Publication: Fonksiyonel kalça eklem merkezi metodunun serebral palsili çocuklarda değerlendirilmesi
Abstract
Amaç: Bu çalışmanın birinci bölümündeki amacı, fonksiyonel kalibrasyon hareketlerinin kalça eklem merkezine (KEM) olan etkilerinin araştırılmasıdır. İkinci ve üçüncü bölümde ise farklı KEM’lerin ve diz eklemi mediolateral eksenlerinin kinematik sonuçlara olan etkilerinin araştırılmasıdır.Gereç ve yöntem: Çalışmaya toplamda 33 SP’li birey dâhil edildi. Çalışmamızın birinci aşamasında kalibrasyon hareketlerinin karakteristiklerinin (hareket tipi, tekrar sayısı ve optik işaretleyici seti) KEM üzerine etkileri değerlendirildi. İkinci aşamada farklı fonksiyonel KEM’lerin ve diz eklemi mediolateral eksenlerinin kinematik sonuçlar üzerine etkileri Yürüyüş Profil Skoru (GPS) ve pik kinematik değerler kullanılarak değerlendirildi. Ayrıca, kinematik verilerin dalga formlarının karekök ortalama (RMS) farkı ve normal ortalama farkı incelendi. Üçüncü aşamada ise fonksiyonel ve tahmin edici metodun kinematik verilere etkileri incelendi.Bulgular: Çalışmanın ilk aşamasında fonksiyonel kalça kalibrasyon hareketinin tipi, SCoRE Residual’ı ve konvansiyonel metoda olan lineer uzaklığı birlikte etkileyen tek faktör olarak bulundu. (p<0,001). Hareketlerin tekrar sayısının sonuçlar üzerinde anlamlı bir fark yaratmadığı belirlendi (p=0,387). Çalışmanın ikinci aşamasında farklı fonksiyonel KEM’ler ve diz ekleminin mediolateral ekseni GPS’i klinik açıdan etkilemedi. Son aşamada ise fonksiyonel ve tahmin edici metot ile elde edilen kalça eklemi kinematik verileri arasında klinik açıdan anlamlı bir fark saptandı.Sonuç: Fonksiyonel kalça kalibrasyon hareketinin tipi KEM’in üç boyutlu düzlemdeki konumunu etkilemektedir. SP’li bireylerin yürüyüş analizi kinematik sonuçları konvansiyonel metodun yanında fonksiyonel metot ile de değerlendirilmelidir.
Objective: The aim of the first part of this study is to investigate the effects of functional calibration movements on the hip joint center (HJC). In the second and third chapters, the aim is to investigate the effects of different HJCs and knee joint mediolateral axes on kinematic results.Material and methods: A total of 33 individuals with CP were included in the study. In the first stage of our study, the effects of the characteristics of the calibration movements (movement type, number of repetitions and marker set) on HJC were evaluated. In the second stage, the effects of different functional HJCs and knee joint mediolateral axes on kinematic outcomes were evaluated using the Gait Profile Score (GPS) and peak kinematic values. In addition, the root mean square difference and the mean difference of the waveforms of kinematic data were investigated. In the third stage, the effects of functional and predictive methods on kinematic data were examined.Results: In the first phase of the study, the type of functional hip calibration motion was found to be the only factor that both affected the SCORE Residual and the linear distance to the conventional method. (p<0.001). It was determined that the number of repetitions of the movements did not make a significant difference in the results (p=0.387). In the second phase of the study, different functional HJCs and the mediolateral axis of the knee joint did not clinically affect GPS. At the last stage, a clinically significant difference was detected between the hip joint kinematics obtained with the functional and predictive method.Conclusion: The type of functional hip calibration movement affects the position of HJC in the three-dimensional plane. The kinematic results of gait analysis of individuals with CP should be evaluated with the functional method as well as the conventional method.
Objective: The aim of the first part of this study is to investigate the effects of functional calibration movements on the hip joint center (HJC). In the second and third chapters, the aim is to investigate the effects of different HJCs and knee joint mediolateral axes on kinematic results.Material and methods: A total of 33 individuals with CP were included in the study. In the first stage of our study, the effects of the characteristics of the calibration movements (movement type, number of repetitions and marker set) on HJC were evaluated. In the second stage, the effects of different functional HJCs and knee joint mediolateral axes on kinematic outcomes were evaluated using the Gait Profile Score (GPS) and peak kinematic values. In addition, the root mean square difference and the mean difference of the waveforms of kinematic data were investigated. In the third stage, the effects of functional and predictive methods on kinematic data were examined.Results: In the first phase of the study, the type of functional hip calibration motion was found to be the only factor that both affected the SCORE Residual and the linear distance to the conventional method. (p<0.001). It was determined that the number of repetitions of the movements did not make a significant difference in the results (p=0.387). In the second phase of the study, different functional HJCs and the mediolateral axis of the knee joint did not clinically affect GPS. At the last stage, a clinically significant difference was detected between the hip joint kinematics obtained with the functional and predictive method.Conclusion: The type of functional hip calibration movement affects the position of HJC in the three-dimensional plane. The kinematic results of gait analysis of individuals with CP should be evaluated with the functional method as well as the conventional method.