Obez Çocuklarda Omurganın Yapısı ve Mobilitesi ile Denge Arasındaki İlişkilerin İncelenmesi: Ön Çalışma

Year 2022, Volume: 7 Issue: 3, 571 - 576, 30.09.2022

Sevtap Günay Uçurum , Damla Karabay , Hilal Uzunlar , Derya Özer Kaya , Berna Eroğlu Filibeli , Bumin Dündar

Abstract

Amaç: Obeziteye bağlı artmış vücut kütlesi ve ağırlık merkezinin değişmesi omurganın yapısı ve mobilitesiyle birlikte dengeyi de etkileyebilmektedir. Bu çalışmanın amacı obez çocuklarda omurga yapı ve mobilitesi ile denge arasındaki ilişkilerin incelenmesiydi.
Gereç ve Yöntem: Çalışmaya obezite tanısı almış, ortanca yaşları 14 yıl (IQR 25/75: 12/16 yıl) ve ortanca vücut kütle indeksleri 34,9 kg/m² (IQR 25/75: 31,9/37,8 kg/m²) olan 14 çocuk dahil edildi. Denge, bilgisayar destekli bir cihaz kullanılarak, omurga yapı ve mobilitesi ise Hocoma Valedo-Shape® cihazı ile değerlendirildi.
Bulgular: Torakal bölge yapısı ile çift ayak gözler açık (r=0,537, p=0,048) ve gözler kapalı denge skorları (r=0,562, p=0,037) arasında orta düzeyde istatiksel olarak anlamlı ilişki tespit edildi. Torakal ve lumbal bölge mobilitesi, lumbal bölge yapısı, sakral/spinal inklinasyon değerleri ile denge parametreleri arasında anlamlı ilişkiler saptanamadı (p>0,05).
Sonuç: Sonuçlarımıza göre, omurganın yapısı ile denge arasında pozitif yönde bir ilişki bulunmaktadır. Özellikle torakal bölgedeki omurga kifotik açı değerinin artması önarka yöndeki salınımları arttırarak dengeyi olumsuz yönde etkileyebilmektedir. Obez çocukların gelişimleri boyunca omurga yapı ve mobilitelerinin takibinin yapılmasının ileriki problemlerin önlenmesinde önemli olduğunu düşünmekteyiz.

Keywords

Obezite, çocuk, omurga açısı, omurga hareketliliği, denge

Supporting Institution

Çalışmada kullanılan cihaz ve ekipmanlar için İKÇÜ Bilimsel Araştırmalar Proje koordinatörlüğüne teşekkür ederiz

Project Number

2018-GAP-SABF-00072017-2ÖNP-SABF-0008)

Thanks

Çalışmamızda veri toplama aşamasına destek olan İlknur Naz Gürşan, Yağız Meteoğlu, Büşra Yaldız ve Büşra Aktaş’a teşekkür ederiz.

Investigation of the Relationships between Structure and Mobility of the Spine and Balance in Obese Children: A Preliminary Study

Abstract

Objective: Increased body mass and changes in the center of gravity due to obesity may affect the structure and mobility of the spine along with balance. The aim of the present study was to examine the relationships between structure and mobility of the spine and balance in obese children.
Material and Method: Fourteen children who were diagnosed with obesity, with a median age of 14 years (IQR 25/75: 12/16 years), and with a median body mass index of 34.9 kg/m² (IQR 25/75: 31.9/37.8 kg/m²) were included. Balance was assessed by using a computer assisted device, while structure and mobility of the spine was evaluated with the Hocoma Valedo-Shape® device.
Results: A moderate statistically significant relationship was found between the structure of the thoracic region and the balance scores of double leg standing with eyes open (r=0.537, p=0.048), and eyes closed (r=0.562, p=0.037). No significant correlations were detected between balance parameters and mobility of thoracic and lumbar regions, structure of lumbar region, and sacral/spinal inclination values (p>0.05).
Conclusion: According to our results, there is a positive relationship between the structure of the spine and balance. The increase in the kyphotic angle of the spine, especially in the thoracic region, may negatively affect the balance by increasing the oscillations in the anterior-posterior direction. We think that monitoring the structure and mobility of the spine of obese children throughout their developments is important for preventing further problems.

Keywords

Obesity, child, spine angle, spine mobility, balance

Project Number

2018-GAP-SABF-00072017-2ÖNP-SABF-0008)

References

• Morales Camacho WJ, Molina Díaz JM, Plata Ortiz S, Plata Ortiz JE, Morales Camacho MA, Calderón BP. Childhood obesity: Aetiology, comorbidities, and treatment. Diabetes Metab Res Rev. 2019 Nov;35(8):e3203.
• Grant-Guimaraes J, Feinstein R, Laber E, Kosoy J. Childhood Overweight and Obesity. Gastroenterol Clin North Am. 2016 Dec;45(4):715-728.
• Pulgaron ER, Delamater AM. Obesity and type 2 diabetes in children: epidemiology and treatment. Curr Diab Rep. 2014 Aug;14(8):508.
• Sinha R, Fisch G, Teague B, Tamborlane WV, Banyas B, Allen K, et al. Prevalence of impaired glucose tolerance among children and adolescents with marked obesity. N Engl J Med. 2002 Mar 14;346(11):802-10.
• Weiss R, Dziura J, Burgert TS, Tamborlane WV, Taksali SE, Yeckel CW, et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med. 2004 Jun 3;350(23):2362-74.
• Merder-Coşkun D, Uzuner A, Keniş-Coşkun Ö, Çelenlioğlu AE, Akman M, Karadağ-Saygı E. Relationship between obesity and musculoskeletal system findings among children and adolescents. Turk J Phys Med Rehabil. 2017 Aug 14;63(3):207-214.
• Wearing SC, Hennig EM, Byrne NM, Steele JR, Hills AP. Musculoskeletal disorders associated with obesity: a biomechanical perspective. Obesity reviews. 2006 Aug;7(3):239-50.
• Akkaya S, Akkaya N. Obezite ve Kas İskelet Sistemi. Turkiye Klinikleri J Endocrin-Special Topics. 2013;6(1):60-4.
• Steinberg N, Nemet D, Pantanowitz M, Eliakim A. Gait Pattern, Impact to the Skeleton and Postural Balance in Overweight and Obese Children: A Review. Sports (Basel). 2018 Jul 31;6(3):75.
• Menegoni F, Galli M, Tacchini E, Vismara L, Cavigioli M, Capodaglio P. Gender-specific effect of obesity on balance. Obesity (Silver Spring). 2009 Oct;17(10):1951-6.
• Dimitri P. The Impact of Childhood Obesity on Skeletal Health and Development. J Obes Metab Syndr. 2019 Mar;28(1):4-17.
• Han A, Fu A, Cobley S, Sanders RH. Effectiveness of exercise intervention on improving fundamental movement skills and motor coordination in overweight/obese children and adolescents: A systematic review. J Sci Med Sport. 2018 Jan;21(1):89-102.
• Tisano A, Alito A, Milardi D, Fazio R, Virelli L, Zanella C, et al. Statistical investigation about spinal clinical asymmetry in a school population. J Orthop. 2020 Aug 18; 22:336-340.
• Jankowicz-Szymańska A, Bibro M, Wodka K, Smola E. Does Excessive Body Weight Change the Shape of the Spine in Children? Child Obes. 2019 Jul;15(5):346-352.
• Wyszyn´ska J, Podgo´rska-Bednarz J, Drza1-Grabiec J, Rachwał M, Baran J, Czenczek-Lewandowska E, et.al. Analysis of relationship between the body mass composition and physical activity with body posture in children. Biomed Res Int 2016; Article ID 1851670:1–10.
• Kuligowski T, Cieślik B, Radziszewski Ł, Czerwiński B, Pióro A. Body Somatic Type Influence on the Spinal Curvatures in Early Age School Children: Preliminary Report. Dev Period Med. 2015 Jul 1;19(3 Pt 2):362- 6.
• Onan D, Ulger O. Investigating the Relationship between Body Mass Index and Pain in the Spine in Children or Adolescents: A Systematic Review. Child Obes. 2021 Mar;17(2):86-99.
• Coelho JJ, Graciosa MD, de Medeiros DL, Pacheco SC, da Costa LM, Ries LG. Influência da flexibilidade e sexo na postura de escolares [Influence of flexibility and gender on the posture of school children]. Rev Paul Pediatr. 2014 Sep;32(3):223-8.
• Colné P, Frelut ML, Pérès G, Thoumie P. Postural control in obese adolescents assessed by limits of stability and gait initiation. Gait Posture. 2008 Jul;28(1):164-9.
• Goulding A, Jones IE, Taylor RW, Piggot JM, Taylor D. Dynamic and static tests of balance and postural sway in boys: effects of previous wrist bone fractures and high adiposity. Gait Posture. 2003 Apr;17(2):136-41.
• Maffeis C, Tatò L. Long-term effects of childhood obesity on morbidity and mortality. Horm Res. 2001;55 Suppl 1:42-5.
• Di Sipio E, Aprile I, Germanotta M, Pecchioli,C, Galli M, Pitocco D, et.al. Technological rehabilitation in patients with diabetic neuropathy: Effects on balance and gait. Gait Posture. 2017; 57:38-39.
• Ye J, Simpson MW, Liu Y, Lin W, Zhong W, Cai S, Zou L. The Effects of Baduanjin Qigong on Postural Stability, Proprioception, and Symptoms of Patients With Knee Osteoarthritis: A Randomized Controlled Trial. Front Med (Lausanne). 2020 Jan 10; 6:307.
• Mannion AF, Knecht K, Balaban G, Dvorak J, Grob D. A new skin-surface device for measuring the curvature and global and segmental ranges of motion of the spine: reliability of measurements and comparison with data reviewed from the literature. Eur Spine J. 2004;13(2):122-36.
• Karakuş A, Özer Kaya D, Toprak Çelenay Ş. Primer Dismenoresi Olan ve Olmayan Kadınlarda Omurga Postür ve Mobilitesinin Karşılaştırılması, Turk J Physiother Rehabil. 2021; 32(1):20-27.
• Aghaei M, Javad S, editors. Effect of Overweight and Obesity on Spinal Deformities for Children 5-7 Years. 54th Annual European Society for Paediatric Endocrinology; 2015 October 1-3; Horm Res Paediatr. 82(1).
• Kılıç BB, Akgül H, Çolak TK. Adolesanlarda Omurganın Sagital Düzlem Dizilimi. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi; 2020; 8(1):23-8.
• Vismara L, Menegoni F, Zaina F, Galli M, Negrini S, Capodaglio P. Effect of obesity and low back pain on spinal mobility: a cross sectional study in women. J Neuroeng Rehabil. 2010 Dec;7(1):1-8.
• González-Sánchez M, Luo J, Lee R, Cuesta-Vargas AI. Spine curvature analysis between participants with obesity and normal weight participants: a biplanar electromagnetic device measurement. Biomed Res Int. 2014;2014:935151.
• Hershkovich O, Friedlander A, Gordon B, Arzi H, Derazne E, Tzur D, Shamiss A, Afek A. Association between body mass index, body height, and the prevalence of spinal deformities. Spine J. 2014 Aug 1;14(8):1581-7.
• Brzęk A, Sołtys J, Gallert-Kopyto W, Gwizdek K, Plinta R. Body posture in children with obesity-the relationship to physical activity (PA). Pediatr Endocrinol Diabetes Metab. 2016;22(4):148-155.
• Demir A, Akın M. The Effect of Exergame Education on Balance in Children. Malaysian Online Journal of Educational Technology, 2020, 8.3: 100-107.
• Cruz-Gómez NS, Plascencia G, Villanueva-Padrón LA, Jáuregui- Renaud K. Influence of obesity and gender on the postural stability during upright stance. Obes Facts. 2011;4(3):212-7.
• Deforche BI, Hills AP, Worringham CJ, Davies PS, Murphy AJ, Bouckaert JJ, et.al. Balance and postural skills in normal-weight and overweight prepubertal boys. Int J Pediatr Obes. 2009 Jan 1;4(3):175-82.
• Sasidharan A, Vijayappan V, Pillai S, Khan F. Correlation between obesity and balance in school children. Int J Ther Rehabil. 2014, 21.1: 36-39.
• de Mello AP, Martins GCDS, Heringer AR, Gamallo RB, Martins Filho LFDS, de Abreu AV, et al. Back pain and sagittal spine alignment in obese patients eligible for bariatric surgery. Eur Spine J. 2019 May;28(5):967- 975.