Ravnotežje, hoja in odzivi na motnje med hojo pri zdravih (starejših) odraslih in pacientih s sladkorno boleznijo : magistrsko delo

Hočevar, Jana (author), Puh, Urška (mentor), Olenšek, Andrej (comentor), Vauhnik, Renata (reviewer)

Uvod: Na slabše reakcije nadzora drže lahko vpliva upad funkcije somatosenzoričnega sistema zaradi staranja ali sladkorne bolezni. Manj učinkovito reaktivno ravnotežje vpliva na povečano tveganje za padce, ki predstavljajo velik problem pri starejših in pacientih. Namen: Želeli smo ugotoviti razlike v ravnotežju, hoji in odzivih na motnje med hojo pri zdravih odraslih in zdravih starejših odraslih ter med zdravimi in pacienti s sladkorno boleznijo. Metode: Vključili smo 19 zdravih preiskovancev starih 50–70 let in štiri preiskovance s sladkorno boleznijo z odsotnim občutkom za lahen dotik na stopalih. Izvedli smo testiranje občutka za dotik na stopalih z monofilamenti, meritve statičnega in dinamičnega ravnotežja (stabilometrija, meje stabilnosti, krajša različica testa za oceno sistemov, udeleženih pri uravnavanju ravnotežja), hitrosti hoje ter odzivov na motnje v medio-lateralni smeri med hojo po tekočem traku s hitrostjo 1 m/s in 0,4 m/s. Rezultati: Skupina 60–69 let je imela v primerjavi s skupino 50–50 let statistično značilno večjo le površino elipse pri stabilometriji (trda podlaga, zaprte oči). Med skupinama so bile razlike zgolj pri odzivih na motnje v lateralni smeri med hojo s hitrostjo 0,4 m/s. Delež odziva stabilizacija je bil pogostejši v skupini 60–69 let, delež odziva poskok pa v skupini 50–59 let. Dominantnost spodnjega uda v opori ni bila povezana z odzivom na motnjo. Le pacienta z nevropatijo sta imela slabše statično in dinamično ravnotežje ter nižjo hitrost sproščene in hitre hoje v primerjavi z zdravimi preiskovanci. Za razliko od zdravih je bila pri obeh pacientih (brez nevropatije) pri odzivih na motnje med hojo s hitrostjo 0,4 m/s prisotna le reakcija koraka (vmesni dostop, križni korak). Zaključek: Skladno s predhodnimi raziskavami naši rezultati kažejo na slabše ravnotežje, nižjo hitrost hoje in drugačne odzive na motnje v lateralni smeri med hojo s hitrostjo 0,4 m/s pri skupini 60–69 let v primerjavi s skupino 50–59 let in pri pacientih s sladkorno boleznijo v primerjavi z zdravimi. V prihodnje svetujemo raziskave na večjem vzorcu in zmanjšanje pristranskosti pri odčitavanju odzivov na motnje med hojo.

• Language: Slovenian
• Keywords: magistrska dela, fizioterapija, ravnotežje, odzivi na motnje, zdravi, starejši odrasli, sladkorna bolezen
• Work type: Master's thesis/paper
• Typology: 2.09 - Master's Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [J. Jereb]
• Year: 2024
• Number of pages: 63 str.
• PID: 20.500.12556/RUL-165273
• UDC: 615.8
• COBISS.SI-ID: 216960515
• Publication date in RUL: 29.11.2024

Secondary language

• Language: English
• Title: Balance, gait and responses to perturbations during walking in healthy (older) adults and patients with diabetes : master thesis

Abstract

Introduction: Decline of the somatosensory system function, which occurs with aging or diabetes, may influence balance control reactions. Less effective reactive balance contributes to an increased risk of falls, which is a significant concern for older adults and patients. Purpose: The aim was to determine the differences in balance, gait and responses to perturbation during walking between healthy adults and healthy older adults and between diabetic patients (with and without diabetic neuropathy) and healthy individuals. Methods: We included 19 healthy participants aged 50–70 and four patients with diabetes mellitus and diminished light touch sensation in their feet. We have tested light touch sensation on feet with monofilaments, measured static and dynamic balance (stabilometry, limits of stability, Mini balance evaluation systems test), gait speed and responses to medio-lateral perturbations during walking on treadmill (speed 1 m/s and 0.4 m/s). Results: There was larger ellipse area in stabilometry (firm surface, eyes closed) in the 60–69-year group compared to the 50–59-year group. Differences between the groups were noted only in responses to perturbations in the lateral direction during walking at a speed of 0.4 m/s. The stabilization response was more frequent in the 60–69-year group, while the jump response was more common in the 50–59-year group. The dominance of the lower limb in support was not associated with the response to perturbation. Only the patients with neuropathy exhibited poorer static and dynamic balance and slower speeds in comfortable and fast walking compared to healthy participants. During responses to perturbations while walking at 0.4 m/s, only the stepping reaction (intermediate step, crossover step) was present in both patients (without neuropathy), unlike in healthy participants. Conclusion: Consistent with previous studies, our results indicate poorer balance, slower walking speed, and different responses to lateral perturbations during walking at 0.4 m/s in the 60–69-year group compared to the 50–59-year group and in patients with diabetes compared to healthy individuals. Future research is recommended with a larger sample size and reduction of bias in interpreting responses to perturbations during walking.

• Keywords: master's theses, physiotherapy, balance, responses to perturbations, healthy, older adults, diabetes mellitus