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The Effect of Application of a Non-Elastic Fixation Belt on the Balance Ability and Fall Prevention in Elderly Women

비탄력 고정식 벨트가 노인 여성의 균형능력과 낙상예방에 미치는 영향

  • Lee, Jang-Tae (Department of Physical Therapy, Graduate School, Konyang University) ;
  • Chon, Seung-Chul (Department of Physical Therapy, College of Medical Science, Konyang University)
  • 이장태 (건양대학교 대학원 물리치료학과) ;
  • 천승철 (건양대학교 의과학대학 물리치료학과)
  • Received : 2016.10.21
  • Accepted : 2017.02.03
  • Published : 2017.02.28

Abstract

The aim of this study was to determine the effect of a non-elastic fixation belt on the balance ability and fall prevention in elderly women. Elderly women experience reduced balance ability and an increased risk of falls due to a weakening of the surrounding sacroiliac joint and pelvic muscles during childbirth and menopause. On the other hand, specific studies are still needed. The subjects were allocated randomly to two groups: control (n=20) and experimental (n=20). The experimental group used a non-elastic fixation belt, whereas the control group had no fixation belt. The balance ability and the fall index were measured in all subjects using a balance measurement device, and the low abdominal muscle thickness was determined in the experimental group using ultrasound imaging for the exact application of the non-elastic fixation belt. The following statistical analysis was performed: an independent t-test for the general characteristics of the subjects, $2{\times}2$ analysis of variance with repeated measures for the balance and fall index score, and a paired t-test for the abdominal muscle thickness. The group ${\times}$ time interaction effect showed significant improvement in the General Stability Index (F1,38=47.24, p=0.001), Fourier Harmony Index (F1,38=88.83, p=0.001), Weight Distribution Index (F1,38=50.21, p=0.001), and Fall Index (F1,38=21.59, p=0.001). The thicknesses of the transverse abdominal (p=0.001) and internal oblique (p=0.001) muscles were increased significantly in the experimental group after using the non-elastic fixation belt. Overall, the application of a non-elastic fixation belt could be effective in improving the balance ability and fall prevention in elderly women.

본 연구의 목적은 노인 여성의 약화된 천장관절 안정화를 위하여 비탄력 고정식 벨트를 적용하여 균형 능력과 낙상예방에 미치는 영향을 알아보고자 하였다. 노인 여성들은 출산과 폐경으로 천장관절의 약화 및 골반 주위근육들의 약화로 인하여 균형능력의 감소와 낙상위험률이 증가된다. 그러나 이와 관련된 연구는 불충분하다. 연구 대상자들은 실험군과 대조군으로 각각 20명씩 무작위로 배정하였으며, 비탄력 고정식 벨트를 실험군에게 적용한 후 균형 측정기를 사용하여 균형능력과 낙상 위험률을 평가하였다. 또한 비탄력 고정식 벨트를 적용한 실험군에서 하복부근육의 근두께를 초음파기기를 사용하여 실험 전후에 측정하였다. 통계방법은 연구대상자의 일반적 특성을 위하여 독립 t-검정, 균형 및 낙상지수를 위하여 $2{\times}2$ 반복 측정 분산분석 및 근두께를 위하여 짝비교 t-검정을 사용하였다. 두 그룹의 교호작용 효과는 안정성 지수(F1,38=47.24, p=0.001), 퓨리에 지수(F1,38=88.83, p=0.001), 체중분포 지수(F1,38=50.21, p=0.001) 및 낙상 지수(F1,38=21.59, p=0.001)에서 모두 통계적으로 유의하게 나타났다. 또한 비탄력 고정식 벨트를 적용한 결과 실험 후 복횡근(p=0.001)과 내복사근(p=0.001)의 근두께는 통계적으로 유의하게 증가하였다. 노인 여성들의 약화된 천장관절의 강화 및 안정화 방법으로 비탄력 고정식 벨트는 균형 및 낙상 예방에 긍정적이며 용이성, 보편성 및 경제적으로 효과적임을 알 수 있었다.

Keywords

References

  1. H. Cohen, C. A. Blatchly, L. L. Gombash, "A study of the clinical test of sensory interaction and balance", Physical therapy, vol. 73, no. 6, pp. 346-351, 1993. https://doi.org/10.1093/ptj/73.6.346
  2. L. Wolfson, R. Whipple, C. A. Derby, P. Amerman, L. Nashner, "Gender differences in the balance of healthy elderly as demonstrated by dynamic posturography", Journal of gerontology, vol. 49, no. 4, pp. M160-167, 1994. DOI: https://doi.org/10.1093/geronj/49.4.M160
  3. J. A. Balogun, K. A. Akindele, J. O. Nihinlola, D. K. Marzouk, "Age-related changes in balance performance", Disability and Rehabilitation, vol. 16, no. 2, pp. 58-62, 1994. DOI: https://doi.org/10.3109/09638289409166013
  4. G. M. Gehlsen, M. H. Whaley, "Falls in the elderly: Part II, Balance, strength, and flexibility", Archives of physical medicine and rehabilitation, vol. 71, no. 10, pp. 739-741, 1990.
  5. L. Damen, H. M. Buyruk, F. Guler-Uysal, F. K. Lotgering, C. J. Snijders, H. J. Stam, "Pelvic pain during pregnancy is associated with asymmetric laxity of the sacroiliac joints", Acta obstetricia et gynecologica Scandinavica, vol. 80, no. 11, pp. 1019-1024, 2001. DOI: https://doi.org/10.1034/j.1600-0412.2001.801109.x
  6. I. Janssen, S. B. Heymsfield, Z. M. Wang, R. Ross, "Skeletal muscle mass and distribution in 468 men and women aged 18-88 yr", Journal of applied physiology, vol. 89, no. 1, pp. 81-88, 2000. https://doi.org/10.1152/jappl.2000.89.1.81
  7. Ministry of health & welfare, "2014 Senior Survey", pp. 510, Ministry of health & welfare, 2014.
  8. J. D. Moreland, J. A. Richardson, C. H. Goldsmith, C. M. Clase, "Muscle weakness and falls in older adults: a systematic review and meta-analysis", Journal of the American Geriatrics Society, vol. 52, no. 7, pp. 1121-1129, 2004. DOI: https://doi.org/10.1111/j.1532-5415.2004.52310.x
  9. J. J. Pel, C. W. spoor, R. H. Goossens, A. L. Pool-Goudzward, "Biomechanical model study of pelvic belt influence on muscle and ligament forces", Journal of biomechanics, vol. 41, no. 9, pp. 1878-1884, 2008. DOI: https://doi.org/10.1016/j.jbiomech.2008.04.002
  10. B. Hungerford, W. Gilleard, P. Hodges, "Evidence of altered lumbopelvic muscle recruitment in the presence of sacroiliac joint pain", Spine, vol. 28, no. 14, pp. 1593-600, 2003. DOI: https://doi.org/10.1097/00007632-200307150-00022
  11. L. Damen, H. M. Buyruk, F. Guler-Uysal, F. K. Lotgering, C. J. Snijders, H. J. Stam, "Pelvic pain during pregnancy is associated with asymmetric laxity of the sacroiliac joints", Acta obstetricia et gynecologica Scandinavica, vol. 80, no. 11, pp. 1019-1024, 2001. DOI: https://doi.org/10.1034/j.1600-0412.2001.801109.x
  12. J. M. Mens, A. Vleeming, C. J. Snijders, H. J. Stam, A. Z. Ginai, "The active straight leg raising test and mobility of the pelvic joints", European spine journal, vol. 8, no. 6, pp. 468-473, 1999. DOI: https://doi.org/10.1007/s005860050206
  13. C. A. Richardson, C. J. Snijders, J. Hides, L. Damen, M. S. Pas, J. Storm, "The relation between the transversus abdominis muscles, sacroiliac joint mechanics, and low back pain", Spine, vol. 27, no. 4, pp. 399-405, 2002. DOI: https://doi.org/10.1097/00007632-200202150-00015
  14. N. Akkaya, N. Doganlar, E. Celik, S. E. Aysse, S. Akkaya, H. R. Gungor, F. Sahin, "Test-retest reliability of $tetrax{(R)}$ static posturography system in young adults with low physical activity level", International journal of sports physical therapy, vol. 10, no. 6, pp. 893-900, 2015.
  15. R. Kohen-Raz, "Application of tetra-ataxiametric posturography in clinical and developmental diagnosis", Perceptual and motor skills, vol. 73, no. 2, pp. 635-656, 1991. DOI: https://doi.org/10.2466/pms.1991.73.2.635
  16. C. R. Kim, M. H. Chun, G. A. Lee, "Assessments of Balance Control Using Tetra-ataxiametric Posturography", Annals of Rehabilitation Medicine, vol. 33, no. 4, pp. 429-435, 2009.
  17. J. M. Mens, L. Damen, C. J. Snijders, H. J. Stam, "The mechanical effect of a pelvic belt in patients with pregnancy-related pelvic pain", Clinical Biomechanics, vol. 21, no. 2, pp. 122-127, 2006. DOI: https://doi.org/10.1016/j.clinbiomech.2005.08.016
  18. A. Vleeming, H. M. Buyruk, R. Stoeckart, S. Karamursel, C. J. Snijders, "An integrated therapy for peripartum pelvic instability: a study of the biomechanical effects of pelvic belts", American journal of obstetrics and gynecology, vol. 166, no. 4, pp. 1243-1247, 1992. DOI: https://doi.org/10.1016/S0002-9378(11)90615-2
  19. S. L. Koppenhaver, J. J. Hebert, J. M. Fritz, E. C. Parent, D. S. Teyhen, J. S. Magel, "Reliability of Rehabilitative Ultrasound Imaging of the Transversus Abdominis and Lumbar Multifidus Muscles", Archives of physical medicine and rehabilitation, vol. 90, no. 1, pp. 87-94, 2009. DOI: https://doi.org/10.1016/j.apmr.2008.06.022
  20. M. E. Daubney, E. G. Culham, "Lower-extremity muscle force and balance performance in adults aged 65 years and older", Physical Therapy, vol. 79, no. 12, pp. 1177-1185, 1999.
  21. B. Stuge, E. Laerum, G. Kikesola, N. Vollestad, "The efficacy of a treatment program focusing on specific stabilizing exercises for pelvic girdle pain after pregnancy: a randomized controlled trial", Spine, vol. 29, no. 4, pp. 351-359, 2004. DOI: https://doi.org/10.1097/01.BRS.0000090827.16926.1D
  22. J. M. Mens, L. Damen, C. J. Snijders, H. J. Stam, "The mechanical effect of a pelvic belt in patients with pregnancy-related pelvic pain", Clinical biomechanics, vol. 21, no. 2, pp. 122-127, 2006. DOI: https://doi.org/10.1016/j.clinbiomech.2005.08.016
  23. K. M. Park, S. Y. Kim, D. W. Oh, "Effects of the pelvic compression belt on gluteus medius, quadratus lumborum, and lumbar multifidus activities during side-lying hip abduction", Journal of electromyography and kinesiology, vol. 20, no. 6, pp. 1141-1145, 2010. DOI: https://doi.org/10.1016/j.jelekin.2010.05.009
  24. K. T. Ratliffe, B. M. Alba, A. Hallum, M. J. Jewell, "Effects of approximation on postural sway in healthy subjects", Physical Therapy, vol. 67, no. 4, pp. 502-506, 1987. https://doi.org/10.1093/ptj/67.4.502
  25. L. Damen, C. W. Spoor, C. J. Snijders, H. J. Stam, "Does a pelvic belt influence sacroiliac joint laxity?", Clinical biomechanics, vol. 17, no. 7, pp. 495-498, 2002. DOI: https://doi.org/10.1016/S0268-0033(02)00045-1
  26. P. W. Hodges, C. A. Richardson, "Inefficient muscular stabilization of the lumbar spine associated with low back pain. A motor control evaluation of transversus abdominis", Spine, vol. 21, no. 22, pp. 2640-2650, 1996. DOI: https://doi.org/10.1097/00007632-199611150-00014
  27. S. Prasansuk, C. Siriyananda, A. N. Nakorn, S. Atipas, S. Chongvisal, "Balance disorders in the elderly and the benefit of balance exercise", Journal of the Medical Association Thailand, vol. 87, no. 10, pp. 1225-1233, 2004.
  28. Kisner C, Colby LA. Therapeutic Exercise: Foundation and techniques, F.A. Davis Company, 2007.
  29. R. W. Baloh, T. Z. Fife, L. Zwerling, T. Socotch, K. Jacobson, T. Bell, K. Beykirch, "comparison of static and dynamic posturography in young and older normal people", Journal of the American Geriatrics Society, vol. 42, no. 4, pp. 402-412, 1994. DOI: https://doi.org/10.1111/j.1532-5415.1994.tb07489.x
  30. C. Gruneberg, B. R. Bloem, F. Honegger, J. H. Allum, "The influence of artificially increased hip and trunk stiffness on balance control in man", Experimental brain research, vol. 157, no. 4, pp. 472-485, 2004. DOI: https://doi.org/10.1007/s00221-004-1861-x
  31. N. E. Shim, M. J. Lee, I. R. Cho, M. Y. Jang. The Change of Balance According to the Wearing of the Flexible Spinal Orthosis. The Journal of Korean Society of Assistive Technology, vol. 1, no. 1, pp. 29-40, 2009.