Gait and Balance Parameters Before and After Parathyroidectomy in Patients With Primary Hyperparathyroidism
Gait and Balance Parameters Before and After Parathyroidectomy in Patients With Primary Hyperparathyroidism
This study will evaluate how Quadriceps Femoris muscle fatigue protocol affect the
 spatio-temporal gait parameters, gait symmetry and balance in individuals with primary
 hyperparathyroidism before and after parathyroidectomy. Study group will consist of 20
 subjects with primary hyperparathyroidism and control group will consist of 20 healthy
 subjects.
Parathyroid hormone, released from the parathyroid gland, plays an important role in keeping
 the ionized calcium in between the reference values in body. Precise control of ionized
 calcium is particularly necessary to ensure the optimal function of physiological processes
 such as providing intracellular signaling, performing neuromuscular functions and bone
 metabolism. When there is a decrease in the level of ionized calcium in the systemic
 circulation due to any reason, increased calcium concentration is maintained as a result of
 the increased absorption of calcium from the kidneys, bones and intestines into the blood via
 increased parathyroid hormone. An error caused by any of the components in this regulatory
 system may cause excessive parathyroid hormone release, causing primary, secondary or
 tertiary hyperparathyroidism. Primary hyperparathyroidism is a common endocrinological
 disorder, which is characterized by excessive release of parathyroid hormone, resulting in a
 defect in the regulation of calcium metabolism. Primary Hyperparathyroidism is the third most
 common endocrine disease and is the most common cause of hypercalcemia. Today, Primary
 Hyperparathyroidism is approximately 0.25-0.66% of the population and it is seen as 3: 1
 times more common in women than men. While the incidence of the disease increases with age,
 it increases dramatically after 50 years of age. The clinical presentation of Primary
 Hyperparathyroidism ranges from asymptomatic disease to the classical symptomatic disease of
 renal and / or musculoskeletal complications. Low plasma 25 Hydroxyvitamin D level; bone
 mineral density, muscle strength, preservation of postural stability and functional
 performance of the musculoskeletal functions such as disruption caused by the person's
 walking and balance activities are adversely affected.In addition, fatigue, pain, and body
 mass index, as a result of the increase in the functional capacity of the person is seriously
 reduced quality of life and psychosocial status is adversely affected. Although there are
 studies related to bone mineral density, muscle strength and function, instability, fatigue,
 etc., which are secondary to PHPT and cause a significant decrease in functional capacity,
 there is no study to investigate the effect of M. quadriceps Femoris ,which has a key role in
 the evaluation of functional capacity, muscle fatigue on the gait and balance parameters in
 the pre and post-treatment period in the literature. The aim of this case-control study is to
 investigate the effect of Quadriceps Femoris muscle fatigue protocol on gait, gait symmetry
 and balance parameters before and after parathyroidectomy in patients Primary
 Hyperparathyroidism and to compare that parameters of these individuals with healthy controls
 with similar demographic characteristics that included in the control group.
Inclusion Criteria:

 -  Study group, include cases with a Primary Hyperparathyroidism

 -  Control group consists of healthy adults with the similar demographic characteristics
 as study group.

 Exclusion Criteria:

 -  The presence of osteoarticular deformities

 -  Walking with assist device

 -  Having a neurological disease that may affect the performance

 -  To have significant and irreversible visual deficits

 -  The body mass index (BMI) is greater than> 40 kg / m²

 -  There is an inability to prevent any of the tests

 -  Individuals with cancer history and chemotherapy (over the last 5 years)

 -  Plasma creatinine level> 150 µmol / L

 -  Use of Cinacalcet or Etalpha

 -  Having a history of diabetes mellitus