Yaşlı Bireylerde Denge ve Proprioseptif Eğitimin Düşme Üzerine Etkileri
Year 2025,
Issue: 26, 762 - 770, 31.08.2025
Havva Ezgi Albayrak
,
Hande Besna Göçen
,
Suzan Aydın
,
Mustafa Oğuz Kethüdaoğlu
,
Aygül Köseoğlu Kurt
,
Mehmet Kaan Altunok
,
Bülent Abut Özsezikli
Abstract
İleri yaşlı bireylerde vücut sistemlerinin zamanla yavaşlamasıyla fizyolojik değişiklikler ve fiziksel inaktiviteler görülür. Sistemlerde meydana gelen her türlü değişim vücut fonksiyonlarında olumlu veya olumsuz etkileşim yaratır. 65 yaş üstü yaşlı yetişkinlerde düşmeler ve düşmeye bağlı yaralanmalar önemli bir sorun olarak kabul edilmektedir. 75 yaş üstü yaşlı yetişkinler de ise bu sorunlar daha da yaygın görülmektedir. Bozulan sistemlerin başında postüral kontrol mekanizmaları gelir. Bu mekanizmaların içerisinde denge ve propriyoseptif sistem yer alır ve bu sistemlerdeki disfonksiyonlar ilerleyen yaş ile artmaktadır. Denge ve koordinasyon problemleri yaşlı yetişkinler arasında düşmeler için önemli bir risk faktörü olarak belirtilmiştir. Aynı zamanda propriyosepsiyon da yaşla birlikte azalmaktadır. Çalışmalar azalan propriyosepsiyonun yaşlılarda düşmelere neden olan önemli bir faktör olduğunu göstermiştir. Vücudun denge koordinasyon sisteminin bozulması ve propriyoseptif sistemin zayıflaması, yaşlı popülasyonda önemli bir mortalite ve morbidite nedeni olan düşme riskinin artmasına neden olur. Bu derlemede ileri yaşlı bireylerde denge ve propriyosepsiyon eğitiminin düşme üzerine olan etkilerinin ortaya konması amaçlanmıştır.
References
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1. Alterovitz SS, Mendelsohn GA. Relationship goals of middle-aged, young-old, and old-old internet daters: An analysis of online personal ads. Journal of Aging Studies. 2013;27(2):159-165.
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3. Meyer M, Constancias F, Vogel T, Kaltenbach G, Schmitt E. Gait disorder among elderly people, psychomotor disadaptation syndrome: Post-fall syndrome, risk factors and follow-up–a cohort study of 70 patients. Gerontology. 2021;67(1):17-24.
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4. Osoba MY, Rao AK, Agrawal SK, Lalwani AK. Balance and gait in the elderly: A contemporary review. Laryngoscope Investig Otolaryngol. 2019;4(1):143-53.
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5. Preszner-Domjan A, Nagy E, Szíver E, Feher-Kiss A, Horvath G, Kranicz J. When does mechanical plantar stimulation promote sensory re-weighing: standing on a firm or compliant surface? European Journal of Applied Physiology. 2012;112:2979-2987.
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9. Etxeberria I, Etxebarria I, Urdaneta E, Yanguas JJ. Age differences among older adults in the use of emotion regulation strategies. What happens among over 85s and centenarians? Aging Ment Health. 2016;20(9):974–980.
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16. Aslan C, Ulus Y, Akyol Y, Bı̇lgı̇cı̇ A, Kuru Ö. Fear of falling in community-dwelling older people: relationship with sleep quality, depression and quality of life. J PMR Sci. 2021;24(1):8-16.
-
17. Duray M. Farklı Fiziksel Aktivite Düzeyine Sahip Olan Yaşlılarda Fiziksel Uygunluk, Düşme Riski ve Düşme Korkusu İlişkisinin İncelenmesi [doctorate thesis]. İzmir, Türkiye: Dokuz Eylül Üniversitesi,2013.
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18. Chang CJ, Yang TF, Yang SW, Chern JS. Cortical modulation of motor control biofeedback among the elderly with high fall risk during a posture perturbation task with augmented reality. Frontiers in Aging Neuroscience. 2016;8:80.
-
19. Tinetti ME, Richman D, Powell L. Falls efficacy as a measure of fear of falling. Journal of Gerontology. 1990;45(6):239-243.
-
20. Rosen T, Mack KA, Noonan RK. Slipping and tripping: Fall injuries in adults associated with rugs and carpets. J Inj Violence Res. 2013;5(1):61-65.
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21. Çınarlı T, Zeliha K. 65 yaş ve üzeri yaşlılarda düşme risk ve korkusunun günlük yaşam aktiviteleri ve yaşam kalitesi üzerine etkisi. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. 2015;4(4):660-679.
-
22. Özkul K. Diyabetli yaşlılarda düşme korkusunun yaşam kalitesine etkisinin değerlendirilmesi [master’s thesis]. Bursa, Türkiye: Uludağ Üniversitesi,2019.
-
23. Biçer S, Demir G. Yaşlı bireylerde düşme ve kazalar. Yaşlı Sorunları Araştırma Dergisi. 2018;11(2):37-40.
-
24. Sapmaz M. Yaşlılarda Düşme Korkusunun Denge ve Çift Görev Performasına Etkisi [doctorate thesis]. Ankara, Türkiye: Yıldırım Beyazıt Üniversitesi,2018.
-
25. Kara B, Yıldırım Y, Genç A, Ekizler S. Geriatriklerde ev ortamı ve yaşam memnuniyetinin değerlendirilmesi ve düşme korkusu ile ilişkisinin incelenmesi. Fizyoterapi Rehabilitasyon. 2009;20(3):190-200.
-
26. Zijlstra GAR, van Haastregt JCM, van Eijk JThM, van Rossum E, Stalenhoef PA, Kempen GIJM. Prevalence and correlates of fear of falling, and associated avoidance of activity in the general population of community-living older people. Age and Ageing. 2007;36(3):304-9.
-
27. Scheffer AC, Schuurmans MJ, van Dijk N, van der Hooft T, de Rooij SE. Fear of falling: measurement strategy, prevalence, risk factors and consequences among older persons. Age and Ageing. 2008;37(1):19-24.
-
28. Akdeniz M, Yaman A, Kılıç S, Yaman H. Aile hekimliğinde önlenebilen sorunlar: Yaşlılarda düşmeler. GeroFam. 2010;1(1).
-
29. Güneş-Gencer GY, İpek L, Kara DS, Uzun F, Çetin SY. Türkiye’de yaşlılarda düşme ve denge ile ilgili yapılmış çalışmaların incelenmesi. Yaşlı Sorunları Araştırma Dergisi. 2021;14(2):70-83.
-
30. Caídas. URL: https://www.who.int/es/news-room/fact-sheets/detail/falls. Yayınlanma Tarihi: 15.07.2019. Accessed April 26, 2025.
-
31. Pyykko I, Jantti P, Aalto H. Postural control in elderly subjects. Age Ageing. 1990;19(3):215–221.
-
32. Eyigör S, Şahin S. Denge Problemleri. In: Göksel SÜ, Saraç F, eds. Geriatride 5 'D'ler. İzmir: Ege Üniversitesi Basımevi, 2011.
-
33. Ruiz GT, Pedroso MD, de la Piedad EC, Vázquez RS, Regalado BS, Ugena ER. Guided home-based vestibular rehabilitation assisted by audiovisual media. Acta Otorrinolaringologica (English Edition). 2010;61(6):397-404.
-
34. Steinmetz HM, Hobson SJ. Prevention of falls among the community-dwelling elderly: An overview. Phys Occup Ther Geriatr. 1995;12(4):13-29.
-
35. Stolze H, Klebe S, Zechlin C, Baecker C, Friege L, Deuschl G. Falls in frequent neurological diseases. J Neurol. 2004;251(1):79-84.
-
36. Fletcher PC, Hirdes JP. Restriction in activity associated with fear of falling among community-based seniors using home care services. Age Ageing. 2004;33(3):273-279.
-
37. Lord SR, Clark RD, Webster IW. Postural stability and associated physiological factors in a population of aged persons. J Gerontol. 1991;46(3):69-76.
-
38. Ko SU, Simonsick EM, Despande N, Studenski S, Ferrucci L. Ankle proprioception associated gait patterns in older adults: results from the BLSA. Medicine and Science in Sports and Exercise. 2016;48(11):2190.
-
39. Tuthill JC, Azim E. Proprioception. Current Biology. 2018;28(5):194-203.
-
40. Antcliff SR, Witchalls JB, Wallwork SB, Welvaert M, Waddington GS. Developing a multivariate prediction model of falls among older community‐dwelling adults using measures of neuromuscular control and proprioceptive acuity: A pilot study. Australasian Journal on Ageing. 2023;00:1-9.
-
41. Kojima G. Frailty as a predictor of future falls among community-dwelling older people: A systematic review and meta-analysis. Journal of the American Medical Directors Association. 2015;16 (12):1027-1033.
-
42. Low DC, Walsh GS, Arkesteijn M. Effectiveness of exercise interventions to improve postural control in older adults: A systematic review and meta-analyses of centre of pressure measurements. Sports Medicine. 2017;47:101-112.
-
43. Pérez-Ros P, Vila-Candel R, Martínez-Arnau FM. A home-based exercise program focused on proprioception to reduce falls in frail and pre-frail community-dwelling older adults. Geriatric Nursing. 2020;41(4):436-444.
-
44. Espejo-Antúnez L, Pérez-Mármol JM, de los Ángeles Cardero-Durán M, Toledo-Marhuenda JV, Albornoz-Cabello M. The effect of proprioceptive exercises on balance and physical function in institutionalized older adults: A randomized controlled trial. Archives of Physical Medicine and Rehabilitation. 2020;101(10):1780-1788.
The Effects of Balance and Proprioceptive Training on Falling in Older Adults
Year 2025,
Issue: 26, 762 - 770, 31.08.2025
Havva Ezgi Albayrak
,
Hande Besna Göçen
,
Suzan Aydın
,
Mustafa Oğuz Kethüdaoğlu
,
Aygül Köseoğlu Kurt
,
Mehmet Kaan Altunok
,
Bülent Abut Özsezikli
Abstract
Physiological changes and physical inactivity are observed in older individuals due to the gradual slowing down of body systems. These changes in the systems lead to a reduction in bodily functions. Falls and fall-related injuries are considered significant problems in adults aged 65 and above, with an even higher prevalence in those aged 75 and above. Proprioceptive systems are among the impaired systems. Dysfunctions of these systems include balance and proprioceptive systems, and dysfunctions in these systems increase with advancing age. Balance and coordination problems have been identified as important risk factors for falls among older adults. Additionally, proprioception decreases with age. Studies have shown that diminished proprioception is a significant contributing factor to falls in the elderly. The disruption of the body's balance and coordination system, along with the weakening of the proprioceptive system, leads to an increased risk of falls, which is a significant cause of mortality and morbidity in the elderly population. This review aims to investigate the impact of balance and proprioception training on fall prevention in elderly populations.
References
-
1. Alterovitz SS, Mendelsohn GA. Relationship goals of middle-aged, young-old, and old-old internet daters: An analysis of online personal ads. Journal of Aging Studies. 2013;27(2):159-165.
-
2. Cuevas-Trisan R. Balance problems and fall risks in the elderly. Clinics in Geriatric Medicine. 2019;35(2):173-183.
-
3. Meyer M, Constancias F, Vogel T, Kaltenbach G, Schmitt E. Gait disorder among elderly people, psychomotor disadaptation syndrome: Post-fall syndrome, risk factors and follow-up–a cohort study of 70 patients. Gerontology. 2021;67(1):17-24.
-
4. Osoba MY, Rao AK, Agrawal SK, Lalwani AK. Balance and gait in the elderly: A contemporary review. Laryngoscope Investig Otolaryngol. 2019;4(1):143-53.
-
5. Preszner-Domjan A, Nagy E, Szíver E, Feher-Kiss A, Horvath G, Kranicz J. When does mechanical plantar stimulation promote sensory re-weighing: standing on a firm or compliant surface? European Journal of Applied Physiology. 2012;112:2979-2987.
-
6. Menz HB, Morris ME, Lord SR. Foot and ankle characteristics associated with impaired balance and functional ability in older people. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2005;60(12):1546-1552.
-
7. Geoba Sa. The World: Life Expectancy. URL: http://geoba.se/population.php?pe=world&type=015&page=2 Yayınlanma Tarihi: 12.03.2015. Accessed April 21, 2025.
-
8. Ambrose AF, Paul G, Hausdorff JM. Risk factors for falls among older adults: a review of the literature. Maturitas. 2013;75:51-61.
-
9. Etxeberria I, Etxebarria I, Urdaneta E, Yanguas JJ. Age differences among older adults in the use of emotion regulation strategies. What happens among over 85s and centenarians? Aging Ment Health. 2016;20(9):974–980.
-
10. Jacobs J, Horak F. Cortical control of postural responses. J. Neural Transm. 2007;114:1339–1348.
-
11. World Health Organization. World report on Ageing And Health. URL: www.who.int Yayınlanma Tarihi: 20.12.2015. Accessed April 20, 2025.
-
12. Türkiye İstatistik Kurumu. TÜİK Kurumsal. URL: https://www.tuik.gov.tr/ Yayınlanma Tarihi: 19.12.2022. Accessed June 25, 2023.
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13. Türkiye İstatistik Kurumu. TÜİK Kurumsal. URL: https://data.tuik.gov.tr/Bulten/Index?p=Elderly-Statistics. Accessed March 28, 2025.
-
14. Gaigbe-Togbe V, Bassarsky L, Gu D, Spoorenberg T, Zeifman L. World population prospects 2022. Department of Economic and Social Affairs, Population Division: New York, NY, USA.
-
15. Nations Department of Economics Affairs Population Division. World Population Ageing 2020 Highlights. URL: https://www.un.org/development/desa/pd. Accessed April 25, 2025.
-
16. Aslan C, Ulus Y, Akyol Y, Bı̇lgı̇cı̇ A, Kuru Ö. Fear of falling in community-dwelling older people: relationship with sleep quality, depression and quality of life. J PMR Sci. 2021;24(1):8-16.
-
17. Duray M. Farklı Fiziksel Aktivite Düzeyine Sahip Olan Yaşlılarda Fiziksel Uygunluk, Düşme Riski ve Düşme Korkusu İlişkisinin İncelenmesi [doctorate thesis]. İzmir, Türkiye: Dokuz Eylül Üniversitesi,2013.
-
18. Chang CJ, Yang TF, Yang SW, Chern JS. Cortical modulation of motor control biofeedback among the elderly with high fall risk during a posture perturbation task with augmented reality. Frontiers in Aging Neuroscience. 2016;8:80.
-
19. Tinetti ME, Richman D, Powell L. Falls efficacy as a measure of fear of falling. Journal of Gerontology. 1990;45(6):239-243.
-
20. Rosen T, Mack KA, Noonan RK. Slipping and tripping: Fall injuries in adults associated with rugs and carpets. J Inj Violence Res. 2013;5(1):61-65.
-
21. Çınarlı T, Zeliha K. 65 yaş ve üzeri yaşlılarda düşme risk ve korkusunun günlük yaşam aktiviteleri ve yaşam kalitesi üzerine etkisi. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. 2015;4(4):660-679.
-
22. Özkul K. Diyabetli yaşlılarda düşme korkusunun yaşam kalitesine etkisinin değerlendirilmesi [master’s thesis]. Bursa, Türkiye: Uludağ Üniversitesi,2019.
-
23. Biçer S, Demir G. Yaşlı bireylerde düşme ve kazalar. Yaşlı Sorunları Araştırma Dergisi. 2018;11(2):37-40.
-
24. Sapmaz M. Yaşlılarda Düşme Korkusunun Denge ve Çift Görev Performasına Etkisi [doctorate thesis]. Ankara, Türkiye: Yıldırım Beyazıt Üniversitesi,2018.
-
25. Kara B, Yıldırım Y, Genç A, Ekizler S. Geriatriklerde ev ortamı ve yaşam memnuniyetinin değerlendirilmesi ve düşme korkusu ile ilişkisinin incelenmesi. Fizyoterapi Rehabilitasyon. 2009;20(3):190-200.
-
26. Zijlstra GAR, van Haastregt JCM, van Eijk JThM, van Rossum E, Stalenhoef PA, Kempen GIJM. Prevalence and correlates of fear of falling, and associated avoidance of activity in the general population of community-living older people. Age and Ageing. 2007;36(3):304-9.
-
27. Scheffer AC, Schuurmans MJ, van Dijk N, van der Hooft T, de Rooij SE. Fear of falling: measurement strategy, prevalence, risk factors and consequences among older persons. Age and Ageing. 2008;37(1):19-24.
-
28. Akdeniz M, Yaman A, Kılıç S, Yaman H. Aile hekimliğinde önlenebilen sorunlar: Yaşlılarda düşmeler. GeroFam. 2010;1(1).
-
29. Güneş-Gencer GY, İpek L, Kara DS, Uzun F, Çetin SY. Türkiye’de yaşlılarda düşme ve denge ile ilgili yapılmış çalışmaların incelenmesi. Yaşlı Sorunları Araştırma Dergisi. 2021;14(2):70-83.
-
30. Caídas. URL: https://www.who.int/es/news-room/fact-sheets/detail/falls. Yayınlanma Tarihi: 15.07.2019. Accessed April 26, 2025.
-
31. Pyykko I, Jantti P, Aalto H. Postural control in elderly subjects. Age Ageing. 1990;19(3):215–221.
-
32. Eyigör S, Şahin S. Denge Problemleri. In: Göksel SÜ, Saraç F, eds. Geriatride 5 'D'ler. İzmir: Ege Üniversitesi Basımevi, 2011.
-
33. Ruiz GT, Pedroso MD, de la Piedad EC, Vázquez RS, Regalado BS, Ugena ER. Guided home-based vestibular rehabilitation assisted by audiovisual media. Acta Otorrinolaringologica (English Edition). 2010;61(6):397-404.
-
34. Steinmetz HM, Hobson SJ. Prevention of falls among the community-dwelling elderly: An overview. Phys Occup Ther Geriatr. 1995;12(4):13-29.
-
35. Stolze H, Klebe S, Zechlin C, Baecker C, Friege L, Deuschl G. Falls in frequent neurological diseases. J Neurol. 2004;251(1):79-84.
-
36. Fletcher PC, Hirdes JP. Restriction in activity associated with fear of falling among community-based seniors using home care services. Age Ageing. 2004;33(3):273-279.
-
37. Lord SR, Clark RD, Webster IW. Postural stability and associated physiological factors in a population of aged persons. J Gerontol. 1991;46(3):69-76.
-
38. Ko SU, Simonsick EM, Despande N, Studenski S, Ferrucci L. Ankle proprioception associated gait patterns in older adults: results from the BLSA. Medicine and Science in Sports and Exercise. 2016;48(11):2190.
-
39. Tuthill JC, Azim E. Proprioception. Current Biology. 2018;28(5):194-203.
-
40. Antcliff SR, Witchalls JB, Wallwork SB, Welvaert M, Waddington GS. Developing a multivariate prediction model of falls among older community‐dwelling adults using measures of neuromuscular control and proprioceptive acuity: A pilot study. Australasian Journal on Ageing. 2023;00:1-9.
-
41. Kojima G. Frailty as a predictor of future falls among community-dwelling older people: A systematic review and meta-analysis. Journal of the American Medical Directors Association. 2015;16 (12):1027-1033.
-
42. Low DC, Walsh GS, Arkesteijn M. Effectiveness of exercise interventions to improve postural control in older adults: A systematic review and meta-analyses of centre of pressure measurements. Sports Medicine. 2017;47:101-112.
-
43. Pérez-Ros P, Vila-Candel R, Martínez-Arnau FM. A home-based exercise program focused on proprioception to reduce falls in frail and pre-frail community-dwelling older adults. Geriatric Nursing. 2020;41(4):436-444.
-
44. Espejo-Antúnez L, Pérez-Mármol JM, de los Ángeles Cardero-Durán M, Toledo-Marhuenda JV, Albornoz-Cabello M. The effect of proprioceptive exercises on balance and physical function in institutionalized older adults: A randomized controlled trial. Archives of Physical Medicine and Rehabilitation. 2020;101(10):1780-1788.