سالمندان، عواقب افتادن و سیر تکاملی تمرینات: مطالعه مروری

نوع مقاله : مقاله مروری

نویسندگان

1 دانشجوی دکتری حرکات اصلاحی و آسیب شناسی ورزشی، دانشکده تربیت بدنی و علوم ورزشی، دانشگاه اصفهان، اصفهان، ایران

2 دانشیار گروه حرکات اصلاحی و آسیب شناسی ورزشی، دانشکده تربیت بدنی و علوم ورزشی، دانشگاه اصفهان، اصفهان، ایران

3 استادیار بیومکانیک ورزشی، دانشکده تربیت بدنی و علوم ورزشی، دانشگاه اصفهان، اصفهان، ایران

چکیده

مقدمه و اهداف
امروزه توجه به پدیده سالمندی، افتادن و عواقب آن و نهایتا دستیابی به روش­هایی برای جلوگیری از افتادن از موارد مورد توجه محققان است. از طرفی دیگر، انتخاب تمرینی که در زمان کم، با تاثیرگذاری زیاد و با حداقل امکانات بتواند در زمینه سالمندان مفید باشد، هدف نهایی محققین است؛ بنابراین هدف مطالعه مروری حاضر بررسی عواقب افتادن و سیر تکاملی تمرینات در زمینه سالمندان است.
مواد و روش­ ها
در تحقیق حاضر با جستجوی مقالاتی که از سال 1984 تا 2017 در زمینه تمرینات سالمندان و افتادن در بانک­های اطلاعاتی معتبر منتشر شده بود، بر اساس معیارهای تحقیق تعداد 55 مقاله به عنوان مقالات نهایی برای مطالعه مروری حاضر انتخاب شد.
یافته­ ها
یافته­ ها نشان داد افزایش سن با اختلال در سیستم­های مختلف بدن انسان همراه بوده و در مجموع توانایی پاسخ به اغتشاش قامت کاهش یافته و کنترل تعادل را تحت تاثیر قرار می­دهد و احتمال افتادن را که یکی از دلایل اصلی مرگ­ومیر سالمندان است، افزایش می­دهد. ریسک­فاکتورهای اختلال قدرت، تعادل و زمان عکس­العمل، مهمترین دلایل مرتبط با افتادن­ها می­باشد و در نهایت نقص تعادل به عنوان قویترین و مهمترین عامل اختلال در کنترل تعادل و افتادن در سالمندان است. از طرفی دیگر، پروتکل­های تمرینی مختلف در جهت بهبود تعادل و پیشگیری از افتادن نتایج متناقضی ارائه کرده است.
نتیجه­ گیری
به نظر می‌رسد اگر مکانیسم ­های اصلی کنترل عصبی پاسچر و تعادل به درستی تقویت نشود، ایجاد هر گونه اغتشاشی مانند سر خوردن، گیر کردن پا به لبه فرش و موارد مشابه می­تواند باعث اختلال در تعادل و افتادن و مشکلات جبران­ناپذیر شود؛ بنابراین مطالعات بیشتری مورد نیاز است تا اثر تمرینات متمرکز بر مکانیسم­های کنترل تعادل را در پیشگیری از افتادن و میزان ماندگاری اثر این تمرینات نشان دهد.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

Elderly, Consequences of Falling, and Evolutionary Exercises: A Review

نویسندگان [English]

  • Hamed Arghavani 1
  • Vahid Zolaktaf 2
  • Shahram Lengan Nejadian 3
1 PhD Candidate of Corrective Exercises, Faculty of Physical Education, University of Isfahan, Isfahan, Iran.
2 Associate Professor of Corrective Exercises, Faculty of Physical Education, University of Isfahan, Isfahan, Iran.
3 Assistance professor of Sport Biomechanics, Faculty of Physical Education, University of Isfahan, Isfahan, Iran.
چکیده [English]

Background and Aim: Attention to the phenomenon of aging, fall, consequences of falling, and finding methods to prevent falling in the elderly are points of interest to many researchers. On the other hand, choosing exercises that, in limited time, can bring about high effects with minimum facilities, are their ultimate goal. Therefore, the aim of the present review study was to investigate the consequences of falling and evolution of training in the elderly.
Materials and Methods: In the current study by searching among related articles published from 1984 to 2017 in the field of elderly training and valid scientific databases, based on the research criteria, 55 articles were selected as the final articles for the present review study.
Results: Increasing age is associated with impaired systematicity of the human body and overall the ability to respond to perturbation decreases affecting the balance control and leading to increase in the chances of falling, which is one of the main causes of mortality in the elderly. Risk factors of strength disorder, balance, and reaction time are the most important causes of falls, and finally, balance disorder is one of the strongest and most important factors in the control of balance and falling in the elderly. In addition, various training protocols for improving balance and preventing falling have been shown to have conflicting outcomes.
Conclusion: According to the results, if the main mechanisms of postural neurological control and balance are not properly strengthened, any perturbation such as glide, stinging to the edge of the carpet, and like can disrupt the balance and fall and result in irreversible problems. Therefore, further studies are needed to illustrate the effect of training focused on balance control mechanisms in preventing falls and persistence rate of this exercises.

کلیدواژه‌ها [English]

  • Elder
  • Exercise
  • Balance
  • Fall
  1. Muir, B. Improving gait characteristics in older adults: The effects of Biodex Balance System SD(TM) and wobble board balance training. West Lafayette, Indiana: Purdue University. 2011; 8(3):36-42.##
  2. Shigematsu, R. Dance-based aerobic exercise may improve indices of falling risk in older women. Age and Ageing. 2002; 10(2):261-266. ##
  3. Lord, S. exercise effect on dynamic stability in older women: a randomized controlled trial. Arch Phys Med Rehabil. 1996; 3(1):232-236. ##
  4. M, Buchner M, Elaine C, Barbara J, Lateur DE, Peter C, et al. The effect of strength and endurance training on gait, balance, fall risk, and health services use in community-living older adults. Journal Gerontology 1997; 52:2I8-224. ##
  5. Engels HJ, Druin J, Zhu W, Kazmierski JF. Effect of low-impact, moderate-intensity exercise training whit and without wrist on functional capacities and mood states in older. 1998; 4(4):239-244. ##
  6. Cosio-Lima, LM. Reinolds, KL. Winter, C. "Effects of physioball and conventional floor exercises on early phase adaptations in back and abdominal core stability and balance in women". J of Strength and conditioning Research. 2003; 17(4):721-725. ##
  7. Prevention, U. C. Falls among older adults. http http://www.cdc.gov/Home and Recreational Safety /Fall /adult falls.html. ##
  8. Province, M. The effects of exercise on falls in elderly patients: a preplanned meta-analysis of the FICSIT trials. JAMA. 1995; 3(3):1341-7. ##
  9. Gillespie LD, Gillespie WJ, Robertson MC, Lamb SE, Cumming RG, Rowe BH. Interventions for preventing falls in elderly people. Cochrane Database Syst Rep. 2001; 3(1):340-348. ##

10. Leavey J. The Comparative Effects of a Six-Week Balance Training Program, Gluteus Medius Strength Training Program, and Combined Balance Training/Gluteus Medius Strength Training Program on Dynamic Postural  control. J Sport Rehabil. 2010; 19(3):268-87##

11. Hornbrook MC, Stevens VJ, Wingfield DJ, Hollis JF, Greenlick MR, Ory MG. Preventing falls among community-dwelling older persons: results from a randomized trial. Gerontologist. 1994; 34(l):16-23. ##

12. Mesquita, A. Effects of two exercise protocols on postural balance of elderly women: a randomized controlled trial. BMC Geriatrics. 2015; 14(4): 2-9. ##

13. Haywood, K. Life Span Motor Development. Human Kinetics. 2009; 13(1) 391-396. ##

14. Bisson, E. Functional balance and dual-task reaction times in older adults are improved by virtual reality and biofeedback training. Cyberpsychol Behav. 2007; 7(3):16-23. ##

15. Fernanda D, Vale R, Giani T, Bacellar S, Dantas E. Effects of a physical activity program on static balance and functional autonomy in elderly women. Macedonian Journal of Medical Sciences. 2010; 3(1):21-6. ##

16. Henwood TR, Taaffe DR. Short-term resistance training and the older adult: The effect of varied programmes for the enhancement of muscle strength and functional performance. Clin Physiol Funct Imaging. 2006; 26(5):305-13. ##

17. Li FZ, Harmer P, Fisher KJ, McAuley E, Chaumeton N, Eckstrom E, Wilson NL. Tai Chi and fall reductions in older adults: a randomized controlled trial. J Gerontol. 2005; 60(2):187-194. ##

18. Vellas BJ, Wayne SJ, Garry PJ, Baumgartner RN. A two-year longitudinal study o f falls in 482 community-dwelling elderly adults. / Gerontol. 1998; 53A(4):M264-274. ##

19. Stevens JA, Ballesteros MF, Mack KA, Rudd RA, DeCaro E, Adler G. Gender differences in seeking care for falls in the aged Medicare population. Am J Prev Med. 2012; 43(1):59-62. ##

20. McMurdo MET, Millar AM, Daly F. A randomized controlled trial o f fall prevention strateg ies in older people's homes . Gerontology. 2000; 4(6):83-87. ##

21. Madeleine B, Marie-Louise B, keith H, Williams A. Effects of Resistance- and Flexibility-Exercise Interventions on Balanceand Related Measures in Older Adults. Journal of Aging and Physical Activity. 2009; 17(2): 444-454. ##

22. Organisation,W.H.Report onfalls:prevention in olderage. Ageing Life Course, FamCommunityHeal. 2008. ##

23. Heinrich, S. Cost of falls in old age: a systematic review. Osteoporosis International. 2012; 9(4) 891-902. ##

24. Bauer C, Gröger I, Rupprecht R, Gaβmann KG. Intersession reliability of force platform parameters in community-dwelling older adults. Arch Phys Med Rehabil. 2008; 89(3): 1977–1982. ##

25. Tannenbaum C, Mayo N, Ducharme F. Older women's health priorities and perceptions of care delivery: the results o f the W OW health survey. Can Med Assoc J. 2005;173(2):153-159. ##

26. Carter, N. Exercise in the prevention of falls in older people: a systematic literature review examining the rationale and the evidence. Sports medicine. 2001; 16(2):427-438. ##

27. Tinetti ME, Williams CS. Falls, injuries due to falls, and the risk o f admission to a nursing home. N Engl J Med. 1997; 337:1279-1284. ##

28. Park, J.-H. The effects of eyeball exercise on balance ability and falls efficacy of the elderly who have experienced a fall. Archives of Gerontology and Geriatrics. 2017; 181-185. ##

29. Avelar, i. The influence of a protocol of aquatic exercises in postural control of obese elderly. revista andaluza de medicina del deporte. 2016; 19(1):2-7. ##

30. Ullmann G, Williams H, Hussey J, Durstine J, McClenaghan B. Effects of Feldenkrais exercises on balance, mobility, balance confidence, and gait performance in community-dwelling adults age 65 and older. Journal of Alternative and Complementary Medicine. 2010; 16(1):97-105. ##

31. Nair KS. Aging muscle. Am J Clin Nutr. 2005; 81(2): 953-963. ##

32. Wiesmeier IK, Dalin D, Maurer C. Elderly use proprioception rather than visual and vestibular cues for postural motor control. Frontiers in Aging Neuroscience. 2015; 7: 97. Doi: 10.3389/fnagi.2015.00097##

33. Vandervoort AA. Aging of the human neuromuscular system. Muscle Nerve. 2002; 25(1):17-25. ##

34. Reeves ND. Adaptation of the tendon to mechanical usage. J Musculoskelet Neuronal Interact. 2006; 6(3): 174-180. ##

35. Rivner MH, Swift TR, Malik K. Influence of age and height on nerve conduction. Muscle and Nerve. 2001; 24(6): 1134-1141. ##

36. Papegaaij S, Taube W, Baudry S, Otten E, Hortobagyi T. Aging causes a reorganization of cortical and spinal control of posture. Front Aging Neurosci. 2014; 6(1):28. Doi: 10.3389/fnagi.2014.00028. ##

37. Silva, P. Long-term benefits of somatosensory training to improve balance of elderly with diabetes mellitus. Journal of Bodywork & Movement Therapies. 2015; 18(3):453-457. ##

38. Allum JHJ, Carpenter MG, Honegger F, Adkin AL, Bloem BR. Age-dependent variations in the direction sensitivity of balance corrections and compensatory arm movements in man. J Physiol. 2002; 542(2):643-663. ##

39. Cherie W, Gregory S, Kolt AB. Defining Pilates exercise: A systematic review. Complementary Therapies in Medicine 2012; 20: 253-262. ##

40. Kenny RA, Rubenstein LZ, Martin FC, Tinetti ME. Guideline for the prevention o f falls in older persons. American Geriatrics Society, British Geriatrics Society, and American Academy o f Orthopaedic Surgeons Panel on Falls Prevention. J A m Geriatr Soc. 2001;49(5):664-672. ##

41. Day L, Fildes B, G ordon I, Fitzharris M, Flamer H, Lord S. Randomised factorial trial of falls prevention among older people living in their own homes. BrM ed J. 2002; 32(5):128-131. ##

42. Youkelatos A, Cumming RG, Lord SR, Rissel C. A randomized, controlled trial o f tai chi for the prevention o f falls: the central Sydney tai chi trial. J A m Geriatr Soc. 2007; 5(5):1185- 1191. ##

43. Aruin, A. Directional specificity of postural muscles in feed-forward postural reactions during fast voluntary arm movements. Exp Brain Res. 1995; 3(2):323-332. ##

44. Alexandrov, A. Feedback equilibrium control during human standing. Biol Cybern. 2005; 309-322. ##

45. Bleuse, s. Effect of age on anticipatory postural adjustments in unilateral arm movement. Gait Posture, 2006; 11(2):203-210. ##

46. Woollacott, M. Changes in posture control across the life span--a systems approach. Phys Ther. 1990; 799-807. ##

47. Laessoe, U. Anticipatory postural control strategies related to predictive perturbations. Gait Posture, 62-68. ##

48. Aruin, A. S. Anticipatory and compensatory postural adjustments in individuals with multiple sclerosis in response to external perturbations. Neuroscience Letters. 2015; 17(4):182-186. ##

49. Saito, H. Relationship between improvements in motor. Human Movement Science performance and changes in anticipatory postural adjustments during whole-body reaching training. 2014; 20(3):69-86. ##

50. Robertson A, Janice J, Eng J, Hung C. The effect of functional electrical stimulation on balance function and balance confidence in community-dwelling individuals with Stroke. Physiotherapy Canada. 2010; 62(2):114-9. ##

51. Behm DG, Bambury A, Cahill F, Power K. Effect of acute static stretching on force, balance, reaction time, and movement time. Medicine and Science in Sports and Exercise. 2004; 36(8):1397-402. ##

52. Aruin, A. Enhancing Anticipatory Postural Adjustments: A Novel Approach to Balance Rehabilitation. Nov Physiother. 2016; 17(1):1-6. ##

53. Kanekar, N. Improvement of anticipatory postural adjustments for balance control: effect of a single training session. Electromyogr Kinesiol. 2015; 14(3):400-405. ##

54. Conceicao, J. S. Changes in Postural Control After a Ball-Kicking Balance Exercise in Individuals With Chronic Ankle Instability. Journal of Athletic Training. 2016; 13(2):480-490. ##

55. Scariot, V. Both anticipatory and compensatory postural adjustments are adapted while catching a ball in unstable standing posture. Journal of Bodywork & Movement Therapies. 2016; 21(4):90-97. ##