تأثیر دو برنامه تمرین عملکردی و پیلاتس بر تعادل پویای زنان سالمند با و بدون پیشینه زمین‌خوردن

Introduction

Aging is defined as a natural physiological process that gradually follows the life cycle. In addition to psychosocial complications, physical losses also occur in old age, leading to slower thinking, depression, functional disability, loss of endurance, immobility, and physical degeneration. Functional changes inherent to the aging process, such as decreased mobility and muscle strength, can lead to imbalance and, consequently, an increased risk of falls in older adults. Falls are the most common problem among older adults, leading to increased morbidity and mortality (3). Most falls occur during walking, mainly due to unforeseen disturbances in dynamic balance caused by slips or slips. Gerards et al. (2021) examined the adaptation of walking to impairments in older adults with and without a history of falls and used the margin of stability to determine the number of steps to recover. Their findings showed that fallers show lower adaptation to walking. These balance disorders cause sudden changes in the person’s center of mass, potentially leading to falls with physical consequences such as injuries, fractures, as well as psychosocial consequences such as fear of falling. The most common fractures caused by falls occur in the hip, spine, arm, and forearm. Of these fractures, hip fractures have serious consequences such as reduced mobility and independence and a high mortality rate in the first three months. One study reported that the main determinants of frequent falls include a history of falls, muscle strength, abnormal postural fluctuations (such as balance and gait disorders), and depression (7). Given that the prevalence of falls in people over 65 years of age is about 33% and tends to increase with age, it is obvious that the ability to contract muscle fibers and neuromuscular activation can lead to a lower incidence of falls (10). Therefore, the aim of this study was to compare the effects of functional exercises (at home) and Pilates in improving dynamic balance in elderly women with and without a history of falls.

Methods

This study was a quasi-experimental research conducted in two stages: pre-test and post-test. The sample consisted of 40 elderly women, aged between 70 and 80 years, who were assigned to four groups of ten participants each: functional exercise (at home) with a history of falling, functional exercise (at home) without a history of falling, Pilates exercise with a history of falling, and Pilates exercise without a history of falling. The inclusion criteria were being in the age range of 70 to 80 years, absence of contraindications for physical activity, and willingness to consistently participate in exercise sessions. Exclusion criteria included having psychiatric conditions like depression, severe physical conditions such as severe respiratory or circulatory problems, using assistive devices like canes, or having undergone surgeries that would hinder participation. The participants gave informed consent and signed a consent form to participate. The sample size was determined using G-Power software. To assess dynamic balance, the Berg Balance Scale was used in both the pre-test and post-test stages. This test consists of 15 items, and each item is rated on a scale from 0 to 5, with 5 representing optimal performance. The maximum score achievable was 46, indicating better balance as the score increased. The exercise protocols included Pilates and functional exercises (at home), conducted for 12 and 8 weeks, respectively. Pilates exercises were performed twice a week for 60 minutes, while functional exercises were done three times a week for 60 minutes per session. Data were analyzed using Shapiro-Wilk test for normality, univariate covariance for between-group comparisons, and paired t-tests for within-group comparisons. SPSS version 23 was used for statistical analysis, with a significance level of 0.05.

Results

The results of the univariate covariance test showed a significant difference in the results of functional exercises (at home) and Pilates in Samand women with and without preeclampsia (P-0.001). The results of the paired t-test showed a significant increase in dynamic balance of elderly women in the functional training groups with and without a history of falls and Pilates training without a history of falls (P-0.001). No significant difference in dynamic balance was observed in the Pilates training group with a history of falls based on the paired t-test.(Table 1).

Table1. Intra-group comparison of mean and standard deviation of dynamic balance in elderly people with and without a history of falls after eight weeks of Pilates and Malacardi exercises (at home).

Conclusion

The results of the present study showed a significant difference in increasing the dynamic balance of elderly women with and without a history of falls after eight weeks of Pilates and functional exercises (at home).There was also a significant difference between functional exercises (at home) and Pilates exercises in improving the dynamic balance of elderly women with and without a history of falls. The results of the present study are consistent with the results of some researchers.Researchers such as Khazai et al. showed that the average scores of dynamic balance and lower body strength after performing Pilates exercises were significantly higher than those of other training groups.Also, Viotto et al. reported in a study that performing Pilates exercises for thirty sessions and twice a week by healthy adult women improved dynamic balance, postural habit to pick up an object from the floor, and fixed body posture (19).The results of Tenier et al. were also based on the fact that an 8-week Pilates training program helps to develop body composition and dynamic balance function in sedentary women.Zarei et al. also found improved dynamic balance (dominant and non-dominant limbs) after 8 weeks of Pilates training.

Both functional training and Pilates significantly increased dynamic balance in older women with and without a history of falls. Therefore, older women can effectively use both of these exercises to strengthen their core muscles and increase their dynamic balance. The increase and improvement in balance as a result of these exercises can improve the quality of life of older women and prevent them from falling.