Examination of Balance Ability

Yıl 2021, Cilt: 4 Sayı: 3, 58 - 80, 31.12.2021

Onur Çoban

Öz

Balance function, one of the biomotor abilities, is affected by the interaction between many motor, sensory and neural systems. It is integrated with the processing of information from visual, vestibular and somatosensory sources by the central nervous system. It is divided into two sub-headings as static and dynamic balance. Static balance is the state in which posture oscillation is minimal during standing. Dynamic balance is the maintenance of the orientation of the posture during movement when more muscle activity must be performed to restore the orientation of the posture when the movement of the muscles disrupts the static posture. In order to maintain the orientation of the stance, it is activated simultaneously in all three systems. The vestibular system monitors the forces of the head associated with angular and linear velocities. The visual system has a say in perceiving the movement of objects. It was the first system to program human activities. The proprioceptive system consists of receptors sensitive to the position and pleasure of body segments, contact with other objects, and the direction of gravity. With aging, there is a decrease in the ability of the central nervous system to process information obtained from the visual, vestibular and proprioceptive systems responsible for maintaining body balance. There are various measurement methods to evaluate balance function. When measuring static balance, the Single Leg Balance Test and the Romberg test can be used. While measuring dynamic balance, Berg balance scale, Tinetti balance assessment method, Get up and Walk Test, Y Balance Test, Star Excursion Balance Test can be used. With the developing technology, measurements can be made with balance systems. These measurements can be performed with the Adaptation test or Biodex Balance System via a platform. Balance training has become popular as a complementary training in recent years. Most often, balance training is used to optimize performance, prevent injury, or provide rehabilitation.

Anahtar Kelimeler

Balance, Proprioception, Vestibular, Visual, Somatosensory

Denge Yetisinin İncelenmesi

Öz

Biyomotor yetilerden denge fonksiyonu, birçok motor, duyusal ve nöral sistem arasındaki etkileşimden etkilenmektedir. Görsel, vestibüler ve somatosensöryel kaynaklardan elde edilen bilginin, merkezi sinir sistemi tarafından işlenmesi ile entegredir. Statik ve dinamik denge olmak üzere iki alt başlığa ayrılmaktadır. Statik denge, ayakta duruş sırasında postür salınımının en az olduğu durumdur. Dinamik denge, hareket sırasında, kasların hareket biçiminin, statik duruşu bozduğu durumlarda postürün yönelimini yeniden sağlamak için daha fazla kas aktivitesinin gerçekleştirilmesi gerektiği durumlarda duruşun yöneliminin sürdürülmesidir. Duruşun yöneliminin sürdürülebilmesi için, üç sistemde aynı anda devrededir. Vestibüler sistem, başın açısal ve doğrusal hızlar ile ilişkisili kuvvetleri izlemektedir. Görsel sistem, cisimlerin hareketinin algılanmasında söz sahibidir. İnsanın aktivitelerini programlayan ilk sistemdir. Propriyoseptif sistem, vücut segmentlerinin pozisyonuna ve hazına, diğer nesnelere temasa ve yer çekimi yönüne duyarlı reseptörlerden oluşmaktadır. Yaşlanma ile birlikte, merkezi sinir sisteminin vücut dengesini korumaktan sorumlu görsel, vestibüler ve propriyoseptif sistemlerden elde edilen bilgiyi işleme yeteneğinde azalma görülmektedir. Denge fonksiyonunu değerlendirmek için çeşitli ölçüm yöntemleri vardır. Statik dengeyi ölçerken, Tek Ayak Denge testi ve Romberg testi kullanılabilir. Dinamik dengeyi ölçerken, Berg denge skalası, Tinetti denge değerlendirme yöntemi, Kalk ve Yürü testi, Y denge testi, Yıldız denge testi kullanılabilir. Gelişen teknoloji ile birlikte denge sistemleri ile ölçümler gerçekleştirilebilmektedir. Bu ölçümler, bir platform aracılığı ile Adaptasyon testi veya Biodex Denge Sistemi ile gerçekleştirilebilir. Denge antrenmanları son yıllarda tamamlayıcı antrenman olarak popüler hale gelmiştir. Çoğu zaman denge antrenmanı, performansı optimize etmek, yaralanmayı önlemek veya rehabilitasyon sağlamak amacıyla kullanılmaktadır.

Anahtar Kelimeler

denge, propriyosepsiyon, vestibüler, görsel, somatosensöryel

Kaynakça

• Abrahamova, D.,Hlavacka, F. (2008) Age-related changes of human balance during quiet stance. Physiological Research, 57 (6), 957. (n.d.).
• Balaban, Ö., Nacır, B., Erdem, H.,Karagöz, A. (2009) Denge fonksiyonunun değerlendirilmesi. J Phys Med Rehabil Sci, 12 (3), 133-139. (n.d.).
• Baloh, R.W.,Kerber, K. (2010). Baloh and Honrubia’s clinical neurophysiology of the vestibular system (c. 77) Oxford university press. (n.d.).
• Blackburn, T., Guskiewicz, K. M., Petschauer, M. A., & Prentice, W. E. (2000). Balance and Joint Stability: The Relative Contributions of Proprioception and Muscular Strength. Journal of Sport Rehabilitation, 9(4), 315–328. https://doi.org/10.1123/jsr.9.4.315
• Blecher, R., Heinemann-Yerushalmi, L., Assaraf, E., Konstantin, N., Chapman, J. R., Cope, T. C., Bewick, G. S., Banks, R. W., & Zelzer, E. (2018). New functions for the proprioceptive system in skeletal biology. In Philosophical Transactions of the Royal Society B: Biological Sciences (Vol. 373, Issue 1759). Royal Society Publishing. https://doi.org/10.1098/rstb.2017.0327
• Bouisset, S., & Do, M.-C. (2008). Posture, dynamic stability, and voluntary movement. Neurophysiologie Clinique/Clinical Neurophysiology, 38(6), 345–362. https://doi.org/10.1016/j.neucli.2008.10.001
• Bressel, E., Yonker, J. C., Kras, J., & Heath, E. M. (n.d.). Comparison of static and dynamic balance in female collegiate soccer, basketball, and gymnastics athletes. Journal of Athletic Training, 42(1), 42–46. http://www.ncbi.nlm.nih.gov/pubmed/17597942
• Cachupe, W. J. C., Shifflett, B., Kahanov, L., & Wughalter, E. H. (2001). Reliability of Biodex Balance System Measures. Measurement in Physical Education and Exercise Science, 5(2), 97–108. https://doi.org/10.1207/S15327841MPEE0502_3
• Cherng, R. J., Chen, J. J., & Su, F. C. (2001). Vestibular System in Performance of Standing Balance of Children and Young Adults under Altered Sensory Conditions. Perceptual and Motor Skills, 92(3_suppl), 1167– 1179. https://doi.org/10.2466/pms.2001.92.3c.1167
• Coughlan, G. F., Fullam, K., Delahunt, E., Gissane, C., Caulfield, B. M., & Sci, M. (2012). A Comparison Between Performance on Selected Directions of the Star Excursion Balance Test and the Y Balance Test. Journal of Athletic Training, 47(4), 366–371. https://doi.org/10.4085/1062-6050-47.4.03
• Cumps, E., Verhagen, E., & Meeusen, R. (2007). Efficacy of a sports specific balance training programme on the incidence of ankle sprains in basketball. Journal of Sports Science & Medicine, 6(2), 212–219. http://www.ncbi.nlm.nih.gov/pubmed/24149331
• Emery, C. A. (2005). Effectiveness of a home-based balance-training program in reducing sports-related injuries among healthy adolescents: a cluster randomized controlled trial. Canadian Medical Association Journal, 172(6), 749–754. https://doi.org/10.1503/cmaj.1040805
• Ergen, E., Ülkar, B., & Eraslan, A. (2007). DERLEME: PROPRİYOSEPSİYON VE KOORDİNASYON (Vol. 42). Fullam, K., Caulfield, B., Coughlan, G. F., & Delahunt, E. (2014). Kinematic analysis of selected reach directions of the star excursion balance test compared with the Y-balance test. Journal of Sport Rehabilitation, 23(1), 27–35. https://doi.org/10.1123/JSR.2012-0114
• Gauchard, G. C., Jeandel, C., Tessier, A., & Perrin, P. P. (1999). Beneficial effect of proprioceptive physical activities on balance control in elderly human subjects. Neuroscience Letters, 273(2), 81–84. https://doi.org/10.1016/S0304-3940(99)00615-1
• Goble, D. J., Coxon, J. P., Wenderoth, N., van Impe, A., & Swinnen, S. P. (2009). Proprioceptive sensibility in the elderly: Degeneration, functional consequences and plastic-adaptive processes. In Neuroscience and Biobehavioral Reviews (Vol. 33, Issue 3, pp. 271–278). https://doi.org/10.1016/j.neubiorev.2008.08.012
• Goble, D. J., Noble, B. C., & Brown, S. H. (2010). Where was my arm again? Memory-based matching of proprioceptive targets is enhanced by increased target presentation time. Neuroscience Letters, 481(1), 54– 58. https://doi.org/10.1016/j.neulet.2010.06.053
• Goldberg, J.M.,Fernández, C. (2011). The vestibular system Wiley Online Library. (n.d.).
• Grace Gaerlan, M., Alpert, P. T., Cross, C., Louis, M., & Kowalski, S. (2012). Postural balance in young adults: The role of visual, vestibular and somatosensory systems. Journal of the American Academy of Nurse Practitioners, 24(6), 375–381. https://doi.org/10.1111/j.1745-7599.2012.00699.x
• Gribble, P. A., & Hertel, J. (2003). Considerations for normalizing measures of the Star Excursion Balance Test. Measurement in Physical Education and Exercise Science, 7(2), 89–100. https://doi.org/10.1207/S15327841MPEE0702_3
• Gürkan, A. C., Demirel, H., Demir, M., Atmaca, E. Ş., Bozöyük, G., & Dane, S. (2016). Effects of Long-Term Training Program on Static and Dynamic Balance in Young Subjects. Clinical & Investigative Medicine, 39(6), 31. https://doi.org/10.25011/cim.v39i6.27497
• HAZAR, F., & TAŞMEKTEPLİGİL, Y. (2008). PUBERTE ÖNCESİ DÖNEMDE DENGE VE ESNEKLİĞİN ÇEVİKLİK ÜZERİNE ETKİLERİNİN İNCELENMESİ. Ankara Üniversitesi Beden Eğitimi ve Spor Yüksekokulu SPORMETRE Beden Eğitimi ve Spor Bilimleri Dergisi, 009–012. https://doi.org/10.1501/Sporm_0000000130
• Hrysomallis, C. (2007). Relationship Between Balance Ability, Training and Sports Injury Risk. Sports Medicine, 37(6), 547–556. https://doi.org/10.2165/00007256-200737060-00007
• Hytönen, M., Pyykkö, I., Aalto, H., & Starck, J. (1993). Postural Control and Age. Acta Oto-Laryngologica, 113(2), 119–122. https://doi.org/10.3109/00016489309135778 JUDGE, J. (2003). Balance training to maintain mobility and prevent disability. American Journal of Preventive Medicine, 25(3), 150–156. https://doi.org/10.1016/S0749-3797(03)00178-8
• Karimi, N., Kahrizi, S., & Torkaman, G. (2008). Evaluation of postural balance using the Biodex balance system in subjects with and without low back pain Blood Coagulation and Exercise Training View project Cartilage Biomechanics in OA and Following Rehabilitation View project. In Article in Pakistan Journal of Medical Sciences Online. https://www.researchgate.net/publication/254278757
• Kim, J. C., Chon, J., Kim, H. S., Lee, J. H., Yoo, S. D., Kim, D. H., Lee, S. A., Han, Y. J., Lee, H. S., Lee, B. Y., Soh, Y. S., & Won, C. W. (2017). The association between fall history and physical performance tests in the community-dwelling elderly: A cross-sectional analysis. Annals of Rehabilitation Medicine, 41(2), 239–247. https://doi.org/10.5535/arm.2017.41.2.239
• Kritz, M. F., & Cronin, J. (n.d.). Static Posture Assessment Screen of Athletes: Benefits and Considerations. https://journals.lww.com/nsca-scj
• Lewis, S., Higham, L., & Cherry, D. B. (1985). Development of an Exercise Program to Improve the Static and Dynamic Balance of Profoundly Hearing-Impaired Children. American Annals of the Deaf, 130(4), 278– 284. https://doi.org/10.1353/aad.2012.1020
• Malliou, P., Gioftsidou, A., Pafis, G., Beneka, A., & Godolias, G. (2004). Proprioceptive training (balance exercises) reduces lower extremity injuries in young soccer players. Journal of Back and Musculoskeletal Rehabilitation, 17(3–4), 101–104. https://doi.org/10.3233/BMR-2004-173-403
• McKeon, P. O., & Hertel, J. (2008). Systematic Review of Postural Control and Lateral Ankle Instability, Part I: Can Deficits Be Detected With Instrumented Testing? Journal of Athletic Training, 43(3), 293–304. https://doi.org/10.4085/1062-6050-43.3.293
• Newton, R. (1989). Review of tests of standing balance abilities. Brain Injury, 3(4), 335–343. https://doi.org/10.3109/02699058909004558
• Oliver, G. D., & di Brezzo, R. O. (n.d.). FUNCTIONAL BALANCE TRAINING IN COLLEGIATE WOMEN ATHLETES. https://journals.lww.com/nsca-jscr
• Pollock, A. S., Durward, B. R., Rowe, P. J., & Paul, J. P. (2000). What is balance? Clinical Rehabilitation, 14(4), 402–406. https://doi.org/10.1191/0269215500cr342oa
• Redfern, M. S., Yardley, L., & Bronstein, A. M. (2001). Visual influences on balance. Journal of Anxiety Disorders, 15(1–2), 81–94. https://doi.org/10.1016/S0887-6185(00)00043-8
• Ruwer, S. L., Rossi, A. G., & Simon, L. F. (n.d.). Balance in the elderly Summary. In BRAZILIAN JOURNAL OF OTORHINOLARYNGOLOGY (Vol. 71, Issue 3). http://www.rborl.org.br/http://www.rborl.org.br/
• Shaffer, S. W., Teyhen, D. S., Lorenson, C. L., Warren, R. L., Koreerat, C. M., Straseske, C. A., & Childs, J. D. (2013). Y-Balance Test: A Reliability Study Involving Multiple Raters. Military Medicine, 178(11), 1264– 1270. https://doi.org/10.7205/MILMED-D-13-00222
• Söderman, K., Werner, S., Pietilä, T., Engström, B., & Alfredson, H. (2000). Balance board training: Prevention of traumatic injuries of the lower extremities in female soccer players? A prospective randomized intervention study. Knee Surgery, Sports Traumatology, Arthroscopy, 8(6), 356–363. https://doi.org/10.1007/s001670000147
• Steindl, R., Kunz, K., Schrott-Fischer, A., & Scholtz, A. (2006). Effect of age and sex on maturation of sensory systems and balance control. Developmental Medicine & Child Neurology, 48(06), 477. https://doi.org/10.1017/S0012162206001022
• Sucan, S. , Yılmaz, A. , Can, Y. & Süer, C. (2005). AKTİF FUTBOL OYUNCULARININ ÇEŞİTLİ DENGE PARAMETRELERİNİN DEĞERLENDİRİLMESİ . Sağlık Bilimleri Dergisi , 14 (1) , 36-43 . Retrieved from https://dergipark.org.tr/en/pub/eujhs/issue/44505/551870. (n.d.).
• Taube, W., Gruber, M., & Gollhofer, A. (2008). Spinal and supraspinal adaptations associated with balance training and their functional relevance. Acta Physiologica, 193(2), 101–116. https://doi.org/10.1111/j.1748-1716.2008.01850.x
• Tinetti, E. (1986). Performance-Oriented Assessment of Mobility Problems in Elderly Patients. In JAGS (Vol. 34).
• Valovich McLeod, T. C., & Hale, T. D. (2015). Vestibular and balance issues following sport-related concussion. Brain Injury, 29(2), 175–184. https://doi.org/10.3109/02699052.2014.965206
• Wilson, B. R., Robertson, K. E., Burnham, J. M., Yonz, M. C., Ireland, M. L., & Noehren, B. (2018). The relationship between hip strength and the Y balance test. Journal of Sport Rehabilitation, 27(5), 445–450. https://doi.org/10.1123/jsr.2016-0187
• Yim-Chiplis, P. K., & Talbot, L. A. (2000). Defining and Measuring Balance in Adults. Biological Research For Nursing, 1(4), 321–331. https://doi.org/10.1177/109980040000100408
• Zech, A., Hübscher, M., Vogt, L., Banzer, W., Hänsel, F., & Pfeifer, K. (2010). Balance Training for Neuromuscular Control and Performance Enhancement: A Systematic Review. Journal of Athletic Training, 45(4), 392–403. https://doi.org/10.4085/1062-6050-45.4.392