Vpliv gibljivosti spodnjih udov na ravnotežje pri starostnikih : pregled literature

Tilinger, Nika (author), Rugelj, Darja (mentor)

Uvod: Dobro ravnotežje je nujna spretnost vsakdanjega življenja, za katero potrebujemo prispevek iz vidnega, vestibularnega in proprioceptivnega sistema ter primerno mišično zmogljivost, reakcijski čas in primerno gibljivost. S starostjo pride do progresivne izgube funkcionalnosti teh sistemov, kar lahko prispeva k ravnotežnemu deficitu. Gibljivost je povezana tudi s padci pri starostnikih. Več raziskovalcev je predlagalo, da so s starostjo povezane spremembe ravnotežja in hoje ter sklepnega gibanja in moči direktno povezane z omejitvami v sklepnem obsegu gibanja. Obseg gibljivosti sklepa je spremenljiv z nenapornim terapevtskim programom, s katerim bi lahko izboljšali spremenjeno funkcijo ravnotežja in hoje v starosti. Namen: Na osnovi pregleda strokovne literature smo želeli predstaviti vpliv gibljivosti sklepov spodnjih udov na ravnotežje pri starostnikih. Metode dela: Pregled znanstvene literature na podlagi vključitvenih in izključitvenih kriterijev. Pregledali smo podatkovne zbirke: PubMed, ScienceDirect, Scopio, WebOfKnowledge in Elsevier. V pregled smo vključili članke, ki so bili napisani v angleškem ali slovenskem jeziku, katerih besedila so bila prosto dostopna, članke, v katerih so preiskovali starostnike in so kot del testiranja uporabili goniometrične meritve velikih sklepov spodnjih udov, članke, v katerih so preiskovali ravnotežje pri starostnikih v povezavi z ravnotežjem, ter vsaj po tri članke, ki so se navezovali na kolk, koleno in gleženj. Rezultati: V pregled je bilo vključenih devet študij, kjer so proučevali vpliv gibljivosti sklepov spodnjih udov na ravnotežje pri starostnikih. V vseh študijah so potrdili, da ima gibljivost pomembno vlogo pri ohranjanju in izboljšanju ravnotežja pri starostnikih. Najbolj pomembna giba za ohranjanje oz. izboljšanje ravnotežja naj bi bila gib dorzalna fleksija v gležnju in gib ekstenzija v kolku. Prav tako je za izboljšanje obsega gibljivosti primeren terapevtski program z dolgim zadržkom raztega (30 sekund in dlje). Razprava in sklep: Iz našega pregleda literature je bilo moč razbrati povezavo med zmanjšano gibljivostjo in starostjo, povezavo med zmanjšano gibljivostjo in povečano pojavnostjo padcev ter med povečano gibljivostjo in izboljšanimi parametri hoje. Povečanje gibljivosti sklepov spodnjih udov se je pokazalo za pomemben aspekt, prek katerega je možno izboljšati ravnotežje pri starostnikih. Ni še enotnega mnenja, kakšen bi moral biti terapevtski program raztezanja za starostnike, kar bi bilo treba raziskati v prihodnje.

• Language: Slovenian
• Keywords: ravnotežje, starostniki, gibljivost, (pasivni) obseg gibanja, gleženj, koleno, kolk
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2017
• PID: 20.500.12556/RUL-93047
• COBISS.SI-ID: 5285739
• Publication date in RUL: 18.07.2017

Secondary language

• Language: English
• Title: The impact of flexibility of lower limbs on balance in older adults : literature review

Abstract

Introduction: Good balance is a necessary skill in everyday life. It requires contributions from the visual, vestibular and proprioceptive system, sufficient muscular strength, reaction time and sufficient flexibility. With age those systems progressively lose their functionality, which leads to a balance deficit. Flexibility is associated with elderly people falling more often. Several researches have suggested that age-related changes in balance, walking, joint movement and muscle strength are directly related to the limitations in joint range of motion. Joint range of motion can be improved with a low-intensity therapeutic program that can enhance the change in function of balance and walking in old age. Purpose: Based on the literature review the goal was to present the effect of lower limb joint flexibility on balance in elderly. Methods: The literature review was based on inclusion and exclusion criteria. Relevant literature was searched in the following databases: PubMed, ScienceDirect, Scopio, WebOfKnowledge and Elsevier. The review included articles written in English or Slovenian that were freely accessible. They studied the elderly and used goniometric measurements of lower limb mobility as a testing tool. Some of the articles studied flexibility in relation to balance in elderly. At least 3 articles focused on hips, knees and ankles. Results: The literature review included 9 articles examining the effect of lower limb joint mobility on balance in elderly people. All of the studies confirmed that joint mobility plays an important role in maintaining and improving balance in elderly. The most important types of movement for maintaining or improving balance are ankle dorsiflexion and hip extension. The key to improve mobility lies in an appropriate therapeutic program that includes long stretches of movement (30 seconds and more). Discussion and conclusion: The review helped to determine a link between reduced mobility and aging, a link between reduced mobility and increased incidence of falls, and a link between improved mobility and improved walk parameters. Increased lower limb joint mobility proved to be an important element in improving balance in elderly people. At the moment there is no agreement about a single therapeutic program for improving flexibility and mobility in elderly, which means that this area offers the opportunity for further research.

• Keywords: balance, elderly, mobility, (passive) range of motion, ankle, knee, hip