Huzurevinde yaşayan yaşlı bireylerde dans temelli egzersiz terapisinin kuvvet, esneklik, denge ve yaşam kalitesine etkilerinin incelenmesi: pilot çalışma

Öz

Amaç: Bu çalışma, huzurevinde yaşayan yaşlı bireylerde dans temelli egzersiz terapisi (DTET) uygulaması sonrası kuvvet, esneklik, denge ve yaşam kalitesindeki değişimleri araştırmak için planlandı.

Yöntem: Çalışmaya 65 yaş üzeri, yaş ortalaması 77,33±2,53 yıl (72-82) olan 12 yaşlı birey dahil edildi. Egzersizler, sabah saatlerinde, grup egzersizi olarak, 8 hafta süresince, haftada 1 seans olmak üzere uzman fizyoterapist eşliğinde uygulandı. Egzersiz programı; 10 dakika ısınma, 45 dakika müzik eşliğinde DTET ve 10 dakika soğuma egzersizleri idi. Tüm değerlendirmeler eğitim sürecinin başında ve sonunda olmak üzere 2 defa uygulandı. Bireylerin fonksiyonel üst ekstremite kas kuvveti Jamar El Dinamometresi ile, alt ekstremite kas kuvveti 30 saniye Otur-Kalk Testi ile, üst gövde esneklikleri Sırt Kaşıma Testi ile, dengeleri hem Tek Bacak Üzerinde Durma Testi hem de düşme korkuları açısından Uluslararası Düşme Etkinlik Ölçeği (U-DEÖ) ile, yaşam kaliteleri EQ-5D Yaşam Kalitesi Ölçeği ile değerlendirildi.

Bulgular: DTET sonrası üst ve alt ekstremite kas kuvveti, üst gövde esnekliği ve denge parametrelerinde gelişme elde edilirken (p<0,05), yaşam kalitesi ve U-DEÖ sonuçlarında gelişme elde edilmedi (p>0,05).

Sonuç: Yapılan bu pilot çalışma ile toplamda 8 saat süren 8 haftalık DTET uygulanması ile kuvvet, esneklik, denge parametrelerine yansıyan iyileşmeler elde edilse de bu süre ve program içeriğinin düşme korkusuna ve yaşam kalitesine etkisi olmadığı görüldü. Edinilen veriler doğrultusunda yaşam kalitesi ve düşme korkusunda iyileşme sağlayabilmek için DTET’ye ilave eğitim parametreleri eklenerek, daha uzun süre takip ve kontrol grubu varlığında çalışmanın devam edilmesine karar verildi.

Anahtar Kelimeler

• Yaşlı
• Huzurevleri
• Dans terapi

Investigation of the effects of dance-based exercise therapy on strength, flexibility, balance, and quality of life in elderly living in the nursing home: a pilot study

Öz

Purpose: This study was planned to investigate changes in strength, flexibility, balance, and quality of life after dance-based exercise therapy (DBET) application in elderly, living in a nursing home.

Methods: The study included 12 people over 65 years of age with 77.33±2.53 years (72-82). Exercises were performed in mornings, as group exercise, for 8 weeks, with 1 session per week, with specialist physiotherapist. Therapy was created with 10 minutes warm-up, 45 minutes DBET accompanied by music, 10 minutes cool-down exercises. Evaluations were applied twice, at beginning and end of training process. Functional upper limb muscle strength of individuals with Jamar Hand Dynamometer, lower limb strength with sit-up test for 30 seconds, upper body flexibility with Back Scratch Test, balance; with both one leg standing test and Fall Efficiency Scale (FES-I) in terms of fear of falling (FOF), quality of life (QOL) was evaluated with EQ-5D Quality of Life Scale.

Results: After therapy, improvement was obtained in upper and lower extremity muscle strength, shoulder flexibility, balance parameters (p<0.05), but no improvement was obtained in QOL and FES-I results (p>0.05).

Conclusion: With this pilot study, although 8 weeks of DBET application, lasted 8 hours, improvements reflected in strength, flexibility, balance parameters; duration and program content didn’t affect FOF and QOL. To improve QOL and FOF in line with data obtained, it was decided to continue study in presence of a follow-up and control group by adding additional training parameters to DBET.

Anahtar Kelimeler

• Aged
• Nursing homes
• Dance therapy

Kaynakça

1. 1. Rubenstein LZ. Falls in older people: Epidemiology, risk factors and strategies for prevention. Age Ageing. 2006;3:37–41.
2. 2. Tiedemann A, Sherrington C, Close JC, et al. Exercise and Sports Science Australia position statement on exercise and falls prevention in older people. J Sci Med Sport. 2011;14:489–495.
3. 3. Filar-Mierzwa K, Długosz M, Marchewka A, et al. The effect of dance therapy on the balance of women over 60 years of age: The influence of dance therapy for the elderly. J Women Aging. 2017;29:348-355.
4. 4. Alpert PT, Miller SK, Wallmann H, et al. The effect of modified jazz dance on balance, cognition, and mood in older adults. J Am Acad Nurse Pract. 2009;21:108–115.
5. 5. Hwang PW, Braun KL. The effectiveness of dance interventions to improve older adults’ health: A Systematic Literature Review. Altern Ther Health Med. 2015;2:64–70.
6. 6. Aboderin IA, Beard JR. Older people’s health in sub-Saharan Africa. Lancet. 2015;385:9–11.
7. 7. Resnick B, Spellbring AM. Understanding what motivates older adults to exercise. J Gerontol Nurs. 2000;26:34–42.
8. 8. Simmons RW. Neuromuscular responses of trained ballet dancers to postural perturbations. Int J Neurosci. 2005;115:1193–1203.

9. 9. Granacher U, Muehlbauer T, Bridenbaugh SA, et al. Effects of a salsa dance training on balance and strength performance in older adults. Gerontology. 2012;58:305–312.
10. 10. Güngen C, Ertan T, Eker E, et al. Standardize Mini Mental Test’in Türk Toplumunda Hafif Demans Tanısında Geçerlik ve Güvenilirliği. Türk Psikiyatri Derg. 2002;13:273-281.
11. 11. Dallesega C, Morris D. The MMSE to Assess the Cognitive State of Elders. Mini-Mental State Examination. J Neurosci Nurs. 1993;25:147-52.
12. 12. Karcıoğlu Ö, Keleş A, Soysal S, et al. Acil Serviste 65 yaş üzerindeki olguların mental durum değerlendirmesinde “Kısa Kognitif Muayene” ve “Kısa Bilişsel Durum” testlerinin karşılaştırılması. İnönü Üniversitesi Tıp Fakültesi Dergisi. 2001;8:127-133.
13. 13. Jones CJ, Rikli RE, Beam WC. A 30-s chair-stand test as a measure of lower body strength in community-residing older adults. Res Q Exerc Sport. 1999;70:113-9.
14. 14. Shechtman O, Gestewitz L, Kimble C. Reliability and validity of the DynEx dynamometer. J Hand Ther. 2005;18:339-347.
15. 15. Solla P, Cugusi L, Bertoli M et al. Sardinian Folk Dance for Individuals with Parkinson’s Disease: A Randomized Controlled Pilot Trial. Altern Complement Med. 2019;25:305-316.
16. 16. Peng X, Liu N, Zhang X et al. Associations between objectively assessed physical fitness levels and sleep quality in community-dwelling elderly people in South China. Sleep Breath. 2019;23:679-685.
17. 17. Springer BA, Marin R, Cyhan T, et al. Normative values for the unipedal stance test with eyes open and closed. J Geriatr Phys Ther. 2007;30:8–15.
18. 18. Ulus Y, Durmus D, Akyol Y, et al. Reliability and validity of the Turkish version of the Falls Efficacy Scale International (FES-I) in community-dwelling older persons. Arch Gerontol Geriatr. 2012;54, 429-433.
19. 19. 2. Sağlıkta Yaşam Kalitesi Kongresi Bildiri Özetleri Kitabı. EURO-QoL (EQ-5D) indeksinin toplum standartları ve psikometrik özellikleri: Manisa kent toplumu örneklemi (n=6026). Eser E, Dinç G, Cengiz B. et al. İzmir: Meta Basımevi; 2007:78.
20. 20. Dolan P, Gudex C, Kind P, et al. The time trade-off method: results from a general population study. Health Econ. 1996;5:141-54.
21. 21. Holmerova I, Machacova K, Vankova H, et al. Effect of the Exercise Dance for Seniors (EXDASE) program on lower-body functioning among institutionalized older adults. J Aging Health. 2010;22:106–19.
22. 22. Janyacharoen T, Laophosri M, Kanpittaya J, et al. Physical performance in recently aged adults after 6 weeks traditional Thai dance: a randomized controlled trial. Clin Interv Aging. 2013;8:855–9.
23. 23. Hopkins DR, Murrah B, Hoeger WW, et al.. Effect of low-impact aerobic dance on the functional fitness of elderly women. Gerontologist. 1990;30:189–92.
24. 24. Earhart GM. A Comparison of Dance Interventions in People With Parkinson Disease and Older Adults. Maturitas. 2015;81:10-6.
25. 25. Song QH, Zhang QH, Xu RM, et al. Effect of Tai-chi exercise on lower limb muscle strength, bone mineral density and balance function of elderly women. Int J Clin Exp Med. 2014;7:1569–76.
26. 26. Shigematsu R, Chang M, Yabushita N, et al. Dance based aerobic exercise may improve indices of falling risk in older women. Age Ageing. 2002;31:261–6.
27. 27. Melzer I, Benjuya N, Kaplanski J, et al. Association between ankle muscle strength and limit of stability in older adults. Age Ageing. 2009;38:119–123.
28. 28. Wu HY, Tu JH, Hsu CH, et al. Effects of low-impact dance on blood biochemistry, bone mineral density, the joint range of motion of lower extremities, knee extension torque, and fall in females. J Aging Phys Act. 2016;24:1–7.
29. 29. Veronese N, Maggi S, Schofield P, et al. Dance movement therapy and falls prevention. Maturitas. 2017;102:1-5.
30. 30. da Silva Borges EG, de Souza Vale RG, et al. Postural balance and falls in elderly nursing home residents enrolled in a ballroom dancing program. Arch Gerontol Geriatr. 2014;59:312–316.
31. 31. Fernandez-Arguelles EL, Rodriguez-Mansilla J, Antunez LE, et al. Effects of dancing on the risk of falling related factors of healthy older adults: a systematic review. Arch Gerontol Geriatr. 2015;60:1–8.
32. 32. Stubbs B, Brefka S, Denkinger MD. What works to prevent falls in community-dwelling older adults? Umbrella review of meta-analyses of randomized controlled. Phys Ther. 2015;95:1095-110.
33. 33. Stevens-Ratchford RG. Ballroom Dance: Linking serious leisure to successful aging. Int J Aging Hum Dev. 2016;83:290-308.