تاثیر استفاده از کفی بافت دار بر پیچیدگی نوسانات مرکز فشار سالمندان با سابقه افتادن

نوع مقاله : مقاله پژوهشی

نویسندگان

1 1. دانشجوی کارشناسی ارشد کاردرمانی، دانشکده علوم توانبخشی، دانشگاه علوم پزشکی شهید بهشتی

2 2. دانشجوی دکترای کاردرمانی، مربی کاردرمانی دانشکده علوم توانبخشی، دانشگاه علوم پزشکی شهید بهشتی

3 3. دانشجوی دکترای علوم اعصاب، مربی کاردرمانی دانشکده علوم توانبخشی، دانشگاه علوم پزشکی ایران

4 4. دانشجوی دکترای علوم اعصاب، دانشکده فناوری های نوین پزشکی، دانشگاه علوم پزشکی تهران. تهران. ایران

5 5. عضو گروه کاردرمانی دانشکده علوم توانبخشی، دانشگاه علوم پزشکی شهید بهشتی. تهران، ایران.

چکیده

مقدمه و اهداف
افزایش سن با کاهش پیچیدگی در سیستم های بیولوژیکی از جمله سیستم کنترل پاسچرال همراه است. سیستم سوماتوسنسوری نقش مهمی در پیچیدگی این سیستم دارد که با افزایش سن از قابلیت اطمینان ورودی های این سیستم کاسته می شود. بنابراین مداخلاتی که با افزایش ورودی های حسی، پیچیدگی فیزیولوژیکی سیستم کنترل پاسچرال را افزایش دهد؛ می تواند باعث افزایش عملکرد تعادلی و کاهش خطر افتادن شود.
 مواد و روش ها
در این مطالعه 8 فرد سالمند با سابقه افتادن با متوسط سنی (53/3±) 25/66  سال به روش نمونه گیری غیر احتمالی ساده انتخاب شدند و پیچیدگی نوسانات مرکز فشار آنان در وضعیت های مختلف با و بدون کفی و با چشم باز و بسته با استفاده از متغیر آنتروپی تقریبی اندازه گیری شد.
 یافته ها
استفاده از کفی بافت دار افزایش معناداری در مقدار آنتروپی تقریبی در جهت داخلی-خارجی در سالمندان با سابقه افتادن ایجاد کرد. آنالیز Post-hoc بین آنتروپی تقریبی داخلی- خارجی شرایط مختلف وضعیتی نشان داد که پارامتر آنتروپی تقریبی داخلی- خارجی افزایش معناداری را در وضعیت چشم بسته با کفی نسبت به وضعیت چشم بسته بدون کفی داشته است (004/0=P). این پارامتر در وضعیت چشم بسته با کفی نسبت به وضعیت چشم باز بدون کفی نیز افزایش معناداری داشت (001/0=P).
 نتیجه گیری
از آنجایی که استفاده از کفی بافت دار پیچیدگی نوسانات پاسچرال را افزایش داد، می تواند در سالمندان با سابقه افتادن به عنوان یک مداخله تعادلی جهت کاهش خطر افتادن استفاده شود.
 
کفی بافت دار، کنترل پاسچرال، پیچیدگی، افتادن، سالمندی، سوماتوسنسوری

کلیدواژه‌ها


عنوان مقاله [English]

Effect of Textured insole on the complexity of center of pressure sway in faller older adults

نویسندگان [English]

  • Marziye Purpirali 1
  • Minoo Kalantari 2
  • Ghorban Taghizadeh 3
  • Hajar Mehdizadeh 4
  • Ashkan Irani 5
1 1. Student Research Committee, MSc Student of Occupational Therapy, Faculty of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 2. PhD Student of Occupational Therapy, Lecturer of Occupational Therapy Department, Faculty of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 3. PhD student of Neurosciences, Lecturer of Occupational Therapy Department, Faculty of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
4 4. PhD student of Neurosciences, Faculty of advanced Technologies in medicine, Tehran University of Medical Sciences, Tehran, Iran, Hajar
5 5. Occupational Therapy Department, Faculty of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
چکیده [English]

Background and Aim: Aging is associated with reduction in the complexity of biological systems such as postural control system. Somatosensory system plays an important role in the complexity of the postural control system which its inputs reliability is reduced with age. Therefore, the interventions that improve complexity of postural control system by increasing sensory input can improve balance performance and reduce risk of falling.
Materials and Methods: In this study 8 faller older adults with the average age of 66.25 (±3.53) years were selected by simple non-probability sampling method. The complexity of the center of pressure (COP) sway was measured by approximate entropy in medial-lateral and anterior-posterior directions in different conditions: using textured insole [with and without textured insole] with open and closed eyes.
Results: Textured insole significantly improved medial-lateral approximate entropy values in faller older adults. The post-hoc analysis of medial-lateral approximate entropy of different postural conditions showed the approximate entropy in eyes closed with textured insole condition increased significantly compared with  eyes closed without textured insole condition (p=0.004). This parameter also increased significantly (p=0.001) in eyes closed with textured insole condition compared with eyes open without textured insole condition.
Conclusion: Since textured insole increased complexity of postural sway, it can be used as an intervention which may reduce the risk of falling in older adults with a history of falling.

کلیدواژه‌ها [English]

  • Textured insole
  • Postural control
  • Complexity
  • Falling
  • aging
  • Somatosensory
  1. Lajoie Y, Gallagher S. Predicting falls within the elderly community: comParison of Postural sway, reaction time, the Berg balance scale and the Activities-sPecific Balance Confidence (ABC) scale for comParing fallers and non-fallers. Archives of gerontology and geriatrics. 2004;38(1):11-26.##
  2. Hatton AL, Dixon J, Rome K, Martin D. Standing on textured surfaces: effects on standing balance in healthy older adults. Age and ageing. 2011;40(3):363-8.##
  3. Melzer I, Benjuya N, KaPlanski J. Postural stability in the elderly: a comParison between fallers and non-fallers. Age and ageing. 2004;33(6):602-7.##
  4. Wanderley FS, Alburquerque-Sendín F, Parizotto NA, Rebelatto JR. Effect of Plantar vibration stimuli on the balance of older women: a randomized controlled trial. Archives of Physical medicine and rehabilitation. 2011;92(2):199-206.##
  5. Costa M, PriPlata A, LiPsitz L, Wu Z, Huang N, Goldberger A, et al. Noise and Poise: Enhancement of Postural comPlexity in the elderly with a stochastic-resonance–based theraPy. EPL [EuroPhysics Letters]. 2007;77(6):68008.##
  6. Baszczyk JW, Klonowski Wo. Postural stability and fractal dynamics. Acta Neurobiol ExP. 2001;61:105-12.##
  7. Cavanaugh JT, Guskiewicz KM, Stergiou N. A nonlinear dynamic aPProach for evaluating Postural control. SPorts Medicine. 2005;35(11):935-50.##
  8. Ladislao L, Fioretti S. Nonlinear analysis of PosturograPhic data. Medical & biological engineering & comPuting. 2007;45(7):679-88.##
  9. Duarte M, Sternad D. ComPlexity of human Postural control in young and older adults during Prolonged standing. ExPerimental Brain Research. 2008;191(3):265-76.##

10. Lockhart TE, Liu J. Differentiating fall-Prone and healthy adults using local dynamic stability. Ergonomics. 2008;51(12):1860-72.##

11. Collins JJ, De Luca CJ. Random walking during quiet standing. Physical review letters. 1994;73(5):764-7.##

12. L Sturnieks D, St George R, R Lord S. Balance disorders in the elderly. NeuroPhysiologie Clinique/Clinical NeuroPhysiology. 2008;38(6):467-78.##

13. Qiu F, Cole M, Davids K, Hennig E, Silburn P, Netscher H, et al. Enhanced somatosensory information decreases Postural sway in older PeoPle. Gait & Posture. 2012;35(4):630-5.##

14. Palluel E, Nougier V, Olivier I. Do sPike insoles enhance Postural stability and Plantar-surface cutaneous sensitivity in the elderly? Age. 2008;30(1):53-61.##

15. Perry SD. Evaluation of age-related Plantar-surface insensitivity and onset age of advanced insensitivity in older adults using vibratory and touch sensation tests. Neuroscience letters. 2006;392(1):62-7.##

16. Corbin DM, Hart JM, Palmieri-Smith R, Ingersoll CD, Hertel J. The effect of textured insoles on Postural control in double and single limb stance. Journal of sPort rehabilitation. 2007;16(4).##

17. Foroughan M, JAFARI Z, SHIRIN BP, Ghaem Magham Faraahani Z, RAHGOZAR M. Validation of mini-mental state examination [MMSE] in the elderly PoPulation of Tehran. Advances in Cognitive Science. 2008. [In Persian]##

18. Toebes MJ, Hoozemans MJ, Furrer R, Dekker J, van Dieën JH. Local dynamic stability and variability of gait are associated with fall history in elderly subjects. Gait & Posture. 2012;36(3):527-31.##

19. Cavanaugh J, Guskiewicz K, Giuliani C, Marshall S, Mercer V, Stergiou N. Detecting altered Postural control after cerebral concussion in athletes with normal Postural stability. British journal of sPorts medicine. 2005;39(11):805-11.##

20. Cavanaugh JT, Mercer VS, Stergiou N. APProximate entroPy detects the effect of a secondary cognitive task on Postural control in healthy young adults: a methodological rePort. Journal of neuroengineering and rehabilitation. 2007;4(1):42.##

21. Pincus SM. APProximate entroPy as a measure of system comPlexity. Proceedings of the National Academy of Sciences. 1991;88(6):2297-301.##

22. Stergiou N. Innovative analyses of human movement: Human Kinetics Publishers; 2004.##

23. Newell KM. Degrees of freedom and the develoPment of Postural center of Pressure Profiles. APPlications of nonlinear dynamics to develoPmental Process modeling. 1998:63-84.##

24. Maurer C, Mergner T, Bolha B, Hlavacka F. Human balance control during cutaneous stimulation of the Plantar soles. Neuroscience letters. 2001;302(1):45-8.##

25. Kennedy PM, Inglis JT. Distribution and behaviour of glabrous cutaneous recePtors in the human foot sole. J Physiol. 2002 Feb 1; 538(Pt 3): 995–1002.##

26. Kavounoudias A, Roll R, Roll J-P. The Plantar sole is a'dynamometric maP'for human balance control. NeurorePort. 1998;9(14):3247-52.##

27. Palluel E, Olivier I, Nougier V. The lasting effects of sPike insoles on Postural control in the elderly. Behavioral neuroscience. 2009;123(5):1141.##

28. Maki BE, Holliday PJ, ToPPer AK. A ProsPective study of Postural balance and risk of falling in an ambulatory and indePendent elderly PoPulation. Journal of Gerontology. 1994;49(2):M72-M84.##

29. Meyer PF, Oddsson LI, De Luca CJ. The role of Plantar cutaneous sensation in unPerturbed stance. ExPerimental Brain Research. 2004;156(4):505-12.##

30. Bauer C, Gröger I, RuPPrecht R, Gaßmann KG. Intrasession reliability of force Platform Parameters in community-dwelling older adults. Archives of Physical medicine and rehabilitation. 2008;89(10):1977-82.##