Publication: Sağlıklı yaşlılarda kombine uygulanan fiziksel ve bilişsel egzersiz programlarının postür kontrolü, denge ve kognitif fonksiyonlar üzerine etkisi
Abstract
Amaç: Yaşlılarda, fiziksel ve kognitif becerilerde azalma meydana geldiği bilinmektedir. Duyu, sinir ve kas iskelet sistemlerinin koordinasyonu ile sağlanan denge performansı yaşlanma ile bozulmaya başlar. Bu nedenle, bu araştırmada yaşlılarda fiziksel egzersizlerin ve kombine egzersizlerin (fiziksel, bilişsel) denge ve kognitif fonksiyonlar üzerine etkisinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Bu araştırmaya; 65-85 yaş aralığında, en az ilkokul mezunu ve günlük yaşam aktivitelerini bağımsız olarak gerçekleştirebilen 45 katılımcı (yaş ort: 71,76±5,49; boy: 159,6± 7,85; kilo ort:73,01± 8,65; BKI ort:28,81± 4,09) dahil edilmiştir. Bu çalışmada her biri 15’er kişiden oluşan 3 ayrı grup bulunmaktadır: fiziksel egzersiz grubu (FEG), kombine egzersiz (KEG: fiziksel ve bilişsel egzersiz) grubu ve kontrol grubu (KG). Egzersiz programları, haftada 3 gün olmak üzere 2 ay süresince toplam 24 seans olarak uygulanmıştır. Egzersiz programlarının etkinliğini değerlendirmek için bilişsel (stroop testi (ST), İşaretleme testi (İT),Weschler görsel üretim alt testi) testler; stabiometre ile çift ayak statik ve dinamik (monoaxial: anterio-posterio proprisepsiyon, slalom ve multiaxial dinamik denge testleri) denge testleri ile 30sn otur kalk testi ve tek ayak üstünde duruş süreleri egzersiz programları öncesi ve sonrasında değerlendirilmiştir. Bulgular: 24 seans olarak uygulanan egzersiz programları sonrasında gruplararası otur-kalk test skorlarında KEG, FEG’e oranla daha fazla artış göstermiştir (p=0,045). Ancak diğer fiziksel ve bilişsel performans parametrelerinde, iki egzersiz grubu arasında anlamlı bir farklılık bulunamamıştır (p>0,05). Her iki egzersiz grubunun Wechsler kısa süreli bellek, otur-kalk test skorları ile slalom yakalanan obje skoru KG’ ye göre anlamlı düzeyde yüksek bulunmuştur (p<0,01). ST düzeltme sayısı ve dinamik denge ortalama yol izleme hatası (ATE) her iki egzersiz grubunda KG’ ye göre anlamlı düzeyde azalmıştır (p<0,01). Gözler kapalı statik ML hız, yalnızca FEG’de KG’ye göre anlamlı düzeyde azalmıştır (p=0,033). Grup içi ön ve son testler karşılaştırıldığında, her iki egzersiz grubunda otur-kalk (p=0,001), tek ayak üstünde statik denge (p=0,044), Wechsler kısa süreli bellek performansı (p=0,001) ve slalom yakalanan obje sayısı (p=0,001) skorları anlamlı düzeyde artmıştır. Ayrıca, ATE (p=0,001), ST düzeltme sayısı (p=0,001) ve süresi (p=0,031), yalnızca egzersiz gruplarında anlamlı düzeyde azalmıştır. KG için fiziksel ve bilişsel test parametrelerinde ön ve son testlerde anlamlı düzeyde bir farklılık bulunamamıştır (p>0,05). Sonuç: Araştırmada, yalnızca otur-kalk testi skorunun KEG’de FEG’e göre daha yüksek bulunmasını, yaşlı katılımcıların bilişsel ve fiziksel egzersizleri eş zamanlı yaparken squat benzeri egzersizler sırasında hareketlerin hızının yavaşlatarak alt ekstremite kaslarının daha uzun süre kasılarak kuvvet artışını sağladığını düşünmekteyiz. Yaşlılarda, FEG ve KEG’in fonksiyonel alt ekstremite kuvvet, denge ve bilişsel test parametlerinin benzer şekilde artması, fiziksel ve bilişsel egzersizlerin yaşlanma sürecindeki önemini göstermektedir. Bu araştırmada, yaşlılarda eş zamanlı olarak uygulanan fiziksel ve bilişsel egzersiz programlarının, klasik fiziksel egzersiz programları ile benzer etkilere sahip olduğu gösterilmiştir. Bu sonuçlar, sağlıklı yaşlanma sürecinde kuvvet, denge ve bilişsel performansını koruyabilmek için karmaşık olmayan klasik fiziksel egzersiz programlarının yeterli olduğunu göstermiştir.
Purpose:It is known that physical and cognitive skills decrease with aging. Balance performance, provided by the coordination of sensory, nervous and musculoskeletal systems, begins to deteriorate with aging. Therefore, this aim of the study was to evaluate the effect of physical exercises and combined exercises (physical, cognitive) on balance and cognitive functions in the elderly. Material and Method: In this study, 45 participants aged 65-85 years, at least primary school graduates and able to perform activities of daily living independently (mean age: 71.76±5.49; height: 159.6± 7.85; weight: 73.01± 8.65; BMI: 28.81± 4.09) were included. In this study, there were 3 separate groups consisting of 15 participants each: physical exercise group (FEG), combined exercise (CEG: physical and cognitive exercise) group and control group (CG). Exercise programs were applied 3 days a week for a total of 24 sessions for 2 months. In order to evaluate the effectiveness of the exercise programs, cognitive tests (stroop test (ST), pointing test (İT), Weschler visual production subtest), biped static and dynamic (monoaxial: anterio-posterio proprioception, slalom and multiaxial dynamic balance tests) balance tests with stabiometer, 30 seconds sit and stand test and standing time on one leg were evaluated before and after the exercise programs. Result: After 24 sessions of exercise programs, CEG increased more than FEG in sit-stand test scores between the groups (p=0.045). However, no significant difference was found between the two exercise groups in other physical and cognitive performance parameters (p>0.05). Wechsler short-term memory, sit-stand test scores and slalom captured object scores of both exercise groups were significantly higher than CG (p<0.01). ST correction number and dynamic balance mean path tracing error (ATE) decreased significantly in both exercise groups compared to CG (p<0.01). Eyes closed static ML velocity decreased significantly only in FEG compared to CG (p=0.033). When in-group pre- and post-tests were compared, sit-to-stand (p=0.001), static balance on one leg (p=0.044), Wechsler short-term memory performance (p=0.001) and number of objects caught in slalom (p=0.001) scores increased significantly in both exercise groups. Moreover, ATE (p=0.001), number of ST corrections (p=0.001) and duration (p=0.031) were significantly decreased only in the exercise groups. For CG, no significant difference was found in physical and cognitive test parameters in pre and post-tests (p>0.05). Conclusion: In the study, only the sit-to-stand test score was found to be higher in CEG than in FEG, suggesting that while the elderly participants performed cognitive and physical exercises simultaneously, the speed of movements slowed down during squat-like exercises and the lower extremity muscles contracted for a longer period of time, resulting in an increase in strength. The similar increase in functional lower extremity strength, balance and cognitive test parameters of FEG and CEG in the elderly shows the importance of physical and cognitive exercises in the aging process. In this study, it was shown that physical and cognitive exercise programs applied simultaneously in the elderly had similar effects as classical physical exercise programs. These results showed that uncomplicated classical physical exercise programs are sufficient to maintain strength, balance and cognitive performance during healthy aging.
Purpose:It is known that physical and cognitive skills decrease with aging. Balance performance, provided by the coordination of sensory, nervous and musculoskeletal systems, begins to deteriorate with aging. Therefore, this aim of the study was to evaluate the effect of physical exercises and combined exercises (physical, cognitive) on balance and cognitive functions in the elderly. Material and Method: In this study, 45 participants aged 65-85 years, at least primary school graduates and able to perform activities of daily living independently (mean age: 71.76±5.49; height: 159.6± 7.85; weight: 73.01± 8.65; BMI: 28.81± 4.09) were included. In this study, there were 3 separate groups consisting of 15 participants each: physical exercise group (FEG), combined exercise (CEG: physical and cognitive exercise) group and control group (CG). Exercise programs were applied 3 days a week for a total of 24 sessions for 2 months. In order to evaluate the effectiveness of the exercise programs, cognitive tests (stroop test (ST), pointing test (İT), Weschler visual production subtest), biped static and dynamic (monoaxial: anterio-posterio proprioception, slalom and multiaxial dynamic balance tests) balance tests with stabiometer, 30 seconds sit and stand test and standing time on one leg were evaluated before and after the exercise programs. Result: After 24 sessions of exercise programs, CEG increased more than FEG in sit-stand test scores between the groups (p=0.045). However, no significant difference was found between the two exercise groups in other physical and cognitive performance parameters (p>0.05). Wechsler short-term memory, sit-stand test scores and slalom captured object scores of both exercise groups were significantly higher than CG (p<0.01). ST correction number and dynamic balance mean path tracing error (ATE) decreased significantly in both exercise groups compared to CG (p<0.01). Eyes closed static ML velocity decreased significantly only in FEG compared to CG (p=0.033). When in-group pre- and post-tests were compared, sit-to-stand (p=0.001), static balance on one leg (p=0.044), Wechsler short-term memory performance (p=0.001) and number of objects caught in slalom (p=0.001) scores increased significantly in both exercise groups. Moreover, ATE (p=0.001), number of ST corrections (p=0.001) and duration (p=0.031) were significantly decreased only in the exercise groups. For CG, no significant difference was found in physical and cognitive test parameters in pre and post-tests (p>0.05). Conclusion: In the study, only the sit-to-stand test score was found to be higher in CEG than in FEG, suggesting that while the elderly participants performed cognitive and physical exercises simultaneously, the speed of movements slowed down during squat-like exercises and the lower extremity muscles contracted for a longer period of time, resulting in an increase in strength. The similar increase in functional lower extremity strength, balance and cognitive test parameters of FEG and CEG in the elderly shows the importance of physical and cognitive exercises in the aging process. In this study, it was shown that physical and cognitive exercise programs applied simultaneously in the elderly had similar effects as classical physical exercise programs. These results showed that uncomplicated classical physical exercise programs are sufficient to maintain strength, balance and cognitive performance during healthy aging.