Comparative Effect of a Balance Training Program and Core Stabilization Program on Factors Related to the Prevention of Falling in Healthy Middle-Aged Individuals: A Double-Blind Randomized Controlled Clinical Trial

Authors

  • Chatwalai Sonthikul Department of Physical Therapy, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
  • Wanida Kaewmunee Department of Physical Therapy, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
  • Porraporn Sriwannawit Department of Physical Therapy, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
  • Jirapinya Kasipan Undergraduate Student of the Department of Physical Therapy, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand.
  • Natthanan Khuatjit Undergraduate Student of the Department of Physical Therapy, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand.
  • Duangkamol Kimakhom Undergraduate Student of the Department of Physical Therapy, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand.
  • Pattaraporn Rueangsuk Undergraduate Student of the Department of Physical Therapy, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand.

DOI:

https://doi.org/10.31584/jhsmr.201950

Keywords:

balance training program, core strength training program, dynamic balance, gait variable, middle age

Abstract

Objectives: The aim of this study to compare the effectiveness of the balance training program (BTP), and the core stabilization program (CSP), on dynamic balance in healthy middle-aged individuals.
Material and Methods: This study was a single-blind randomized controlled trial design. Forty-two healthy middle-aged participants were randomly assigned to the BTP group (n=21), or the CSP group (n=21). Participants in both groups received an intervention program (balance training or core stabilization) 3 times a week, for 60 minutes, over 6 weeks. The primary outcome was the dynamic balance measured by the timed up and go test. The other outcomes were: core muscle endurance, muscle strength of the lower extremities, the flexibility of the lower back and hamstring muscles, and gait variables. The measurements included: the prone bridge endurance test, 5 times sit to stand test, sit and reach test and a wireless movement monitoring inertial sensor system, respectively. All outcomes were measured at baseline, and then after 6 weeks. The data were analyzed by the Independent Sample t-test between groups, and the paired t-test within either group.
Results: After 6 weeks, there was no statistically significant difference between the groups in either dynamic balance, or other variables, however, a statistically significant difference was found in core muscle endurance (p-value=0.003). In so saying, the BTP group, statistically significant improvements were found only in core muscle endurance, the flexibility of the lower back and hamstring muscles, and gait variables from pre- to post-test. Moreover, in the CSP group, there was a statistically significant difference from pre- to post-test in all measured outcomes.
Conclusion: The Core stabilization program is not superior to a balance training program, for the improvement ofdynamic balance. Although, after 6 weeks of training, the study found that the Core stabilization program was effective for improving dynamic balance. This finding may point out that the Core stabilization program helps improve balance in a middle-aged person

References

1. Hopewell S, Adedire O, Copsey BJ, Boniface GJ, Sherrington C, Clemson L, et al. Multifactorial and multiple component interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev 2018. doi: 10.1002/14651858.CD012221.

2. McClure RJ, Turner C, Peel N, Spinks A, Eakin E, Hughes K. Population based interventions for the prevention of fall related injuries in older people. Cochrane Database Syst Rev 2005. doi: 10.1002/14651858.CD004441.

3. Cameron ID, Dyer SM, Panagoda CE, Murray GR, Hill KD, Cumming RG, et al. Interventions for preventing falls in older people in care facilities and hospitals. Cochrane Database Syst Rev 2018. doi: 10.1002/14651858.CD005465.

4. Sherrington C, Fairhall NJ, Wallbank GK, Tiedemann A, Michaleff ZA, Howard K, et al. Exercise for preventing falls in older people living in the community. Cochrane Database Syst Rev 2019. doi: 10.1002/14651858.CD012424.

5. Kendrick D, Kumar A, Carpenter H, Zijlstra GR, Skelton DA, Cook JR, et al. Exercise for reducing fear of falling in older people living in the community. Cochrane Database Syst Rev 2014. doi: 10.1002/14651858.CD009848.

6. Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson LM, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev 2012. doi: 10.1002/14651858.CD007146.

7. Howe TE, Rochester L, Neil F, Skelton DA, Ballinger C. Exercise for improving balance in older people. Cochrane Database Syst Rev 2011. doi: 10.1002/14651858.CD004963.

8. Berk L. Development through the lifespan. 7th ed. Hoboken: Pearson Education; 2017.

9. Talbot LA, Musiol RJ, Witham EK, Metter EJJBph. Falls in young, middle-aged and older community dwelling adults: perceived cause, environmental factors and injury. BMC Public Health 2005;5:1-9.

10. Petrofsky JS, Cuneo M, Dial R, Pawley AK, Hill J. Core strengthening and balance in the geriatric population. J Appl Res 2005;5:423-33.

11. Arshinta IN, Fitriana LA, Adikusuma T, Rohaedi S, Putri TP. Cardiorespiratory endurance and balance of elderly dementia patients in nursing home. IOP Conf Ser Mater Sci Eng 2018. doi: 10.1088/1757-899X/288/1/012084.

12. Granacher U, Muehlbaue T, Zahner L, Gollhofer A, Kressig RW. Comparison of traditional and recent approaches in the promotion of balance and strength in older adults. Sports Med 2011;41:377-400.

13. Muehlbauer T, Besemer C, Wehrle A, Gollhofer A, Granacher UJG. Relationship between strength, power and balance performance in seniors. Gerontology 2012;58:504-12.

14. Rogers ME, Page P, Takeshima N. Balance training for the older athlete. Int J Sports Phys Ther 2013;8:517-30.

15. Anderson GS, Deluigi F, Belli G, Tentoni C, Gaetz MB. Training for improved neuro-muscular control of balance in middle aged females. J Bodyw Mov Ther 2016;20:10-8.

16. Nepocatych S, Ketcham CJ, Vallabhajosula S, Balilionis G. The effects of unstable surface balance training on postural sway, stability, functional ability and flexibility in women. J Sports Med Phys Fitness 2018;58:27-34.

17. Kim E, Lee HJ. The effects of deep abdominal muscle strengthening exercises on respiratory function and lumbar stability. J Phys Ther Sci 2013;25:663-5.

18. Behm DG, Drinkwater EJ, Willardson JM, Cowley PM. The use of instability to train the core musculature. Appl Physiol Nutr Metab 2010;35:91-108.

19. Kibler WB, Press J, Sciascia A. The role of core stability in athletic function. Sports Med 2006;36:189-98.

20. Anderson GS, Deluigi F, Belli G, Tentoni C, Gaetz MB. Training for improved neuro-muscular control of balance in middle-aged females. J Bodyw Mov Ther 2016;20:10-8.

21. Granacher U, Muehlbaue T, Gruber M. A qualitative review of balance and strength performance in healthy older adults: impact for testing and training. J Aging Res 2012;2012:1-16.

22. Dunsky A, Zeev A, Netz Y. Balance performance is task specific in older adults. Biomed Res Int 2017;2017:1-7.

23. Strand SL, Hjelm J, Shoepe TC, Fajardo MA. Norms for an isometric muscle endurance test. J Hum Kinet 2014;40:93-102.

24. Goldberg A, Chavis M, Watkins J, Wilson T. The five-timessit-to-stand test: validity, reliability and detectable change in older females. Aging Clin Exp Res 2012;24:339-44.

25. Jordre B, Schweinle W, Beacom K, Graphenteen V, Ladwig A. The five times sit to stand test in senior athletes. J Geriatr Phys Ther 2013;36:47-50.

26. Baltaci G, Un N, Tunay V, Besler A, Gerçeker S. Comparison of three different sit and reach tests for measurement of hamstring flexibility in female university students. Br J Sports Med 2003;37:59-61.

27. Fang X, Liu C, Jiang Z. Reference values of gait using APDM movement monitoring inertial sensor system. R Soc Open Sci 2018;5:1-10.

28. Kim HJ, Park I, Lee HJ, Lee O. The reliability and validity of gait speed with different walking pace and distances
against general health, physical function, and chronic disease in aged adults. J Exerc Nutr Biochem 2016;20:46-50.

29. Kollmitzer J, Ebenbichler GR, Sabo A, Kerschan K, Bochdansky T. Effects of back extensor strength training versus balance training on postural control. Med Sci Sports Exerc 2000;32:1770-6.

30. Beling J, Roller M. Multifactorial intervention with balance training as a core component among fall-prone older adults J Geriatr Phys Ther 2009;32:125-33.

31. Donath L, Roth R, Hürlimann C, Zahner L, Faude O. Pilates vs. balance training in health community-dwelling seniors: a 3-arm, randomized controlled trial. Int J Sports Med 2016;37:202-10.

32. Taylor-Piliae RE, Haskell WL, Stotts NA, Froelicher ES. Improvement in balance, strength, and flexibility after 12 weeks of Tai chi exercise in ethnic Chinese adults with cardiovascular disease risk factors. Altern Ther Health Med 2006;12:50-8.

33. Ekstrom RA, Donatelli RA, Carp KC. Electromyographic analysis of core trunk, hip, and thigh muscles during 9 rehabilitation exercises. J Orthop Sports Phys Ther 2007;37:754-62.

34. Aggarwal A, Kumar S, Kumar D. Effect of core stabilization training on the lower back endurance in recreationally active individuals. J Musculoskelet Res 2010;13:167-76.

35. Mohammadi M, Kaldırımcı M, Kazemi SE, Mızrak O, Tuğrulhanşam C. The effect of Pilates exercise on gait speed
and strength of lower limb in elderly male. Adv Appl Sci Res 2015;6:1-6.

36. Sekendiz B, Cug M, Korkusuz F. Effects of Swiss-ball core strength training on strength, endurance, flexibility, and balance in sedentary women. J Strength Cond Res 2010;24:3032-40.

37. Hoglund LT, Pontiggia L, Kelly JD. A 6-week hip muscle strengthening and lumbopelvic-hip core stabilization program to improve pain, function, and quality of life in persons with osteoarthritis: a feasibility pilot study 2018;4:1-14.

38. Newell D, Shead V, Sloane L. Changes in gait and balance parameters in elderly subjects attending an 8-week supervised Pilates programme. J Bodyw Mov Ther 2012;16:549-54.

39. Schellenberg KL, Lang JM, Chan KM, Burnham RS. A clinical tool for office assessment of lumbar spine stabilization endurance: prone and supine bridge maneuvers. Am J Phys Med Rehabil 2007;86:380-6.

40. Hicks GE, Simonsick EM, Harris TB, Newman AB, Weiner DK, Nevitt MA, et al. Trunk muscle composition as a predictor of reduced functional capacity in the health, aging, and body composition study: the moderating role of back pain. J Gerontol A Biol Sci Med Sci 2005;60:1420-4.

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Published

2019-05-08

How to Cite

1.
Sonthikul C, Kaewmunee W, Sriwannawit P, Kasipan J, Khuatjit N, Kimakhom D, Rueangsuk P. Comparative Effect of a Balance Training Program and Core Stabilization Program on Factors Related to the Prevention of Falling in Healthy Middle-Aged Individuals: A Double-Blind Randomized Controlled Clinical Trial. J Health Sci Med Res [Internet]. 2019 May 8 [cited 2024 Dec. 23];37(3):171-8. Available from: https://he01.tci-thaijo.org/index.php/jhsmr/article/view/177181

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