Zusammenfassung
Hintergrund: Zur Erhaltung von Balance und Gleichgewicht verarbeitet die posturale Kontrolle v. a.
visuelle, vestibuläre und propriozeptive Informationen und setzt diese in adäquate
motorische Reaktionen um. Bisher bleibt noch unklar, welchen Einfluss körperliche
Konstitution und Belastung auf Motorik und somit posturale Stabilität haben. Ziel
dieser Studie war daher, mittels computerunterstützter dynamischer Posturografie (CDP)
den Einfluss von Größe, BMI, Geschlecht und akuter körperlicher Ausbelastung auf das
Gleichgewicht zu untersuchen. Probanden und Methoden: 84 Probanden wurden nach standardisierten Fragebogen zu Größe, BMI und sportlicher
Aktivität befragt und dann die posturale Stabilität bestimmt. 17 weitere Probanden
wurden mittels Fahrradergometrie ausbelastet. Nach definiertem Protokoll fand hier
die CDP in Ruhe, bei maximaler Belastung und dann in 5-minütigen Abständen bis zur
Erholung statt. Ergebnisse: Größe, Geschlecht und regelmäßige körperliche Aktivität hatten keinen Einfluss auf
die Balancefähigkeit. Ein deutlicher Effekt konnte hingegen bei akuter körperlicher
Belastung beobachtet werden: Unmittelbar nach Ausbelastung verschlechterte sich die
posturale Stabilität im Vergleich zum Ausgangswert um 44 % (p < 0,017). Bereits 15
Minuten später wurde eine vollständige Erholung beobachtet. Schlussfolgerung: Während Größe und regelmäßiger Freizeitsport nicht die Balancefähigkeit beeinflussen,
führen hoher BMI und akute Ausbelastung zu einer deutlichen Reduktion der posturalen
Stabilität. Die Ergebnisse können daher das ansteigende Verletzungsrisiko nach starker
Beanspruchung gut erklären, insbesondere bei Sportarten, welche ein hohes Maß an Gleichgewichtsvermögen
erfordern.
Abstract
Context and objective: In order for balance to be maintained, the postural control system must process above
all visual, vestibular and proprioceptive information and translate this input into
appropriate motor responses. The influence of bodily constitution and physical activity
on motor responses and thus on postural stability is still unclear. To use computerized
dynamic posturography (CDP) to investigate the influence of body height, body mass
index (BMI), regular sporting activity and acute maximal exercise on balance. Subjects and methods: Eighty-four subjects completed a standardized questionnaire on their height, BMI
and sporting activity. We then assessed the postural stability of the subjects. Seventeen
further subjects performed a maximal exercise test on a bicycle ergometer. We used
CDP and a predefined protocol to assess balance at rest, at maximal exercise and then
at 5-minute intervals until recovery. Results: Body height and regular physical activity did not influence balance ability. By contrast,
BMI and acute physical exercise had a strong effect. Immediately after maximal exercise,
postural stability deteriorated by 44 % compared to the baseline level (p < 0.017).
Complete recovery occurred within only 15 minutes. Conclusions: Whereas body height and regular physical activity do not influence balance performance,
a high BMI value and acute maximal exercise lead to a considerable decrease in postural
stability. Our results can thus explain the increasing risk of injury after strenuous
physical activity, especially in association with sports that require excellent balance.
Schlüsselwörter
posturale Stabilität - Posturografie - BMI - körperliche Belastung - Konstitution
Key words
postural stability - posturography - BMI - physical activity - bodily constitution
Literatur
- 1
Maurer C, Mergner T, Peterka R J.
Multisensory control of human upright stance.
Exp Brain Res.
2006;
171(2)
231-250, Epub 2005 Nov 24
- 2
Raper S A, Soames R W.
The influence of stationary auditory fields on postural sway behaviour in man.
Eur J Appl Physiol Occup Physiol.
1991;
63 (5)
363-367
- 3
Friden T, Roberts D, Ageberg E.
Review of knee proprioception and the relation to extremity function after an anterior
cruciate ligament rupture.
JOrthopSportsPhysTher.
2001;
31 (10)
567-576
- 4
Hettinga D L.
Normal joint structures and their reaction to injury.
JOrthopSportsPhysTher.
1979;
1
83-88
- 5
Jerosch J, Prymka M.
Proprioception and joint stability.
KneeSurgSportsTraumatolArthrosc.
1996;
4 (3)
171-179
- 6
Borah D, Wadhwa S, Singh U et al.
Age related changes in postural stability.
Indian J Physiol Pharmacol.
2007;
51(4)
395-404
- 7
Gonzalez R amirez A, Lazaro del Nogal M.
Evaluation of postural control systems in elderly patients with repeated falls.
Rev Esp Geriatr Gerontol.
2008;
43 (2)
71-75
- 8
Haibach P S.
Aging and time-to-postural stability following a visual perturbation.
Aging Clin Exp Res.
2007;
19 (6)
438-443
- 9
Aydog E, Bal A.
Evaluation of dynamic postural balance using the Biodex Stability System in rheumatoid
arthritis patients.
Clin Rheumatol.
2006;
25 (4)
462-467
- 10
Hue O, Simoneau M, Marcotte J et al.
Body weight is a strong predictor of postural stability.
Gait Posture.
2007;
26 (1)
32-38
- 11
Nagy E, Toth K, Janositz G.
Postural control in athletes participating in an ironman triathlon.
Eur J Appl Physiol.
2004;
92
407-413
- 12
Palm H G, Strobel J, Achatz G et al.
The Role and Interaction of Visual and Auditory Afferents in Postural Stability.
Gait Posture.
2009;
30 (3)
328-333
- 13
Pincivero D M, Lephart S M, Henry T.
Learning effects and reliability of the Biodex Stability System.
JAthlTrain.
1995;
30
P48
- 14 Spanaus W. Herzfrequenzkontrolle im Ausdauersport. Dissertation Philosophische
Fakultät Düsseldorf: Heinrich-Heine-Universität; 2000
- 15
Angyan L, Teczely T, Angyan Z.
Factors affecting postural stability of healthy young adults.
Acta Physiol Hung.
2007;
94 (4)
289-299
- 16
Greve J.
Correlation between body mass index and postural balance.
Clinics.
2007;
62 (6)
717-720
- 17
Genthon N, Rougier P.
Influence of an asymmetrical body weight distribution on the control of undisturbed
upright stance.
J Biomech.
2005;
38 (10)
2037-2049
- 18
Anker L C, Weerdesteyn V, Nes I J et al.
The relation between postural stability and weight distribution in healthy subjects.
Gait Posture.
2008;
27 (3)
471-477
- 19
Deforche B I, Hills A P, Worringham C J et al.
Balance and postural skills in normal-weight and overweight prepubertal boys.
Int J Pediatr Obes.
2008;
29
1-8
- 20
Allard van P, Nault M L, Hinse S et al.
Relationship between morphologic somatotypes and standing posture equilibrium.
Ann Hum Biol.
2001;
28 (6)
624-633
- 21
Lakie M, Caplan N, Loram I D.
Human balancing of an inverted pendulum with a compliant linkage: neural control by
anticipatory intermittent bias.
J Physiol.
2003;
551 (Pt 1)
357-370
- 22
Winter D A, Patla A E, Prince F et al.
Stiffness Control of Balance in Quiet Standing.
J Neurophysiol.
1998;
80
1211-1221
- 23
Berger W, Trippel M, Discher M et al.
Influence of subjects’ height on the stabilization of posture.
Acta Otolaryngol.
1992;
112 (1)
22-30
- 24
Davlin C D.
Dynamic balance in high level athletes.
Percept Mot Skills.
2004;
98 (3 Pt 2)
1171-1176
- 25
Paillard T, Noe F.
Postural performance and strategy in the unipedal stance of soccer players at different
levels of competition.
J Athl Train.
2006;
41 (2)
172-176
- 26
Petrella R J, Cunningham D A.
Influence of age and physical training on postural adaptation.
Can J Sport Sci.
1989;
14 (1)
4-9
- 27
Derave W, Tombeux N, Cottyn J et al.
Treadmill exercise negatively affects visual contribution to static postural stability.
Int J Sports Med.
2002;
23
44-49
- 28
Lepers R.
Posture control after prolonged exercise.
Eur J Appl Physiol.
1997;
76
55-61
- 29
Chamarro A, Fernández-Castro J.
The perception of causes of accidents in mountain sports: a study based on the experiences
of victims.
ccid Anal Prev.
2009;
41 (1)
197-201, Epub 2008 Nov 21
Dr. Hans-Georg Palm
Klinik für Unfallchirurgie und Orthopädie, Bundeswehrkrankenhaus Ulm
Oberer Eselsberg 40
89081 Ulm
Email: hg_palm@yahoo.de
