پژوهش در توانبخشی ورزشی

پژوهش در توانبخشی ورزشی

تأثیر هشت هفته تمرینات تعادلی و ماندگاری آن بر استراتژی بازیابی تعادل در سالمندان با خطر سقوط: یک کارآزمایی بالینی

نوع مقاله : مقاله پژوهشی

نویسندگان
1 دانشگاه تهران پردیس بین الملل کیش
2 دانشکده تربیت بدنی و علوم ورزشی دانشگاه تهران
3 گروه آسیب شناسی ورزشی و حرکات اصلاحی، دانشکده تربیت بدنی و علوم ورزشی، دانشگاه شهید باهنر کرمان، کرمان، ایران.
10.22084/rsr.2025.26793.1653
چکیده
زمینه و هدف: یکی از عوامل مؤثر در جلوگیری از سقوط سالمندان، حفظ تعادل و درمان مشکلات تعادلی است. هدف تحقیق بررسی تأثیر 8 هفته تمرینات تعادلی و ماندگاری آن بر استراتژی بازیابی تعادل در سالمندان با خطر سقوط بود.
روش بررسی: از بین 200 سالمند کهریزک استان البرز با دامنه سنی60 - 75 سال، 60 نفر به طور هدفمند براساس معیارهای ورود و خروج، به 2 گروه، کنترل و تجربی تقسیم شدند. برای اندازه‌گیری تعادل (آزمون تعادلی برگ)، اندازه‌گیری کنترل پاسچر (آزمون تعادلی زمان برخاستن و حرکت کردن، آزمون تک‌ پا) و اندازه‌گیری دقت حس‌عمقی مفاصل مچ پا و زانو (عکس‌برداری دیجیتال و نرم‌افزار اتوکد) استفاده شد. جهت مقایسه میانگین اطلاعات پیش‌آزمون و پس‌آزمون، آزمون تحلیل واریانس ترکیبی استفاده شد. سطح معنی‌داری 95 درصد درنظر گرفته شد.
نتایج: آزمون تحلیل کوواریانس چند متغیره و اثرات مقایسه زوجی نمرات پس‌آزمون برای متغیرها شامل: تعادل، کنترل پاسچر و حس عمقی نشان داد بین گروه‌های آزمایش و کنترل، تفاوت معنی‌داری وجود دارد (05≥p).
نتیجه‌گیری: نتایج نشان داد اجرای هشت هفته تمرینات تعادلی در سالمندان، موجب ارتقای کنترل پاسچر، تعادل و افزایش دقت حس عمقی در مفاصل اندام تحتانی و نیز بهبود معنی‌داری در توانایی کنترل پاسچر افراد شود. پس از اعمال تمرینات با وجود کاهش نسبی در غالب بودن استراتژی ران برای بازیابی تعادل (مفصل ران/ مفصل مچ پا) این تغییرات بهبود معنی‌داری در استراتژی بازیابی تعادل داشت و سازگاری‌های عصبی بدست آمده توسط این تمرینات برای دورۀ طولانی مدت باقی ماند. پیشنهاد می‌گردد تحقیقات آتی به بررسی تأثیر تمرینات تعادلی در یک دورۀ بیش از هشت هفته تمرینات بر استراتژی‌های بازیابی تعادل بپردازد.
کلیدواژه‌ها
موضوعات

1.   Rudger R, Alizadeh MH, Sahibzamani M. The effect of eight weeks of balance training and its durability on balance recovery strategy in the elderly with fall risk: Quasi-experimental. J Rehabil Res Dev. 2025;62(1):[Page numbers].
2.   World Health Organization. Ageing and health. Geneva: WHO; 2022.
3.   Mirzaei M, Darabi S, Babapour N. Aging population in Iran and rising healthcare costs. Salamand J Sci Res. 2017;12(2):156-9.
4.   Zarei H, Nursteh A, Bumi K. The effect of combined exercise (strength and stretching) on balance, fall risk and quality of life of the elderly. Bimonthly Scientific-Research Journal of Rehabilitation Medicine. 2018;7(2):201-8.
5.   Bogle Thorbahn LD, Newton RA. Use of the Berg Balance Test to predict falls in elderly persons. Physical Therapy. 1996;76(6):576-83.
6.   Liu J, Wang XQ, Zheng JJ, Pan YJ, Hua YH, Zhao SM, et al. Effects of Tai Chi versus proprioception exercise program on neuromuscular function of the ankle in elderly people: a randomized controlled trial. Evid Based Complement Alternat Med. 2012;2012:[Page numbers].
7.   Lopes KT, Costa D, Santos L, Castro D, Bastone A. Prevalência do medo de cair em uma população de idosos da comunidade e sua correlação com mobilidade, equilíbrio dinâmico, risco e histórico de quedas. Brazilian Journal of Physical Therapy. 2009;13:223-9.
8.   Resende SM, Rassi CM. Effects of hydrotherapy in balance and prevention of falls among elderly women. Brazilian Journal of Physical Therapy. 2008;12:57-63.
9.   Carter ND, Kannus P, Khan K. Exercise in the prevention of falls in older people. Sports Medicine. 2001;31(6):427-38.
10. Neuls PD, Clark TL, Van Heuklon NC, Proctor JE, Kilker BJ, Bieber ME, et al. Usefulness of the Berg Balance Scale to predict falls in the elderly. Journal of Geriatric Physical Therapy. 2011;34(1):3-10.
11. Vickers NJ. Animal communication: when i’m calling you, will you answer too? Current Biology. 2017;27(14):R713-R715.
12. Dhebar F. Interventions for increasing balance and confidence in older adults: a review. International Journal of Physiotherapy and Research. 2014;2(4):631-6.
13. Zammit G, Wang-Weigand S, Peng X. Use of computerized dynamic posturography to assess balance in older adults after nighttime awakenings using zolpidem as a reference. BMC Geriatrics. 2008;8(1):1-7.
14. Papalia GF, Papalia R, Diaz Balani LA, Torre G, Zampogna B, Vasta S, et al. The effects of physical exercise on balance and prevention of falls in older people: A systematic review and meta-analysis. Journal of Clinical Medicine. 2020;9(8):2595.
15. Hinman R, Bennell K, Metcalf B, Crossley K. Balance impairments in individuals with symptomatic knee osteoarthritis: a comparison with matched controls using clinical tests. Rheumatology. 2002;41(12):1388-94.
16. Menz HB, Lord SR, Fitzpatrick RC. Age‐related differences in walking stability. Age and Ageing. 2003;32(2):137-42.
17. Cheshme pD, Ghasemi B, Moradi. Comparison of the effect of closed motor chain exercises and deep receptor neuromuscular facilitation on ankle joint proprioception in elderly men. Research in Sports Rehabilitation. 2016;4(8):55-64.
18. Blackburn T, Guskiewicz KM, Petschauer MA, Prentice WE. Balance and joint stability: the relative contributions of proprioception and muscular strength. Journal of Sport Rehabilitation. 2000;9(4):315-28.
19. Jafarnejad K. Establishing of balance norm for guidance level boy student of guilan province. Master’s thesis, University of Guilan; 2010.
20. Koohboomi M, Norasteh AA, Samami N. Effect of Yoga training on physical fitness and balance in elderly females. Iranian Journal of Ageing. 2015;10(3):26-35.
21. Rahmani M, Heirani A, Yazdanbakhsh K. The effect of Pilates training on improving the reaction time and balance of sedentary elderly men. Journal of Modern Rehabilitation. 2015;9(3):44-53.
22. Dastmanesh S, Sahebozamani M, Karimi MT. Effect of otago and tai chi exercise programs on balance and risk of falls in elderly men. The Scientific Journal of Rehabilitation Medicine. 2019;8(1):156-64.
23. Amiridis IG, Hatzitaki V, Arabatzi F. Age-induced modifications of static postural control in humans. Neuroscience Letters. 2003;350(3):137-40.
24. Bennie S, Bruner K, Dizon A, Fritz H, Goodman B, Peterson S. Measurements of balance: comparison of the Timed" Up and Go" test and Functional Reach test with the Berg Balance Scale. Journal of Physical Therapy Science. 2003;15(2):93-7.
25. Chisholm D, Collis M, Kulak L, Davenport W, Gruber N. Physical activity readiness. BC Med J. 1975;17(2):375-8.
26. Sadeghi H, Norouzi H, Karimi Asl A, Montazer M. Functional training program effect on static and dynamic balance in male able-bodied elderly. Iranian Journal of Ageing. 2008;3(2):565-71.
27. Hertel J. Functional anatomy, pathomechanics, and pathophysiology of lateral ankle instability. Journal of Athletic Training. 2002;37(4):364.
28. Samani A, Rahnama R, Raisi S, Nejadian L. The effect of three months of square stepping and resistance exercises on postural balance and fear of falling in elderly women. Sports Medicine Studies. 2019;11(25):59-80.
29. Asl T, Sedaghati, Javazi. Comparison of functional balance and probability of falls in the elderly with and without a history of falls living in care centers. Sports Biomechanics Quarterly. 2020;6(2):134-43.
30. Shafi’i A, Daneshjoo A, Al-Zamani S, Mansour M. The effect of eight weeks of aquatic exercises on postural control and balance recovery strategies in elderly men aged 60-70 years. Bimonthly Scientific-Research Journal of Rehabilitation Medicine. 2022;10(6):1326-37.
31. Dehkhavarghani MZ, Hamed S, Saidi F, Rajabi. The effect of circadian rhythm on knee joint position sense changes in college male football players. Research in Rehabilitation Sciences. 2015;11(2):122-9.
32. Stillman BC. An investigation of the clinical assessment of joint position sense. Melbourne: University of Melbourne; 2000.
33. Šarabon N, Kozinc Ž. Effects of resistance exercise on balance ability: Systematic review and meta-analysis of randomized controlled trials. Life. 2020;10(11):284.
34. Pallant J. SPSS survival manual: A step by step guide to data analysis using IBM SPSS. London: Routledge; 2020.
35. Newell D, Shead V, Sloane L. Changes in gait and balance parameters in elderly subjects attending an 8-week supervised Pilates programme. Journal of Bodywork and Movement Therapies. 2012;16(4):549-54.
36. Bernardo LM. The effectiveness of Pilates training in healthy adults: An appraisal of the research literature. Journal of Bodywork and Movement Therapies. 2007;11(2):106-10.
37. Barrett C, Smerdely P. A comparison of community-based resistance exercise and flexibility exercise for seniors. Australian Journal of Physiotherapy. 2002;48(3):215-9.
38. Kuo YL, Tully EA, Galea MP. Sagittal spinal posture after Pilates-based exercise in healthy older adults. Spine. 2009;34(10):1046-51.
39. Buchner DM, Cress ME, De Lateur BJ, Esselman PC, Margherita AJ, Price R, et al. The effect of strength and endurance training on gait, balance, fall risk, and health services use in community-living older adults. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 1997;52(4):M218-M224.
40. Khaje Nemat K, Sadeghi H, Sahebzamani M. The effect of 8 weeks of strength training on static and dynamic balance in healthy men. Journal of Exercise Science and Medicine. 2014;6(1):45-55.
41. Nagy E, Feher-Kiss A, Barnai M, Domján-Preszner A, Angyan L, Horvath G. Postural control in elderly subjects participating in balance training. European Journal of Applied Physiology. 2007;100(1):97-104.
42. Vieira FT, Faria LM, Wittmann JI, Teixeira W, Nogueira LAC. The influence of Pilates method in quality of life of practitioners. Journal of Bodywork and Movement Therapies. 2013;17(4):483-7.
43. Teasdale N, Stelmach GE, Breunig A. Postural sway characteristics of the elderly under normal and altered visual and support surface conditions. Journal of Gerontology. 1991;46(6):B238-B244.
44. Shumway-Cook A, Woollacott M, Kerns KA, Baldwin M. The effects of two types of cognitive tasks on postural stability in older adults with and without a history of falls. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 1997;52(4):M232-M240.
45. Mackey DC, Robinovitch SN. Mechanisms underlying age-related differences in ability to recover balance with the ankle strategy. Gait & Posture. 2006;23(1):59-68.
46. Hossein ML, Lajevardi T, Taghizadeh Q. The effect of mental exercises on the fear of falling in performing satisfactory activities and lower limb function in community-dwelling elderly - a clinical trial. Komesh. 2018;21(4):619-27.
47. Dias N, Kempen GI, Todd C, Beyer N, Freiberger E, Piot-Ziegler C, et al. Die deutsche version der falls efficacy scale-international version (FES-I). Zeitschrift für Gerontologie und Geriatrie. 2006;39(4):297-300.
48. Irez B. Pilates exercise positively affects balance, reaction time, muscle strength, number of falls and psychological parameters in 65+ years old women. Ankara: Middle East Technical University; 2009.
49. Irez GB, Ozdemir RA, Evin R, Irez SG, Korkusuz F. Integrating Pilates exercise into an exercise program for 65+ year-old women to reduce falls. Journal of Sports Science & Medicine. 2011;10(1):105.
50. Kaesler D, Mellifont R, Kelly PS, Taaffe D. A novel balance exercise program for postural stability in older adults: a pilot study. Journal of Bodywork and Movement Therapies. 2007;11(1):37-43.
51. Rodriguez C. (Note: Reference title not fully provided in source text, assumed based on context or missing citation key). See Source Text Context.
52. Sharma V, Kaur J. Effect of core strengthening with pelvic proprioceptive neuromuscular facilitation on trunk, balance, gait, and function in chronic stroke. Journal of Exercise Rehabilitation. 2017;13(2):200.
53. Bakhtiary AH, Fatemy E, Hedayati R, Ghorbani R, Gillani M. The relationship between hamstring muscle shortness and dynamic and static balances in young healthy individuals. Komesh. 2015:536-43.
54. Mnazari M, Kehrizsangi Q, Gholamali, Negahban. Comparison of eight weeks of shoulder girdle, pelvic girdle and combined exercise programs on the balance of people with upper crossed syndrome. Komesh. 2021;23(4):510-9.
55. Ahmadabadi F, Avandi SM, Aminian-Far A. Correlation between sway parameters of center of pressure in static and dynamic balance indices with eyes closed after four weeks static warm up in skilled gymnast athletes. Koomesh. 2017:102-12