SAĞLIKLI BİREYLERE STANDART DENGE EĞİTİMİNİN DİNAMİK, STATİK DENGE VE FONKSİYONELLİK ÜZERİNE ETKİLERİ

Son on yıldan beri uygulanan birçok rehabilitasyon programında, denge ve fonksiyonel antrenman programı, rehabilitasyonun vazgeçilmez unsurlarından biridir. Literatüre göre, rehabilitasyon programlarında uygulanan denge eğitiminin bireyin dengesini ve pozisyonel hissini geliştirip, düşme oranını azaltmaktadır, dolayısıyla tekrar yaralanmaların önlenmesinde etkili olduğu belirtilmektedir. Çalışmanın amacı 8 haftalık standart denge ekipmanları ile yapılan denge eğitiminin, statik ve dinamik denge üzerine etkilerini araştırmaktır. Gereç ve Yöntem: Çalışmaya 18 sağlıklı erkek birey (yaş X±SD: 23,7±2,8yıl, vücut kütle indeksi X±SD: 22,4±2,6 kg/cm2) çalışmaya dahil edildi. Çalışmaya dahil edilen bireylere standart denge ekipmanları kullanılarak denge eğitimi uygulandı. Bütün bireyler haftada 3 gün olmak üzere, 8 hafta süreyle denge eğitimi aldı. Bireylerin dengeleri eğitim öncesi ve sonrası değerlendirildi. Statik denge, Flamingo denge testi (FDT) ile, dinamik denge Y denge testi (YDT) ile, fonksiyonel parametreler ise, Tek bacak sıçrama (TBS) ve Fonksiyonel uzanma testi (FUT) ile değerlendirildi. Verilerin istatistiksel analizi Wilcoxon testi ile yapıldı. Bulgular: 8 haftalık denge eğitimi sonrasında YDT anterior (p=0,001) ve posteriomedial (p=0,014) yönlerde ayrıca FDT (p=0,011), FUT (p=0,007) ve TBS testinde (p=0,005) istatistiksel olarak anlamlı gelişme görülürken, YDT’nin posteriolateral yönünde anlamlı bir gelişme gözlemlenmedi (p=0,116). Sonuç: Standart denge ekipmanları ile uygulanan denge eğitimi ile sağlıklı bireylerde, dinamik, statik denge ve fonksiyonel parametrelerin geliştirilmesinde kullanılabilir. 

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  • 1. Howe TE, Rochester L, Jackson A, Banks PM, Blair VA. Exercise for improving balance in older people. Cochrane Database Syst Rev. 2007; 17(4):CD004963. 2. Rugelj D. The effect of functional balance training in frail nursing home residents. Arch Gerontol Geriatr. 2010; 50(2): 192-97. 3. McKeon PO, Ingersoll CD, Kerrigan DC, Saliba E, Bennett BC, Hertel J. Balance training improves function and postural control in those with chronic ankle instability. Med Sci Sports Exerc. 2008; 40(10): 1810-19. 4. Gonçalves DFF, Ricci NA, Coimbra AMV. Functional balance among older adults from the community. Rev Bras Fisioter. 2009; 13(4):316-23. 5. Liao CD, Liou TH, Huang YY, Huang YC. Effects of balance training on functional outcome after total knee replacement in patients with knee osteoarthritis: a randomized controlled trial. Clin Rehabil. 2013; 27(8): 697-709. 6. Diracoglu D, Aydin R, Baskent A, Celik A. Effects of kinesthesia and balance exercises in knee osteoarthritis. J Clin Rheumatol. 2005;11(6): 303-10. 7. Galeano, D, Brunetti F, Torricelli D, Piazza S, Pons JL. A tool for balance control training using muscle synergies and multimodal interfaces. Biomed Res Int. 2014; doi: 10.1155/2014/565370. 8. Baltaci G, Harput G, Haksever B, Ulusoy B, Ozer H. Comparison between Nintendo Wii Fit and conventional rehabilitation on functional performance outcomes after hamstring anterior cruciate ligament reconstruction: prospective, randomized, controlled, double-blind clinical trial. Knee Surg Sports Traumatol Arthrosc. 2013; 21(4): 880-7 9. Oliver GD, Di Brezzo R. Functional balance training in collegiate women athletes. J Strength Cond Res. 2009; 23(7): 2124-9. 10. Son SM, Park MK, Lee NK. Influence of Resistance Exercise Training to Strengthen Muscles across Multiple Joints of the Lower Limbs on Dynamic Balance Functions of Stroke Patients. J Phys Ther Sci. 2014; 26(8): 1267-9. 11. Walaszek R, Chwała W, Walaszek K, Burdacki M, Błaszczuk J. Evaluation of the accuracy of the postural stability measurement with the Y-Balance Test based on the levels of the biomechanical parameters. Acta Bioeng Biomech. 2017; 19(2): 121-8. 12. Michell TB, Ross SE, Blackburn JT, Hirth CJ, Guskiewicz KM. Functional balance training, with or without exercise sandals, for subjects with stable or unstable ankles.. J Athl Train. 2006; 41(4): 393-8. 13. Oddsson LI, Karlsson R, Konrad J, Ince S. A rehabilitation tool for functional balance using altered gravity and virtual reality. J Neuroeng Rehabil. 2007; 10: 4-25. 14. Breithaupt-Groegler K, Coch C, Coenen M, Donath F, Erb-Zohar K, Francke K, et al. Who is a 'healthy subject'? consensus results on pivotal eligibility criteria for clinical trials. Eur J Clin Pharmacol. 2017; 73(4): 409-16. 15. Lephart SM, Princivero DM, Giraldo JL, Fu Fh. The role of proprioception in the management and rehabilitation of athletic injuries. Am J Sports Med. 1997; 25: 130-7. 16. Plisky PJ, Gorman PP, Butler RJ, Kiesel KB, Underwood FB, Elkins B. The Reliability of an Instrumented Device for Measuring Components of the Star Excursion Balance Test. N Am J Sports Phys Ther. 2009; 4(2): 92-9. 17. Tsigilis N, Douda H, Tokmakidis SP. Test-retest reliability of the Eurofit test battery administered to university students. 2002; 95(3): 1295-300. 18. Sawle L, Freeman J, Jonathan Marsden J. Intra-rater relıabılıty of the multıple sıngle-leg hop-stabılızatıon test and relatıonshıps wıth age, leg domınance and traınıng. Int J Sports Phys Ther. 2017; 12(2): 190–8. 19. Lin YH, Chen TR, Tang YW, Wang CY. A reliability study for standing functional reach test using modified and traditional rulers. Percept Mot Skills. 2012; 115(2): 512-20. 20. Zhao Y, Chung PK, Tong TK. Effectiveness of a balance-focused exercise program for enhancing functional fitness of older adults at risk of falling: A randomised controlled trial. Geriatr Nurs. 2017; 01(17): 4572-97 21. Zhang X, Hu M, Lou Z, Liao B. Effects of strength and neuromuscular training on functional performance in athletes after partial medial meniscectomy. J Exerc Rehabil. 2017; 13(1): 110-6. 22. Bruno P. The use of "stabilization exercises" to affect neuromuscular control in the lumbopelvic region: a narrative review. J Can Chiropr Assoc. 2014; 58(2): 119-30. 23. Wang L, Lee M, Zhang Z, Moodie J, Cheng D, Martin J. Does preoperative rehabilitation for patients planning to undergo joint replacement surgery improve outcomes? A systematic review and meta-analysis of randomised controlled trials. BMJ Open. 2016; 6(2): e009857. 24. Leavey V, Sandrey M, Dahmer G. Comparative effects of 6-week balance, gluteus medius strength, and combined programs on dynamic postural control. J Sport Rehab. 2010;19: 268287. 25. Strøm M, Thorborg K, Bandholm T, Tang L, Zebis M, Nielsen K, Bencke J. Ankle joint control during single legged balance using common balance traninig devices - Implications for rehabilitation strategies. Int J Sports Phys Ther. 2016;11(3):388-99. 26. Linek P, Sikora D, Wolny T, Saulicz E. Reliability and number of trials of Y Balance Test in adolescent athletes. Musculoskelet Sci Pract. 2017; 31: 72-5. 27. Gürkan AC, Demirel H, Demir M, Atmaca EŞ, Bozöyük G, Dane S. Effects of Long-Term Training Program on Static and Dynamic Balance in Young Subjects. Clin Invest Med. 2016; 39(6): 27497. 28. Behm DG, Muehlbauer T, Kibele A, Granacher U. Effects of Strength Training Using Unstable Surfaces on Strength, Power and BalancePerformance Across the Lifespan: A Systematic Review and Meta-analysis. Sports Med. 2015; 45(12): 1645-69.