Ayak Bileği Fonksiyonel İnstabilitesi Olan Hastalarda İzokinetik ve Proprioseptif Egzersizlerin Etkinliği

Yıl 2018, Cilt: 7 Sayı: 1, 139 - 148, 31.03.2018

Feyzan Cankurtaran

Öz

Ayak bileği fonksiyonel instabilitesi
(FAİ) olan hastalarda izokinetik ve proprioseptif egzersizlerin, kas kuvveti,
denge, proprioseptif duyu ve ayak bileği fonksiyonları üzerine etkilerini
araştırmak amacıyla planlandı. 28 Olgu rastgele 3 gruba ayrılarak 1. gruba
izokinetik, 2. gruba proprioseptif egzersizler verildi ve 3. grup kontrol
grubundan oluştu. Denge, kas kuvveti, propriosepsiyon ve fonksiyonel durum
değerlendirildi. Sonuçlar Grup 3 ile karşılaştırıldığında denge, eklem pozisyon
hissi ve fonksiyonel skala yönünden istatistiksel olarak anlamlı fark
saptandı(p<0,05). Grup 2 ve 3 arasında izokinetik kuvvet yönünden fark yoktu
(p>0,05). Grup 1 ve Grup 2 karşılaştırıldığında denge, eklem pozisyon hissi
ve fonksiyonel skala değerlerinde anlamlı fark bulunmadı (p>0,05).
izokinetik kuvvet açısından karşılaştırıldığında Grup 1 lehine istatistiksel
fark saptandı (p<0,05). Kronik dönemde de olsa FAİ durumunda verilecek
egzersiz programlarının denge, propriosepsiyon, kuvvet ve fonksiyonellik
üzerinde olumlu katkılar sağladığı görüldü. Her yönüyle kombine programların bu
hasta grubunda daha iyi sonuçlar verebileceğini sonucuna varıldı.

Anahtar Kelimeler

Ayak bileği, Lateral ligaman, Kinestezi, Direnç eğitimi

Kaynakça

• . Postle K, Pak D, Smith TO. Effectiveness of proprioseptive exercises for ankle ligament injury in adults: A systematic literature and meta-analysis 2012:17:285-291. 2. Smith BI, Docherty CL, Simon J, Klossner J, Schrader J. Ankle strength and force sense after a progressive 6-week strength-training program in people with functional ankle instability.Journal of Athletic Training 2012:47(3):282-288. 3. Hubbard TJ, Kominski TW, Griend V.A, Kovalenski JE. Quantative assesment of mechanical laxity in the functionally unstable ankle. Medicine&Science in Sports&Exercise 2004:36(5):760-766. 4. Munn J, Beard DJ, Refshauge KM, Lee RJ. Do functional-performance tests detect impairment in subjects with ankle instability? J Sport Rehabil 2002:11:40-50. 5. Kaminski TW, Buckley BD, Powers ME, Hubbard TJ, Ortiz C. Effect of strength and propriocepton training on eversion to inversion strength ratios in subjects with unilateral functional ankle instability. BrJSports Med 2003; 37:410-415. 6. Mattacola C6, Dwyer MK.Rehabilitation of the ankle after acute sprain or chronic instability.Journal of Athletic Training 2002;37(4):413-429. 7. Kaikkonen A, Kannus P, Jarvinen M. A performance test protocol and scoring scale for the evaluation of ankle injuries. Am J Sports Med 1994; 22(4):462-469. 8. Hansen MS, Dieckmann B, Jensen K, Jakobsen BW. The reliability of balance tests performed on the kinesthetic ability trainer (KAT). Knee Surg Sports Traumatol Arthrosc 2000;8(3):180-185. 9. Akalın E, Gülbahar S. İzokinetik değerlendirme ve analiz yöntemleri. II. İzmir Fiziksel Tıp ve Rehabilitasyon Ortopedi ve Travmatoloji Günleri Kurs Kitabı. İzmir;2006.s.1-27. 10. Sekir U, Yıldız Y, Hazneci B, Ors F, Saka T, Aydın T. Reliability of a functional test battery evaluating functionality, proprioception, and strength in recreational athletes with functional ankle instability. Eur J Phys Rehabil Med 2008;44:407-415. 11. Willems T, Witvrouw E, Verstyft J, Vaes P, Clercq DD. Proprioception and muscle strength in subjects with a history of ankle sprains and chronic instability. Journal of Athletic Training, 2002;37(4):487-493. 12. Matsusaka N,Yokoyama S,Tsurusaki T,İnokuchi S,Okita M.Effect of ankle disk training combined with tactile stimulation to the leg and fast on functional instability of the ankle .AM J sports Med 2001;29(1):2-30. 13. Ben Moussa Zouita M, Majdoub O, Ferchichi H, Grandy K, Dziri C, Ben Salah FZ. The effect of 8-weeks proprioseptive exercise program in postural sway and isokinetic strength of ankle sprains of Tunisian athletes 2013:56:634-643. 14. Lee AJY,Lin WH.Twelve-week biomechanical ankle platform system training on postural stability and ankle proprioception in subjects with unilateral function ankle instability.Clinical Biomechanics 2008;23:1065-1072 15. Rozzi SL, Lephart SM,Sterner R, Kuligowski L: Balance training for persons with functionally unstable ankles. J Orthop Sports Phys Ther.1999;29(8):478-486. 16. Hazneci B, Yıldız Y, Sekir U, Aydın T, Kalyon TA. Efficacy of isokinetic exercise on joint position sense and muscle strength in patellofemoral pain syndrome. AmJ Phys Med Rehabil 2005;84:521-527. 17. Bouet V, Gahery Y. Muscular exercise improves knee position sense in humans.Neurosci Lett.2000;4:143-146. 18. Munn J, Sullivan SJ, Schneiders AG. Evidence of sensorimotor deficits in functional ankle instability: a systematic review with meta-analysis. J Scien Med Sport.2010;13:2-12. 19. Docherty CL, Moore JH, Arnold BL. Effects of strength training on strength development and joint position sense in functionally unstable ankles.J Athl Train. 1998;33:310-314. 20. Sekir U, Yıldız Y, Hazneci B, Ors F, Aydın T. Effect of isokinetic training on strength, functionality and proprioceptional ankle instability. Knee Surg Sports Traumatol Arthrosc 2006;14(6):573-582. 21. Munn J, Beard DJ, Refshauge KM,et al. Eccentric muscle strenght in functional ankle instability. Med Sci Sports Exerc. 2003;35:245-250. 22. Arnold BL, Docherty CL. Low-Load eversion force sense, self-reported ankle instability, and frequency of giving way. J Athl Train. 2006;41(3):233-238.1. 23. Han K, Ricard MD, Fellingham GW. Effects of a 4-week exercise program on balance using elastic tubing as a perturbation force for individuals with a history of ankle sprains.Journal of Orthopaedic &Sports Physical Theraphy 2009;39(4):246-255 24. Eils E, Rosenbaum DA. Multi-station proprioceptive exercise program in patients with ankle instability. Medicine and Science in Sports andExercise 2001;33(12):1991-1998. 25. Ismail MM, Ibrahim MM, Youssef EF, El Shorbagy KM.Plyometric training versus resistive exercises after acute lateral ankle sprain. Foot Ankle Int 2010 ;31(6):523-30 26. Rose A,Lee RJ, Williams RM, Thomson LC ve ark. Functional instability in non-contact ankle ligaman injuries. Br.J.Sports Med,2000;34:352-358. 27. Jerosch J,Schoppe R. Midterm effects of ankle joint supports on sensomotor and sport-specific capabilities.Knee surg sports Travmatal Arthroscopy 2000;8:252-259. 28. Haywood K.L, Hargreaves J, Lamb S E. Multi-item outcome measures for lateral ligament injury of the ankle:a structured review. Journal of Evaluation in Clinical Practice 2004;10(2):339-352.