Doktori védés adatlapja

The Semmelweis University
and the Clinical Medicine Doctoral School
invites you to the doctoral defense of the thesis of

Kynsburg Ákos Péter



The location and date of defense: ., 10.07.2009 15:00:00

Short thesis: kynsburgakos.e.pdf
Full text of the dissertation: kynsburgakos.d.pdf

Dr. Hangody László, osztályvezető főorvos
Dr. Mády Ferenc, egyetemi docens
Dr. Hidas Péter, főorvos

Dr. Karlinger Kinga, tudományos főmunkatárs
Dr. Kiss Rita, egyetemi adjunktus
Main goal of my study was to prove the positive proprioceptive effect of a preventively applied neuromuscular training in competitive athletes of a high-risk sport – with an epidemiologically already proven preventive effect on ankle ligament injuries. First, in order to identify the sport with the highest injury-risk, I defined the sports-specific incidence of ankle injuries based on comparable literature data. Processing 119 relevant papers in full-text, published until February 2002, only 61 provided comparable exposition-based, sports- and ankle-specific incidence data. Based on these data, contact team sports feature the highest injury-risk, with handball at the top of the list. Applying the neuromuscular training in a therapeutic fashion for 6 weeks on young athletes with chronic lateral talocrural instability I observed, that the proprioceptive sensory function of the ankle plantarflectors – represented by the posterior slopes – on the injured side didn’t differ significantly from healthy controls before the start of the programme; at follow-up this function improved vastly and became significantly better, compared to controls. This is an indirect sign on the preventive effect of the training. In accordance with the epidemiological data I examined the proprioceptive sensory effect of preventively applied neuromuscular training on twenty ankles of ten elite-level female handball players. As a result proprioceptive sensory function of the ankle improved in all directions as well as in every single directions strongly significant, also in comparison to healthy controls. This also justifies the name “proprioceptive training” for this preventive method. Regarding improvement between single directions, and also between dominant and non-dominant sides, there were no significant differences. In comparison to the therapeutic group it can be stated, that in patients with chronic lateral talocrural instability proprioceptive training should be continued on long-term at a lower intensity after it was successfully applied therapeutically. While applying proprioceptive drills in a preventive fashion, incidence changes have been similar to those of earlier epidemiological studies, investigating larger samples. As conclusion I consider the incorporation of proprioceptive drills into the regular training regimen in contact team sports indispensable, in other sports recommended for the prevention of ankle injuries.
Halasi T., Kynsburg Á., Tállay A., Berkes I.: Development of a new activity score for the evaluation of ankle instability. Am J Sports Med, 32:899-908; 2004.
Halasi T., Kynsburg Á., Tállay A., Berkes I.: Changes in joint position sense after surgically treated chronic lateral ankle instability. Br J Sports Med, 39: 818-824; 2005.
Kynsburg Á., Halasi T., Tállay A., Berkes I.: Changes in joint position sense after conservatively treated chronic lateral ankle instability. Knee Surg Sports Traumatol Arthrosc, 14: 1299-1306; 2006.
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