RELATIONSHIP OF LOWER EXTREMITY MUSCLE STRENGTH, RANGE OF HIP MOTION AND SUBTALAR ANGLE WITH DYNAMIC BALANCE

Öz

Purpose: To determine the relationship between lower extremity muscle strength, hip joint range of motion, and subtalar angle with dynamic balance in healthy individuals. Methods: Sixty-nine healthy and volunteer individuals (age=22.1±71.25 years;47 females, 22 males) were included in our study. Dynamic balances of the individuals were evaluated with the Y balance test (YBT), lower extremity muscle strengths were evaluated with a hand-held dynamometer, hip joint range of motions and subtalar angles were evaluated with a universal goniometer. Results: There was a positive significant correlation between lower extremity muscle strength, hip external rotation range of motions and, YBT (p<0.05). Stepwise multiple linear regression analysis showed that hamstring muscle strength was a significant and independent predictor of the dominant leg YBT composite score with 22% of the variance and the non-dominant leg YBT composite score with 32% of the variance. Conclusion: Hamstring muscle strength was found to be a predictor of dynamic balance in healthy individuals. Improvement of hamstring muscle strength bilaterally may also contribute to dynamic balance in healthy individuals.

Anahtar Kelimeler

• hamstring muscles
• lower extremity
• muscle strenght
• postural balance

ALT EKSTREMİTE KAS KUVVETİ, KALÇA EKLEM HAREKET AÇIKLIĞI VE SUBTALAR AÇININ DİNAMİK DENGE İLE İLİŞKİSİ

Öz

Amaç: Sağlıklı bireylerde alt ekstremite kas kuvveti, kalça eklemi hareket açıklığı ve subtalar açının dinamik denge ile olan ilişkisini belirlemekti. Yöntem: Çalışmamıza 69 sağlıklı ve gönüllü birey (yaş=22,17±1,25 yıl; 47 kadın, 22 erkek) dahil edildi. Bireylerin dinamik dengeleri Y denge testi (YDT), alt ekstremite kas kuvvetleri el dinamometresi, kalça eklem hareket açıklıkları ve subtalar açıları ise universal gonyometre ile değerlendirildi. Sonuçlar: YDT ile alt ekstremite kas kuvvetleri ve kalça eksternal rotasyon hareket açıklıkları arasında pozitif anlamlı bir ilişki vardı (p<0,05). Kademeli çoklu doğrusal regresyon analizi, hamstring kas kuvvetinin, dominant bacak YDT kompozit skorunun %22 varyans, non-dominant bacak YDT kompozit skorunun %32 varyans ile anlamlı ve bağımsız belirleyicisi olduğunu gösterdi. Tartışma: Hamstring kas kuvveti, sağlıklı bireylerde dinamik dengenin bir belirleyicisi olarak bulundu. Hamstring kas kuvvetinin bilateral olarak geliştirilmesi sağlıklı bireylerde dinamik dengeye de katkı sağlayabilir.

Anahtar Kelimeler

• Alt ekstremite
• Hamstring kasları
• Kas kuvveti
• Postural denge

Kaynakça

1. 1. Winter DA, Patla AE, Frank JS. Assessment of balance control in humans. Med Prog Technol. 1990;16(1-2):31-51.
2. 2. Gribble PA, Hertel J. Considerations for normalizing measures of the Star Excursion Balance Test. Meas Phys Educ Exerc Sci. 2003;7(2):89-100.
3. 3. Gribble PA, Hertel J, Plisky P. Using the Star Excursion Balance Test to assess dynamic postural-control deficits and outcomes in lower extremity injury: a literature and systematic review. J. Athl. Train. 2012;47(3):339-57.
4. 4. Patla AE. Strategies for dynamic stability during adaptive human locomotion. IEEE Eng. Med. Biol. Mag. 2003;22(2):48-52.
5. 5. Tropp H, Ekstrand J, Gillquist J. Stabilometry in functional instability of the ankle and its value in predicting injury. Med Sci Sports Exerc. 1984;16(1):64-6.
6. 6. Watson AWS. Ankle sprains in players of the field-games Gaelic football and hurling. J Sports Med Phys Fitness . 1999;39(1):66.
7. 7. Sato K, Mokha M. Does core strength training influence running kinetics, lower-extremity stability, and 5000-M performance in runners? J. Strength Cond. Res. 2009;23(1):133-40.
8. 8. Mattacola CG, Dwyer MK, Miller AK, Uhl TL, McCrory JL, Malone TR. Effect of orthoses on postural stability in asymptomatic subjects with rearfoot malalignment during a 6-week acclimation period. Arch. Phys. Med. Rehabil. 2007;88(5):653-60.

9. 9. Tropp H. Commentary: functional ankle instability revisited. J. Athl. Train. 2002;37(4):512.
10. 10. Dujardin F, Selva O, Mejjad O, Pasero D, Piraux J, Thomine J. Intra and interindividual variations of pelvic mobility in normal adult walk. Rev Chir Orthop Reparatrice Appar Mot . 1995;81(7):592-600.
11. 11. Donahoe B, Turner D, Worrell T. The use of functional reach as a measurement of balance in boys and girls without disabilities ages 5 to 15 years. Pediatr Phys Ther. 1994;6(4):189-93.
12. 12. Tinetti ME. Performance‐oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc . 1986;34(2):119-26.
13. 13. Berg KO, Wood-Dauphinee SL, Williams JI, Maki B. Measuring balance in the elderly: validation of an instrument. Can. J. Public Health. 1992;83:S7-11.
14. 14. Plisky PJ, Rauh MJ, Kaminski TW, Underwood FB. Star Excursion Balance Test as a predictor of lower extremity injury in high school basketball players. J Orthop Sports Phys Ther. 2006;36(12):911-9.
15. 15. Kinzey SJ, Armstrong CW. The reliability of the star-excursion test in assessing dynamic balance. J Orthop Sports Phys Ther. 1998;27(5):356-60.
16. 16. Gordon AT, Ambegaonkar JP, Caswell SV. Relationships between core strength, hip external rotator muscle strength, and star excursion balance test performance in female lacrosse players. Int. J. Sports Phys. Ther. 2013;8(2):97.
17. 17. Gabbard C, Hart S. A question of foot dominance. J. Gen. Psychol. 1996;123(4):289-96.
18. 18. Chimera NJ, Smith CA, Warren M. Injury history, sex, and performance on the functional movement screen and Y balance test. J. Athl. Train. 2015;50(5):475-85.
19. 19. 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.
20. 20. Thorborg K, Petersen J, Magnusson SP, Hölmich P. Clinical assessment of hip strength using a hand‐held dynamometer is reliable. Scand J Med Sci Sports. 2010;20(3):493-501.
21. 21. Van der Ploeg R, Oosterhuis H. The" make/break test" as a diagnostic tool in functional weakness. J. Neurol. Neurosurg. Psychiatry. 1991;54(3):248-51.
22. 22. Lu Y-M, Lin J-H, Hsiao S-F, Liu M-F, Chen S-M, Lue Y-J. The relative and absolute reliability of leg muscle strength testing by a handheld dynamometer. J. Strength Cond. Res. 2011;25(4):1065-71.
23. 23. Almeida GPL, das Neves Rodrigues HL, de Freitas BW, de Paula Lima PO. Reliability and validity of the hip stability isometric test (HipSIT): a new method to assess hip posterolateral muscle strength. J Orthop Sports Phys Ther. 2017;47(12):906-13.
24. 24. Otman AS, Demirel H, Sade A. Tedavi Hareketlerinde Temel Değerlendirme Prensipleri. 3. Baskı. Ankara: Hacettepe Üniversitesi Fizik Tedavi ve Rehabilitasyon Yüksekokulu Yayınları; 2003.
25. 25. Bek N. Ayak Bileği ve Ayak Problemleri. Ankara: Hipokrat Kitapevi; 2018.
26. 26. Peat J, Barton B, Elliott E. Statistics workbook for evidence-based health care: John Wiley & Sons; 2009.
27. 27. Shimwell L, Fatoye F, Selfe J. The validity of the modified Star Excursion Balance Test as a predictor of knee extensor and hip abductor strength. Int. J. Physiother. 2017;5(1):1863-71.
28. 28. Wilson BR, Robertson KE, Burnham JM, Yonz MC, Ireland ML, Noehren B. The relationship between hip strength and the Y balance test. J. Sport Rehabil. 2018;27(5):445-50.
29. 29. Clagg S, Paterno MV, Hewett TE, Schmitt LC. Performance on the modified star excursion balance test at the time of return to sport following anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther. 2015;45(6):444-52.
30. 30. Lee D-K, Kim G-M, Ha S-M, Oh J-S. Correlation of the Y-balance test with lower-limb strength of adult women. J. Phys. Ther. Sci. 2014;26(5):641-3.
31. 31. Myers H, Christopherson Z, Butler RJ. Relationship between the lower quarter Y-balance test scores and isokinetic strength testing in patients status post ACL reconstruction. Int. J. Sports Phys. Ther. 2018;13(2):152.
32. 32. Robinson R, Gribble P. Kinematic predictors of performance on the Star Excursion Balance Test. J. Sport Rehabil. 2008;17(4):347-57.
33. 33. Ohkoshi Y, Yasuda K, Kaneda K, Wada T, Yamanaka M. Biomechanical analysis of rehabilitation in the standing position. Am J Sports Med. 1991;19(6):605-11.
34. 34. Gribble PA, Robinson RH, Hertel J, Denegar CR. The effects of gender and fatigue on dynamic postural control. J. Sport Rehabil. 2009;18(2):240-57.
35. 35. Hubbard TJ, Kramer LC, Denegar CR, Hertel J. Correlations among multiple measures of functional and mechanical instability in subjects with chronic ankle instability. J. Athl. Train. 2007;42(3):361.
36. 36. Overmoyer GV, Reiser RF. Relationships between lower-extremity flexibility, asymmetries, and the Y balance test. J. Strength Cond. Res. 2015;29(5):1240-7.
37. 37. Nakagawa TH, Petersen RS. Relationship of hip and ankle range of motion, trunk muscle endurance with knee valgus and dynamic balance in males. Phys Ther Sport. 2018;34:174-9.
38. 38. Cote KP, Brunet ME, II BMG, Shultz SJ. Effects of pronated and supinated foot postures on static and dynamic postural stability. J. Athl. Train. 2005;40(1):41.