Yaşlı Bireylerde Fonksiyonel Denge Testlerinin Statik Postürografi Testleri ile Karşılaştırılması

Yıl 2019, Cilt: 10 Sayı: 4, 369 - 376, 13.12.2019

ECE Acar , Tamer Çankaya

Öz

Özet

Amaç: Bu çalışmanın amacı yaşlı bireylerde fonksiyonel denge
testleri ile statik postüral denge parametreleri arasındaki ilişkiyi ve bu
parametrelerin yaş ile değişimi açıklamaktı. 

Materyal-Metot: Araştırma
65 yaş üzeri sağlıklı bireyler ile yürütüldü. Dengenin fonksiyonel
değerlendirilmesinde Berg denge ölçeği ve Tinetti düşme etkinlik ölçeği
kullanıldı. Statik postüral denge ölçümleri kuvvet platformu aracılığı ile
stabilite alanı ve salınım alanının belirlenmesini içerdi.

Bulgular: Araştırmaya
yaş ortalaması 73,42±5,91 50 birey (30 kadın, 20 erkek) dahil edildi.

Fonksiyonel
değerlendirme yöntemleri ile stabilite alanı ve salınım alanı arasındaki ilişki
incelendiğinde anlamlı bir ilişki olmadığı görüldü (p>0,05). Bireylerin Berg
denge testi ve Tinetti düşme etkinlik ölçeği puanları arasındaki ilişki
incelendiğinde her ikisi arasında negatif yönlü yüksek dereceli bir ilişki
olduğu belirlendi (p=0,000,
r=-0,860). Stabilite alanı ve salınım alanına ait parametreler arasında düşük
ve orta kuvvette ilişki belirlendi (p<0,05; 0,300<r<0,500).
Fonksiyonel testlerin bireylerin yaşı ile ilişkili olmadığı görüldü
(p>0,05). Postürografik test parametrelerinde ise ön stabilite alanının
yaşın artması ile azaldığı (p=0,010,
r=-0,359), sert zeminde gözler kapalı iken anteroposterior salınım alanı da
yaşın artması ile azalırken, köpük zeminde gözler açık iken anteroposterior
salınım alanının yaş ilerledikçe arttığı belirlendi (p=0,006, r=-0,384; p=0,025,
r=0,318).

Sonuç:
Fonksiyonel denge testleri ve postürografik denge parametreleri denge
fonksiyonlarının ayrı bileşenlerini değerlendirdiğinden yöntemlerin
birbirlerinin yerine kullanımı uygun değildir. Yaş ile meydana gelen
değişimlerin izlenmesinde postürografik yöntemlerin kullanımı daha açıklayıcı
olabilir. 

Anahtar Kelimeler

Fonksiyonel Denge, Postüral Denge, Yaşlı

Comparison of Functional Balance Tests and Static Posturography Tests in Elderly People

Öz

Objective: Aim
of the study was to explain relationship between functional balance tests and
static postural balance parameters and to explain change of these parameters
with age in elderly individuals.

Material-Method: The study was conducted with healthy individuals over
65 years of age. Berg balance scale and Tinetti fall efficiency scale were used
for functional balance tests. Static postural balance measurements included the
determination of stability area and sway area by force platform.

Results:
50 individuals (30 female, 20 male) with mean age of 73.42±5.91 were included
the study. There was no significant relationship between functional balance
tests and the stability area or sway area (p>0.05). There was a high degree
negative correlation between Berg balance test and Tinetti fall efficacy test (p=0,000,
r=-0,860). There was low-to-medium correlation between parameters of the
stability area and the sway area (p<0.05; 0.300<r<0.500).Functional
tests were not corelated with the age of the individuals (p> 0.05).When wieved from posturographic test
parameters, anterior stability area decreased with increasing age (p=0,010, r
=-0,359), while anteroposterior sway area on hard floor eyes closed position
was decreased with the increase of age, it was determined that anteroposterior
sway area on foam floor eyes open position increased as the age progresses
(p=0.006,r=-0.384; p=0.025, r=0.318).

Conclusions:
Since functional balance tests and posturographic balance parameters evaluate
the individual components of balance functions, it is not appropriate to use
the methods interchangeably. The use of posturographic methods to follow the
changes in age may be more illustrative.

Anahtar Kelimeler

Functional Balance, Postural Balance, Elderly

Kaynakça

• Abrahamova D, Hlavačka F. Age-related changes of human balance during quiet stance. Physiol Res 2008; 57(6): 957-64.
• Tucker MG, Kavanagh JJ, Barrett RS, Morrison S. Age-related differences in postural reaction time and coordination during voluntary sway movements. Hum Mov Sci 2008; 27(5): 728-37.
• Cuevas-Trisan R. Balance problems and fall risks in the elderly. Phys Med Rehabil Clin N Am 2017; 28(4): 727-37.
• Özsoy G, Özsoy İ, İlçin N, Tekin N, Savcı S. Yaşlı bireylerde denge, fonksiyonel egzersiz kapasitesi ve periferal kas kuvveti arasındaki ilişki. SDÜ Sağlık Bilimleri Dergisi. 2017;8(1):28-32.
• Benvenuti F, Mecacci R, Gineprari I, Bandinelli S, Benvenuti E, Ferrucci L, et al. Kinematic characteristics of standing disequilibrium: reliability and validity of a posturographic protocol. Arch Phys Med Rehabil 1999; 80(3): 278-87.
• Downs S, Marquez J, Chiarelli P. Normative scores on the berg balance scale decline after age 70 years in healthy community-dwelling people: a systematic review. J Physiother 2014; 60(2): 85-9.
• Whitney S, Wrisley D, Furman J. Concurrent validity of the berg balance scale and the dynamic gait index in people with vestibular dysfunction. Physiother Res Int 2003; 8(4): 178-86.
• Mancini M, Horak FB. The relevance of clinical balance assessment tools to differentiate balance deficits. Eur J Phys Rehabil Med 2010; 46(2): 239.
• Park S-H. Tools for assessing fall risk in the elderly: a systematic review and meta-analysis. Aging Clin Exp Res 2018; 30(1): 1-16.
• Kamińska M, Brodowski J, Karakiewicz B. Fall risk factors in community-dwelling elderly depending on their physical function, cognitive status and symptoms of depression. Int J Environ Res Public Health 2015; 12(4): 3406-16.
• Pajala S, Era P, Koskenvuo M, Kaprio J, Törmäkangas T, Rantanen T. Force platform balance measures as predictors of indoor and outdoor falls in community-dwelling women aged 63–76 years. J Gerontol A Biol Sci Med Sci 2008; 63(2): 171-8.
• Nepocatych S, Ketcham CJ, Vallabhajosula S, Balilionis G. The effects of unstable surface balance training on postural sway, stability, functional ability and flexibility in women. J Sports Med Phys Fitness 2018; 58(1-2): 27-34.
• Błaszczyk JW. The use of force-plate posturography in the assessment of postural instability. Gait Posture 2016; 44: 1-6.
• Frykberg GE, Lindmark B, Lanshammar H, Borg J. Correlation between clinical assessment and force plate measurement of postural control after stroke. J Rehabil Med 2007; 39(6): 448-53.
• Ulus Y, Durmus D, Akyol Y, Terzi Y, Bilgici A, Kuru O. 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(3): 429-33.
• Bauer C, Gröger I, Rupprecht R, Gaßmann KG. Intrasession reliability of force platform parameters in community-dwelling older adults. Arch Phys Med Rehabil 2008; 89(10): 1977-82.
• Kilroy EA, Crabtree OM, Crosby B, Parker A, Barfield WR. The effect of single-leg stance on dancer and control group static balance. Int J Exerc Sci 2016; 9(2): 110.
• Holbein-Jenny MA, McDermott K, Shaw C, Demchak J. Validity of functional stability limits as a measure of balance in adults aged 23–73 years. Ergonomics 2007; 50(5): 631-46.
• Soto-Varela A, Faraldo-García A, Rossi-Izquierdo M, Lirola-Delgado A, Vaamonde-Sánchez-Andrade I, del-Río-Valeiras M, et al. Can we predict the risk of falls in elderly patients with instability? Auris Nasus Larynx 2015; 42(1): 8-14.
• Viveiro LAP, Gomes GCV, Bacha JMR, Carvas NJ, Kallas ME, Reis M, et al. Reliability, validity, and ability to identity fall status of the berg balance scale, balance evaluation systems test (bestest), mini-bestest, and brief-bestest in older adults Who live in nursing home. J Geriatr Phys Ther 2018; 4: 1-10.
• Visser JE, Carpenter MG, van der Kooij H, Bloem BR. The clinical utility of posturography. Clin Neurophysiol 2008; 119(11): 2424-36.
• Gil AW, Oliveira MR, Coelho VA, Carvalho CE, Teixeira DC, Silva Jr RAd. Relationship between force platform and two functional tests for measuring balance in the elderly. Braz J Phys Ther 2011; 15(6): 429-35.
• Nguyen USD, Kiel DP, Li W, Galica AM, Kang HG, Casey VA, et al. Correlations of clinical and laboratory measures of balance in older men and women. Arthritis Care Res 2012; 64(12): 1895-902.
• Sabchuk RAC, Bento PCB, Rodacki ALF. Comparison between field balance tests and force platform. Rev bras med esporte 2012;18(6):404-8.
• Sawacha Z, Carraro E, Contessa P, Guiotto A, Masiero S, Cobelli C. Relationship between clinical and instrumental balance assessments in chronic post-stroke hemiparesis subjects. J Neuroeng Rehabil 2013; 10(1): 95.
• Ortuño-Cortés MA, Martín-Sanz E, Barona-de Guzmán R. Static posturography versus clinical tests in elderly people with vestibular pathology. Acta Otorrinolaringol Esp 2008; 59(7): 334-40.
• Cho K, Lee K, Lee B, Lee H, Lee W. Relationship between postural sway and dynamic balance in stroke patients. J Phys Ther Sci 2014; 26(12): 1989-92.
• Jogi P, Overend T, Kramer J. Comparisons of clinically based outcome measures and laboratory-based outcome measure for balance in patients following total hip and knee arthroplasty. Orthop Res Rev 2017; 9: 23-33.
• Cleary K, Skornyakov E. Predicting falls in older adults using the four square step test. Physiother Theory Pract 2017; 33(10): 766-71.
• Roman-Liu D. Age-related changes in the range and velocity of postural sway. Arch Gerontol Geriatr 2018; 77: 68-80.
• Piirtola M, Era P. Force platform measurements as predictors of falls among older people–a review. Gerontology 2006; 52(1): 1-16.
• Johnson GR, Pandyan AD. The activity in the three regions of the trapezius under controlled loading conditions—an experimental and modelling study. Clin Biomech 2005;20(2): 155-61.
• Riemann BL, Lininger M, Kirkland MK, Petrizzo J. Age related changes in balance performance during self-selected and narrow stance testing. Arch Gerontol Geriatr 2018; 75: 65-9.
• Hughes MA, Duncan PW, Rose DK, Chandler JM, Studenski SA. The relationship of postural sway to sensorimotor function, functional performance, and disability in the elderly. Arch Phys Med Rehabil 1996; 77(6): 567-72.
• Stel VS, Smit JH, Pluijm SM, Lips P. Balance and mobility performance as treatable risk factors for recurrent falling in older persons. J Clin Epidemiol 2003; 56(7): 659-68.