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Tasapainolle ei ole olemassa universaalia määritelmää mutta se tiedetään, että sitä kontrolloivat useat eri mekanismit. Ikääntyminen aiheuttaa siinä heikkenemistä, joka aiheutuu muutoksista sekä sensorisissa että motorisissa prosesseissa. Kaatumisesta aiheutuneiden vammojen määrä kasvaa koko ajan ikääntyneillä. Heidän onkin havaittu pärjäävän nuoria huonommin sekä staattisissa että dynaamisissa testeissä mutta dynaamisissa testeissä ero on vieläkin suurempi. Erityisesti dynaamisten ominaisuuksin tutkiminen on tärkeää sillä staattiset testit eivät välttämättä paljasta tasapaino-ongelmia tai ikääntymiseen liittyviä eroja yhtä hyvin kuin dynaamiset testit. Tämän tutkimuksen suoritti loppuun 4 ikääntynyttä (2 naista ja 2 miestä) ja 8 nuorta (5 naista ja 3 miestä). Ikääntyneiden keski-ikä oli 68,5 (±2,5) vuotta ja nuorten 24,0 (±3,6) vuotta. He suorittivat 14-viikkoisen progressiivisen voimaharjoitusjakson. Voimaharjoittelu toteutettiin ohjatusti 2 krt/vk. Kaikki tutkittavat testattiin sekä ennen että jälkeen voimaharjoitusjakson. Testeihin sisältyi (1) maksimaaliset isometriset polven ojennus ja koukistus sekä nilkan plantaari- ja dorsifleksiot; (2) M-aalto ja H-refleksi seisten soleuksesta levossa (3) H-refleksi ja staattinen tasapainotesti (4) staattiset tasapainotestit (5) dynaamiset tasapainotestit (6) dynaamiset tasapainotestit sähköstimulaation kanssa. Voimaharjoittelun seurauksena kaikki nuorten MVC tulokset paranivat. Kuitenkaan ikääntyneiden MVC tulokset eivät muuttuneet. Nuorten polven fleksion tahdonalainen EMG-aktiivisuus parani sekä MVC:n (33,9 ± 27,4 %; P ˂0,05) että RFD:n (40,4 ± 38,4 %; P ˂0,05) aikana. Ikääntyneiden tahdonalaiset lihasaktiivisuudet (EMG) eivät muuttuneet. Staattisen tasapainon testeissä ei havaittu selkeitä muutoksia eikä eroja ryhmien välillä. Dynaamisen tasapainon testeissä ikääntyneillä() havaittiin suurempi displacement post arvo sekä ennen (ikääntyneet: 51,9 ± 8,4 mm; nuoret: 33,6 ± 11,0 mm; P˂0,05) että jälkeen (ikääntyneet: 41,5 ± 3,6 mm; nuoret: 29,2 ± 8,3 mm; P ˂0,05) voimaharjoitusjakson mutta muissa arvoissa ei havaittu eroja tai muutoksia tutkimuksen aikana kummallakaan ryhmällä. Tasapainohäiriön aikana mitatuissa venytysrefleksivasteissa ei havaittu muutoksia harjoittelun seurauksena mutta ikääntyneiden SLR-vasteen todettiin olevan suurempi kuin nuorilla (ikääntyneet 0,037 ± 0,015 mV/M_max; nuoret 0,022 ± 0,007 mV/M_max; P ˂0,05) ennen harjoittelua. Venytysrefleksin latenssin todettiin olevan merkittävästi suurempi ikääntyneillä kuin nuorilla (ikääntyneet: 44,75 ± 14,73 ms; nuoret 36,25 ± 6,32 ms; P ˂0,05) mutta harjoitusjaksolla ei ollut vaikutusta siihen. Voimaharjoittelulla ei ollut vaikutuksia levossa tai tasapainohäiriön aikana mitattuihin H-reflekseihin tai niiden latensseihin. Häiriötestin aikana mitatuissa H/M-suhteissa ei havaittu selkeää eroa tai muutosta tutkimuksen aikana. Tutkimuksen päätulokset olivat: 1) Lyhyt progressiivinen voimaharjoittelu ei paranna ikääntyneiden tai nuorten tutkittavien tasapainokykyä reagoitaessa nopeaan tasapainohäiriöön. 2) Sillä ei myöskään näytä olevan vaikutuksia soleuksen H- tai venytysrefleksivasteisiin. 3) Mitään korrelaatioita tasapaino-ominaisuuksien tai venytysrefleksivasteiden ja voimaominaisuuksien välillä ei havaittu. 4) Ikääntyneillä havaittiin pidempi venytysrefleksin latenssi nuoriin verrattuna. Tutkimuksen rajoituksina täytyy kuitenkin huomioida tutkittavien pieni lukumäärä. Tulevaisuudessa tulisi selvittää, mikä voimantuotto-ominaisuus on tärkeintä tasapainokyvyn kannalta ja kuinka tasapainoa tulisi harjoittaa. Lisäksi tulevissa tutkimuksissa tutkittavat voisi jakaa tasapainokyvyn mukaan huonon ja hyvin tasapainon vertalailuryhmiin.
There is no universal definition on balance but there are several different mechanisms, which control it. Ageing leads to poorer balance control, which is due to modifications on sensoric and motoric processes. The number of injuries caused by falling accidents is increasing in elderly people. It has been noticed that elderly people have poorer balance in static and dynamic tests but the difference between young and elderly is even greater with dynamic than with static condition. Particularly dynamic balance studies are needed because static measurements do not necessarily reveal balance problems or age-related differences as clearly as dynamic balance tests. There were 4 elderly (2 women and 2 men) and 8 young (5 women and 3 men) who finished this study. Elderly subjects were 68.5 (±2.5) years old and young subjects were 24.0 (±3.6) years old. Subjects completed a 14-week progressive strength training intervention. Training sessions were performed two times per week under supervision. Subjects had measurements before and after the training intervention. Measurements included; (1) voluntary isometric contraction of knee extension and flexion as well as ankle plantar- and dorsiflexion, (2) standing rest M-wave and H-reflex from soleus, (3) H-reflex and static balance test; (4) static balance test, (5) dynamic balance tests, and (6) dynamic balance test with electrical stimulation. As a result of training intervention all the MVC results of young subjects improved. However, MVC results of elderly subjects remain unchanged. Muscle activity of knee flexion during MVC (33,9 ± 27,4 %; P ˂0,05) and RFD (40,4 ± 38,4 %; P ˂0,05) improved on young. Voluntary activations of elderly were not changed. There were not clear changes or differences between the groups on static balance results. Displacement post value was higher with elderly than young before (elderly: 51,9 ± 8,4 mm; young: 33,6 ± 11,0 mm; P˂0,05) and after (elderly: 41,5 ± 3,6 mm; young: 29,2 ± 8,3 mm; P ˂0,05) intervention but no changes or other differences were found from dynamic measurements. EMG results during dynamic measurements of soleus and tibialis were unchanged, and there were not clear differences between the groups. Stretch reflex responses remained unchanged but the elderly group had higher SLR-response than young (elderly 0,037 ± 0,015 mV/M_max; young 0,022 ± 0,007 mV/M_max; P ˂0,05) before intervention. Stretch reflex latensies were statistically higher in elderly than young subjects (elderly: 44,75 ± 14,73 ms; young 36,25 ± 6,32 ms; P ˂0,05) but no changes were observed previously intervention. Rest values of H-reflex amplitude and latensy remained unchanged in both groups. After the training intervention H/M ratio during perturbations was unchanged and there were not clear differences between the groups. The main conclusions of the study were; (1) Short progressive strength training intervention does not improve balance control of subjects during sudden perturbation. (2) It does not have effects on H- or stretch reflex responses of soleus. (3) There were no relationships between balance variables or stretch refelex responses and strength characteristics. (4) Elderly subjects have significantly longer stretch reflex latency than young. These findings are relative to the limitations of the present study, such as low subject numbers and highly functioning elderly subjects at baseline. In future, different force parameters for balance control could been investigated and how the balance control should be trained. Moreover, in the future, subjects could be divided into the groups based on their balance ability.
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[{"key": "dc.contributor.advisor", "value": "Piirainen Jarmo", "language": "", "element": "contributor", "qualifier": "advisor", "schema": "dc"}, {"key": "dc.contributor.advisor", "value": "Walker Simon", "language": "", "element": "contributor", "qualifier": "advisor", "schema": "dc"}, {"key": "dc.contributor.author", "value": "Allonen, Juho", "language": null, "element": "contributor", "qualifier": "author", "schema": "dc"}, {"key": "dc.date.accessioned", "value": "2017-09-06T06:53:31Z", "language": "", "element": "date", "qualifier": "accessioned", "schema": "dc"}, {"key": "dc.date.available", "value": "2017-09-06T06:53:31Z", "language": "", "element": "date", "qualifier": "available", "schema": "dc"}, {"key": "dc.date.issued", "value": "2017", "language": null, "element": "date", "qualifier": "issued", "schema": "dc"}, {"key": "dc.identifier.other", "value": "oai:jykdok.linneanet.fi:1721828", "language": null, "element": "identifier", "qualifier": "other", "schema": "dc"}, {"key": "dc.identifier.uri", "value": "https://jyx.jyu.fi/handle/123456789/55280", "language": "", "element": "identifier", "qualifier": "uri", "schema": "dc"}, {"key": "dc.description.abstract", "value": "Tasapainolle ei ole olemassa universaalia m\u00e4\u00e4ritelm\u00e4\u00e4 mutta se tiedet\u00e4\u00e4n, ett\u00e4 sit\u00e4 kontrolloivat useat eri mekanismit. Ik\u00e4\u00e4ntyminen aiheuttaa siin\u00e4 heikkenemist\u00e4, joka aiheutuu muutoksista sek\u00e4 sensorisissa ett\u00e4 motorisissa prosesseissa. Kaatumisesta aiheutuneiden vammojen m\u00e4\u00e4r\u00e4 kasvaa koko ajan ik\u00e4\u00e4ntyneill\u00e4. Heid\u00e4n onkin havaittu p\u00e4rj\u00e4\u00e4v\u00e4n nuoria huonommin sek\u00e4 staattisissa ett\u00e4 dynaamisissa testeiss\u00e4 mutta dynaamisissa testeiss\u00e4 ero on viel\u00e4kin suurempi. Erityisesti dynaamisten ominaisuuksin tutkiminen on t\u00e4rke\u00e4\u00e4 sill\u00e4 staattiset testit eiv\u00e4t v\u00e4ltt\u00e4m\u00e4tt\u00e4 paljasta tasapaino-ongelmia tai ik\u00e4\u00e4ntymiseen liittyvi\u00e4 eroja yht\u00e4 hyvin kuin dynaamiset testit. T\u00e4m\u00e4n tutkimuksen suoritti loppuun 4 ik\u00e4\u00e4ntynytt\u00e4 (2 naista ja 2 miest\u00e4) ja 8 nuorta (5 naista ja 3 miest\u00e4). Ik\u00e4\u00e4ntyneiden keski-ik\u00e4 oli 68,5 (\u00b12,5) vuotta ja nuorten 24,0 (\u00b13,6) vuotta. He suorittivat 14-viikkoisen progressiivisen voimaharjoitusjakson. Voimaharjoittelu toteutettiin ohjatusti 2 krt/vk. Kaikki tutkittavat testattiin sek\u00e4 ennen ett\u00e4 j\u00e4lkeen voimaharjoitusjakson. Testeihin sis\u00e4ltyi (1) maksimaaliset isometriset polven ojennus ja koukistus sek\u00e4 nilkan plantaari- ja dorsifleksiot; (2) M-aalto ja H-refleksi seisten soleuksesta levossa (3) H-refleksi ja staattinen tasapainotesti (4) staattiset tasapainotestit (5) dynaamiset tasapainotestit (6) dynaamiset tasapainotestit s\u00e4hk\u00f6stimulaation kanssa. Voimaharjoittelun seurauksena kaikki nuorten MVC tulokset paranivat. Kuitenkaan ik\u00e4\u00e4ntyneiden MVC tulokset eiv\u00e4t muuttuneet. Nuorten polven fleksion tahdonalainen EMG-aktiivisuus parani sek\u00e4 MVC:n (33,9 \u00b1 27,4 %; P \u02c20,05) ett\u00e4 RFD:n (40,4 \u00b1 38,4 %; P \u02c20,05) aikana. Ik\u00e4\u00e4ntyneiden tahdonalaiset lihasaktiivisuudet (EMG) eiv\u00e4t muuttuneet. Staattisen tasapainon testeiss\u00e4 ei havaittu selkeit\u00e4 muutoksia eik\u00e4 eroja ryhmien v\u00e4lill\u00e4. Dynaamisen tasapainon testeiss\u00e4 ik\u00e4\u00e4ntyneill\u00e4() havaittiin suurempi displacement post arvo sek\u00e4 ennen (ik\u00e4\u00e4ntyneet: 51,9 \u00b1 8,4 mm; nuoret: 33,6 \u00b1 11,0 mm; P\u02c20,05) ett\u00e4 j\u00e4lkeen (ik\u00e4\u00e4ntyneet: 41,5 \u00b1 3,6 mm; nuoret: 29,2 \u00b1 8,3 mm; P \u02c20,05) voimaharjoitusjakson mutta muissa arvoissa ei havaittu eroja tai muutoksia tutkimuksen aikana kummallakaan ryhm\u00e4ll\u00e4. Tasapainoh\u00e4iri\u00f6n aikana mitatuissa venytysrefleksivasteissa ei havaittu muutoksia harjoittelun seurauksena mutta ik\u00e4\u00e4ntyneiden SLR-vasteen todettiin olevan suurempi kuin nuorilla (ik\u00e4\u00e4ntyneet 0,037 \u00b1 0,015 mV/M_max; nuoret 0,022 \u00b1 0,007 mV/M_max; P \u02c20,05) ennen harjoittelua. Venytysrefleksin latenssin todettiin olevan merkitt\u00e4v\u00e4sti suurempi ik\u00e4\u00e4ntyneill\u00e4 kuin nuorilla (ik\u00e4\u00e4ntyneet: 44,75 \u00b1 14,73 ms; nuoret 36,25 \u00b1 6,32 ms; P \u02c20,05) mutta harjoitusjaksolla ei ollut vaikutusta siihen. Voimaharjoittelulla ei ollut vaikutuksia levossa tai tasapainoh\u00e4iri\u00f6n aikana mitattuihin H-reflekseihin tai niiden latensseihin. H\u00e4iri\u00f6testin aikana mitatuissa H/M-suhteissa ei havaittu selke\u00e4\u00e4 eroa tai muutosta tutkimuksen aikana. Tutkimuksen p\u00e4\u00e4tulokset olivat: 1) Lyhyt progressiivinen voimaharjoittelu ei paranna ik\u00e4\u00e4ntyneiden tai nuorten tutkittavien tasapainokyky\u00e4 reagoitaessa nopeaan tasapainoh\u00e4iri\u00f6\u00f6n. 2) Sill\u00e4 ei my\u00f6sk\u00e4\u00e4n n\u00e4yt\u00e4 olevan vaikutuksia soleuksen H- tai venytysrefleksivasteisiin. 3) Mit\u00e4\u00e4n korrelaatioita tasapaino-ominaisuuksien tai venytysrefleksivasteiden ja voimaominaisuuksien v\u00e4lill\u00e4 ei havaittu. 4) Ik\u00e4\u00e4ntyneill\u00e4 havaittiin pidempi venytysrefleksin latenssi nuoriin verrattuna. Tutkimuksen rajoituksina t\u00e4ytyy kuitenkin huomioida tutkittavien pieni lukum\u00e4\u00e4r\u00e4. Tulevaisuudessa tulisi selvitt\u00e4\u00e4, mik\u00e4 voimantuotto-ominaisuus on t\u00e4rkeint\u00e4 tasapainokyvyn kannalta ja kuinka tasapainoa tulisi harjoittaa. Lis\u00e4ksi tulevissa tutkimuksissa tutkittavat voisi jakaa tasapainokyvyn mukaan huonon ja hyvin tasapainon vertalailuryhmiin.", "language": "fi", "element": "description", "qualifier": "abstract", "schema": "dc"}, {"key": "dc.description.abstract", "value": "There is no universal definition on balance but there are several different mechanisms, which control it. Ageing leads to poorer balance control, which is due to modifications on sensoric and motoric processes. The number of injuries caused by falling accidents is increasing in elderly people. It has been noticed that elderly people have poorer balance in static and dynamic tests but the difference between young and elderly is even greater with dynamic than with static condition. Particularly dynamic balance studies are needed because static measurements do not necessarily reveal balance problems or age-related differences as clearly as dynamic balance tests. There were 4 elderly (2 women and 2 men) and 8 young (5 women and 3 men) who finished this study. Elderly subjects were 68.5 (\u00b12.5) years old and young subjects were 24.0 (\u00b13.6) years old. Subjects completed a 14-week progressive strength training intervention. Training sessions were performed two times per week under supervision. Subjects had measurements before and after the training intervention. Measurements included; (1) voluntary isometric contraction of knee extension and flexion as well as ankle plantar- and dorsiflexion, (2) standing rest M-wave and H-reflex from soleus, (3) H-reflex and static balance test; (4) static balance test, (5) dynamic balance tests, and (6) dynamic balance test with electrical stimulation. As a result of training intervention all the MVC results of young subjects improved. However, MVC results of elderly subjects remain unchanged. Muscle activity of knee flexion during MVC (33,9 \u00b1 27,4 %; P \u02c20,05) and RFD (40,4 \u00b1 38,4 %; P \u02c20,05) improved on young. Voluntary activations of elderly were not changed. There were not clear changes or differences between the groups on static balance results. Displacement post value was higher with elderly than young before (elderly: 51,9 \u00b1 8,4 mm; young: 33,6 \u00b1 11,0 mm; P\u02c20,05) and after (elderly: 41,5 \u00b1 3,6 mm; young: 29,2 \u00b1 8,3 mm; P \u02c20,05) intervention but no changes or other differences were found from dynamic measurements. EMG results during dynamic measurements of soleus and tibialis were unchanged, and there were not clear differences between the groups. Stretch reflex responses remained unchanged but the elderly group had higher SLR-response than young (elderly 0,037 \u00b1 0,015 mV/M_max; young 0,022 \u00b1 0,007 mV/M_max; P \u02c20,05) before intervention. Stretch reflex latensies were statistically higher in elderly than young subjects (elderly: 44,75 \u00b1 14,73 ms; young 36,25 \u00b1 6,32 ms; P \u02c20,05) but no changes were observed previously intervention. Rest values of H-reflex amplitude and latensy remained unchanged in both groups. After the training intervention H/M ratio during perturbations was unchanged and there were not clear differences between the groups. The main conclusions of the study were; (1) Short progressive strength training intervention does not improve balance control of subjects during sudden perturbation. (2) It does not have effects on H- or stretch reflex responses of soleus. (3) There were no relationships between balance variables or stretch refelex responses and strength characteristics. (4) Elderly subjects have significantly longer stretch reflex latency than young. These findings are relative to the limitations of the present study, such as low subject numbers and highly functioning elderly subjects at baseline. In future, different force parameters for balance control could been investigated and how the balance control should be trained. Moreover, in the future, subjects could be divided into the groups based on their balance ability.", "language": "en", "element": "description", "qualifier": "abstract", "schema": "dc"}, {"key": "dc.description.provenance", "value": "Submitted using Plone Publishing form by Juho Allonen (jualallo) on 2017-09-06 06:53:31.039385. Form: Pro gradu -lomake (https://kirjasto.jyu.fi/julkaisut/julkaisulomakkeet/pro-gradu-lomake). 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