Daunoravičienė, Algė

Magistro baigiamasis darbas – reikšmingas žingsnis profesinio bei akademinio augimo kelyje. Tai galimybė gilintis į dominančias temas, formuoti kritinį požiūrį į šiuolaikinius iššūkius reabilitacijos srityje, pritaikyti sukauptas žinias, parodyti kūrybiškumą, kritinį mąstymą ir gebėjimą savarankiškai spręsti aktualias reabilitacijos srities problemas. Šios metodinės rekomendacijos skirtos Lietuvos sveikatos mokslų universiteto Medicinos akademijos Slaugos fakulteto reabilitacijos krypties antrosios pakopos studijų programos magistrantams, siekiantiems tikslingai, kryptingai ir kokybiškai parengti savo magistro baigiamąjį darbą. Rekomendacijose nuosekliai apžvelgiami svarbiausi magistro baigiamojo darbo rengimo aspektai – nuo bendrųjų nuostatų ir pagrindinių sąvokų iki struktūrinių, metodologinių bei techninių reikalavimų. Pirmojoje šių metodinių rekomendacijų dalyje išdėstytos bendrosios nuostatos, antrojoje – pagrindinės sąvokos, magistranto ir darbo vadovo funkcijos, pareigos ir atsakomybė, trečiojoje – baigiamojo darbo rengimo ir gynimo tvarka, ketvirtojoje – baigiamojo darbo reikalavimai, o penktojoje dalyje pateikiami priedai, kuriuose yra dokumentai, reikalingi rengiant magistro baigiamąjį darbą. Tikimės, kad šios metodinės rekomendacijos atsakys į klausimus, iškylančius rengiant magistro baigiamąjį darbą ir padės rasti tinkamus sprendimus bei taps praktiniu įrankiu, padėsiančiu sėkmingai įveikti kiekvieną baigiamojo darbo rengimo etapą. Linkime kūrybiškumo, atkaklumo ir akademinio įkvėpimo siekiant paversti Jūsų idėjas prasmingu ir vertingu moksliniu darbu.

Non-specific low back pain (LBP) is a major health concern associated with a sedentary lifestyle. Understanding the multifactorial risk factors is essential for developing effective management and prevention strategies.

Introduction. Systematic, long-term equestrian training influences the dynamic balance, posture, and musculoskeletal function of riders [1]. Riding requires the ability to adapt to constantly changing balance conditions, not only to perform technical elements but also to reduce the risk of falls and injuries [2]. Studies show that riding develops postural control, motor skills, and muscle tone, however, differences between riders with varying experience remains unclear. Understanding how experience influences balance and posture is key, as even advanced riders may develop asymmetries that increase injury risk [3]. This study aims to assess muscle strength, dynamic balance, and injury risk in riders with different experience levels. Research methods and organization. The study was approved by the LSMU Bioethics Centre and conducted from June to December 2024 at the physiotherapy clinic “Aktyvus Judėjimas.” A total of 29 participants (age 25.07 (3.23)) were divided into two groups based on horseback riding experience: 8–10 years (n=13, age 23.85 (2.48)) and 11–20 years (n=16, age 26.06 (3.49)). Mean age did not significantly differ between groups (t(27) = -1.925; p = 0.065). Inclusion criteria: active equestrian participation ≥8 years, regular competition attendance, no other sports, no musculoskeletal pain in the past 3 months, and no injuries in the past 2 years that disrupted training. Lower limb and trunk muscle strength was assessed using a Lafayette dynamometer, measuring maximum isometric strength of the thigh extensors, flexors, abductors, adductors, internal and external rotators, and trunk flexors and extensors. Each muscle group was tested three times. Participants maintained resistance for 3 seconds, with a 45-second rest between trials. The highest value was recorded [4,5]. Dynamic balance and injury risk were assessed using the Y-Balance Test (YBT). Participants stood on one leg and used the other to push a marker in three directions—forward, backward-inward, and backward-outward. Each leg was tested three times per direction, and the best result was used for analysis. Distance was measured and normalized to leg length. Differences between legs and a composite score related to injury risk were analyzed [6]. Data analysis was performed using IBM SPSS Statistics 29.0. The Mann-Whitney U test was used for small independent samples (n<30). Quantitative data are presented as median (xme), minimum (xmin), maximum (xmax), and mean (x), formatted as xme (xmin–xmax; x). Qualitative data are presented as percentages. Associations between qualitative variables were tested using χ², and strength of associations was evaluated with Cramér’s V. The significance level was set at α = 0.05. Results. There was no statistically significant difference in the strength of the right and left thigh flexor muscles between riders with varying levels of riding experience (U=88.0; p=0.480; U=93.0; p=0.627). In the group of riders with 11–20 years of experience, the strength of the right thigh extensor muscles was 31.95 (26.5–45.4; 33.76) kg, and the left was 32.70 (26.2–47.5; 34.27) kg. In the group with less experience, the tested muscle strength was 28.10 (16.30–41.1; 26.71) kg for the right and 28.0 (15.9– 39.9; 26.55) kg for the left leg. These differences were statistically significant for both the right (U=45.0; p=0.010) and left (U=39.5; p=0.005) sides. Thigh abductor strength in both limbs did not differ significantly between groups (U=88.0; p=0.480; U=93.0; p=0.627). However, significantly greater adductor strength was observed in the more experienced group (right: U=53.5; p=0.027; left: U=48.5; p=0.015). No statistically significant differences were identified in thigh external rotation strength (right: U=76.0; p=0.219; left: U=88.5; p=0.497). Internal rotation strength was significantly higher in riders with 11–20 years of experience (right: U=42.0; p=0.007; left: U=41.0; p=0.006). More experienced riders exhibited significantly greater trunk extensor 32.25 (24.70–38.9; 31.75) kg and flexor 32.25 (35.1–42.5; 39.11) kg strength compared to less experienced participants: extensors – 21.90 (19.70–27.6; 22.52) kg; flexors – 28.30 (27.0–30.3; 28.48) kg (U=5.0; p<0.001; U=0.0; p<0.001). The YBT revealed significantly greater reach distances in all directions among riders with 11–20 years of experience: anterior (right: U=50.0; p=0.018; left: U=57.0; p=0.039), posteromedial (right: U=56.0; p=0.035; left: U=53.0; p=0.025), and posterolateral (right: U=50.0; p=0.019; left: U=44.0; p=0.009). When assessing lower limb injury risk, 53.8% (n=7) of riders with 8–10 years of experience were at risk, compared to 12.5% (n=2) with 11–20 years (V=0.44; p=0.041). Conclusions. Riders with longer horseback riding experience exhibited greater strength in the right and left thigh extensors, adductors, internal rotators, as well as back and abdominal muscles compared to those with less experience. The strength of the right and left thigh flexors, abductors, and external rotators did not differ between the two groups. More experienced riders demonstrated better dynamic balance and a lower risk of lower limb injuries.

Introduction. Ankle sprains are the most common lower limb injury among athletes, accounting for 16-40% of all sport-related injuries [1]. Improving balance control is one of the ways to help prevent ankle joint injuries. Proprioception plays a key role in controlling balance, and proprioception training exercises are one of the most important measures to reduce ankle injuries [3]. A review of the scientific literature shows that few studies evaluate the risk of ankle injuries in young individuals (12-15 years old) using proprioception training programs. Aim of the study: to evaluate the impact of a proprioception training program on dynamic and static balance in 12-15-year-old basketball players. Research methods and organization. The study was conducted at the Capital Basketball School, from September to November 2024. The study was approved by the LSMU Bioethics Center, No. 2024 -BEC3-T-023. Written consent to participate in the study was obtained from the participants and their parents (guardians). The study involved 20 individuals, who were divided into two groups: the experimental group (n=10) and the control group (n=10). During the study period, both groups participated in regular basketball training sessions. The experimental group underwent a 9-week proprioception training program. The program was conducted three times a week, every other day, with a duration of ⁓20 minutes. Average age of the experimental group - 13.90(1.10) and control group -14.00(1.05). Inclusion criteria: 12-15 years of age; Attending basketball training at least 3 times a week and at least 2 years; No ankle or knee injuries in the past six months; Not participating in training for other sports Research methods: Dynamic balance was assessed using the Y Balance Test. The participant was asked to push a block in three directions: anterior, lateral, posterior. The final result was calculated using a special formula that takes into account the participant's legs length [4]. Static balance was assessed using the Balance Error Scoring System (BESS). Participants had to perform three standing tasks on a solid surface and platform: standing with feet together, on the non-dominant leg, heel-to-toe position, with the dominant leg in front [5]. Data analysis was performed using IBM SPSS Statistics 29.0 software. To compare two related samples with small sample sizes, the nonparametric Wilcoxon test was applied, for two independent samples, the non-parametric MannWhitney-Wilcoxon test was used. Data were presented as median (Md), minimum (min), and maximum (max) values, mean (m) – Md(min – max; m); average. The difference was considered statistically significant when p<0.05. Results. In the experimental group, the median of the left leg Y balance test results before the intervention was 125,50 (103-154; 124,30), and after – 133,50 (111-159; 133,50). A statistically significant difference was found (Z = -2,807; p = 0.005). The median of the right leg results before the intervention was 22 (91–155; 122,20), and after – 132 (101–162; 133,10). A statistically significant difference was found (Z = -2.807; p = 0.005). In the control group, the median of the Y test for the left leg before the 9-week period was 115,50 (98–129; 115,10), and after – 121 (102–140; 120,70). A statistically significant difference was found (Z = -2.812; p = 0.005). The median of the right leg before the 9-week period was 114,50 (101–137; 114,40), and after – 121,50 (108–143; 121,50). A statistically significant difference was found (Z = -2,809; p = 0.005). When comparing the results of both groups at the first testing session, the right and left leg Y - test results were similar, respectively (U=34; p=0.225) and (U=27; p=0.082). After the intervention, statistically significant results were found for the left leg (U=22.50; p=0.037) and the right leg (U=23; p=0.040). When evaluating static balance, the experimental group’s BESS score before the intervention was 50 (44 - 54; 49.70), and after the intervention, it was 56 (52 - 58; 55.40). The difference was statistically significant (Z=-2.820; p=0.005). In the control group, the BESS score at the first testing session was 50.50 (45 - 59; 50.50), after 9 weeks - 55.50 (50 - 60; 55.10). A statistically significant difference was found (Z=-2.818; p=0.005). Before the intervention, the experimental group’s BESS test result did not significantly change from the control group (U=47.50; p=0.849). After the intervention, there was no significant difference in the BESS test results between the experimental and control groups (U=47; p=0.853). Conclusions. The dynamic balance of basketball players aged 12-15 improved after nine weeks of proprioception exercises. Although dynamic balance also improved for those attending regular basketball training, a greater effect was observed in the experimental group. When assessing the changes in the static balance of young basketball players, a similar improvement was observed both in those attending regular basketball training and those additionally performing proprioception training exercises.

This research aims to assess dynamic balance, muscle strength, and pain in young women with generalized joint hypermobility. Research methods: A cross-sectional research design was used in this study. The Beighton scale was used to assess joint hypermobility; the Y test was performed to assess injury risk; a hand-held dynamometer was applied to assess upper extremities’ muscle strength; the McGill tests were used for evaluation of the endurance of trunk muscles’ strength; a numeric analog scale and pain map were used to assess pain intensity and localization. Participants: Twenty-fve young females (age: 22(18–28; 21,16) years; body mass index: (23, 19,2–24, 23,2) kg/m²) participated in this study. Results: The median Beighton score value was 7 (4-9;7.48) points. The Y balance test revealed that 36% (n=9) of the participants were at risk of injury when standing on the dominant leg, and 64% (n=16) when standing on the non-dominant leg. 64% (n=16) of the young women had a normal grip strength of the dominant hand, and 56% (n=14) had normal non-dominant handgrip strength. Only 20% (n=5) of young women with joint hypermobility had an abdominal-to-back muscle strength endurance ratio within the normal range and lateral muscle endurance ratio was within the normal range only in 16% of women. Conclusions: Our pilot study showed that young women with joint hypermobility have reduced hand muscle strength, an imbalance in trunk muscle static endurance and an increased risk of injury in more than half of the subjects. As many as 76% of the young women in this study reported experiencing pain in different areas of the body.

Generalized joint hypermobility (GJH) is prevalent among young adults, necessitating effective monitoring of musculoskeletal health, particularly among college-aged females. This study aimed to identify physical fitness and health-related quality of life (HR-QoL) characteristics associated with GJH.

Introduction. As the intensity of physical activity increases, so does the body's demand for oxygen, which is needed to release energy from glucose (1). That's why focusing on breathing during physical activity is important. Breathing exercises, separate from physical or other exercises, can reduce back pain (2), improve trunk stability and fitness (3). Breathing exercises are often combined with movements of the limbs or trunk, such as “Plank”, elbow-leg or postural stability exercises. Combining exercises can have a synergistic effect, as the respiratory muscles are involved in both breathing and postural control (3). The aim of the research was to assess the electrical activity of trunk muscles during the exercise with different breathing techniques. [...].

Introduction. Dance like any other sport requires certain skills, one of them is balance. The adoption of correct or stable posture through balance is significant because it supports and protects the body from injury (2). Almost 70% of all injuries in dancers occur in the lower extremity (LE) (1). Balance is an ability to maintain a posture through the interactions between the musculoskeletal system and the nervous system and to maintain a state of equilibrium while keeping the center of gravity within the base of support (2). Dynamic balance is an important criterion used during LE injury prediction, prevention, and rehabilitation (3). Research aim - to evaluate static and dynamic balance in folk dancers and cheerleaders. [...].

Introduction. Physical fitness was lower in Lithuanian children and adolescents compared with European values and with the results for Lithuanian school children in the previous decades (3,4). It is widely recognized that physical activity and physical fitness are important indicators of health, which shows brain health, emotional regulation, mood and etc., of children and adolescents (1,2). The aim of this study was to evaluate the change in the indicators of physical fitness of 16-17-year-old adolescents by applying for individual health programs through physical exercises. [...].

Introduction. Canoe sprinting is a sport, which involves unstable surface where it’s necessary to maintain a stable posture, and trunk stability is necessary (1). Most of the muscle power during the movements in the boat is focused on stabilizing the trunk. Keeping the trunk as stable as possible can ensure proper force distribution to both limbs and perform technical movements (2,3). Trunk muscle endurance and stability are the components that are inseparable from sports activities because it's thought that increases in one or both will improve athletic performance as well as aid in the treatment and prevention of injury (4,5). The aim of this study was to evaluate trunk muscle endurance and stability of 12-16-year-old kayakers and canoeists. [...].