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DOI: 10.14526/2070-4798-2020-15-4-27-37
The indices of congruence, mobility and degrees of freedom of large joints of extremities and a spine as reference points for fitness lessons projection in
40-55 year-old men
Sofiya S. Kovanova'*, Olga N. Stepanova2
1Shuya branch of Ivanovo State University Shuya, Russia ORCID: 0000-0003-2414-1070, [email protected]* 2Moscow Pedagogical State University Moscow, Russia
ORCID: 0000-0002-4114-2801, [email protected]
Abstract: Men and women of middle age are the most frequent visitors of fitness centers. The first signs of aging appear during middle age: hormonal background decreases, excess weight appears, connective tissue loses elasticity, the first signs of spine and joints structural-functional disorders appear. It is important not to miss the moment of degenerative disorders, to realize timely diagnostics and build health-improving conditional training program of lessons, taking into account the revealed disorders. Materials. The article presents the results of a complex diagnostics of congruence, mobility and degrees of freedom of large joints and a spine among men of middle age (40-55 years-old), who go in for fitness. 60 men of middle age took part in the research. The material of testing were the reference points for the methodology creation of health-improving conditional (fitness) training in men of the second period of middle age with structural-functional disorders of spine and large joints. Research methods. Analysis and summarizing literary sources on the research problem, anamnesis, anthropometric measurements, testing, assessment of the knee and hip joints functional mobility using the KOOS and HOOS questionnaires, mathematical and statistical data processing by the method of average values. Results. We estimated the degree of freedom, mobility of large joints and spine among 40-55 year-old men, revealed structural-functional disorders of locomotor apparatus. Conclusion. The results of the research were the reference points for the orientation determination and content choice of health-improving conditional (fitness) training in men of the second period of middle age.
Keywords: 40-55 year-old men; degree of freedom, congruence, flexibility and mobility of large joints and spine; fitness testing; health-improving and conditional (fitness) training for men of the second period of adulthood.
For citation: Sofiya S. Kovanova*, Olga N. Stepanova. The indices of congruence, mobility and degrees of freedom of large joints of extremities and a spine as reference points for fitness lessons projection among 40-55 year-old men. Russian Journal of Physical Education and Sport. 2020; 15(4): 25-32. DOI: 10.14526/2070-4798-2020-15-4-27-37
INTRODUCTION
Most frequent attenders of fitness centers are the men of middle age (40-55 years-old). In spite of the fact that at this age period men preserve sufficiently high training level of motor functions and have favorable preconditions for sufficient health-improving [6, 7, 9, 10, 14] and even sports results achievement [15, 16], they have the first signs of aging: hormonal background decreases [3, 4], excess weight [12], connective tissue elasticity loss [11], chronic diseases exasperation owing to bad habits [8], degenerative- dystrophic changes [17] and, as a result, structural-functional disorders
of spine and joints [5, 11, 14, 16, 17]. It means that during an individual health-improving conditional (fitness) training program creation in men of middle age it is important to take into account the kind and degree of structural-functional disorders of spine and joints and in accordance with these facts select and include into the training program means of their correction and prevention [18,19].
In this connection the objectives of the research work were the following: first of all, congruence, mobility and degree of freedom of large extremities joints and spine estimation in men of the second period of adulthood; secondly,
recommendations creation concerning the choice of health-improving conditional (fitness) training means in 40-55 year-old men. They have different kinds of structural-functional disorders of spine and joints.
MATERIALS AND METHODS
Congruence, mobility and degree of freedom of large extremities joints and spine estimation in 40-55 year-old men we realized using the following diagnostic procedures (tests and scales):
- sacral clearing test, faber test, posh test, squish test, alternate gillet test, with the help of which we estimated stability of sacral- iliac spine;
- gaenslen test, lumbar quadrant test, resisted abduction test, fortin's sign, posteroanterior mobility, prone instability test, resisted abduction test (stability), standing forward flexion test, by means of which we estimated mobility of lumbar spine;
- active sit-up test, extensor endurance test, alternate gillet test, prone instability test, spine rotators and multifidus test, sphinx test - for the level of core muscles development estimation;
- crossed straight leg raise test, slump test, straight leg raise test - to reveal hernia and protrusion;
- gower's sign, prone knee bend test, seated forward flexion test, supine to long sit test, supine to long sit test - in order to reveal curvature of spine (deviation from the front axis);
- «knee toward the wall» test - for mobility of ankle joint estimation;
- neer's test, hawkin's test, drop arm test,
belly press test, lift off test, adduction and external rotation test, jobe test -in order to estimate mobility and congruency of a shoulder joint;
- «The knee injury and osteoarthritis outcome score» questioning scale (KOOS) - in order to estimate functional mobility of a knee joint [1];
- «Hip disability and osteoarthritis outcome score» questioning scale (HOOS) - in order to estimate functional mobility of a hip joint [2].
In order to estimate health state and constitution of the respondents we used the methods of anamnesis and anthropometry. The results of the research and testing were handled using descriptive statistics methods.
Special attention in the research was paid to the functional state of lumbar cord and sacral part of spinal cord and large joints (hip, knee, ankle and shoulder joints) estimation according to the following directions: mobility, functionality (in everyday life, during sport lessons and active rest), pain (degree of manifestation, character, factors, which cause pain syndrome), symptoms, injuries in the past, general life quality.
The research was held on the basis of «SKFITNESS» fitness-club (Moscow, Russia). Research sampling - 60 men of middle age (40-55 years-old), who had club card and directed toward the center of testing of the mentioned fitness-club.
RESEARCH RESULTS AND DISCUSSION
During anthropometric changes we revealed that the respondents had hypersthenic (endomorphic) type of constitution and overweight (table 1).
Table 1 - Constitution indices in 40-55 year-old men, who train in fitness-club «SKFITNESS» (Moscow, Russia) (n=6o)
№ Indices X ± CT
1 Height, cm 181,6 ± 1,5
2 Weight, kg 101,5 ± 2,65
5 Thorax circumference, cm 110,3 ± 9,72
3 Wrist circumference 18,5 ± 3,25
Results of the movements estimation amplitude and restrictions in mobility of lumbar cord revelation, power and ability of core muscles
extensibility diagnostics (prelum, posterior, spine extensor muscles, spine muscles) [18] are presented in table 2.
Table 2 - Mobility and stability of spinal column estimation in 40-55 year-old men (according to core muscles test results) (n=6o)
Test Positive result (% of respondents)
Active sit-up test 0
Extensor endurance test 100
Prone instability test 80
Spine rotators and multifidus test 16
Sphinx test 0
Alternate gillet test 100
Table 2 presents that in body holding test in static position «active sit-up test» 100% of the respondents showed "negative" result, as none of them was able to hold the position more than 5 seconds without load redistribution on lumbar spine. Test for the development of spine muscles-extensors «Extensor endurance test» fulfilled all respondents. 80% of the respondents showed "positive" result in body holding test using the bench «prone instability test», 20% of respondents had pain in lumbus. Rotation in lumbar spine test "spine rotators and multifidus test" was fulfilled successfully only by 16% of respondents, 84% of respondents had asymmetry in movements, they were unable to support pelvis and held neutral spine position with the raised hand; drawing hand Table 3 - Testing results in 40-55 year-old men for 1
aside caused their disbalance, body position became stable only in 2 seconds. In «sphinx test», which was held in order to estimate asymmetry of hip joint and posteriors during lumbus tension in prone position. All respondents had the asymmetry 3-6° of neutral point. «Alternate gillet test» (norm-the absence of movements) showed respondents' compensatory reactions during leg lifting from standing position, though in this test all respondents had positive results.
Tests for hernia and protrusions (table 3) revelation were held with the respondents. They didn't have plastic disorders in spinal column in anamnesis (28 people). If anamnesis had trauma without further diagnostics, tests were not held.
rnia and protrusions revelation (n=28)
Test Positive result (% respondents)
Crossed straight leg raise test 92
Slump test 46
Straight leg raise test 23
In «crossed straight leg raise test», which was held in prone position, 92% of respondents had the pain within the range 74-84° (with "negative" values since 90°), which proves "positive" result of testing the most part of the group. In «slump test», which was held in sitting position, "positive" result was registered in 46% of respondents (others had pain increase during the forward lean). Only 23% of the respondents went through «straight leg raise test» successfully; others had pain increase in spine during bending in hip joint till 30-35° angle (norm 40° and higher).
Testing showed that almost all respondents had the pain, caused by hernia or protrusion in
lumbar spine (92%) and only 4% of respondents had protrusions in cervical spine (in anamnesis). After positive reaction to the test (hernia and protrusion was revealed), the respondent was recommended to go through the test using magnetic resonance imaging and consult a surgeon before the beginning of fitness lessons.
«Gaenslen test», which was held during hip flexion (table 4), showed that 26% of respondents had pain in iliac-lumbar muscle; «lumbar quadrant test»; 46% of respondents had movements restrictions during side leans.
Table 4 - Results of lumbar spine mobility diagnostics in 40-55 year-old men (n=6o)
Test Positive result (% respondents)
Gaenslen test 26
Lumbar quadrant test 54
Resisted abduction test 23
Fortin's sign 100
Standing forward flexion test 100
«Resisted abduction test», in order to estimate the power of adductors, gluteus medius and minimus muscles in static regimen (stability of position) and fulfilled from prone position was positive in 23% of respondents. «Fortin's sign», which characterizes the presence of located source of pain in lumbar - iliac fascia, was positive among all respondents (because of hernia in lumbar spine, intensified by the fact that respondents were in Table 5 - Stability estimation of sacral part of spinal
the sitting position most of the time). «Standing forward flexion test», for hypomobility of the spine estimation (during the lean forward), was positive among all respondents.
During «posh test» (twisting, outer rotation) and «faber test» there was no sharp pain in sacral-iliac part among the respondents. It proves stability of the mentioned part of the spine (table 5).
cord in 40-55 year-old men (n=60)
Test Positive result (% respondents)
Faber test 0
Posh test 0
Alternate gillet test 100%
«Alternate gillet test» was held together with core muscles estimation. Its results prove uneven distribution of the load on spine muscles.
Let's consider the results of knee and hip joints functionality estimation in the examined 4055 year-old men during everyday and sports life according to each direction: pain, symptoms, activity restriction in everyday life, joints functioning during sport and active rest, general life quality according to ioo-point questionnaire scale «The knee injury and osteoarthritis outcome score» (KOOS) h «Hip Disability and Osteoarthritis Outcome Score» (HOOS) [1, 2].
Speaking about symptomatology respondents mentioned moderate-constant level of pain at rest, sitting positions and dorsal positions and during simple motor actions fulfillment. Pain increase was during descents, while going upstairs, squats on toes, during complete knee joint flexion, during side jerks, lunges and during supporting load (jumps, running). The average score was 36. Difficult-coordinating exercises (in case of complete flexion of knee joint), jumps and cyclic exercises (running, cycling) were fulfilled by the respondents with some difficulty and caused strong pain in knee joint. The respondents estimated life quality as low
(in the average 18 points from 100 possible) because of constant (everyday) pain, anxiety, restriction or refusal to fulfill some motor actions, uncertainty in the possibility to fulfill this or that motor action. It restricted considerably everyday motor activity of the respondents.
Apart from defining pain, symptoms, difficulties of everyday actions fulfillment, activity and knee injuries influence on life quality, we realized the diagnostics of the power of an active apparatus of knee joint - hip flexor and extensor muscles, with the help of «leg extension» and «leg flexion» tests using block type training-simulators. The average weight during hip extension was 40 kg in terms of 4-5 repetitions fulfillment. It proves weak and the average power of flexor muscles (biceps of the thigh, semimembranosus muscle, semitendinous muscle). It should be noted that testing was held on "injured leg" using block training simulator "Crossover" (double regulated link), where the average weight of the link was 30 kg in terms of the repetitions amount equal to 6. During extension fulfillment the average weight of the link was 30-35 kg in terms of 5 repetitions. It also showed weak functionality of a thigh quadriceps.
Ankle joint mobility estimation in "knee
toward the wall" test showed "good" value of this index among all respondents (23,0±3,4 cm).
Acromioclavicular joint diagnostics [5, 13, 15] according to «neer's test» and «hawkin's test» from sitting and standing position showed positive result. Pain and "crunch in the joint" appeared both in case of inner shoulder rotation and in anterolateral part of a shoulder. «Drop arm test» showed that the respondents didn't have problems Table 6 - Congruence of shoulder joint estimation in
with rotator cuff. All respondents were able to fulfill smooth movements and were able to hold static tension without pain within a long time period.
Tests for subscapular muscle tendons estimation «liftofftest» and «jobetest»,supraspinous muscle tendons estimation «adduction and external rotation test» [19] showed negative result. It proved the absence of micro injuries in tendons.
40-55 year-old men (n=6o)
Tests Positive result (% respondents)
Neer's test 100
Hawkin's test 100
Drop arm test 0
Belly press test 0
Lift off test 0
Adduction and external rotation test 0
Jobe test 0
The results of diagnostics showed that shoulder joint instability in this age group is caused by not developed power of the upper shoulder girdle muscles.
Taking into account the results of anamnesis and testing we defined typological groups of 4055 year-old men. They have similar structural-functional disorders of spinal column and joints:
- group A - the respondents with spinal column disorders (hernia, protrusions, spinal curvature, 1st degree scoliosis, osteochondrosis);
- group K - the respondents with disorders and knee joints diseases (partial or complete menisci damage in remission, partial damage of ligaments and
tendons);
- group F - the respondents with foot arch damage (platypodia: longitudinal platypodia and transverse platypodia, hypomobile foot);
- group S - respondents with shoulder joint mobility disorder;
- group T - respondents with hip joint mobility disorder.
For each group we created the program of health-improving conditional (fitness) training. Table 7 presents the recommended means of fitnesstraining, regimens of their use and additional means of health improvement (massage, water procedures, thermo procedures, pharmacological means).
Table 7 - Recommended means of health-improving conditional (fitness) training in 40-55 year-old men with structural-functional disorders of spine and joints
Structural-functional disorders of spinal column and joints
Recommended means of fitness-training
The ratio of the used means of fitness-training
Additional means of health improvement
Spinal column disorders (hernia, protrusions, spinal curvature, 1st degree scoliosis, osteochondrosis) (group A)
Isometric, isotonic exercises for local muscle groups; functional exercises, directed toward spinal column mobility increase, in terms of the axis of pain syndrome location; exercises with unsteady supports; overhead training; static and static-dynamic exercises; exercises with resistance; exercises with own body weight; exercises with the objects; accurate- coordinating exercises; ideomotor exercises; exercises for core muscles; "cyphosis" exercises.
Isometric, isotonic exercises -10-15%.
Local
exercises-20-40%.
Exercises with equipment, at unsteady supports-
40-55%.
Massage, water procedures (salt baths), kinesiotaping, myofascial release, health-improving nutrition, vitaminmineral complexes.
Knee joints disorders
(partial or complete menisci damage in remission, partial damage of ligaments and tendons) (group K)
Stretching of the main muscles-stabilizer (quadriceps, hips biceps, calf muscles, soleus muscles); exercises for resistance; overhead training; exercises for muscles-stabilizers strengthening; functional balance exercises; exercises with unsteady supports; tractive and resistive exercises. Carefully and according to special program it is permitted to use vibrational training at a platform.
Stretching of the main muscles-stabilizers- 2025%.
Exercises for resistance - 1015%.
Exercises at unsteady supports and with additional equipment use -
50-55%.
Kinesiotaping, myofascial release,
muscle toning, magnetotherapy, vibrational platform, health-improving nutrition, vitaminmineral complexes.
Foot arch damage (longitudinal platypodia and transverse platypodia, hypomobile foot) (group F)
Exercises, which increase space between articular surfaces of foot bones; exercises for foot flexibility; exercises in prospects and projections of physiological movements; exercises of local character, which take into account compensation in movements; work with toes; ideomotor exercises; exercises for shin and foot (rising on toes, heels); exercises on unstable surfaces and unsteady supports
Exercises for foot flexibility-
10-15.
Exercises for space increase between the joint surfaces-
35%.
Exercises for a shin and a foot-20-25%.
Exercises at unstable surfaces and supports -15%._
Myofascial release, massage, kinesiotaping, self-massage, ultrasound, cryotherapy, muscle toning, health improving nutrition.
Structural-functional disorders of spinal column and joints Recommended means of fitness-training The ratio of the used means of fitness-training Additional means of health improvement
Shoulder joint mobility disorder (group S) Exercises tor cervical spine mobilization; exercises for shoulder blade mobilization; exercises for holding and relaxation during active and passive shoulder rotation; broadest muscle of back and smaller pectoral muscle relaxation and release. Cervical part mobilization- 1525%. Release, exercises for holding and relaxation - 2025%. Exercises for broadest muscles of back relaxation -25-35%. Kinesiotaping, myofascial release, massage, taking non-steroid antiphlogistic drugs. Antiphlogistic ointments use, massage, water procedures, health improving nutrition.
Hip joint mobility disorder (group H) Exercises for hip joints muscles-stabilizers trophism strengthening and improvement (pelvic floor muscles, glutes, adductors, hip flexors and extensors); half-knee bends with the support; exercises for flexion and extension, hip abduction and reduction at the training simulators and without weight (including static tension of the mentioned muscles). Exercises, which improve trophism of muscles-stabilizers- 2535%. Exercises for flexion and extension, hip abduction and reduction - 45%. Static exercises-10-15%. Kinesiotaping, massage, magnetotherapy, ointments, myofascial release, taking vitamins and microelements in complexes, health improving nutrition.
Materials in table 7 can form the base for individual programs creation of health-improving conditional (fitness) training in middle age men. They take into account the kind and degree of structural-functional disorders intensity in spine and joints.
CONCLUSION
The offered scheme of health-improving conditional (fitness) training is successfully used in fitness-club "SKFITNESS" in Moscow since 2017. Its use provides the following objectives realization: homeostasis normalization, constitution parameters improvement, connective tissue elasticity and extensibility improvement, mobility and congruence of large joints and spine improvement, reduction of chronic illnesses and degenerative- dystrophic changes of spine and large joints of the upper and lower extremities, the intensity of pain syndrome decrease, the level of physical readiness increase, psycho-emotional status improvement and the index of life quality increase in 40-55 year-old men.
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Submitted: 06.10.2020 Author's information:
Sofiya S. Kovanova - Post-graduate Student, Shuisk Branch of Ivanovo State University, 155908, Russia, Ivanovo region, Shuya, Kooperativnaya str., House 24, e-mail: [email protected]* Olga N. Stepanova - Doctor of Pedagogics, Professor, Moscow Pedagogical State University, 119571, Russia, Moscow, Vernadskogo avenue, House 88, e-mail: [email protected], stepanova.
