رابطة آمادگی کارکردی، انتظار از پیامد تمرین، کارآمدی تمرین و ترس از افتادن در سالمندان ساکن در شهر قم

Introduction

According to the United Nations, the world's elderly population is increasing, and developing Asian countries are aging faster than other countries. Our country is also aging rapidly. As adults age, declines in motor function occur, including slower reaction time, decreased balance and posture, decreased muscle strength and control, decreased joint flexibility, and changes in gait patterns, which may be related to aging, disease, lifestyle, or a combination of these factors. Functional fitness, defined as the ability to perform daily activities safely, independently, and without fatigue, plays an important role in the health and quality of life of older adults. In recent years, a number of functional fitness specialists have promoted functional fitness programs as a way to maintain age-appropriate activity and independence in older adults. The present study aimed to investigate the relationship between functional fitness, exercise outcome expectation, exercise efficacy, and fear of falling among community-dwelling older adults.

Methods

The method of this study was descriptive correlational. The statistical population of this study was the elderly in Qom. The variables of this study were functional fitness, expectation of exercise outcome, exercise efficacy, and fear of falling in the elderly. From the statistical population, 351 people were selected as a convenience sample. Inclusion criteria included permanent residence in Qom city, being 60 years of age or older, being able to walk independently, not having visual problems, not having paralysis or lower limb amputation, and verbal consent to participate in the study. Data collection tools included a demographic questionnaire, Elderly,s Activities of Daily Life Scale (Iran-ADLs), Multidimensional Outcome Expectations for Exercise Scale, Self-efficacy for Exercise Scale, Persian Version of Fall Efficacy Scale-International (FES-I). The questionnaires were distributed among the elderly in Qom. The method of accessing the elderly was as follows: 1) By visiting parks and talking to individuals and who were willing to cooperate, they completed the questionnaires; 2) By visiting medical complexes and talking to doctors and elderly people, if they agreed, the questionnaires were collected. 3). Another part of the questionnaires was collected by referring to the Education and Training Retirees Center and the Police Retirees Center, and another part of the questionnaires was completed by the grandparents of the children participating in language schools in Qom. 4) A limited number of questionnaires were also prepared electronically. A total of 351 questionnaires were provided to the researcher out of the 500 distributed questionnaires. After collecting the questionnaires, the raw data were entered into SPSS-16 software for final analysis.Descriptive statistics, such as calculating the mean, determining the correlation coefficient, and drawing tables, were used to analyze the data.

Results

The correlation coefficient between the variable of functional readiness and expectation of the outcome of training is equal to 0.57, which is significant at the 0.05. As a result, it can be said that the increase in functional readiness is associated with the increase in the expectation of the outcome of training. Also, the correlation between all components of functional readiness and all components of the expectation of the outcome of training is significant at the 0.001 error level. The correlation between the functional readiness variable and exercise efficiency at the 0.95 confidence level is 0.01. This result shows that there is no significant relationship between the two variables. Also, no significant relationship was observed for any of the functional readiness components with exercise efficiency. The correlation coefficient between the functional readiness variable and the fear of falling is -0.65. As a result, it can be said that an increase in functional readiness is associated with a decrease in the fear of falling and vice versa. Also, a significant indirect relationship was observed between all 5 components of functional readiness and the fear of falling variable (P≤0.05). The correlation coefficient between the variable of expectation of the outcome of training and the effectiveness of training is equal to 0.09, which is not significant at the 0.95 confidence level. Of course, in evaluating the relationship between the effectiveness of training and the components of expectation of the outcome of training, it was determined that there is a significant relationship between the self-evaluation component and the effectiveness of training (P≤0.05), but no significant relationship was observed in relation to the other two components, namely physical and social (P≥0.05). There is a significant relationship between the variable of expectation of the outcome of training and fear of falling at the 0.95 confidence level. As a result, it can be claimed that with increasing scores of expectation of the outcome of training, scores of fear of falling decrease and vice versa. There is also a significant negative relationship between the variable of fear of falling and each of the three components of physical (-0.32), social (-0.33) and self-evaluation (-0.35) (P≤0.05).

Conclusion

Functional fitness is one of the physiological aspects of the life of older adults that can be affected by falls and fear of falling. The results of the present study also showed that there is a negative relationship between functional fitness and fear of falling in the elderly. That is, with increasing functional fitness, the fear of falling in the elderly decreases, and with decreasing functional fitness, the fear of falling increases. According to the results of this study, fear of falling decreases with anticipation of the outcome of exercise. Therefore, it is recommended that more studies and psychological interventions be conducted on anticipation, which is a subjective indicator. It is recommended that future studies compare the fear of falling in women with the fear of falling in elderly men. The limitations of this study include the selection of samples from Qom city and the lack of control for some diseases and disabilities, such as a history of previous open surgery, etc. Overall, the results showed that by increasing physical fitness and improving functional fitness, the fear of falling in the elderly decreases. While recommending that the elderly living in the community engage in regular physical activity and exercise, these findings can be used to design exercise interventions for the elderly.

Footnote

Ethical approval: This research has been approved in the Department of Motor Behavior and Sport Psychology, Faculty of Sport Sciences, and the Vice Chancellor for Research, Arak University, in the form of a master's thesis. The principle of confidentiality was observed in the use of data, especially for people with disabilities.

Funding: This research was not financially supported by any organization.

 Authors’ contribution:  The study concept andb desighn: D. K; Analysis and interpretation of data: E. T; Drafting of the manuscript: D. K.; Critical revision of the manuscript: D. K.; Statistical analysis: E. T.

Conflict of interest: According to the authors, this article has no conflict of interest.

Acknowledgments: We sincerely thank the respected administrators and staff of the Faculty of Sport Sciences, Arak University, and the dear grandparents who patiently cooperated with us in conducting the research, especially in completing the questionnaires.