Sağlıklı Bireylerde Torakolumbal Fasya Gevşetme Tekniklerinin Eklem Hareket Açıklığı, Eklem Pozisyon Hissi ve Enduransa Etkilerinin İncelenmesi: Pilot Çalışma

Year 2021, Volume: 2 Issue: 3, 12 - 24, 29.09.2021

Mustafa Oğuz Kethüdaoğlu , Ertuğrul Demirdel

Abstract

Amaç: Bu çalışmanın amacı; sağlıklı bireylerde iki farklı torakolumbal fasya gevşetme tekniğinin eklem hareket açıklığı (EHA), endurans ve eklem pozisyon hissine (EPH) etkilerinin incelenmesidir.
Yöntem: Bireylerin gövde fleksiyon ve ekstansiyon EHA ölçümleri dijital açıölçer kullanılarak değerlendirildi. Üç kez ölçüm yapıldı ve ortalaması açı cinsinden kaydedildi. Bireylerin EPH ölçümü için, fleksiyon ile her iki taraf lateral fleksiyon yönlerinde 30 derecedeki; ekstansiyon yönünde 15 derecedeki pozisyon öğretildi. Daha sonra üçer kez bu açıları bulmaları istendi ve sapma miktarının mutlak değerlerinin ortalaması alındı. Gövde fleksör ve ekstansör kaslarının enduransı McGill Endurans Testi ile değerlendirildi ve süre saniye cinsinden kaydedildi. Bireyler basit rastgele randomizasyon yöntemi ile iki gruba ayrılarak, bir gruba Graston Tekniği bir gruba da Theragun Teknik uygulanarak tüm değerlendirmeler uygulama sonrası bir kez daha tekrarlandı ve sonuçlar uygun istatistiksel yöntemlerle analiz edildi.
Bulgular: Çalışmamıza her bir grupta 9’ar kişi olmak üzere toplam 18 kişi dahil edildi. Her iki gruptaki bireyler yaş, vücut kütle indeksi ve cinsiyet dağılımı bakımından benzerdi (p>0,05). Graston Teknik grubunda, EHA’nın her iki yönde arttığı ve sağ lateral fleksiyon yönündeki EPH sapma miktarında azalma olduğu belirlendi (p<0,05). Theragun Teknik grubunda da EHA’nın her iki yönde arttığı görülürken, fleksiyon, ekstansiyon ve sol lateral fleksiyon yönlerindeki EPH sapma miktarında azalma olduğu belirlendi (p<0,05). İki grupta da endurans ölçümlerinde herhangi bir anlamlı fark bulunmadı (p>0,05).
Sonuç: Sonuç olarak torakolumbal fasyaya uygulanan Graston Teknik ve Theragun Teknik, EHA’yı arttırıp EPH’yi geliştirmektedir. Her iki tekniğin de endurans üzerindeki etkilerin belirlenmesinde daha uzun süreli takip sonuçlarının değerlendirilmesi faydalı olacaktır.

Keywords

Eklem hareket açıklığı, fasya, pozisyon hissi

Investigation of the Effects of Thoracolumbal Fascia Release Techniques on Range of Motion, Joint Position Sense and Endurance in Healthy Individuals: Pilot Study

Abstract

Aim: To examine the effects of two different thoracolumbar fascia release techniques on range of motion (ROM), endurance and joint position sense (JPS) in healthy individuals.
Method: Trunk flexion and extension ROM measurements of individuals were evaluated using a digital protractor. Measurements were made three times and average was recorded in angle. For the measurement of JPS, individuals were taught a position of 30 degrees in the flexion and lateral flexion directions on both sides, 15 degrees in the extension direction. Individuals were asked to find these angles three times and absolute values of deviation amount were averaged. Endurance of trunk flexor and extensor muscles was evaluated with the McGill Endurance Test and the time was recorded in seconds. Individuals were divided into two groups with a simple randomization method, Graston Technique was applied to one group and Theragun Technique was applied to one group, and all evaluations were repeated after the intervention, and the results were analyzed with appropriate statistical methods.
Results: A total of 18 people were included in our study, 9 people in each group. Individuals in both groups were similar in terms of age, body mass index, and gender distribution (p>0.05). In GrastonTechnique group, it was determined that ROM increased in both directions and there was a decrease in deviation of JPS in right lateral flexion direction (p<0.05). In TheragunTechnique group, it was observed that ROM increased in both directions, and there was a decrease in amount of deviation in JPS in flexion, extension, left lateral flexion directions (p<0.05). There was no significant difference in endurance measurements in both groups (p>0.05).
Conclusion: Consequently, Graston Technique and Theragun Technique applied to thoracolumbal fascia increase ROM and improve JPS. It will be useful to evaluate results of longer follow-up to determine effects of both techniques on endurance.

Keywords

Range of motion, fascia, position sense

References

• Willard FH, Vleeming A, Schuenke MD, Danneels L, Schleip R. The thoracolumbar fascia: Anatomy, function and clinical considerations. J Anat. 2012;221(6):507–36.
• Benjamin M. The fascia of the limbs and back - A review. J Anat. 2009;214(1):1–18.
• Neville C, Nguyen H, Ross K, Wingood M, Peterson EW, Dewitt JE, vd. Lower-limb factors associated with balance and falls in older adults a systematic review and clinical synthesis. J Am Podiatr Med Assoc. 2020;110(5):1–29.
• Day JA, Stecco C, Stecco A. Application of Fascial Manipulation© technique in chronic shoulder pain-Anatomical basis and clinical implications. J Bodyw Mov Ther. 2009;13(2):128–35.
• Schleip R. Fascia sports and movements. Taipeh,Taiwan: Starkworks; 2019.
• Hansen C, Stevens L. Exercise Duration and Mood State.pdf. C. 20, Health Psychology. 2001. s. 267–75.
• Taimela S, Kankaanpää M, Luoto S. The Effect of Lumbar Fatigue on the Ability to Sense a Change in Lumbar Position: A Controlled Study. Spine (Phila Pa 1976) [Internet]. 1999;24(13). Available at: https://journals.lww.com/spinejournal/Fulltext/1999/07010/The_Effect_of_Lumbar_Fatigue_on_the_Ability_to.9.aspx
• Patel R, Patel A. Effect of Theragun on the improvement of back flexibility: A case study. J Dent Med Sci. 2020;32(5):15–6.
• Griefahn A, Oehlmann J, Zalpour C, von Piekartz HJM. Do exercises with the foam roll short impact on the thoracolumbar fascia? A randomized, controlled trial. J Bodyw Mov Ther. 2015;19(4):671.
• Toprak Çelenay Ş, Özkan T, Ünlüer NÖ. Short-term effects of trunk Kinesio Taping on trunk muscle endurance and postural stability in healthy young adults: A randomized controlled trial. Turkish J Physiother Rehabil. 2019;30(2):89–96.
• Davis HL, Alabed S, Chico TJA. Effect of sports massage on performance and recovery: a systematic review and meta-analysis. BMJ Open Sport Exerc Med [Internet]. 01 Mayıs 2020;6(1):e000614. Available at: http://bmjopensem.bmj.com/content/6/1/e000614.abstract
• David E, Amasay T, Ludwig K, Shapiro S. The Effect of Foam Rolling of the Hamstrings on Proprioception at the Knee and Hip Joints. Int J Exerc Sci [Internet]. 2019;12(1):343–54. Available at: http://www.ncbi.nlm.nih.gov/pubmed/30899339%0Ahttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC6413844
• Cho SH, Kim SH. Immediate effect of stretching and ultrasound on hamstring flexibility and proprioception. J Phys Ther Sci. 2016;28(6):1806–8.
• Junker D, Stöggl T. The training effects of foam rolling on core strength endurance, balance, muscle performance and range of motion: A randomized controlled trial. J Sport Sci Med. 2019;18(2):229–38.
• Ozsoy G, Ilcin N, Ozsoy I, Gurpinar B, Buyukturan O, Buyukturan B, vd. Response to: Non-specific low back pain in elderly and the effects of Myofascial release technique combined with core stabilization exercise: Not just muscles [response to letter]. Clin Interv Aging. 2019;14:1947–9.
• Gehlsen GM, Ganion LR, Helfst R. Fibroblast responses to variation in soft tissue mobilization pressure. Med Sci Sports Exerc [Internet]. 1999;31(4):531–5. Available at: http://europepmc.org/abstract/MED/10211847
• Davidson CJ, Ganion LR, Gehlsen GM, Verhoestra B, Roepke JE, Sevier TL. Rat tendon morphologic and functional changes resulting from soft tissue mobilization. Med Sci Sports Exerc. 1997;29(3):313–9.
• Mohamed MN, El Shiwi AMF. Effect of Therapeutic Exercises With or Without Positional Release Technique in Treatment of Chronic Mechanical Low Back Pain Patients: a Randomized Controlled Trial. Egypt J Occup Med. 2014;38(2):125–39.
• Gong W. The influence of lumbar joint mobilization on joint position sense in normal adults. J Phys Ther Sci. 2014;26(12):1985–7.
• McGill SM, Childs A, Liebenson C. Endurance times for low back stabilization exercises: Clinical targets for testing and training from a normal database. Arch Phys Med Rehabil. 1999;80(8):941–4.
• McGill S. Low Back Disorders. Evidence-Based Prevention and Rehabilitation Stuart. J Can Chiropr Assoc. 2010;130(5):76–76.
• Crothers AL, French SD, Hebert JJ, Walker BF. Spinal manipulative therapy, Graston technique® and placebo for non-specific thoracic spine pain: a randomised controlled trial. Chiropr Man Therap [Internet]. 2016;24(1):16. Available at: https://doi.org/10.1186/s12998-016-0096-9
• Kujala RP, Davis CD, Young L. The effect of handheld percussion treatment on vertical jump height. International Journal of Exercise Science: Conference Proceedings: 8(7), 75. Available at: https://digitalcommons.wku.edu/ijesab/vol8/iss7/75