Effect of hypertension on muscle strength, balance, and mobility in older adults

Year 2024, Volume: 11 Issue: 1, 47 - 55, 18.04.2024

Farzin Hajebrahimi , Devrim Tarakcı , Hanefi Özbek , Miray Budak , Candan Algun

https://doi.org/10.15437/jetr.1092224

Abstract

Purpose: Hypertension (HT) can exacerbate impaired blood pressure regulation and thus increase the
risk of falls. The higher incidence of HT and impaired balance in older adults may lead to the hypothesis
of an association between HT and physical function in older individuals. The purpose of this study was to
investigate the effects of HT on muscle strength, balance, and mobility in older adults and the
relationship between them.
Methods: Sixty-one older adults were included in the study and individuals with systolic blood pressure
≥140 mmHg or diastolic blood pressure ≥90 mmHg formed the Hypertensive group (n=31), while the
others formed the Normotensive group (n=30). Quadriceps Femoris (QF) muscle strength was
evaluated with a hand-held dynamometer, mobility was evaluated with the Timed Up and Go Test (TUG),
balance performance was evaluated with the Nintendo Wii Fit Balance Board (NWBB), and physiological
age was evaluated with Wii Fit Age (WFA). The systolic and diastolic blood pressure were measured
before the balance test.
Results: TUG and NWBB scores between groups were significantly better in the Normotensive group
(p<0.05). In both Hypertensive and Normotensive groups, there was a negative correlation between QF
muscle strength and TUG score, and a positive correlation between QF muscle strength and NWBB
score (p<0.05).
Conclusion: HT may worsen mobility and balance in older adults. Further studies are required to better
understand HT and establish better appropriate interventions for older hypertensive adults.

Keywords

Hypertension, Postural balance, Functional status, Frail elderly, Exergaming.

Yaşlı erişkinlerde hipertansiyonun kas gücü, denge ve mobiliteye etkisi

Abstract

Amaç: Hipertansiyon (HT), kan basıncı regülasyonunda bozulma ile şiddetlendirerek düşme riskini
arttırabilmektedir. Yaşlı erişkinlerde daha yüksek HT insidansı ve bozulmuş denge, HT ile fiziksel
fonksiyonlar arasında bir ilişki olduğu hipotezine yol açabilmektedir. Bu çalışmanın amacı, yaşlı
erişkinlerde hipertansiyonun kas kuvveti, denge ve mobiliteye etkisini ve onlarla ilişkisini incelemekti.
Yöntem: Çalışmaya 61 yaşlı birey dahil edildi ve sistolik kan basıncı ≥140 mmHg veya diyastolik kan
basıncı ≥90 mmHg olan bireyler Hipertansif grubu (n=31), diğerleri Normotansif grubu (n=30) oluşturdu.
Quadriceps Femoris (QF) kas gücü dinamometre ile, mobilite Zamanlı Kalk ve Yürü Testi (ZKYT), denge
performansı Nintendo Wii Fit Balance Board (NWBB) ve fizyolojik yaş Wii Fit Age (WFA) ile
değerlendirildi. Denge testinden önce sistolik ve diyastolik kan basıncı ölçüldü.
Bulgular: Gruplar arasında ZKYT ve NWBB skorları, Normotansif grubunda anlamlı olarak daha iyiydi
(p<0,05). Hem Hipertansif hem de Normotansif grubunda, QF kas kuvveti ile ZKYT skoru arasında
negatif yönde, QF kas kuvveti ile NWBB skoru arasında pozitif yönde anlamlı ilişki bulundu (p<0,05).
Sonuç: HT, yaşlı erişkinlerde mobiliteyi ve dengeyi kötüleştirebilmektedir. HT'yi daha iyi anlamak ve
yaşlı hipertansif yetişkinleri için daha uygun müdahaleler oluşturmak için daha fazla çalışmaya ihtiyaç
vardır.

Keywords

Hipertansiyon, Postür dengesi, Fonksiyonel durum, Kırılgan yaşlılar, Exergaming.

References

• Del Pinto R, Ferri C. Hypertension management at older age: an update. High Blood Press Cardiovasc Prev. 2019;26:27-36.
• Franklin SS, Jacobs MJ, Wong ND, et al. Predominance of Isolated Systolic Hypertension Among Middle-Aged and Elderly US Hypertensives: Analysis Based on National Health and Nutrition Examination Survey (NHANES) III. Hypertension. 2001;37:869-874.
• Weber MA, Schiffrin EL, White WB, et al. Clinical Practice Guidelines for the management of hypertension in the community: A Statement by the American Society of Hypertension and the International Society of Hypertension. J Clin Hypertens. 2014;16:14-26.
• Yong V, Saito Y, Chan A. Changes in the Prevalence of Mobility Limitations and Mobile Life Expectancy of Older Adults in Singapore, 1995- 2005. J Aging Health. 2010;22:120-140.
• Hajjar I, Lackland DT, Cupples LA, et al. Association Between Concurrent and Remote Blood Pressure and Disability in Older Adults. Hypertension. 2007;50:1026-1032.
• Nascimento C de M, Mambrini JV de M, de Oliveira CM, et al. Diabetes, hypertension and mobility among Brazilian older adults: findings from the Brazilian National Household Sample Survey (1998, 2003 and 2008). BMC Public Health. 2015;15:591.
• Hajjar I, Quach L, Yang F, et al. Hypertension, White Matter Hyperintensities, and Concurrent Impairments in Mobility, Cognition, and Mood: The Cardiovascular Health Study. Circulation. 2011;123:858-865.
• Acar S, Demırbüken İ, Algun C, et al. Is hypertension a risk factor for poor balance control in elderly adults? J Phys Ther Sci. 2015;27:901- 904.
• Sturnieks DL, St George R, Lord SR. Balance disorders in the elderly. Neurophysiol Clin Neurophysiol. 2008;38:467-478.
• Spencer RJ, Wendell CR, Giggey PP, et al. Judgment of Line Orientation: an examination of eight short forms. J Clin Exp Neuropsychol. 2013;35:160-166.
• Hausdorff JM, Herman T, Baltadjieva R, et al. Balance and Gait in Older Adults With Systemic Hypertension. Am J Cardiol. 2003;91:643-645. Hajebrahimi et al54 Journal of Exercise Therapy and Rehabilitation
• Huurnink A, Fransz DP, Kingma I, et al. Comparison of a laboratory grade force platform with a Nintendo Wii Balance Board on measurement of postural control in single-leg stance balance tasks. J Biomech. 2013;46:1392- 1395.
• Liuzzo DM, Peters DM, Middleton A, et al. Measurements of weight bearing asymmetry using the Nintendo Wii Fit Balance Board are not reliable for older adults and ındividuals with stroke. J Geriatr Phys Ther. 2017;40:37-41.
• Clark RA, Bryant AL, Pua Y, et al. Validity and reliability of the Nintendo Wii Balance Board for assessment of standing balance. Gait Posture. 2010;31:307-310.
• Fuentes-García A. Katz Activities of Daily Living Scale. In: Michalos AC, editor. Encyclopedia of Quality of Life and Well-Being Research [Internet]. Dordrecht: Springer Netherlands; 2014 [cited 2022 Sep 9]. p. 3465-3468. Available from: http://link.springer.com/10.1007/978-94-007-0753-5_1572.
• Education OM. Mini-mental state examination (MMSE) [Internet]. Oxford Medical Education. 2015 [cited 2022 Sep 9]. Available from: https://oxfordmedicaleducation.com/geriatrics/mini-mental-state-examination-mmse/.
• Yelnik A, Bonan I. Clinical tools for assessing balance disorders. Neurophysiol Clin Neurophysiol. 2008;38:439-445.
• Jorgensen MG, Laessoe U, Hendriksen C, et al. Intrarater Reproducibility and Validity of Nintendo Wii Balance Testing in Community-Dwelling Older Adults. J Aging Phys Act. 2014;22:269-275.
• Chang WD, Chang WY, Lee CL, et al. Validity and reliability of Wii Fit Balance Board for the assessment of balance of healthy young adults and the elderly. J Phys Ther Sci. 2013;25:1251-1253.
• Buford TW. Hypertension and aging. Ageing Res Rev. 2016;26:96-111.
• Faul F, Erdfelder E, Lang AG, et al. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39:175-191.
• Ozcan Kahraman B, Ozsoy I, Akdeniz B, et al. Test-retest reliability and validity of the timed up and go test and 30-second sit to stand test in patients with pulmonary hypertension. Int J Cardiol. 2020;304:159-163.
• How to cite IBM SPSS Statistics or earlier versions of SPSS [Internet]. 2022 [cited 2022 Sep 9]. Available from: https://www.ibm.com/support/pages/how-cite-ibm-spss-statistics-or-earlier-versions-spss.
• Buch A, Kis O, Carmeli E, Keinan-Boker L, Berner Y, Barer Y, et al. Circuit resistance training is an effective means to enhance muscle strength in older and middle aged adults. Ageing Res Rev. 2017;37:16-27.
• Damas Nogueira FR, Libardi CA, Vechin FC, et al. Comparison of maximal muscle strength of elbow flexors and knee extensors between younger and older men with the same level of daily activity. Clin Interv Aging. 2013:8:401-407.
• Abdelhafiz AH, Marshall R, Kavanagh J, et al. Management of hypertension in older people. Expert Rev Endocrinol Metab. 2018;13:181-191.
• Rosano C, Longstreth WT, Boudreau R, et al. High blood pressure accelerates gait slowing in well-functioning older adults over 18-years of follow-up. J Am Geriatr Soc. 2011;59:390-307.
• Mahinrad S, Kurian S, Garner CR, et al. Cumulative blood pressure exposure during young adulthood and mobility and cognitive function in midlife. Circulation. 2020;141:712-724.
• Okamura M, Konishi M, Saigusa Y, et al. Impact of grip strength and gait speed on exercise tolerance in patients with pulmonary hypertension without left heart disease. Heart Vessels. 2022;37:1928-1936.
• Zhang Z, Fan Z, Zhang J. Correlation between frail status and lower extremity function in elderly inpatients with hypertension. Nutr Hosp. 2022;39:39-45.
• Abellan Van Kan G, Rolland Y, Andrieu S, et al. Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people an International Academy on Nutrition and Aging (IANA) Task Force. J Nutr Health Aging. 2009;13:881-889.
• Abate M, Di Iorio A, Pini B, et al. Effects of hypertension on balance assessed by computerized posturography in the elderly. Arch Gerontol Geriatr. 2009;49:113-117.
• Timmermans ST, Reijnierse EM, Pasma JH, et al. Blood pressure change does not associate with Center of Pressure movement after postural transition in geriatric outpatients. BMC Geriatr. 2018;18:10.
• Perera S, Studenski S, Chandler JM, et al. Magnitude and patterns of decline in health and function in 1 year affect subsequent 5-year survival. J Gerontol A Biol Sci Med Sci. 2005;60:894-900.
• Odden MC, Peralta CA, Berlowitz DR, et al. Effect of intensive blood pressure control on gait speed and mobility limitation in adults 75 years or older: a randomized clinical trial. JAMA Intern Med. 2017;177:500-507.
• Vermeulen J, Neyens JC, van Rossum E, Set al. Predicting ADL disability in community-dwelling elderly people using physical frailty indicators: a systematic review. BMC Geriatr. 2011;11:33.
• Heffernan KS, Manini TM, Hsu FC, et al. Relation of Pulse Pressure to Long-Distance Gait Speed in Community-Dwelling Older Adults: Findings from the LIFE-P Study. Scuteri A, editor. PLoS ONE. 2012;7:e49544.