{"id":811,"date":"2023-08-29T10:30:10","date_gmt":"2023-08-29T10:30:10","guid":{"rendered":"https:\/\/blogs.uef.fi\/uefllt\/?p=811"},"modified":"2023-12-10T11:40:55","modified_gmt":"2023-12-10T11:40:55","slug":"young-type-1-diabetes-subjects-sway-more-than-healthy-persons-when-somatosensory-system-is-challenged-in-static-standing-postural-stability-tests","status":"publish","type":"post","link":"https:\/\/blogs.uef.fi\/uefllt\/2023\/08\/29\/young-type-1-diabetes-subjects-sway-more-than-healthy-persons-when-somatosensory-system-is-challenged-in-static-standing-postural-stability-tests\/","title":{"rendered":"Young type 1 diabetes subjects sway more than healthy persons when somatosensory system is challenged in static standing postural stability tests"},"content":{"rendered":"\n<p>Tyypin 1 diabetes on autoimmuunisairaus, jossa elimist\u00f6 ei pysty tuottamaan insuliinia. Diabeetikoilla voi olla kohonnut verensokeritaso diabeteksen hoidon ollessa ep\u00e4tasapainossa, mik\u00e4 voi ajan my\u00f6t\u00e4 aiheuttaa diabetekseen liittyvi\u00e4 komplikaatioita. Ensimm\u00e4isin\u00e4 n\u00e4kyvin\u00e4 oireina voi olla esimerkiksi pienten verisuonten ja \u00e4\u00e4reishermoston toiminnan h\u00e4iri\u00f6t, jotka voivat heikent\u00e4\u00e4 el\u00e4m\u00e4laatua ja lis\u00e4t\u00e4 terveydenhuollon tarvetta. Terveydenhuollossa onkin t\u00e4rke\u00e4\u00e4 huomioida kaikki hoitoon liittyv\u00e4t parannukset, kun k\u00e4sitell\u00e4\u00e4n diabetesta ja siihen liittyvi\u00e4 komplikaatioita.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Aiemmissa tutkimuksissa<\/h2>\n\n\n\n<p>Aiemmat tutkimukset ovat osoittaneet selvi\u00e4 eroja tasapainonhallinnassa pitk\u00e4aikaista diabeettista neuropatiaa sairastavien potilaiden ja terveiden kontrollihenkil\u00f6iden v\u00e4lill\u00e4 (Boucher et al. 1995, Bonnet et al. 2009, Almurdhi et al. 2017). Perifeerinen neuropatia on tunnistettu yhdeksi syyksi tasapainoh\u00e4iri\u00f6ille. Lis\u00e4ksi diabeetikoilla on havaittu olevan huomattavasti enemm\u00e4n huojuntaliikett\u00e4 verrattuna normaaleihin terveisiin henkil\u00f6ihin (Boucher et al. 1995, Uccioli et al. 1995). Kirjallisuudessa on kuitenkin olemassa ristiriitaisia tutkimustuloksia. Bonnet et al. (2009) eiv\u00e4t havainneet eroja diabeetikoiden ja terveiden kontrollihenkil\u00f6iden v\u00e4lill\u00e4 staattisessa tasapainossa ilman komplikaatioita. Kun taas Oppenheim et al. (1999) esittiv\u00e4t, ett\u00e4 haastavissa tilanteissa ilmenee joitakin tasapainon hallinnan eroja, ja heid\u00e4n mukaansa diabeetikoiden tasapainonhallinta ja -kyky voivat erota terveist\u00e4 ihmisist\u00e4.<\/p>\n\n\n\n<figure class=\"wp-block-image size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"375\" height=\"213\" src=\"https:\/\/blogs.uef.fi\/uefllt\/wp-content\/uploads\/sites\/165\/2023\/08\/Picture1-1.jpg\" alt=\"Tutkimuksessa aiheena oli tyypin 1 diabetes ja tasapaino. Kuvan l\u00e4hde: https:\/\/www.pexels.com\/\" class=\"wp-image-826\" style=\"width:375px;height:213px\" srcset=\"https:\/\/blogs.uef.fi\/uefllt\/wp-content\/uploads\/sites\/165\/2023\/08\/Picture1-1.jpg 375w, https:\/\/blogs.uef.fi\/uefllt\/wp-content\/uploads\/sites\/165\/2023\/08\/Picture1-1-300x170.jpg 300w\" sizes=\"auto, (max-width: 375px) 100vw, 375px\" \/><\/figure>\n\n\n\n<p><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Tutkimuksen osallistujat ja toteutus<\/h2>\n\n\n\n<p>HUMEA laboratoriossa It\u00e4-Suomen yliopiston terveystieteiden, liikunta -ja urheilul\u00e4\u00e4ketieteen sek\u00e4 teknillisen fysiikan laitoksen yhteisty\u00f6ss\u00e4 tekem\u00e4 tutkimus keskittyi selvitt\u00e4m\u00e4\u00e4n tyypin 1 diabeetikoiden tasapainoa ja sen hallintaa. T\u00e4m\u00e4 julkaistu tutkimus on osa <a href=\"https:\/\/sites.uef.fi\/humea\/projects\/diames\/\">DIAMES &#8211; Diabetes Mellitus Exercise and Stress -tutkimusta.<\/a> Tutkimukseen osallistui yhteens\u00e4 53 koehenkil\u00f6\u00e4, joista 18 sairasti tyypin 1 diabetesta ja 35 olivat terveit\u00e4 kontrollihenkil\u00f6it\u00e4. Tyypin 1 diabetesta sairastavien ryhm\u00e4n osalta osallistumiskriteerit olivat ik\u00e4 18\u201350 vuotta, kehon koostumus oli normaali tai liev\u00e4sti ylipainoinen (BMI 18\u201335), tyypin 1 diabeteksen kesto 3\u201325 vuotta eik\u00e4 osallistujalla saanut olla diabetekseen liittyvi\u00e4 kliinisesti todettuja komplikaatioita. Kontrolliryhm\u00e4ll\u00e4 oli vastaavat kriteerit, mutta heilt\u00e4 vaadittiin hyv\u00e4\u00e4 terveydentilaa ilman kroonisia sairauksia.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"481\" src=\"https:\/\/blogs.uef.fi\/uefllt\/wp-content\/uploads\/sites\/165\/2023\/08\/Picture2-1024x481.jpg\" alt=\"Tutkimus toteutettiin HUMEA laboratoriossa.\" class=\"wp-image-817\" srcset=\"https:\/\/blogs.uef.fi\/uefllt\/wp-content\/uploads\/sites\/165\/2023\/08\/Picture2-1024x481.jpg 1024w, https:\/\/blogs.uef.fi\/uefllt\/wp-content\/uploads\/sites\/165\/2023\/08\/Picture2-300x141.jpg 300w, https:\/\/blogs.uef.fi\/uefllt\/wp-content\/uploads\/sites\/165\/2023\/08\/Picture2-768x361.jpg 768w, https:\/\/blogs.uef.fi\/uefllt\/wp-content\/uploads\/sites\/165\/2023\/08\/Picture2.jpg 1472w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<p><a href=\"https:\/\/sites.uef.fi\/humea\/humea-laboratory\/\">Humea lab\/Uef<\/a><\/p>\n\n\n\n<p>Tasapainoa ja asennonhallintaa mitattiin voimalevyll\u00e4, jossa suoritettiin seisten teht\u00e4vi\u00e4 60 sekuntia kest\u00e4vi\u00e4 mittauksia silm\u00e4t auki, silm\u00e4t kiinni sek\u00e4 p\u00e4\u00e4 taakse taivutettuna niin sanotussa \u201dhead tilt\u201d asennossa. Kolme testi\u00e4 suoritettiin ilman vaahtomuovipatjaa ja kolme 3 cm paksuisen vaahtomuovipatjan kanssa, joka oli asetettu voimalevyn p\u00e4\u00e4lle (ep\u00e4vakaa pehmuste).<\/p>\n\n\n\n<p>T\u00e4ss\u00e4 tutkimuksessa merkitt\u00e4vi\u00e4 eroja diabeetikoiden ja terveiden kontrollihenkil\u00f6iden v\u00e4lill\u00e4 havaittiin vain testeiss\u00e4, joissa ep\u00e4vakaa vaahtomuovipatja oli k\u00e4yt\u00f6ss\u00e4 voimalevyn p\u00e4\u00e4ll\u00e4 haastaen asennon- ja tasapainon hallintaa. Varsinkin muutos silm\u00e4t auki vs. silm\u00e4t kiinni oli diabeetikoilla suurempi terveisiin kontrolleihin n\u00e4hden. Tulokset viittaavat siihen, ett\u00e4 diabetes itsess\u00e4\u00e4n, ilman tunnistettuja komplikaatioita, voi aiheuttaa muutoksia tasapainon hallinnassa.<\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"160\" height=\"239\" src=\"https:\/\/blogs.uef.fi\/uefllt\/wp-content\/uploads\/sites\/165\/2023\/08\/Picture3.jpg\" alt=\"Tulokset viittaavat siihen, ett\u00e4 diabetes itsess\u00e4\u00e4n, ilman tunnistettuja komplikaatioita, voi aiheuttaa muutoksia tasapainon hallinnassa. Kuvan l\u00e4hde: https:\/\/www.pexels.com\/\" class=\"wp-image-820\" \/><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">Yhteenveto<\/h2>\n\n\n\n<p>Yhteenvetona tutkimuksemme osoittaa, ett\u00e4 tyypin 1 diabetes voi heikent\u00e4\u00e4 tasapainoa, vaikka kliinisesti diagnosoituja komplikaatioita ei olisikaan. Heikentym\u00e4t huomattiin silloin, kun visuaalinen palaute oli estetty ja somatosensorinen j\u00e4rjestelm\u00e4 oli haastettu ep\u00e4vakaan vaahtomuovipatjan avulla. T\u00e4m\u00e4 viittaa siihen, ett\u00e4 puutteet liittyv\u00e4t todenn\u00e4k\u00f6isesti somatosensorisen j\u00e4rjestelm\u00e4n toimintaan. Oletamme, ett\u00e4 painekeskipisteen huojunnan arviointi tasapainosta voi tarjota herk\u00e4n tavan tunnistaa potilaat, joilla on varhaisia diabetekseen liittyvi\u00e4 komplikaatioita, jotka vaikuttavat tasapainoon ja siten lis\u00e4\u00e4v\u00e4t kaatumisriski\u00e4. Varhaisen puutteiden havaitseminen ja asianmukaiset toimenpiteet voivat auttaa ennaltaehk\u00e4isem\u00e4\u00e4n ja v\u00e4hent\u00e4m\u00e4\u00e4n kaatumisia.<\/p>\n\n\n\n<p>\u201cTutkimusta rahoittivat EFSD\/JDRF\/Lilly sek\u00e4 <a href=\"https:\/\/diabetestutkimus.fi\/\">Diabetestutkimuss\u00e4\u00e4ti\u00f6<\/a>.\u201d<\/p>\n\n\n\n<p><a href=\"https:\/\/doi.org\/10.1111\/cpf.12849\">https:\/\/doi.org\/10.1111\/cpf.12849<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/full\/10.1111\/cpf.12849\">https:\/\/onlinelibrary.wiley.com\/doi\/full\/10.1111\/cpf.12849<\/a><\/p>\n\n\n\n<p>Almurdhi, M.M., Brown, S.J., Bowling, A.J., Boulton, M., Jeziorska, M.,Malik, R.A. &amp; Reeves, N.D. (2017) Altered walking strategy andincreased unsteadiness in participants with impaired glucosetolerance and type 2 diabetes relates to small\u2010fibre neuropathybut not vitamin D defiency.Diabetic&nbsp;&nbsp; Medicine, 34(6), 839\u2013845<\/p>\n\n\n\n<p>Bonnet C, Carello C, Turvey MT. Diabetes and postural stability: Review and hypotheses. J. Mot. Behav. 2009<\/p>\n\n\n\n<p>Boucher P, Teasdale N, Courtemanche R, et al. Postural stability in diabetic polyneuropathy. Diabetes Care (1995); 18<\/p>\n\n\n\n<p>Oppenheim U, Kohen-Raz R, Alex D, et al. Postural characteristics of diabetic neuropathy. Diabetes Care (1999); 22<\/p>\n\n\n\n<p>Uccioli L, Giacomini PG, Monticone G, et al. Body sway in diabetic neuropathy. Diabetes Care (1995); 18<\/p>\n\n\n\n<p>Terveisin,<\/p>\n\n\n\n<p>jatko-opiskelija Kim Lesch<\/p>\n\n\n\n<p>Researcher, MSc\/Physiotherapist<\/p>\n\n\n\n<p>Institute of Biomedicine\/ Sports and Exercise Medicine<\/p>\n\n\n\n<p>Faculty of Health Sciences<\/p>\n\n\n\n<p>University of Eastern Finland<\/p>\n\n\n\n<p><a href=\"kim.lesch@uef.fi\">kim.lesch(a)uef.fi<\/a>, +358504360919<\/p>\n\n\n\n<p>Lue lis\u00e4\u00e4 tutkimusaiheisia tekstej\u00e4 <a href=\"https:\/\/blogs.uef.fi\/uefllt\/category\/tutkimus\/\">t\u00e4\u00e4lt\u00e4<\/a>!<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tyypin 1 diabetes on autoimmuunisairaus, jossa elimist\u00f6 ei pysty tuottamaan insuliinia. Diabeetikoilla voi olla kohonnut verensokeritaso diabeteksen hoidon ollessa ep\u00e4tasapainossa, mik\u00e4 voi ajan my\u00f6t\u00e4 aiheuttaa diabetekseen liittyvi\u00e4 komplikaatioita. Ensimm\u00e4isin\u00e4 n\u00e4kyvin\u00e4 oireina voi olla esimerkiksi pienten verisuonten ja \u00e4\u00e4reishermoston toiminnan h\u00e4iri\u00f6t, jotka voivat heikent\u00e4\u00e4 el\u00e4m\u00e4laatua ja lis\u00e4t\u00e4 terveydenhuollon tarvetta. Terveydenhuollossa onkin t\u00e4rke\u00e4\u00e4 huomioida kaikki hoitoon liittyv\u00e4t [&hellip;]<\/p>\n","protected":false},"author":481,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[115],"tags":[193,42,16,196,46,7],"class_list":["post-811","post","type-post","status-publish","format-standard","hentry","category-tutkimus","tag-diames","tag-humea","tag-liikunta-ja-urheilulaaketiede-2","tag-tasapaino","tag-tyypin-1-diabetes","tag-uef"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Young type 1 diabetes subjects sway more than healthy persons when somatosensory system is challenged in static standing postural stability tests - UEF Liikunta- ja urheilul\u00e4\u00e4ketiede<\/title>\n<meta name=\"description\" content=\"Miten tyypin 1 diabetes vaikuttaa tasapainoon ja sen hallintaan? 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