Document Type : Original Article

Authors

1 MS.c in Sport Pathology and Corrective Exercise, Faculty of Physical Education and Sport Sciences. University of Allameh Tabatabai, Tehran, Iran

2 Associate Professor, Faculty of Physical Education and Sports Science, University of Allameh Tabatabai, Tehran, Iran

3 Assistant Professor, Faculty of Physical Education and Sports Science, University of Allameh Tabatabai, Tehran, Iran

Abstract

Background and Aim: Falling is a major health problem among elderly that has significant affect their health and life
quality, but it can be possibly prevented by development of muscle strength. The purpose of this study was to investigate
the relationship between strength of spine extensor muscles with dynamic balance and fear of falling in elderly people.
Materials and Methods: 68 elderly men and woman with mean age of 70±5.43 years, height of 157.29±8.59 cm and
weight of 70.64±9.63 kg were randomly recruited among volunteers. Dynamometer, biodex stability system and modified MFES questionnaire were used to assess strength of spine extensor muscles, dynamic balance and fear of falling
respectively. This research was an empirical and causal relationship study, and to elicit the results, Pearson correlation
coefficient was used and significance level was considered if pcorrelation between strength of spine extensor muscles and dynamic balance in anterior-posterior direction (p=0.0001), while no significant correlation was shown between strength of spine extensor muscles and dynamic balance in media-lateral direction (p=0.29). In addition, there was a significant positive correlation between strength of spine extensor muscles and fear of falling (p=0.01). Conclusion: Strength of spine extensor muscles is an effective factor to maintain balance at anterior-posterior direction and fear of falling 

Keywords

Akbari Kamrani, A.H., Azadi, F., Akbari Kamrani, M., Pejmanfard, P., & Siyadat, S. (2007). Effect of Romberg Exercise
on falls in elderly with a history of falls. Journal of Elderly, 3(4), 246-251. [Persian]
Akbari Kamrani, A.H., Azadi, F., Froughan, M., Siyadat, S., & Koldi, A. (2007). Details of falls in elderly people living in
nursing home. Journal of Elderly, 2(1), 101-105. [Persian]
Delbaere, K., Crombez, G., Vanderstraeten, G., Willems, T., & Cambier, D. (2004). Fear-related avoidance of activities,
falls and physical frailty, A prospective community-based cohort study. Age Ageing, 4(33), 368-373.
Deshpande, N., Metter, E.J., Bandinelli, S., Lauretani, F., Windham, B.G., & Ferrucci, L. (2008). Psychological, physical and sensory correlates of fear of falling and consequent activity restriction in the elderly: The InCHIANTI Study. American Journal of Physical Medicine & Rehabilitation, 87(5), 354-362.
Fathi Rezaie, Z., Aslankhani, M.A., Farsi, A., Abdoli, B., & Zamani Sani, H. (2010). A comparison of three functional
Tests of balance in identifying fallers from non-fallers in elderly people. Knowledge & Health, 4(44),22-27. [Persian]
Harding, S., & Gardner, A. (2009). Fear of falling. Australian Journal of Advanced Nursing, 27(1):94-100.
Howe, T.E., Rochester, L., Neil, F., Skelton, D.A., & Ballinger, C. (2011). Exercise for improving balance in older people.
The Cochrane Database of Systematic Reviews, 9(11), 25-35.
Kasukawa, Y., Miyakoshi, N., Hongo, M., Ishikawa, Y., Noguchi, H., Kamo, K., Sasaki, H., Murata, K., & Shimada Y.
(2009). Relationships between falls, spinal curvature, spinal mobility and back extensor strength in elderly people.
Journal of Bone and Mineral Metabolism, 1(28), 82-87.
Kool, B., Ameratunga, S., Robinson, E., & Jackson, R. (2007). Hospitalisations and deaths due to unintentional falls at
home among working-aged New Zealanders. Injury Journal, 38(5), 570-575.
Lachman, M.E., Howland, J., Tennstedt, S., Jette, A., Assmann, S., & Peterson, E.W. (1998). Fear of falling and activity
restriction: the survey of activities and fear of falling in the elderly (SAFE). The Journals of Gerontology Series B:
Psychological Sciences and Social Sciences, 1(53), 43-50.
Limburg, P.J., Sinaki, M., Rogers, J.W., Caskey, P.E., & Pierskalla, B.K. (1991). A useful technique for measurement of
back strength in osteoporotic and elderly patients. Mayo Clinic Proceedings, 1(66), 39-44.
Lord, S. R., Ward, J. A., Williams, P., & Anstey, K. J. (1993). An epidemiological study of falls in older community-dwelling
women: the Randwick falls and fractures study. Australian Journal of Public Health, 17(3), 240-245. 
Mannion, A.F., Adams, M.A., Cooper, R.G., & Dolan, P. (1995). Prediction of maximal back muscle strength from indices
of body mass and fat-free body mass. Rheumatology, 1(38), 652-655.
Mika, A., Unnithan, V.B., & Mika, P. (2005). Differences in thoracic kyphosis and in back muscle strength in women with
bone loss due to osteoporosis. Journal of Spine, 2(30), 241-246.
Miyakoshi, N., Hongo, M., Maekawa, S., Ishikawa, Y., Shimada, Y., & Itoi, E. (2007). Back extensor strength and lumbar
spinal mobility are predictors of quality of life in patients with postmenopausal osteoporosis. Osteoporosis International,
10(18), 1397-1403.
Miyakoshi, N,. Itoi, E., Kobayashi, M., & Kodama, H. (2003). Impact of postural deformities and spinal mobility
on quality of life in postmenopausal osteoporosis. Osteoporosis International, 12(14), 1007-1112.
Naomi, A. (2004). Hand wellness for older adult. Functional Journal, 7(12), 1-10.
Nik, N. (2011). The effects of yoga techniques to balance and fear of falling in the elderly. Master of Science Thesis, Shiraz University of Medical Sciences. [Persian]
Nodehi Moghadam, A., & Ehsanifar, F. (2006). Mobility impairment investigate the abnormality of Elderly Welfare
rehabilitation center in Tehran. Journal of Elderly, 2(1), 125-131. [Persian]
Oh, D.H., Park, J.E., Lee, E.S., Oh, S.W., Cho, S.I., Jang, S.N., & Baik, H.W. (2012). Intensive exercise reduces the fear of additional falls in elderly people: findings from the Korea falls prevention study. The Korean Journal of Internal Medicine, 4(27), 417-425.
Pendelton, H.M.,& Schultz-Krohn, W. (2006). Special needs for the older adult, Pedrettis occupational therapy: Practice skills for physical dysfunction. 6th edition. Baltimore USA.
Petrofsky, J.S., Batt, J., Davis, N,. & Lohman, E. (2007). Core muscle activity during exercise on a mini stability ball
compared with abdominal crunches on the floor and on a swiss ball. Journal of Applied Research in Clinical and
Exprimental Therapeutics, 3(7), 255-263.
Pi spences, A. (1999). Aging procces in human. Translated by: Ghafari, A.N., & Hashemi, F. Tehran: Fabrication of
Behzisty Organization and Welfare Science and Rehabilitation University. [Persian]
Post, R.B.,& Leferink, V.J. (2004). Spinal mobility: sagittal range of motion measured with the SpinalMouse, a
new non-invasive device. Archives of Orthopaedic and Trauma Surgery, 3(124), 187-192.
Rasteh, H., Olyaei, G.R., Abdolvahab, M., Jalili, M., & Jalaei, S.H. (2009). Efficacy of Cawthorne & Cooksey exercise on
balance improvement in elderly persons in Mashhad. Journal of Modern Rehabilitation, 2(3), 49-53. [Persian]
Reiss, P.T., & Huang, L. (2012). Smoothness selection for penalized quantile regression splines. The International
Journal of Biostatistics, 1(8), 24-34.
Rosenberg, I.H., & Roubenoff, R. (1995). Stalking sarcopenia. Journal of Annals of Internal Medicine,123(9), 727-728.
Schmid, A.A., Van Puymbroeck, M., & Koceja, D.M. (2010). Effect of 12-week yoga intervention on fear of falling and
balance in older adults: a pilot study. Archives of Physical Medicine and Rehabilitation, 91(4), 576-583.
Schmid, A., Acuff, M., Doster, K., Gwaltney-Duiser, A., Whitaker, A., Damush, T., & Hendrie, H. (2009). Poststroke fear of
falling in the hospital setting. Top Stroke Rehabilitation, 16(5), 357-366. 
Schmitz, R., & Arnold, B. (1988). Intertester and intratester reliability of a dynamic balance protocol using the biodex
stability system. Journal of Sport Rehabilitation, 2(7), 37-42.
Sheffer, A.C., Schuurmans, M.J., Van Dijk, N., Van Der Hooft, T., & De Rooij, S.E. (2008). Fear of falling: measurement
strategy, prevalence, risk factors and consequences among older persons. Age and Ageing, 37(1), 19-24.
Sinaki, M., Brey, R.H., Hughes, C.A., Larson, D.R., & Kaufman, K.R. (2005). Balance disorder and increased risk of falls
in osteoporosis and kyphosis: significance of kyphotic posture and muscle strength. Osteoporosis International, 8(16),
1004-1010.
Sinaki, M., Khosla, S., Limburg, P.J., Rogers, J.W., & Murtaugh, P.A. (1993). Muscle strength in osteoporotic versus
normal women. Osteoporosis International, 1(3), 8-12.
Sinaki, M., Itoi, E., Wahner, H.W., Wollan, P., Gelzcer, R., Mullan, B.P., Collins, D.A., & Hodgson, S.F. (2002). Stronger
back muscles reduce the incidence of vertebral fractures: a prospective 10 year follow-up of postmenopausal women.
Bone, 6(30), 836-841.
Volpe, R., & Lewko, J. (2008). The prevention of sports injury. 1th edition. Toronto, Ontario Neurotrauma Foundation.
Walsh, M.C,. Hunter, G.R., Livingstone, M.B. (2006). Sarcopenia in premenopausal and postmenopausal women with
osteopenia, osteoporosis and normal bone mineral density. Osteoporosis International, 17(1), 61-67.
Williams, H.G., McClenaghan, BA., & Dickerson, J., (1997). Spectral characteristics of postural control in elderly
individuals. Archives of Physical Medicine and Rehabilitation, 78(7), 737-744.