diplomsko delo
Gaja Štendler (Author), Sonja Hlebš (Reviewer), Polona Palma (Mentor), Tjaž Brezovar (Co-mentor)

Abstract

Uvod: Zvin gležnja je ena najpogostejših mišično-skeletnih poškodb, ki pogosto vodi v razvoj kronične nestabilnosti gležnja (KNG). KNG je povezana z mehanskimi in funkcionalnimi spremembami, ki vključujejo proprioceptivne primanjkljaje, moten živčno-mišični nadzor in spremenjeno mišično aktivnost. Posamezniki s KNG kažejo spremenjene vzorce mišične aktivnosti med hojo, kar vpliva na njihovo biomehaniko in povečuje tveganje za nadaljnje poškodbe. Namen: Namen diplomskega dela je na podlagi pregleda literature opredeliti spremembe v mišični aktivnosti pri osebah s KNG med hojo. Metode dela: Iskanje literature je potekalo v elektronski podatkovni zbirki PubMed z uporabo ključnih besed »ankle instability« AND »muscle activ*« AND »walking«. Vključene so bile prosto dostopne raziskave objavljene v zadnjih desetih letih. Rezultati: Ob upoštevanju vključitvenih in izključitvenih kriterijev je bilo v končni pregled vključenih sedem raziskav. KNG vpliva na mišično aktivnost, kar se kaže v spremembah aktivacije in koordinacije mišic spodnjih udov in trupa. Raziskave potrjujejo spremembe v delovanju mišic, zlasti mišic peroneus longus in gluteus medius. Mišica peroneus longus, se pogosto aktivira prej, močneje in dlje kot pri zdravih posameznikih, za povečanje stabilnosti sklepa. Kljub temu so rezultati deloma nasprotujoči, saj nekatere raziskave poročajo o zmanjšani aktivnosti te mišice in posledično manj učinkoviti absorpciji sil. Tudi pri mišici gluteus medius prihaja do neskladij med raziskavami. Nekatere kažejo na zmanjšano, druge pa na povečano aktivacijo kot kompenzacijo za ohranjanje ravnotežja in stabilnosti med hojo. Razprava in zaključek: Rezultati raziskav se med seboj razlikujejo. Nekatere ugotovitve so skladne s hipotezami, druge pa jim nasprotujejo. Razlike bi lahko bile posledica različnega vzorca, uporabljenih protokolov ali variabilnosti v učinkovitosti kompenzacijskih strategij med posamezniki. Spremenjena mišična aktivnost lahko do določene mere kompenzira zmanjšano stabilnost gležnja, vendar so te prilagoditve lahko povezane tudi s povečanim tveganjem za utrujenost in preobremenitev mišic. Kljub omejitvam raziskave prispevajo k boljšemu razumevanju biomehanskih in živčno-mišičnih prilagoditev, povezanih s KNG. Bolj celostno razumevanje sprememb pri hoji bi lahko dosegli s sočasno analizo EMG meritev in kinetičnih ter kinematičnih podatkov. To bi omogočilo razvoj učinkovitejših fizioterapevtskih pristopov, usmerjenih v izboljšanje stabilnosti sklepa in preprečevanje ponovnih poškodb. Nadaljnje raziskave na tem področju so zaželene.

Keywords

diplomska dela;fizioterapija;kronična nestabilnost gležnja;mišična aktivnost;EMG;biomehanika hoje;vpliv;

Data

Language: Slovenian
Year of publishing:
Typology: 2.11 - Undergraduate Thesis
Organization: UL ZF - University College of Health Studies
Publisher: [G. Štendler]
UDC: 615.8
COBISS: 241121795 Link will open in a new window
Views: 120
Downloads: 24
Average score: 0 (0 votes)
Metadata: JSON JSON-RDF JSON-LD TURTLE N-TRIPLES XML RDFA MICRODATA DC-XML DC-RDF RDF

Other data

Secondary language: English
Secondary title: ǂThe ǂeffect of chronic ankle instability on muscle activity during walking - a literature review
Secondary abstract: Introduction: Ankle sprain is one of the most common musculoskeletal injuries and often leads to the development of chronic ankle instability (CAI). CAI is associated with mechanical and functional changes, including proprioceptive deficits, impaired neuromuscular control, and altered muscle activity. Individuals with CAI exhibit altered patterns of muscle activity during walking, which affects their biomechanics and increases the risk of further injuries. Purpose: The purpose of the thesis is to identify changes in muscle activity during walking in individuals with CAI, based on a literature review. Methods: Literature was searched in the PubMed electronic database using the keywords »ankle instability« AND »muscle activ*« AND »walking«. Open-access studies published within the last ten years were included. Results: Considering the inclusion and exclusion criteria, seven studies were included in the final review. CAI affects muscle activity, resulting in altered activation and coordination of the lower limb and trunk muscles. Research confirms altered muscle function, particularly in the peroneus longus and gluteus medius muscles. The peroneus longus is often activated earlier, with higher intensity, and for longer periods of time to improve joint stability compared to healthy individuals. However, the results are partly contradictory, as some studies report lower activity of this muscle and consequently less effective force absorption. The results for the gluteus medius muscle are similarly contradictory, with some studies showing decreased activation and others showing increased activation as a compensatory strategy to maintain balance and stability during walking. Discussion and Conclusion: Research results vary. Some results support the original hypotheses, others contradict them. These differences may be due to variations in the participant samples, the protocols used, or the effectiveness of the compensatory strategies across individuals. Altered muscle activity may partially compensate for reduced ankle stability, but such adaptations may also lead to increased muscle fatigue and overuse. Despite all the limitations, the studies reviewed contribute to a better understanding of the biomechanical and neuromuscular adaptations associated with CAI. This knowledge will allow the development of more effective physiotherapeutic approaches to improve joint stability and prevent recurrent injuries. Based on the literature review, individualized treatment and the pursuit of greater symmetry between limbs appear to be appropriate. Further research in this area is encouraged.
Secondary keywords: diploma theses;physiotherapy;chronic ankle instability;muscle activity;EMG;gait biomechanics;impact;
Type (COBISS): Bachelor thesis/paper
Study programme: 0
Thesis comment: Univ. v Ljubljani, Zdravstvena fak., Oddelek za fizioterapijo
Pages: 26 str.
ID: 26712093