Genç Erişkinlerde Ayak Bileği Hareket açıklığı, Kas Kuvveti ve Denge Arasındaki İlişki

Year 2020, Volume: 11 Issue: 2, 217 - 223, 15.06.2020

Murat Tomruk , Melda Soysal Tomruk , Emrullah Alkan , Nihal Gelecek

Abstract

AMAÇ: Ayak bileği ekleminin yeterli hareket açıklığına sahip olması ve ayak bileği çevresindeki kasların düzgün çalışmasının dengenin sağlanması, sürdürülmesi ve düşmelerin önlenmesi açısından önemli olduğu öne sürülmektedir. Çalışmanın amacı sağlıklı genç erişkinlerde ayak bileği hareket açıklığı, kas kuvveti ve denge arasındaki ilişkileri incelemek ve ek olarak statik ve dinamik dengeyi belirleyen ayak bileği ile ilişkili faktörleri tespit etmekti.
MATERYAL-METOT: Tanımlayıcı tipte olan çalışmaya 94 sağlıklı genç erişkin alındı. Bireylerin statik ve dinamik dengesi Biodex Denge Sistemi kullanılarak Duyusal Etkileşimli Denge (DED) Testi ve Kararlılık Sınırları Testi (KST) ile değerlendirildi. Dorsifleksiyon hareket açıklığı Ayak Yerde Öne Hamle (AYÖH) Testi ile, dorsifleksör kas kuvveti (DFKK) elle tutulur dinamometre ile ölçüldü. Değişkenler arasındaki ilişkinin analizi için Spearman Korelasyon Analizi, dengeyi belirleyen faktörlerin tespiti için doğrusal regresyon analizi yapıldı.
BULGULAR: Sol AYÖH ile DED testi sonuçlarından Gözler Kapalı Sert Zemin Salınım İndeksi (SZ Sİ) arasında pozitif yönde, düşük güçte korelasyon bulundu (p=0.038, r=0.214). KST skoru ile ise hiçbir değişken arasında anlamlı ilişki tespit edilmedi (p>0.05). Regresyon analizi sonuçlarına göre Gözler Açık SZ Sİ’nin tek anlamlı belirleyicisinin sol DFKK olduğu görüldü (p=0.047, varyasyonun %4’ü).
SONUÇ: Genç erişkinlerde dorsifleksiyon hareket açıklığı ile gözler açık sert zemin statik denge arasında negatif yönde anlamlı ilişki bulunmaktadır. Çalışmada statik dengenin tek belirleyicisinin sol DFKK olduğu görülmüş, ancak kas kuvveti varyasyonun %4 gibi oldukça düşük bir kısmını açıklamıştır.

Keywords

denge, ayak bileği, kas kuvveti, hareket açıklığı, genç erişkin

References

• Horak FB. Clinical measurement of postural control in adults. Phys Ther. 1987;67(12):1881-5.
• Kisner C, Colby LA, Borstad J. Therapeutic exercise: foundations and techniques, 6. baskı, Philadelphia: F.A. Davis; 2017.
• Balci B, Soysal Tomruk M. Denge Eğitimi. In: Gelecek N, editor. Terapatik Egzersiz Güncel Yaklaşımlar. İzmir: O’Tıp Kitabevi; 2016. p. 203-21.
• Gatev P, Thomas S, Kepple T, Hallett M.Feedforward ankle strategy of balance during quiet stance in adults. J Physiol, 1999;514(3):915-28.
• Shumway-Cook A, Wollacott MH. Motor Control: Theory and Practical Applications, 2. baskı. Baltimore: Williams and Wilkins Inc.; 2001.
• Han J, Anson J, Waddington G, Adams R, Liu Y. The role of ankle proprioception for balance control in relation to sports performance and injury. Biomed Res Int, 2015:842-4.
• Spink MJ, Fotoohabadi MR, Wee E, Hill KD, Lord SR, Menz HB. Foot and ankle strength, range of motion, posture, and deformity are associated with balance and functional ability in older adults. Arch Phys Med Rehabil, 2011;92(1):68-75.
• Pope R, Herbert R, Kirwan J. Effects of ankle dorsiflexion range and pre-exercise calf muscle stretching on injury risk in army recruits. Aust J Physiother, 1998;44(3):165-172.
• Khanuja K, Joki J, Bachmann G, ve ark. Gait and balance in the aging population: fall prevention using innovation and technology. Maturitas, 2018;110:51-6.
• 1Mecagni C, Smith JP, Roberts KE, O'Sullivan SB. Balance and ankle range of motion in community-dwelling women aged 64 to 87 years: a correlational study. Phys Ther, 2000;80(10):1004-11.
• Lord SR, Clark RD, Webster IW. Postural stability and associated physiological factors in a population of aged persons. J Gerontol, 1991;46(3):69-76.
• Aoyama M, Suzuki Y, Onishi J, Kuzuya M. Physical and functional factors in activities of daily living that predict falls in community-dwelling older women. Geriatr Gerontol Int, 2011;11(3):348-57.
• Park YH, Park SH, Kim SH, Choi GW, Kim HJ. Relationship between isokinetic muscle strength and functional tests in chronic ankle instability. J Foot Ankle Surg, 2019;58(6):1187-1191.
• Terada M, Harkey MS, Wells AM, Pietrosimone BG, Gribble PA. The influence of ankle dorsiflexion and self-reported patient outcomes on dynamic postural control in participants with chronic ankle instability. Gait Posture, 2014;40(1):193-7.
• Sherafat S, Salavati M, Takamjani E, Akhbari B, Mohammadirad S, Mazaheri M ve ark. Intrasession and intersession reliability of postural control in participants with and without nonspecific low back pain using the Biodex Balance System. J Manipulative Physiol Ther, 2013;36(2):111-8.
• Pickerill ML ve Harter RA. Validity and reliability of limits-of-stability testing: a comparison of 2 postural stability evaluation devices. J Athl Train, 2011;46(6):600-6.
• Powden CJ, Hoch JM, Hoch MC. Reliability and minimal detectable change of the weight-bearing lunge test: A systematic review. Man Ther, 2015;20(4):524-32.
• Kimura M, Ogata Y, Akebi T, Ochi M, Hachisuka K, Saeki S. Development and reliability of a hand-held dynamometer device to measure the ankle dorsiflexor muscle strength. J Rehabil Assist Technol Eng, 2018;5:205-16.
• Streiner DL, Norman GR, Cairney J. Health measurement scales: a practical guide to their development and use, 5. baskı. Oxford: Oxford University Press; 2015.
• Gajdosik RL, Vander Linden DW, Williams AK. Influence of age on length and passive elastic stiffness characteristics of the calf muscle-tendon unit of women. Phys Ther, 1999;79(9):827-38.
• Loram ID, Maganaris CN, Lakie M. The passive, human calf muscles in relation to standing: the non-linear decrease from short range to long range stiffness. J Physiol, 2007;584(2):661-75.
• Bok SK, Lee TH, Lee SS. The effects of changes of ankle strength and range of motion according to aging on balance. Ann Rehabil Med, 2013;37(1):10-6.
• Kim SG ve Kim WS. Effect of ankle range of motion (ROM) and lower-extremity muscle strength on static balance control ability in young adults: a regression analysis. Med Sci Monit, 2018;24:3168-75.
• Sahin N, Baskent A, Cakmak A, Salli A, Ugurlu H, Berker E. Evaluation of knee proprioception and effects of proprioception exercise in patients with benign joint hypermobility syndrome. Rheumatol Int, 2008;28(10):995-1000.
• Ferrell WR, Tennant N, Sturrock RD, Ashton L, Creed G, Brydson G ve ark. Amelioration of symptoms by enhancement of proprioception in patients with joint hypermobility syndrome. Arthritis Rheum, 2004;50(10):3323-8.
• Miller HN, Rice PE, Felpel ZJ, Stirling AM, Bengtson EN, Needle AR. Influence of mirror feedback and ankle joint laxity on dynamic balance in trained ballet dancers. J Dance Med Sci, 2018;22(4):184-191.
• Barone R, Macaluso F, Traina M, Leonardi V, Farina F, Di Felice V. Soccer players have a better standing balance in nondominant one-legged stance. Open Access J Sports Med, 2010;2:1-6.
• Laughton CA, Slavin M, Katdare K, Nolan L, Bean JF, Kerrigan DC ve ark. Aging, muscle activity, and balance control: physiologic changes associated with balance impairment. Gait Posture, 2003;18(2):101-8.
• Handrigan GA, Berrigan F, Hue O, Simoneau M, Corbeil P, Tremblay A ve ark. The effects of muscle strength on center of pressure-based measures of postural sway in obese and heavy athletic individuals. Gait Posture, 2012;35(1):88-91.
• Muehlbauer, T., A. Gollhofer, and U. Granacher, Association of balance, strength, and power measures in young adults. J Strength Cond Res, 2013. 27(3): p. 582-9.
• Muehlbauer T, Gollhofer A, Granacher U. Associations between measures of balance and lower-extremity muscle strength/power in healthy individuals across the lifespan: a systematic review and meta-analysis. Sports Med, 2015;45(12):1671-92.
• Greve J, Alonso A, Bordini AC, Camanho GL. Correlation between body mass index and postural balance. Clinics (Sao Paulo), 2007;2(6):717-20.
• Southard V, Dave A, Douris P. Exploring the role of body mass index on balance reactions and gait in overweight sedentary middle-aged adults: a pilot study. J Prim Care Community Health, 2010;1(3):178-83.
• Hue O, Simoneau M, Marcotte J, Berrigan F, Dore J, Marceau P ve ark. Body weight is a strong predictor of postural stability. Gait Posture, 2007;26(1):32-8.
• Hergenroeder AL, Wert DM, Hile ES, Studenski SA, Brach JS. Association of body mass index with self-report and performance-based measures of balance and mobility. Phys Ther, 2011;91(8):1223-34.