Skolyozlu bireylerde izometrik egzersizlersırasında latissimus dorsi kasının lateral ve medialparça aktivasyonlarının değerlendirilmesi
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Dosyalar
Tarih
2023
Yazarlar
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Yayıncı
Kırıkkale Üniversitesi / Sağlık Bilimleri Enstitüsü / Fizyoterapi ve Rehabilitasyon Ana Bilim Dalı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Çalışmamızın amacı skolyozlu bireylerde izometrik egzersizler sırasında latissimus dorsi kasının lateral ve medial parça kassal aktivasyonlarını değerlendirmektir. Çalışmaya 18-35 yaş aralığında 20'si sağlıklı 20'si skolyozlu olmak üzere toplamda 40 birey dahil edildi. Skolyozlu bireylerin Cobb açıları 35 derece altıydı. Bireylerin gövde rotasyonu (gibozite) değerlendirmesi Adam's testi yapılarak ve skolyometre kullanılarak gerçekleştirildi. Maksimum İstemli İzometrik Kasılma (MİİK) ve egzersizler sırasındaki kassal aktivasyon değerlendirmeleri için yüzeyel elektromyografi (EMG) cihazı kullanıldı. Bireylere duvar kenarında izometrik omuz internal rotasyonu, yüzüstü pozisyonda izometrik omuz ekstansiyonu, izometrik lat pull down ve izometrik body lifting egzersizleri yaptırıldı. Üst ekstremite fonksiyonellik değerlendirmesi Kol, Omuz ve El Sorunları Hızlı Anketi (Quick-DASH) anketi kullanılarak yapıldı. MİİK değerleri arasında sağlıklı ve skolyozlu bireyler arasında fark yoktu (p>0,05). Skolyozlu bireylerde duvar kenarında izometrik egzersizde sağ latissimus dorsi medial parçasının sağlıklı bireylere göre kassal aktivasyonunun daha az olduğu bulundu (p<0.05). Yüzüstü pozisyonda izometrik omuz ekstansiyonunda skolyozlu bireylerde sağlıklı bireylere göre sağ latissimus dorsi lateral ve medial parçalarının kassal aktivasyonunun daha az olduğu gözlemlendi (p<0.05). İzometrik lat pull down'da sağ latissimus dorsi medial parçanın kassal aktivasyonu sağlıklı bireylerde skolyozlu bireylere daha fazlaydı (p<0.05). İzometrik body lifting (caudal depression)'de sağlıklı bireylerde sol latissimus dorsi lateral parça skolyozlu bireylere göre aktivasyonu daha fazlaydı (p<0.05). Apex'in yönüne göre gruplar arasında MİİK ölçüm değerleri açısından istatistiksel olarak anlamlı derecede farklılık görülmedi (p>0,05). İzometrik body lifting (caudal depression)'de sağ Latissimus Dorsi (LD) lateral parça kassal aktivasyonu apexi sağda olan bireylerde apexi solda olan bireylere göre anlamlı derecede daha yüksektir (p<0.05). İzometrik lat pull down'da sağ LD lateral parça kassal aktivasyonu apex'i sağda olan bireylerde apex'i solda olan bireylere göre anlamlı derecede daha yüksektir (p<0.05). Quick-Dash skorları incelendiği zaman skolyozu olan bireylerin üst ekstremite fonksiyonelliği sağlıklı bireylere göre anlamlı derecede az olduğu görüldü (p<0.05). Sonuç olarak, skolyozlu bireylerde izometrik egzersizlerin latissimus dorsi kasının lateral ve medial parça kassal aktivasyonlarını etkilediği bulundu. Skolyozlu bireylerde latissimus dorsinin kas içi dengesini sağlayabilmek adına sağ tarafta duvar kenarında izometrik omuz internal rotasyonu ve sol tarafta ise yüzüstü pozisyonda izometrik omuz ekstansiyonu tek taraflı kullanılarak PSSE (Fizyoterapötik Skolyoza Özgü Egzersiz) programına başlanabilir. Apex'i solda olan bireylerde sağ LD lateral parçası bir süre tek taraflı çalıştırılarak PSSE programına başlanabilir. PSSE'nin ilerleyen aşamalarında simetrik egzersizler PSSE programına eklenebilir.
The aim of our study is to evaluate the lateral and medial part muscle activations of the latissimus dorsi muscle during isometric exercises in individuals with scoliosis. A total of 40 individuals, 20 healthy and 20 with scoliosis, between the ages of 18-35 participated in the study. Cobb angles of individuals with scoliosis were less than 35 degrees. Trunk rotation (gibbosity) evaluation of the participants was performed by Adam's test and using a scoliometer. A Superficial electromyography (EMG) device was used for the evaluation of muscle activation during Maximal Voluntary Isometric Contraction (MVIC) and exercises. Individuals performed isometric shoulder internal rotation at the wall, isometric shoulder extension in the prone position, isometric lat pull down and isometric body lifting exercises. Upper extremity functionality assessment was performed using the shortened disabilities of the arm, shoulder and hand questionnaire (Quick-DASH). There was no difference in MVIC values between healthy and scoliotic individuals (p>0.05). It was found that the muscle activation of the medial part of the right latissimus dorsi was lower in isometric exercise at the wall edge in individuals with scoliosis compared to healthy individuals (p<0.05). It was observed that the muscle activation of the lateral and medial parts of the right latissimus dorsi was less in individuals with scoliosis in isometric shoulder extension in the prone position than in healthy individuals (p<0.05). Muscle activation of the right latissimus dorsi medial part in isometric lat pull-down was higher in healthy individuals than in individuals with scoliosis (p<0.05). In isometric body lifting (caudal depression), muscle activation was higher in healthy individuals than in individuals with left latissimus dorsi lateral fragment scoliosis (p<0.05). There was no statistically significant difference between the groups in terms of MVIC measurement values according to the direction of Apex (p>0.05). In isometric body lifting (caudal depression), right Latissimus Dorsi (LD) lateral part muscle activation is significantly higher in individuals with right apex than individuals with left apex (p<0.05). In isometric lat pull down, right LD lateral part muscle activation was significantly higher in individuals with right apex than individuals with left apex (p<0.05). When the Quick-Dash scores were examined, it was observed that the upper extremity functionality of individuals with scoliosis was significantly reduced compared to healthy individuals (p<0.05). As a result, it was found that isometric exercises affect the lateral and medial part of muscle activations of the latissimus dorsi muscle in individuals with scoliosis. In order to maintain the intramuscular balance of the latissimus dorsi in individuals with scoliosis, the PSSE (Physiotherapeutic Scoliosis Specific Exercises) program can be started with unilateral isometric shoulder internal rotation at the wall edge on the right side and isometric shoulder extension in the prone position on the left side. In individuals with left apex, the right LD lateral part can be operated unilaterally for a while and the program can be started. In the later stages of PSSE, symmetrical exercises can be added to the PSSE program.
The aim of our study is to evaluate the lateral and medial part muscle activations of the latissimus dorsi muscle during isometric exercises in individuals with scoliosis. A total of 40 individuals, 20 healthy and 20 with scoliosis, between the ages of 18-35 participated in the study. Cobb angles of individuals with scoliosis were less than 35 degrees. Trunk rotation (gibbosity) evaluation of the participants was performed by Adam's test and using a scoliometer. A Superficial electromyography (EMG) device was used for the evaluation of muscle activation during Maximal Voluntary Isometric Contraction (MVIC) and exercises. Individuals performed isometric shoulder internal rotation at the wall, isometric shoulder extension in the prone position, isometric lat pull down and isometric body lifting exercises. Upper extremity functionality assessment was performed using the shortened disabilities of the arm, shoulder and hand questionnaire (Quick-DASH). There was no difference in MVIC values between healthy and scoliotic individuals (p>0.05). It was found that the muscle activation of the medial part of the right latissimus dorsi was lower in isometric exercise at the wall edge in individuals with scoliosis compared to healthy individuals (p<0.05). It was observed that the muscle activation of the lateral and medial parts of the right latissimus dorsi was less in individuals with scoliosis in isometric shoulder extension in the prone position than in healthy individuals (p<0.05). Muscle activation of the right latissimus dorsi medial part in isometric lat pull-down was higher in healthy individuals than in individuals with scoliosis (p<0.05). In isometric body lifting (caudal depression), muscle activation was higher in healthy individuals than in individuals with left latissimus dorsi lateral fragment scoliosis (p<0.05). There was no statistically significant difference between the groups in terms of MVIC measurement values according to the direction of Apex (p>0.05). In isometric body lifting (caudal depression), right Latissimus Dorsi (LD) lateral part muscle activation is significantly higher in individuals with right apex than individuals with left apex (p<0.05). In isometric lat pull down, right LD lateral part muscle activation was significantly higher in individuals with right apex than individuals with left apex (p<0.05). When the Quick-Dash scores were examined, it was observed that the upper extremity functionality of individuals with scoliosis was significantly reduced compared to healthy individuals (p<0.05). As a result, it was found that isometric exercises affect the lateral and medial part of muscle activations of the latissimus dorsi muscle in individuals with scoliosis. In order to maintain the intramuscular balance of the latissimus dorsi in individuals with scoliosis, the PSSE (Physiotherapeutic Scoliosis Specific Exercises) program can be started with unilateral isometric shoulder internal rotation at the wall edge on the right side and isometric shoulder extension in the prone position on the left side. In individuals with left apex, the right LD lateral part can be operated unilaterally for a while and the program can be started. In the later stages of PSSE, symmetrical exercises can be added to the PSSE program.
Açıklama
Anahtar Kelimeler
Fizyoterapi ve Rehabilitasyon = Physiotherapy and Rehabilitation
