4 haftalık dinamik denge antrenmanı ayak bileği ve diz eklemi pozisyon algılama hissini geliştiremedi

Amaç: Çalışmalar denge antrenmanının denge antrenmanını geliştirdiğini ve tekrar eden sakatlıkları azalttığı net bir şekilde ortaya koymuştur. Bununla beraber denge antrenmanının proprioseptif çıktılar (pozisyon algılama hissi) üzerine etkisi halen tartışmalı bir konudur. Bazı çalışmalar denge antrenmanının pozisyon algılama hissi üzerine pozitif etkilerini bulurken diğerleri anlamlı olmayan sonuçlar bildirmişlerdir. Bu nedenle bu çalışmanın amacı hareketli zemin antrenmanları kullanılarak yapılan dinamik denge antrenmanlarının alt ekstremite pozisyon algılama hissi üzerine etkisini araştırmaktır. Çalışma Ortamı: Üniversite Araştırma Laboratuvarı Katılımcılar: Yirmi sağlıklı erkek (yaş: 22.5 ± 4.58 yıl, boy uzunluğu: 181.58 ± 7.57 cm, vücut ağırlığı:85.25 ±10.67 kg, BMI: 25.87 ± 3.01 kg/m2) ve 16 sağlıklı kadın (yaş: 20.87 ± 3.4 yıl, boy uzunluğu: 164.13 ± 6.15 cm, vücut ağırlığı: 63.75 ±13.3 kg, BMI: 23.53 ± 3.94 kg/m2 ) çalışmaya gönüllü olarak katılmıştır. Yöntem: Bütün katılımcılar 4 hafta boyunca bir antrenman seansı 30 dakika süren toplam 12 antrenmana katılmışlardır. Her antrenman seansında uygulanan spesifik egzersizler; 1- Dört yönde (anterior, lateral, anteriomedial ve anteriolateral) Bosu topunun üzerine tek ayakla zıplama-dengeyi sağlama ve başlangıç pozisyonuna tek ayak geri zıplama, 2- Tek ayak üzerinde mini-squat hareketi, 3- Bosu üzerinde tek ayak üzerinde dururken rastgele belirtilen hedeflere dokunma, 4- Bosu üzerinde statik olarak dengede durma Ölçümler: Ayak bileği ve diz eklemi pozisyon algılama hissi, pasif pozisyonlanma protokolünün pasif tekrarı yöntemiyle ölçüldü. Ayak bileği ölçümlerinde hedef açı inversiyon pozisyonunda 10° ve 20° olarak, diz eklemi ölçümlerinde ise diz fleksiyondayken 30° ve 45° olarak belirlendi. Dominant bacağın mutlak ortalama hata değeri eklem pozisyon algısının değerlendirilmesinde kullanıldı. Bulgular: Hareketli zemin antrenmanının temelini oluşturduğu 4 haftalık dinamik denge antrenmanının sonunda mutlak hata skorları ayak bileği 10° inversiyon için 2.29±1.61° ’den 2.09±1.86 ° ’ye, diz eklemi 30° fleksiyon 5.07±2.78° ’ den 4.80±2.55 ° ’ye, diz eklemi 45° fleksiyon pozisyonu için 4.12±2.19°’den 3.87±2.25° ’ ye gelişse de bu gelişimler istatistiksel olarak anlamlı bulunmamıştır (p > 0.05). Sonuç: Ayak bileği 10 ° inversiyon ve diz eklemi 30°,45° fleksiyon pozisyonları için gelişimler gözlense de % 95 güven aralığında etki büyüklüğünün “küçük” olarak bulunmuştur. Mutlak hata oranında anlamlı bir gelişim gözlenememesinin nedenleri çalışmanın metodolojisi, katılımcıların özellikleri ve antrenmanın doz-etki cevabından kaynaklı olabilir.

4-weeks Dynamic Balance training fails to improve ankle and knee joint position sense

Objective: Research clearly shows that balance training improves balance and reduces recurrent injuries. However, theexisting data is inconclusive about the effect of balance training exercises on proprioceptive outcomes. While somestudies have reported positive effects of balance training on position sense other have reported insignificant findings.For that reason the purpose of this study was to determine if a dynamic balance training program centered on the use ofunstable surface exercises can improve lower extremity joint position sense.Setting: University Research LaboratoryParticipants: Twelve healthy men (age: 22.5 ± 4.58 years, height: 181.58 ± 7.57 cm, weight:85.25 ±10.67 kg, BMI:25.87 ± 3.01 kg/m2) and 16 healthy women (age: 20.87 ± 3.4 years, height: 164.13 ± 6.15 cm, weight: 63.75 ±13.3 kg,BMI: 23.53 ± 3.94 kg/m2 ) volunteered to participate.Intervention(s): All participants underwent a total of 12 supervised training sessions over a 4-week period of time witheach session lasting about 30 minutes. The specific exercises that were performed during each training session included:1) hop to stabilization onto and off of a BOSU ball in four directions (anterior, lateral, anteriomedial, and anteriolateral;2) mini-squats on a BOSU ball while in a single limb stance; 3) unanticipated reach sequences while stabilizing on aBOSU ball in a single limb stance; and 4) static single limb stance on a BOSU ball.Main Outcome Measure(s): Ankle joint position sense and knee joint position sense were assessed by a passivereproduction of passive positioning protocol. Target angles of 10° and 20° of inversion were used for ankle jointposition sense; 30° and 45° of knee flexion were used for knee joint position sense assesment. Average absolute errorfor the dominant limb quantifed joint-position sense.Results: At the end of 4 weeks dynamic balance training program centered on the use of unstable surface, absoluteerror score for ankle inversion at 10° improved from 2.29±1.61 to 2.09±1.86, knee flexion at 30° improved from5.07±2.78 to 4.80±2.55, and knee flexion at 45° improved from 4.12±2.19 to 3.87±2.25. However, this improvementswere not significant (p>0.05)Conclusions: There were improvements noted (absolute error decreased for 10o of inversion and 30o and 45o of kneeflexion) despite the lack of significant differences and small effect sizes with 95% CIs that crossed 0. The lack of asignificant improvement in absolute errors scores could be due to methodological considerations, participantcharacteristics and/or a training volume dose response.

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