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Tasapainon puutteet ovat merkittävä tekijä työikäisten tapaturmissa ja johtavat usein sairaalahoitoon, aiheuttaen Suomessa vuositasolla 420 miljoonan euron kustannukset. Vuonna 2013 54% vakavasti loukkaantuneista oli miehiä ja 46% naisia. 69% tapauksista liittyi heikentyneeseen päivittäiseen toimintakykyyn. Nykyisin työterveyshuollolla ei ole käytössä vakiintunutta fyysisen toimintakyvyn testistöä. Tutkimuksen tarkoituksena oli selvittää uudenlaisen dynaamisen tasapainon testauslaitteen käyttökelpoisuutta päivittäisen toimintakyvyn arvioinnissa ja etsiä mahdollisia eroja sukupuolten välillä. 72 osallistujaa, WOMEN (n=34, 52 ± 5,5 vuotta) ja MEN (n=37, 49 ± 6,5 vuotta), suoritti tutkimuksen loppuun. Dynaaminen tasapaino mitattiin viidellä pääsarjalla, jotka kukin koostuivat 16 kappaleesta 30 cm anteroposteriorista häiriötä (SLOW: v=10 cm/s, MIDSLOW: v=13 cm/s, MID: v=16 cm/s, MIDFAST: v=19 cm/s, FAST: v=21 cm/s,) käyttäen erikoisvalmisteista tasapainolaitetta. Maksimaalinen painekeskipisteen poikkeama (peakD) analysoitiin ja keskiarvoistettiin 3-6 hyväksytyn häiriön osalta kumpaankin suuntaan. Lisäksi mitattiin isometrisen polven ojennuksen ja plantaarifleksion voimantuotto (maksimivoima, voimantuottonopeus ja -aika) sekä keskivartalon (vartalon ojennus ja koukistus) maksimivoima. Eteenpäinhorjunnassa miehillä oli naisia alhaisempi peakD nopeuksilla MIDFAST (6,8%, p<0.01) ja FAST (8,6%, p<0.01), kun taas taaksepäinhorjunnassa miehillä oli alhaisempi peakD kaikilla viidellä nopeudella SLOW - FAST (10,8±%, p<0.01, 11,0%, p<0.01, 8,9%, p<0.01, 9,5%, p<0.01, 10,7%, p<0.01). Vaikka isometrisessä polven ojennuksessa reaktioajan 28,7%, p<0.001) ja voimantuottonopeuden (119%, p<0.001) suhteen sekä plantaarifleksiossa (82,1%, p<0.001) voimantuottonopeuden suhteen oli samansuuntaisia eroja, ei sukupuolittaisessa tarkastelussa löydetty merkitseviä yhteyksiä tasapaino- ja voimamuuttujien välillä. Ryhmää kokonaisuutena tarkasteltaessa korrelaatioita löytyi, ja myös antropometria (rasvaprosentti, rasvaton lihasmassa) korreloi (rasvaprosentti FAST-nopeudella posterior-suunnassa p<0.001, r=.490, rasvaton lihasmassa FAST-nopeudella posterior-suunnassa p<0.01, r=.-416) koko ryhmällä tasapainon kanssa. Naisilla oli säännönmukaisesti miehiä heikompi dynaaminen tasapaino erityisesti taaksepäin horjuttaessa, mutta voimantuottoaikojen erot eivät yksinään riittäneet selittämään tasapainoeroja. Dynaaminen tasapaino on mutkikas ilmiö. Maksimipoikkeaman lisäksi on jatkossa syytä tarkastella myös muita parametreja kuten poikkeaman liikeradan pituutta. Aiemmin on osoitettu, että voimantuottonopeus korreloi dynaamisen tasapainon kanssa ikääntyneillä, muttei nuorilla. On mahdollista, että keski-ikäisillä naisilla havaittu miehiä matalampi voimantuotto liittyy korkeampaan kaatumisonnettomuuksien riskiin myöhemmällä iällä.
Balance deficiencies significantly contribute to falling accidents and hospitalization among working age population, at a total cost of 420 mEUR per year in Finland. In 2013. 69% of the incidents were related to poor daily functional capacity. Currently, there are no standards for physical performance testing in occupational health. The present study assessed if a novel dynamic balance perturbation device would measure daily functional capacity and if gender differences would be observed. 71 participants, WOMEN (n=34, 49 ± 5,5 years) and MEN (n=37, 51 ± 6,5 years), completed the study. Dynamic balance was measured with 5 main sets of 16 anteroposterior perturbations each with 30 cm amplitude (SLOW: v=10 cm/s, MIDSLOW: v=13 cm/s, MID: v=16 cm/s, MIDFAST: v=19 cm/s, FAST: v=21 cm/s) using a custom made dynamic balance device. Maximal peak displacement of center of pressure (peakD) of 3-6 acceptable perturbations from each direction as well as isometric knee extension and plantar flexion force production were analyzed and averaged. In forward sway, MEN had lower peakD during FAST (9,4%, p<0.01) situation than WOMEN, while in backward sway, MEN had lower peakD during all five velocities from SLOW to FAST (12,1%, p<0.01, 12,3%, p<0.01, 9,8%, p<0.01, 10,5%, p<0.01, 12,0%, p<0.01), respectively. Even though similar differences were observed in isometric knee extension (28,7%, p<0.05) rate of force development (RFD) and (119%, p<0.001) RFD time as well as plantar flexion (82,1%, p<0.001) RFD, no significant correlations were found between balance and force parameters in either group. When combined, correlations began to appear.
WOMEN showed consistently poorer dynamic balance in comparison to MEN, especially in the posterior direction, but the differences in RFD alone do not adequately explain the balance contrasts. Previously it has been shown that RFD correlated with dynamic balance control in elderly but not in young. The lower RFD observed within middle aged women compared to men is possibly related to an increased risk of falling accidents and injuries later in life.
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[{"key": "dc.contributor.advisor", "value": "Piirainen, Jarmo", "language": "", "element": "contributor", "qualifier": "advisor", "schema": "dc"}, {"key": "dc.contributor.author", "value": "Glad, Antti", "language": "", "element": "contributor", "qualifier": "author", "schema": "dc"}, {"key": "dc.date.accessioned", "value": "2021-07-02T09:43:02Z", "language": null, "element": "date", "qualifier": "accessioned", "schema": "dc"}, {"key": "dc.date.available", "value": "2021-07-02T09:43:02Z", "language": null, "element": "date", "qualifier": "available", "schema": "dc"}, {"key": "dc.date.issued", "value": "2021", "language": "", "element": "date", "qualifier": "issued", "schema": "dc"}, {"key": "dc.identifier.uri", "value": "https://jyx.jyu.fi/handle/123456789/76968", "language": null, "element": "identifier", "qualifier": "uri", "schema": "dc"}, {"key": "dc.description.abstract", "value": "Tasapainon puutteet ovat merkitt\u00e4v\u00e4 tekij\u00e4 ty\u00f6ik\u00e4isten tapaturmissa ja johtavat usein sairaalahoitoon, aiheuttaen Suomessa vuositasolla 420 miljoonan euron kustannukset. Vuonna 2013 54% vakavasti loukkaantuneista oli miehi\u00e4 ja 46% naisia. 69% tapauksista liittyi heikentyneeseen p\u00e4ivitt\u00e4iseen toimintakykyyn. Nykyisin ty\u00f6terveyshuollolla ei ole k\u00e4yt\u00f6ss\u00e4 vakiintunutta fyysisen toimintakyvyn testist\u00f6\u00e4. Tutkimuksen tarkoituksena oli selvitt\u00e4\u00e4 uudenlaisen dynaamisen tasapainon testauslaitteen k\u00e4ytt\u00f6kelpoisuutta p\u00e4ivitt\u00e4isen toimintakyvyn arvioinnissa ja etsi\u00e4 mahdollisia eroja sukupuolten v\u00e4lill\u00e4. 72 osallistujaa, WOMEN (n=34, 52 \u00b1 5,5 vuotta) ja MEN (n=37, 49 \u00b1 6,5 vuotta), suoritti tutkimuksen loppuun. Dynaaminen tasapaino mitattiin viidell\u00e4 p\u00e4\u00e4sarjalla, jotka kukin koostuivat 16 kappaleesta 30 cm anteroposteriorista h\u00e4iri\u00f6t\u00e4 (SLOW: v=10 cm/s, MIDSLOW: v=13 cm/s, MID: v=16 cm/s, MIDFAST: v=19 cm/s, FAST: v=21 cm/s,) k\u00e4ytt\u00e4en erikoisvalmisteista tasapainolaitetta. Maksimaalinen painekeskipisteen poikkeama (peakD) analysoitiin ja keskiarvoistettiin 3-6 hyv\u00e4ksytyn h\u00e4iri\u00f6n osalta kumpaankin suuntaan. Lis\u00e4ksi mitattiin isometrisen polven ojennuksen ja plantaarifleksion voimantuotto (maksimivoima, voimantuottonopeus ja -aika) sek\u00e4 keskivartalon (vartalon ojennus ja koukistus) maksimivoima. Eteenp\u00e4inhorjunnassa miehill\u00e4 oli naisia alhaisempi peakD nopeuksilla MIDFAST (6,8%, p<0.01) ja FAST (8,6%, p<0.01), kun taas taaksep\u00e4inhorjunnassa miehill\u00e4 oli alhaisempi peakD kaikilla viidell\u00e4 nopeudella SLOW - FAST (10,8\u00b1%, p<0.01, 11,0%, p<0.01, 8,9%, p<0.01, 9,5%, p<0.01, 10,7%, p<0.01). Vaikka isometrisess\u00e4 polven ojennuksessa reaktioajan 28,7%, p<0.001) ja voimantuottonopeuden (119%, p<0.001) suhteen sek\u00e4 plantaarifleksiossa (82,1%, p<0.001) voimantuottonopeuden suhteen oli samansuuntaisia eroja, ei sukupuolittaisessa tarkastelussa l\u00f6ydetty merkitsevi\u00e4 yhteyksi\u00e4 tasapaino- ja voimamuuttujien v\u00e4lill\u00e4. Ryhm\u00e4\u00e4 kokonaisuutena tarkasteltaessa korrelaatioita l\u00f6ytyi, ja my\u00f6s antropometria (rasvaprosentti, rasvaton lihasmassa) korreloi (rasvaprosentti FAST-nopeudella posterior-suunnassa p<0.001, r=.490, rasvaton lihasmassa FAST-nopeudella posterior-suunnassa p<0.01, r=.-416) koko ryhm\u00e4ll\u00e4 tasapainon kanssa. Naisilla oli s\u00e4\u00e4nn\u00f6nmukaisesti miehi\u00e4 heikompi dynaaminen tasapaino erityisesti taaksep\u00e4in horjuttaessa, mutta voimantuottoaikojen erot eiv\u00e4t yksin\u00e4\u00e4n riitt\u00e4neet selitt\u00e4m\u00e4\u00e4n tasapainoeroja. Dynaaminen tasapaino on mutkikas ilmi\u00f6. Maksimipoikkeaman lis\u00e4ksi on jatkossa syyt\u00e4 tarkastella my\u00f6s muita parametreja kuten poikkeaman liikeradan pituutta. Aiemmin on osoitettu, ett\u00e4 voimantuottonopeus korreloi dynaamisen tasapainon kanssa ik\u00e4\u00e4ntyneill\u00e4, muttei nuorilla. On mahdollista, ett\u00e4 keski-ik\u00e4isill\u00e4 naisilla havaittu miehi\u00e4 matalampi voimantuotto liittyy korkeampaan kaatumisonnettomuuksien riskiin my\u00f6hemm\u00e4ll\u00e4 i\u00e4ll\u00e4.", "language": "fi", "element": "description", "qualifier": "abstract", "schema": "dc"}, {"key": "dc.description.abstract", "value": "Balance deficiencies significantly contribute to falling accidents and hospitalization among working age population, at a total cost of 420 mEUR per year in Finland. In 2013. 69% of the incidents were related to poor daily functional capacity. Currently, there are no standards for physical performance testing in occupational health. The present study assessed if a novel dynamic balance perturbation device would measure daily functional capacity and if gender differences would be observed. 71 participants, WOMEN (n=34, 49 \u00b1 5,5 years) and MEN (n=37, 51 \u00b1 6,5 years), completed the study. Dynamic balance was measured with 5 main sets of 16 anteroposterior perturbations each with 30 cm amplitude (SLOW: v=10 cm/s, MIDSLOW: v=13 cm/s, MID: v=16 cm/s, MIDFAST: v=19 cm/s, FAST: v=21 cm/s) using a custom made dynamic balance device. Maximal peak displacement of center of pressure (peakD) of 3-6 acceptable perturbations from each direction as well as isometric knee extension and plantar flexion force production were analyzed and averaged. In forward sway, MEN had lower peakD during FAST (9,4%, p<0.01) situation than WOMEN, while in backward sway, MEN had lower peakD during all five velocities from SLOW to FAST (12,1%, p<0.01, 12,3%, p<0.01, 9,8%, p<0.01, 10,5%, p<0.01, 12,0%, p<0.01), respectively. Even though similar differences were observed in isometric knee extension (28,7%, p<0.05) rate of force development (RFD) and (119%, p<0.001) RFD time as well as plantar flexion (82,1%, p<0.001) RFD, no significant correlations were found between balance and force parameters in either group. When combined, correlations began to appear.\nWOMEN showed consistently poorer dynamic balance in comparison to MEN, especially in the posterior direction, but the differences in RFD alone do not adequately explain the balance contrasts. Previously it has been shown that RFD correlated with dynamic balance control in elderly but not in young. The lower RFD observed within middle aged women compared to men is possibly related to an increased risk of falling accidents and injuries later in life.", "language": "en", "element": "description", "qualifier": "abstract", "schema": "dc"}, {"key": "dc.description.provenance", "value": "Submitted by Miia Hakanen (mihakane@jyu.fi) on 2021-07-02T09:43:02Z\nNo. of bitstreams: 0", "language": "en", "element": "description", "qualifier": "provenance", "schema": "dc"}, {"key": "dc.description.provenance", "value": "Made available in DSpace on 2021-07-02T09:43:02Z (GMT). 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