Ankle Dorsiflexors Strength Improves Balance Performance in Elderly: A Corelational Study.

Year 2014, Volume: 11 Issue: 2, 60 - 65, 01.06.2014

Shehab Mahmoud Abd El-kader Eman M. Ashmawy

https://doi.org/10.15197/sabad.1.11.40

Abstract

The physical ability to maintain balance when moving and the ability to move independently are central requisites for independent living and are thus two important focuses in geriatric rehabilitation. It has been suggested that a decrease in the ability to generate force in the lower extremity muscles contribute to balance impairment and falling. The purpose of this study was to detect balance performance response to improved strength of dorsiflexors muscles in elderly. Fifty healthy elderly subjects, their age ranged 65-75 years, participated in this study. Twenty five subjects (training group) were trained with resisted exercises plus electrical nerve stimulation of ankle dorsiflexors muscles, three times a week for 8 weeks. The control group, included twenty five subjects, received no treatment intervention except encouragement for performing their usual activity of daily living over the 8 weeks of the study. The ankle dorsiflexors muscles force was measured by the hand held dynamometer in Kg and the balance control was measured by the Berg Balance Scale (BBS), the Functional Reach Test (FRT) and the Timed Get Up-Go Test (GUG). These measurements wevr5re applied for both groups before and after 8 weeks. The BBS, FRT and GUG values showed significant changes (12.9%, 35.7% and 51.9% respectively) following training in the trained group. There were no significant changes (0.67%, 6.95% and 14.4%) in the same measures of the control group after 8 weeks. Improved ankle dorsiflexors strength enhances balance performance in elderly

Keywords

Balance, ankle dorsiflexors strength, resisted exercises, electrical nerve stimulation, elderly

Ankle Dorsiflexors Strength Improves Balance Performance in Elderly: A Corelational Study.

Abstract

Hareket sırasında dengeyi sağlama fiziksel yeteneği ve bağımsız hareket etme yeteneği bağımsız yaşamak için ana gerekliliklerdir ve geriatrik tıbbın iki önemli odak noktasıdır. İleri sürülmüştür ki, alt eksremite kaslarında kuvvet oluşturma yeteneğindeki düşüş denge bozukluğu ve düşmeye neden olmaktadır. Bu çalışmanın amacı yaşlılarda dorsifleksör kaslarda yapılan kuvvet geliştirmeye karşı denge performansı değişimini araştırmaktı. Elli sağlıklı yaşlı birey, yaşları 65-75 arasında değişen, çalışmaya alındı. Yirmi beş bireye (egzersiz grubu) 8 hafta, haftada 3 kez direnç egzersizi artı ayak bileği dorsifleksör kaslara elektrik sinir uyası uygulandı. Yirmi beş kişiden oluşan kontrol grubuna çalışma süresi olan 8 hafta boyunca rutin günlük yaşam aktivitelerini yapmaya teşvik dışında herhangi bir tedavi girişimi uygulanmadı. Ayak bileği dorsifleksör kas gücü kg olarak elle tutulan dinamometre ile ölçüldü ve denge kontrolü Berg denge Skalası (BDS). Fonksiyonel Reach Testi (FRT) ve Timed Get up Go Test (GUG) testi ile ölçüldü. Bu ölçümler her iki gruba başlangıçta ve 8 hafta sonra uygulandı. Çalışma grubunda çalışmayı takiben BDS, FRT ve GUG değerlerinde belirgin değişiklik görüldü (sırasıyla %12.9 %35.7 ve %51.9%). Sekiz hafta sonunda kontrol grubunun aynı ölçüm değerlerinde belirgin değişiklik görülmedi (%0.67, %6.95 ve %14.4). Artırılmış ayak bileği dorsifleksör kuvveti yaşlılarda denge performansını geliştirir

Keywords

Denge, ayak bileği dorsifleksör kuvveti, direnç egzersizi, elektrik sinir uyarısı, yaşlı

References

• Tinetti M. Preventing falls in elderly persons. N Engl J Med 2003; 348: 42–9.
• Royal College of nursing. Clinical practice guideline for the assessment and prevention of falls in older people, Royal College of Nursing, London 2004: 16–28.
• American Geriatrics Society, British Geriatrics Society, American Academy of Orthopaedic Surgeons. Guidelines for the prevention of falls in older persons. J Am Geriatr Soc 2001; 49: 664–72.
• Perell K, Nelson A, Goldman R, Luther S, Prieto-Lewis N, Rubenstein L. Fall risk assessment measures: an analytic review. J Gerontol A Biol Sci Med Sci 2001; 56: M761–6.
• Donald I, Bulpitt C. The prognosis of falls in elderly peo- ple living at home. Age Ageing 1999; 28: 121–5.
• Brown M, Sinacore D, Host H. The relationship of strength to function in the older adult. J Gerontol A Biol Sci Med Sci 1995; 50: 55-9.
• Horlings C, Van Engelen B, Allum J, Bloem B. A weak bal- ance: the contribution of muscle weakness to postural instability and falls. Nat Clin Prac Neurol 2008; 4: 504–15.
• Barrett R, Hyde S, Scott O, Dubowitz V. Changes in cen- ter of gravity in boys with Duchenne muscular dystrophy. Muscle Nerve 1988; 45: 1157–63.
• Lehmann K, Sunnerhagen K, Willén C. Postural control in persons with late effects of polio. Acta Neurol Scand 2006; 113: 55–61.
• Lord S, Menz H. Visual contributions to postural stability in older adults. Gerontology 2000; 456: 306–10.
• Messier S, Royer T, Craven T, O'Toole M, Burns R, Ettinger W. Long-term exercise and its effect on balance in older, osteoarthritic adults: results from the Fitness, Arthritis, and Seniors Trial (FAST). J Am Geriatr Soc 2000; 48: 131–8.
• Buchner D, Cress M, de Lateur B, Esselman P, Margherita A, Price R. The effect of strength and endurance train- ing on gait, balance, fall risk, and health services use in community-living older adults. J Gerontol A Biol Sci Med Sci 1997; 52: M218–24.
• Wolf S, Barnhart H, Ellison G, Coogler C. The effect of Tai Chi Quan and computerized balance training on postural stability in older subjects. Atlanta FICSIT Group. Balance- impaired and injuries: cooperative studies on interven- tion techniques. Phys Ther 1997; 77: 382–4.
• Yoon S, Lee J, Kim Y, Kim Y, Cho W, Park C. Change in ankle dorsiflexion range of motion and ultrasonographic images of the tibialis anterior with age. J Physic Ther Sci 2011; 23(5): 813-5.
• Lord S, Ward J, Williams P, Anstey K. Physiological fac- tors associated with falls in older community-dwelling women. J Am Geriatr Soc 1994; 42: 1110–7.
• Berg K, Wood-Dauphinee S, Williams J. The balance scale: reliability assessment with elderly residents and patients with an acute stroke. Scand J Rehabil Med 1995; 27: 27– 36.
• Mecagni C, Smith P, Roberts K, O’suzllivan S. Balance and ankle range of motion in community- dwelling women aged 64 to 87 years: A co relational study. Phys Ther 2000; 80: 1004-11.
• Brawn M , Holloszy J. Effects of a low-intensity exercise program on selected physical performance characteristics of 60 to 70 years olds. Aging 1991; 3: 129-39.
• Daubney M, Culham E. Lower extremity muscle force and balance performance in adults aged 65 years and older- Phys Ther 1999; 79: 1177-85.
• Tigpen M, Light K, Greet G. Turning difficulty characteris- tics of adults aged 65 years or older. Physiotherapy 2000; 80: 1174-1187.
• Cook S, Gruber W, Baldwin M, Liao S. The effect of mul- tidimensional exercises on balance, Mobility and fall risk in community-dwelling older adults. Phys Ther 1997; 77: 46-57.
• Province M, Hadley E, Hornbrook M. The effects of exer- cise on falls in elderly patients. JAMA 1995; 272: 1341- 1347.
• Stefen T, Haker T, Mollinger L. Age and gender-related test performance in community-dwelling elderly people: Six-minute walk test, Berg balance scale, Timed up & go test and Gait speed. Phys Ther 2002; 82: 128-37.
• Podsiadlo D, Richardson S. The timed “up and go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991; 39: 142-8, 1991.
• Roberts B. Effects of walking on balance among elders, Nurs Res 1989; 38:180-3.
• Brawn M, Holloszy J. Effects of a low-intensity exercise program on selected physical performance characteristics of 60 to 70 years olds. Aging 1991; 3: 129-39.
• Tinetti M, Baker D, Mc-Away G. A multifactorial interven- tion to reduce the risk of falling among elderly people living in the community N Engl J Med 1994; 331: 821-7.
• Pfeifer A, Cramfield T, Wagner S, Craik R. Muscle strength: A comparison of electrical stimulation and vo- litional isometric contractions in adults over 65 years. Physiotherapy Canada 1997; 1: 32-9.