, Hägg S, Nyberg L, Rolander B, Kammerlind AS. The Cone Evasion Walk test: Reliability and validity in acute stroke. Physiotherapy Research International. 2019 Jan;24(1):e1744.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
BackgroundHip osteoarthritis (OA) is associated with joint pain and stiffness, reduced balance, impeded mobility, and loss of functional independence [1]. Falls are the leading cause of fatal and nonfatal injuries among older adults and people with hip OA. Fall-related injuries and circumstances such as hip fractures and subsequent arthroplasty procedures put a significant burden on financial resources and healthcare systems [2]. Therefore, the identification and prevention of falls are easier, cheaper, and more effective for all parties in healthcare. The Cone Evasion Walk Test (CEW) is a dual-tasked performance measurement that was designed for evaluating dynamic balance, proactive gait control, and fall risk by assessing the ability to evade obstacles [3].ObjectivesThe aim of this study was to investigate the reliability and validity of the CEW in patients with hip OA and estimate the minimal clinically important difference (MCID) of the CEW.MethodsTwenty-seven patients with hip OA were included in this study. Patients performed trials for the CEW and the Timed up and Go Test (TUG). Between the CEW trials, patients got to rest for an hour.ResultsThe analysis showed that the CEW has excellent reliability and validity in hip OA (p<0.001). The relative (ICC coefficient) and absolute (SEM and SRD95) reliability of the CEW were 0.95, 0.53, and 1.46 respectively. The Spearman correlation coefficient with the TUG was 0.65.ConclusionThe CEW was shown to be effective in terms of evaluating the function, dynamic balance, mobility, and fall risk with an additional attention-demanding task in patients with hip OA. The low MCID value (1.46) provides a sensitive measure of alterations in a patient’s condition. Therefore, the CEW may be a better assessor of the proactive gait control, fall risk, mobility, and dynamic balance activities in the everyday community than the existing performance measures.References[1]Smith TO, Higson E, Pearson M, Mansfield M. Is there an increased risk of falls and fractures in people with early diagnosed hip and knee osteoarthritis? Data from the Osteoarthritis Initiative. Int J Rheum Dis. 2018 Jun;21(6):1193–201.[2]Kim J, Foucher K. Fall experiences from the perspectives of people with osteoarthritis: in their own words. Disabil Rehabil [Internet]. 2022 [cited 2023 Jan 14]; Available from:https://pubmed.ncbi.nlm.nih.gov/36519505/[3]Sjöholm H, Hägg S, Nyberg L, Rolander B, Kammerlind AS. The Cone Evasion Walk test: Reliability and validity in acute stroke. Physiotherapy Research International. 2019 Jan;24(1):e1744.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
BackgroundFalls represent a major health problem for older adults and often lead to disability and mortality. Each year 30% to 50% of community-dwelling older adults report a fall and almost 75% of falls occur in bedrooms or bathrooms, and 41% of all falls occur during transfers [1,2]. Patients with hip osteoarthritis (OA) have many hip and age-related dysfunctions including muscle weakness, sensory loss, gait and balance deficits, which all increase the risk of falls [3]. Task-specificity has been shown to be a critical factor in the effectiveness of fall-reducing interventions [4]. The Lie-to-Sit-to-Stand-to-Walk Transfer Test (LSSWT) was created to measure complicated transfer abilities in older people [5]. However, the LSSWT’s reliability and validity are not known in patients with hip OA.ObjectivesThe aim of this study was to investigate the reliability, validity, and minimal clinically important difference (MCID) of the LSSWT in patients with hip OA.MethodsTwenty-seven patients with hip OA were included in this study. Patients performed trials for the LSSWT and the Timed up-and-go (TUG) test. Between the trials, patients rested for an hour to prevent fatigue.ResultsThe relative (ICC coefficient) and absolute (SEM and SRD95) reliability of the LSSWT were 0.95, 0.49, and 1,35 respectively. The Pearson correlation coefficient between the LSSWT and the TUG was 0.69.ConclusionThe analysis showed that the LSSWT has excellent reliability and high validity in hip OA. (p<0.001). The low MCID of the LSSWT (1.35) shows its sensitivity and can be used as a responsive outcome measure of interventions and fall risk. the LSSWT also can be valuable in determining independent transferring ability, admissions, or discharges from/to healthcare/residential facilities.References[1]Johnson EG, Meltzer JD. Effect of sitting pause times on postural stability after supine-to-standing transfer in dimly lit environments. Journal of Geriatric Physical Therapy. 2012 Jan;35(1):15–9.[2]Atay S, Vurur S, Erdugan N. Opinions of Nurses About the Evaluation of Risk of Falling Among Inpatients. Rehabil Nurs [Internet]. 2017 [cited 2023 Jan 15];42(6):E19–24. Available from:https://pubmed.ncbi.nlm.nih.gov/27278821/[3]Arnold CM, Gyurcsik NC. Risk Factors for Falls in Older Adults with Lower Extremity Arthritis: A Conceptual Framework of Current Knowledge and Future Directions. Physiotherapy Canada. 2012 Jul;64(3):302–14.[4]Kim J, Foucher K. Fall experiences from the perspectives of people with osteoarthritis: in their own words. Disabil Rehabil [Internet]. 2022 [cited 2023 Jan 14]; Available from:https://pubmed.ncbi.nlm.nih.gov/36519505/[5]Reicherz A, Brach M, Cerny J, Nicolai S, Becker C, Lindemann U. Development of the Lie-to-Sit-to-Stand-to-Walk Transfer (LSSWT) test for early mobilization in older patients in geriatric rehabilitation. Z Gerontol Geriatr. 2011 Aug 21;44(4):262–7.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
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