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ORIJINAL ARAŞTIRMA

Tek Seans Egzantrik Egzersizin Propriyosepsiyon ve Oksidatif Stres Üzerine Etkisi: Ön Çalışma
The Effect of a Single Session of Eccentric Exercise on Proprioception and Oxidative Stress in Knee Osteoarthritis: A Preliminary Study
Received Date : 06 Feb 2020
Accepted Date : 15 Jun 2020
Available Online : 28 Sep 2020
Doi: 10.31609/jpmrs.2020-74173 - Makale Dili: EN
J PMR Sci. 2020;23(3):191-200
ÖZET
Amaç: Diz osteoartriti tedavisinde izokinetik güçlendirme egzersizleri yaygın olarak uygulanmaktadır. Bu çalışmanın temel amacı, diz osteoartritinde eksantrik egzersizin propriosepsiyon üzerine etkilerini incelemektir. Ayrıca, oksidatif hasar ve yorgunluk da araştırılmıştır. Gereç ve Yöntemler: Diz osteoartriti olan 12 hasta ve 11 sağlıklı kadının dominant bacağına eksantrik egzersiz seansı uygulandı. Gecikmiş başlangıçlı kas ağrı (DOMS), izometrik pik tork (IPT), görsel geri bildirimli ve bildirimsiz eklem pozisyon açısı (JPA) ve eklem reaksiyonu açıları (JRA), serum keratin kinaz (CK), potasyum (K), laktat dehidrojenaz (LDH), malondialdehid (MDA), nitrikoksit (NO) ve glutatyon egzersizden hemen önce, hemen sonra, 24 ve 72. saatlerde değerlendirildi. Bulgular: Gruplar arasında yaş, ilk laboratuvar değerleri, DOMS, IPT, JPA, JRA, CK, K, LDH, MDA, NO ve glutatyon düzeyleri benzerdi (p>0,05). Yüksek yoğunluklu eksantrik egzersize yanıt olarak, her iki grupta da kas hasarı (DOMS, CK), oksidatif streste artış (MDA) ve propriyosepsiyonda bozulma (JPA, JRA) saptandı (p<0,05). Görsel geri bildirim olmadığında, zaman ve gruptan bağımsız olarak JPA ve JRA değerleri belirgin yüksekti (p≤0,001). Sonuç: Erken başlangıçlı diz osteoartrit rehabilitasyonunda, kas gücünü artırmak ve propriyoseptif algıyı arttırarak uygun motor yanıtını sağlamak için propriyoseptif egzersiz ile kombine bireysel eksantrik egzersiz protokollerinin uygulanmasını tavsiye ediyoruz. Egzersize bağlı oksidatif stres, optimum performans ve iyileşme sürecinde göz önünde bulundurulması gereken bir unsurdur.
ABSTRACT
Objective: Isokinetic strengthening exercises are widely used in the rehabilitation of knee osteoarthritis. The main aim of the present study was to examine the effects of eccentric exercise on proprioception in knee osteoarthritis. In addition, the oxidative damage and fatigue were also investigated. Material and Methods: Twelve patients with knee osteoarthritis, and eleven healthy women underwent an eccentric exercise session of the dominant leg. Delayedonset muscle soreness (DOMS), isometric peak torque (IPT), joint position angle (JPA) and joint reaction angles (JRA) with and without visual feed-back, serum creatine kinase (CK), potassium (K), lactate dehydrogenase (LDH), malondialdehyde (MDA), nitric oxide (NO) and glutathione were evaluated before, immediatedly after, 24th and 72nd h after the exercise. Results: No significant difference was found between the groups in terms of age, baseline laboratory variables, IPT, DOMS, JPA, JRA, CK, K, LDH, MDA, NO, and glutathione levels (p>0.05) Muscle damage (DOMS, CK), increased oxidative stress (MDA) and impaired proprioception (JPA,JRA) were occured in response to high intensity eccentric exercise in both groups (p<0.05). The angles deviating from the reference angle (JPA) and JRA values independent of time and group was significantly higher in without visual feedback measurements (p≤0.001). Conclusion: In early onset knee osteoarthritis rehabilitation, we recommend individual eccentric exercise protocols combined with proprioceptive exercise to improve muscle strength and to ensure proper motor response by increasing the proprioceptive perception. Exercise induced oxidative stress is an important consideration for optimal performance, and recovery process.
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