AYAK BİLEĞİ EKİN DEFORMİTESİ OLAN TİP 2 DİYABET HASTALARINDA GERME EGZERSİZİNİN AYAK TABAN BASINCINA AKUT ETKİSİ

Yasin Yurt; Serpil Mıhçıoğlu; Mehtap Malkoç; Selma Uzuner; Buse Sezerel; Hayriye Tomaç

doi:10.21653/tjpr.665168

Research Article

AYAK BİLEĞİ EKİN DEFORMİTESİ OLAN TİP 2 DİYABET HASTALARINDA GERME EGZERSİZİNİN AYAK TABAN BASINCINA AKUT ETKİSİ

Year 2019, Volume: 30 Issue: 3, 176 - 182, 20.12.2019

Yasin Yurt , Serpil Mıhçıoğlu , Mehtap Malkoç , Selma Uzuner Buse Sezerel Hayriye Tomaç

https://doi.org/10.21653/tjpr.665168

Abstract

Amaç: Plantar fleksör kısalığına bağlı olarak gelişen ayak bileği ekin deformitesinin, tip 2 diyabeti
olan bireylerde ön ayak taban basıncını artırarak ülser oluşumuna neden olduğu bilinmektedir.
Amacımız ayak bileği ekin deformitesi olan tip 2 diyabetli bireylerde germe egzersizinin ayak taban
basıncına akut etkisini incelemekti.
Yöntem: Ayak bileği ekin deformitesi olan toplam 25 tip 2 diyabetli birey araştırmaya dahil edildi.
Bireylerin 21’i bilateral ve dördü unilateral ekin deformitesine sahip olduğu için, toplam 46 ayak
analiz edildi. Ekin deformitesi, diz ekstansiyonda iken ayak bileğinin 0°’den az dorsifleksiyonu olarak
tanımlandı. Ayak taban basıncı ölçümü için pedobarografik platform kullanıldı ve ayak tabanı 10
bölgeye ayrılarak tepe plantar basınç değerleri hesaplandı. Duvar kenarında 10 tekrarlı yapılan
plantar fleksör germe egzersizi öncesinde, hemen sonrasında ve aradan bir saat geçtikten sonra
aynı ölçüm tekrarlandı.
Sonuçlar: Germe egzersizinin hemen sonrasında yapılan ölçümlerde, dördüncü metatars bölgesi
hariç tüm metatars başlarında tepe plantar basınç azaldı (p<0,01). Germeden bir saat sonra yapılan
ölçüm sonuçları germe öncesi değerlere benzer bulundu (p>0,05).
Tartışma: Plantar fleksör kısalığı bulunan tip 2 diyabetlilerde tek setlik germe egzersizi ile ön ayak
taban basıncı kısa süreli olarak azalmaktadır. Plantar fleksörlerin esnekliğinin uzun süreli egzersiz
programları ile artırılması diyabetiklerde artmış olan ön ayak ülserleri riskini azaltabilir.

Keywords

Ayak Bileği, Diyabetik Ayak

References

1. Jaacks LM, Siegel KR, Gujral UP, Narayan KM. Type 2 diabetes: A 21st century epidemic. Best Pract Res Clin Endocrinol Metab. 2016;30(3):331-43.
2. Boulton AJ, Vileikyte L, Ragnarson-Tennvall G, Apelqvist J. The global burden of diabetic foot disease. Lancet. 2005;366(9498):1719-24.
3. Singh N, Armstrong DG, Lipsky BA. Preventing foot ulcers in patients with diabetes. JAMA. 2005;293(2):217-28.
4. Diyabet 2020 Vizyon ve Hedefler. 2010-2020 Ulusal Diyabet Stratejisi, Sonuç Dökümanı. Türk Diyabet Vakfı, İstanbul; 2010.
5. Ragnarson Tennvall G, Apelqvist J. Prevention of diabetes-related foot ulcers and amputations: a cost-utility analysis based on Markov model simulations. Diabetologia. 2001;44(11):2077-87.
6. Ortegon MM, Redekop WK, Niessen LW. Cost-effectiveness of prevention and treatment of the diabetic foot: a Markov analysis. Diabetes Care. 2004;27(4):901-7.
7. Vinik AI, Nevoret ML, Casellini C, Parson H. Diabetic neuropathy. Endocrinol Metab Clin North Am. 2003;42(4):747-87.
8. Tesfaye S, Chaturvedi N, Eaton SE, Ward JD, Manes C, Ionescu- Tirgoviste C, et al. Vascular risk factors and diabetic neuropathy. N Engl J Med. 2005;352(4):341-50.
9. Fowler MJ. Microvascular and macrovascular complications of diabetes. Clin Diabetes. 2008;26(2):77-82.
10. Crisp AJ, Heathcote JG. Connective tissue abnormalities in diabetes mellitus. J R Coll Physicians Lond. 1984;18(2):132-41.
11. Vlassara H, Brownlee M, Cerami A. Nonenzymatic glycosylation: role in the pathogenesis of diabetic complications. Clin Chem. 1986;32(Suppl 10):B37-41.
12. Mueller MJ, Diamond JE, Delitto A, Sinacore DR. Insensitivity, limited joint mobility, and plantar ulcers in patients with diabetes mellitus. Phys Ther. 1989;69(6):453-9.
13. Zimny S, Schatz H, Pfohl M. The role of limited joint mobility in diabetic patients with an at risk foot. Diabetes Care. 2004;27:942-86.
14. Lavery LA, Armstrong DG, Boulton AJ, Diabetes Research G. Ankle equinus deformity and its relationship to high plantar pressure in a large population with diabetes mellitus. J Am Podiatr Med Assoc. 2002;92(9):479-82.
15. Reiber GE, Lipsky BA, Gibbons GW. The burden of diabetic foot ulcers. Am J Surg. 1998;176(Suppl 2A):5-10.
16. Caselli A, Pham H, Giurini JM, Armstrong DG, Veves A. The forefoot-to-rearfoot plantar pressure ratio is increased in severe diabetic neuropathy and can predict foot ulceration. Diabetes Care. 2002;25(6):1066-71.
17. Orendurff MS, Rohr ES, Sangeorzan BJ, Weaver K, Czerniecki JM. An equinus deformity of the ankle accounts for only a small amount of the increased forefoot plantar pressure in patients with diabetes. J Bone Joint Surg Br. 2006;88(1):65-8.
18. Bus SA, Valk GD, van Deursen RW, Armstrong DG, Caravaggi C, Hlavacek P, et al. The effectiveness of footwear and offloading interventions to prevent and heal foot ulcers and reduce plantar pressure in diabetes: a systematic review. Diabetes Metab Rev. 2008;24(Suppl 1):162-80.
19. York RM, Perel-Gerson KL, Barr M, Durham J, Roper JM. Motor learning of a gait pattern to reduce forefoot plantar pressures in individuals with diabetic peripheral neuropathy. PM&R. 2009:1(5):434-41.
20. Pataky Z, Rodriguez DL, Golay A, Assal M, Assal JP, Hauert CA. Biofeedback for foot offloading in diabetic patients with peripheral neuropathy. Diabet Med. 2010:27:61-4.
21. Dijs HM, Roofthooft JM, Driessens MF, De Bock PG, Jacobs C, Van Acker KL. Effect of physical therapy on limited joint mobility in the diabetic foot: a pilot study. J Am Podiatr Med Assoc. 2000;90(3):126-32.
22. Goldsmith JR, Lidtke RH, Shott S. The effects of range-of-motion therapy on the plantar pressures of patients with diabetes mellitus. J Am Podiatr Med Assoc. 2002;92(9):483-90.
23. Sartor CD, Hasue RH, Cacciari LP, Butugan MK, Watari R, Passaro AC, et al. Effects of strengthening, stretching and functional training on foot function in patients with diabetic neuropathy: results of a randomized controlled trial. BMC Musculoskelet Disord. 2014;15(137):1-13.
24. Redmond AC, Crosbie J, Ouvrier RA. Development and validation of a novel rating system for scoring standing foot posture: the Foot Posture Index. Clin Biomech. 2006;21(1):89-98.
25. Guldemond NA, Leffers P, Sanders AP, Schaper NC, Nieman F, Walenkamp GHIM. Daily-life activities and in-shoe forefoot plantar pressure in patients with diabetes. Diabetes Res Clin Pract. 2007;77(2):203-9.
26. Apelqvist J, Bakker K, van Houtum WH, Nabuurs-Franssen MH, Schaper NC. International consensus and practical guidelines on the management and the prevention of the diabetic foot. International Working Group on the Diabetic Foot. Diabetes Metab Rev. 2000;16(Suppl 1):84-92.
27. Bus SA, Lange A. A comparison of the 1-step, 2-step and 3-step test protocols for obtaining barefoot plantar pressure data in the diabetic neuropathic foot. Clin Biomech. 2005;20(1):892-9.

Year 2019, Volume: 30 Issue: 3, 176 - 182, 20.12.2019

Yasin Yurt , Serpil Mıhçıoğlu , Mehtap Malkoç , Selma Uzuner Buse Sezerel Hayriye Tomaç

https://doi.org/10.21653/tjpr.665168

Abstract

References

1. Jaacks LM, Siegel KR, Gujral UP, Narayan KM. Type 2 diabetes: A 21st century epidemic. Best Pract Res Clin Endocrinol Metab. 2016;30(3):331-43.
2. Boulton AJ, Vileikyte L, Ragnarson-Tennvall G, Apelqvist J. The global burden of diabetic foot disease. Lancet. 2005;366(9498):1719-24.
3. Singh N, Armstrong DG, Lipsky BA. Preventing foot ulcers in patients with diabetes. JAMA. 2005;293(2):217-28.
4. Diyabet 2020 Vizyon ve Hedefler. 2010-2020 Ulusal Diyabet Stratejisi, Sonuç Dökümanı. Türk Diyabet Vakfı, İstanbul; 2010.
5. Ragnarson Tennvall G, Apelqvist J. Prevention of diabetes-related foot ulcers and amputations: a cost-utility analysis based on Markov model simulations. Diabetologia. 2001;44(11):2077-87.
6. Ortegon MM, Redekop WK, Niessen LW. Cost-effectiveness of prevention and treatment of the diabetic foot: a Markov analysis. Diabetes Care. 2004;27(4):901-7.
7. Vinik AI, Nevoret ML, Casellini C, Parson H. Diabetic neuropathy. Endocrinol Metab Clin North Am. 2003;42(4):747-87.
8. Tesfaye S, Chaturvedi N, Eaton SE, Ward JD, Manes C, Ionescu- Tirgoviste C, et al. Vascular risk factors and diabetic neuropathy. N Engl J Med. 2005;352(4):341-50.
9. Fowler MJ. Microvascular and macrovascular complications of diabetes. Clin Diabetes. 2008;26(2):77-82.
10. Crisp AJ, Heathcote JG. Connective tissue abnormalities in diabetes mellitus. J R Coll Physicians Lond. 1984;18(2):132-41.
11. Vlassara H, Brownlee M, Cerami A. Nonenzymatic glycosylation: role in the pathogenesis of diabetic complications. Clin Chem. 1986;32(Suppl 10):B37-41.
12. Mueller MJ, Diamond JE, Delitto A, Sinacore DR. Insensitivity, limited joint mobility, and plantar ulcers in patients with diabetes mellitus. Phys Ther. 1989;69(6):453-9.
13. Zimny S, Schatz H, Pfohl M. The role of limited joint mobility in diabetic patients with an at risk foot. Diabetes Care. 2004;27:942-86.
14. Lavery LA, Armstrong DG, Boulton AJ, Diabetes Research G. Ankle equinus deformity and its relationship to high plantar pressure in a large population with diabetes mellitus. J Am Podiatr Med Assoc. 2002;92(9):479-82.
15. Reiber GE, Lipsky BA, Gibbons GW. The burden of diabetic foot ulcers. Am J Surg. 1998;176(Suppl 2A):5-10.
16. Caselli A, Pham H, Giurini JM, Armstrong DG, Veves A. The forefoot-to-rearfoot plantar pressure ratio is increased in severe diabetic neuropathy and can predict foot ulceration. Diabetes Care. 2002;25(6):1066-71.
17. Orendurff MS, Rohr ES, Sangeorzan BJ, Weaver K, Czerniecki JM. An equinus deformity of the ankle accounts for only a small amount of the increased forefoot plantar pressure in patients with diabetes. J Bone Joint Surg Br. 2006;88(1):65-8.
18. Bus SA, Valk GD, van Deursen RW, Armstrong DG, Caravaggi C, Hlavacek P, et al. The effectiveness of footwear and offloading interventions to prevent and heal foot ulcers and reduce plantar pressure in diabetes: a systematic review. Diabetes Metab Rev. 2008;24(Suppl 1):162-80.
19. York RM, Perel-Gerson KL, Barr M, Durham J, Roper JM. Motor learning of a gait pattern to reduce forefoot plantar pressures in individuals with diabetic peripheral neuropathy. PM&R. 2009:1(5):434-41.
20. Pataky Z, Rodriguez DL, Golay A, Assal M, Assal JP, Hauert CA. Biofeedback for foot offloading in diabetic patients with peripheral neuropathy. Diabet Med. 2010:27:61-4.
21. Dijs HM, Roofthooft JM, Driessens MF, De Bock PG, Jacobs C, Van Acker KL. Effect of physical therapy on limited joint mobility in the diabetic foot: a pilot study. J Am Podiatr Med Assoc. 2000;90(3):126-32.
22. Goldsmith JR, Lidtke RH, Shott S. The effects of range-of-motion therapy on the plantar pressures of patients with diabetes mellitus. J Am Podiatr Med Assoc. 2002;92(9):483-90.
23. Sartor CD, Hasue RH, Cacciari LP, Butugan MK, Watari R, Passaro AC, et al. Effects of strengthening, stretching and functional training on foot function in patients with diabetic neuropathy: results of a randomized controlled trial. BMC Musculoskelet Disord. 2014;15(137):1-13.
24. Redmond AC, Crosbie J, Ouvrier RA. Development and validation of a novel rating system for scoring standing foot posture: the Foot Posture Index. Clin Biomech. 2006;21(1):89-98.
25. Guldemond NA, Leffers P, Sanders AP, Schaper NC, Nieman F, Walenkamp GHIM. Daily-life activities and in-shoe forefoot plantar pressure in patients with diabetes. Diabetes Res Clin Pract. 2007;77(2):203-9.
26. Apelqvist J, Bakker K, van Houtum WH, Nabuurs-Franssen MH, Schaper NC. International consensus and practical guidelines on the management and the prevention of the diabetic foot. International Working Group on the Diabetic Foot. Diabetes Metab Rev. 2000;16(Suppl 1):84-92.
27. Bus SA, Lange A. A comparison of the 1-step, 2-step and 3-step test protocols for obtaining barefoot plantar pressure data in the diabetic neuropathic foot. Clin Biomech. 2005;20(1):892-9.

There are 27 citations in total.

Details

Primary Language	Turkish
Subjects	Health Care Administration
Journal Section	Araştırma Makaleleri
Authors	Yasin Yurt Serpil Mıhçıoğlu Mehtap Malkoç Selma Uzuner This is me Buse Sezerel This is me Hayriye Tomaç This is me
Publication Date	December 20, 2019
Published in Issue	Year 2019 Volume: 30 Issue: 3

Cite

APA	Yurt, Y., Mıhçıoğlu, S., Malkoç, M., Uzuner, S., et al. (2019). AYAK BİLEĞİ EKİN DEFORMİTESİ OLAN TİP 2 DİYABET HASTALARINDA GERME EGZERSİZİNİN AYAK TABAN BASINCINA AKUT ETKİSİ. Türk Fizyoterapi Ve Rehabilitasyon Dergisi, 30(3), 176-182. https://doi.org/10.21653/tjpr.665168
AMA	Yurt Y, Mıhçıoğlu S, Malkoç M, Uzuner S, Sezerel B, Tomaç H. AYAK BİLEĞİ EKİN DEFORMİTESİ OLAN TİP 2 DİYABET HASTALARINDA GERME EGZERSİZİNİN AYAK TABAN BASINCINA AKUT ETKİSİ. Turk J Physiother Rehabil. December 2019;30(3):176-182. doi:10.21653/tjpr.665168
Chicago	Yurt, Yasin, Serpil Mıhçıoğlu, Mehtap Malkoç, Selma Uzuner, Buse Sezerel, and Hayriye Tomaç. “AYAK BİLEĞİ EKİN DEFORMİTESİ OLAN TİP 2 DİYABET HASTALARINDA GERME EGZERSİZİNİN AYAK TABAN BASINCINA AKUT ETKİSİ”. Türk Fizyoterapi Ve Rehabilitasyon Dergisi 30, no. 3 (December 2019): 176-82. https://doi.org/10.21653/tjpr.665168.
EndNote	Yurt Y, Mıhçıoğlu S, Malkoç M, Uzuner S, Sezerel B, Tomaç H (December 1, 2019) AYAK BİLEĞİ EKİN DEFORMİTESİ OLAN TİP 2 DİYABET HASTALARINDA GERME EGZERSİZİNİN AYAK TABAN BASINCINA AKUT ETKİSİ. Türk Fizyoterapi ve Rehabilitasyon Dergisi 30 3 176–182.
IEEE	Y. Yurt, S. Mıhçıoğlu, M. Malkoç, S. Uzuner, B. Sezerel, and H. Tomaç, “AYAK BİLEĞİ EKİN DEFORMİTESİ OLAN TİP 2 DİYABET HASTALARINDA GERME EGZERSİZİNİN AYAK TABAN BASINCINA AKUT ETKİSİ”, Turk J Physiother Rehabil, vol. 30, no. 3, pp. 176–182, 2019, doi: 10.21653/tjpr.665168.
ISNAD	Yurt, Yasin et al. “AYAK BİLEĞİ EKİN DEFORMİTESİ OLAN TİP 2 DİYABET HASTALARINDA GERME EGZERSİZİNİN AYAK TABAN BASINCINA AKUT ETKİSİ”. Türk Fizyoterapi ve Rehabilitasyon Dergisi 30/3 (December 2019), 176-182. https://doi.org/10.21653/tjpr.665168.
JAMA	Yurt Y, Mıhçıoğlu S, Malkoç M, Uzuner S, Sezerel B, Tomaç H. AYAK BİLEĞİ EKİN DEFORMİTESİ OLAN TİP 2 DİYABET HASTALARINDA GERME EGZERSİZİNİN AYAK TABAN BASINCINA AKUT ETKİSİ. Turk J Physiother Rehabil. 2019;30:176–182.
MLA	Yurt, Yasin et al. “AYAK BİLEĞİ EKİN DEFORMİTESİ OLAN TİP 2 DİYABET HASTALARINDA GERME EGZERSİZİNİN AYAK TABAN BASINCINA AKUT ETKİSİ”. Türk Fizyoterapi Ve Rehabilitasyon Dergisi, vol. 30, no. 3, 2019, pp. 176-82, doi:10.21653/tjpr.665168.
Vancouver	Yurt Y, Mıhçıoğlu S, Malkoç M, Uzuner S, Sezerel B, Tomaç H. AYAK BİLEĞİ EKİN DEFORMİTESİ OLAN TİP 2 DİYABET HASTALARINDA GERME EGZERSİZİNİN AYAK TABAN BASINCINA AKUT ETKİSİ. Turk J Physiother Rehabil. 2019;30(3):176-82.

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