Yaşlı Bireylerde Fonksiyonel Denge Testlerinin Statik Postürografi Testleri ile Karşılaştırılması

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

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.

Keywords:

Functional Balance, Postural Balance, Elderly,

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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.