The Journal of Korean Physical Therapy

The Korean Society of Physical Therapy (대한물리치료학회)
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The Effects of Sensorimotor Training on Balance and Muscle Activation During Gait in Older Adults

감각운동훈련이 노인의 균형 및 보행에 미치는 영향

  • Jeong, Tae-Gyeong (Department of Rehabilitation Science, Graduate School, Daegu University) ;
  • Park, Jeong-Seo (Department of Rehabilitation Science, Graduate School, Daegu University) ;
  • Choi, Jong-Duk (Department of Physical Therapy, College of Natural Science, Daejeon University) ;
  • Lee, Ji-Yeun (Department of Physical Therapy, Andong Science College) ;
  • Kim, Jin-Sang (Department of Physical Therapy, College of Rehabilitation Science, Daegu University)
  • 정태경 (대구대학교 대학원 재활과학과) ;
  • 박정서 (대구대학교 대학원 재활과학과) ;
  • 최종덕 (대전대학교 자연과학대학 물리치료학과) ;
  • 이지연 (안동과학대학 물리치료과) ;
  • 김진상 (대구대학교 재활과학대학 물리치료학과)
  • Received : 2011.03.29
  • Accepted : 2011.08.07
  • Published : 2011.08.25
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Abstract

Purpose: The purpose of this study was to evaluate the effect of 6-week sensorimotoor training on balance ability and lower limb muscle activation during gait in older adults. Methods: Twenty-four community-dwelling older adults between 65 and 90 years of age participated in this study. In the older adults of the experimental group (n=12), the sensorimotor training program was performed bare feet. General exercise was performed in the control group (n=12). Then, both groups exercised three times a week for forty minutes over a 6-week period. Balance ability was evaluated by One leg stand (OLS) test for determining the static balance and Timed Up & Go (TUG) test for determining the dynamic balance. In addition, muscle activation of the dominant lower limb tibialis anterior and gastrocnemius medialis muscles were measured by surface EMG to evaluate muscle activation during gait. Results: A significant improvement was seen in the one leg standing (OLS) time after exercise in both the sensorimotor training (SMT) group and general exercise (GE) group (p<0.05) and the change in the SMT group was greater than that in the GE group (p<0.05). A significant reduction was seen in the Timed Up & Go (TUG) test time after exercise in both the SMT group and GE group (p<0.05). Also, a significant increase was seen in muscle activation of tibialis anterior muscle after exercise in the SMT group (p<0.05), but no such significant increase was seen in the GE group (p>0.05). Conclusion: These results suggest that sensorimotor training improves the balance in older adults and has a more positive effect on muscular strength and gait. Sensorimotor training provided a variance of training environment and COG exercise of the body is thought to be a more effective exercise program that improves balance and gait ability in older adults.

Keywords

References

  1. Prohaska TR, Keller ML, Leventhal EA et al. Impact of symptoms and aging attribution on emotions and coping. Health Psychol. 1987;6(6):495-514.
  2. Bae CY, Lee YJ. Geriatric medicine. Seoul, Korea Medicine Book Publisher, 1996:251-79.
  3. Woollacott MH, Shumway-Cook A, Naschner LM. Aging and posture control: changes in sensory organization and muscular coordination. Int J Aging Hum Dev. 1986;23(2): 97-114. https://doi.org/10.2190/VXN3-N3RT-54JB-X16X
  4. Anacker SL, Di Fabio RP. Influence of sensory inputs on standing balance in community-dwelling elders with a recent history of falling. Phys Ther. 1992;72(8):575-84.
  5. Winter DA. The biomechanics and motor control of human gait: normal, elderly and pathological. 2nd ed. Waterloo, University of Waterloo Press. 1991:86-117.
  6. Prince F, Corriveau H, Hebert R et al. Gait in the elderly. Gait & Posture. 1997;5(2):128-35. https://doi.org/10.1016/S0966-6362(97)01118-1
  7. Yoon NM, Yoon HJ, Park JS et al. The comparative study on age-associated gait analysis in normal korean. J Kor Soc Phys Ther. 2010;22(2):15-24.
  8. Yun SH, Kim BO. Gait analysis: An introduction. Seoul, Sejin Book Co., 1994:74-5.
  9. Schilke JM. Slowing the aging process with physical activity. J Gerontol Nurs. 1991;17(6):4-8.
  10. Shephare RJ. Exercise and aging: extending independence in older adults. Geriatrics. 1993;48(5):61-4.
  11. Kim HR. Causality analysis of muscle activation, physical strength and daily living abilities change among the elderly due to a health promotion exercise program. J Kor Soc Phys Ther. 2010;22(4):73-81.
  12. Mihalko SL, McAuley E. Strength training effect on subjective well-being and physical function in the elderly. J Aging Phys Act. 1996;4(1):56-68.
  13. Janda V, Vavrova M. Sensory motor stimulation. In: Libenson C, Rehabilitation of the spine: A practitioner's manual, Baltimore, Willams & Wilkins. 1996:319-28.
  14. Janda V. Muscles and motor control in low back pain: assessment and management. In: Twomey LT, Physical therapy of the low back, New York, Churchill Livingstone, 1987:253-78.
  15. Liebenson C. Functional fitness training-Part 2. J Bodyw Mov Ther. 2006;10(3):208-10. https://doi.org/10.1016/j.jbmt.2006.04.002
  16. Springer BA, Marin R, Cyhan T et al. Normative values for the unipedal stance test with eyes open and closed. J Geriatr Phys Ther. 2007;30(1):8-15. https://doi.org/10.1519/00139143-200704000-00003
  17. Podsiadlo D, Richardson S. The timed "Up & Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142-8.
  18. Kim JH. Reliability and validity of gait assessement tools for elderly person. J Kor Soc Phys Ther. 2009;21(1):41-8.
  19. Rainold A. Melchiorri G. Caruso I. A method for positioning electrodes during surface EMG recordings in lower limb muscles. J Neurosci Methods. 2004;134(1):37-43. https://doi.org/10.1016/j.jneumeth.2003.10.014
  20. Yang JF, Winter DA. Surface EMG profiles during different walking cadences in humans. Electroencephalogr Clin Neurophysiol. 1985;60(6):485-91. https://doi.org/10.1016/0013-4694(85)91108-3
  21. Shumway-Cook A, Horak FB. Assessing the influence of sensory interaction of balance. Suggestion from the field. Phys Ther. 1986;66(10):1548-50.
  22. Bae YS, Um KM, Kim NS et al. The effect of proprioceptive exercise of ankle joint on postural alignment in woman elderly person. J Kor Soc Phys Ther. 2009;21(3):53-60.
  23. Chiang JH, Wu G. The influence of foam surfaces on biomechanical variables contributing to postural control. Gait Posture. 1997;5(3):239-45. https://doi.org/10.1016/S0966-6362(96)01091-0
  24. Taube W, Kullmann N, Leukel C et al. Differential reflex adaptations following sensori-motor and strength training in young elite athletes. Int J Sports Med. 2007;28(12): 999-1005. https://doi.org/10.1055/s-2007-964996
  25. Schubert M, Beck S, Taube W et al. Balance training and ballistic strength training are associated with task-specific corticospinal adaptations. Eur J Neurosci. 2008;27(8): 2007-18. https://doi.org/10.1111/j.1460-9568.2008.06186.x
  26. Myer GD, Ford KR, Brent JL et al. The effects of plyometric vs. dynamic stabilization and balance training on power, balance, and landing force in female athletes. J Strength Cond Res. 2006;20(2):345-53.
  27. Beck S, Taube W, Gruber M et al. Task-specific changes in motor evoked potentials of lower limb muscles after different training interventions. Brain Res. 2007;1179(7): 51-6.
  28. Judge JO, Lindsey C, Underwood M et al. Balance improvements in older women: effects of exercise training. Phys Ther. 1993;73(4):254-62.
  29. Lord SR, Ward JA, Williams P et al. The effect of a 12-month exercise trial on balance, strength, and falls in older women: a randomized controlled trial. J Am Geriatr Soc. 1995;43(11): 1198-206.
  30. McMurdo ME, Millar AM, Daly F. A randomized controlled trial of fall prevention strategies in old peoples' homes. Gerontology. 2000;46(2):83-7. https://doi.org/10.1159/000022139
  31. Freeman MA, Dean MR, Hanham IW. The etiology and prevention of functional instability of the foot. J Bone Joint Surg Br. 1965;47(4):678-85.
  32. Campbell AJ, Borrie MJ, Spears GF. Risk factors for falls in a community-based prospective study of people 70 years and older. J Gerontol. 1989;44(4):112-7. https://doi.org/10.1093/geronj/44.4.M112
  33. Paterno MV, Myer GD, Ford KR et al. Neuromuscular training improves single-limb stability in young female athletes. J Orthop Sports Phys Ther. 2004;34(6):305-16.
  34. Madureira MM, Takayamm L, Gallinaro AL et al. Balance training program is highly effective in improving functional status and reducing the risk of falls in elderly women with osteoporosis: a randomized controlled trial. Osteoporos Int. 2007;18(4):419-25. https://doi.org/10.1007/s00198-006-0252-5
  35. Alexander NB. Gait disorders in older adults. J Am Geriatr Soc. 1996;44(4):434-51.
  36. Tinetti ME, Doucette J, Claus E et al. Risk factors for serious injury during falls by older persons in the community. J Am Geriatr Soc. 1995;43(11):1214-21.
  37. Hof AL. The force resulting from the action of mono-and biarticular muscles in a limb. J Biomech. 2001;34(8):1085-9. https://doi.org/10.1016/S0021-9290(01)00056-2
  38. Warren GL, Maher RM, Higbie EJ. Temporal patterns of plantar pressures and lower-leg muscle activity during walking: effect of speed. Gait Posture. 2004;19(1):91-100. https://doi.org/10.1016/S0966-6362(03)00031-6
  39. den Otter AR, Geurts AC, Mulder T et al. Speed related changes in muscle activity from normal to very slow walking speeds. Gait Posture. 2004;19(3):270-8. https://doi.org/10.1016/S0966-6362(03)00071-7