European Journal of Physical Education and Sport Science
ISSN: 2501 - 1235
ISSN-L: 2501 - 1235
Available on-line at: www.oapub.org/edu
10.6084/m9.figshare.3382819
Volume 1│Issue 2│2016
THE IMPACT OF STABILITY RANGE EXERCISES ON
GAIT PARAMETER AND QUALITY OF LIFE
AMONG ACTIVE ELDER WOMEN
Mina Bikdeli1, Neda Ghadimi1,
Fatemeh Royatvand Ghiasvand2, Behnaz Ganji Samin3
MSc Sport Pathology, Karaj Branch, Islamic Azad University, Karaj, Iran
1
MSc Sport Biomechanics, Karaj Branch, Islamic Azad University, Karaj, Iran
2
Ph.D Sport Pathology, School of Physical Education and Sport Sciences,
3
Tehran University, Tehran, Iran
Abstract:
The purpose of this research is to discuss the impacts of stability range exercises on
certain gait parameters and quality of life among active elder women. The population of
this research includes 100 women aged between 61 and 88 years who inhabit in the
nursing home of Kahrizak, Karaj. Among the population, 40 individuals matched our
research criterions and consequently, these 40 were selected as the sample group. The
subjects’ age range was 61-88 years, also their height range was 139.5-160cms and their
weight range was 48-88 kilograms. The subjects of the experimental group were
administered 24 sessions of reformation exercises. In addition, the control group
performed morning exercises, under the supervision of the facility’s coach. The
collected statistical data were subjected to further analyses through the independent-t
and independent-t tests as well as the Kolmogorov-Smirnoff test for confirming the
normality of data distributions at the confidence level of P= 0.05. Results indicated that
stability range exercises are capable of increasing the lengths of both the left and right
paces significantly. The variables of life quality, pace speed, pace frequency, stance time
and swing time were significantly increased among the subjects of experimental group,
however compared to the control group; this increase was not statistically significant.
Keywords: stability range, kinematic parameters, gaiting, life quality, elder
Copyright © The Author(s). All Rights Reserved
Published by Open Access Publishing Group ©2015.
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AMONG ACTIVE ELDER WOMEN
Introduction
Population aging and rapid increase in the number of elders is a global phenomenon.
Recued birth rate and increased life expectancy have led to faster growth of the
population of elders compared to the growth rate of total population (Jadidi et al. 2011).
Since the population of a society’s elders is known as a fragile stratum, this population
is faced with a series of problems specific to their ages which, however by reforming the
life style is avoidable (Heidari and Shahbazi, 2012). In this context, a healthy life style is
a method of living which supports the supplication, maintenance and promotion of the
general health level as well as improving the life quality of an individual (Hekmatpoor
et al, 2014). In addition, the global organization of health considers life quality as an
individual’s perception of his or her life, values, goals, standards and interests.
Furthermore, in recent years the implication of the concept of life quality has
been identified as an important index for evaluation of personal decision making health
and judgment about society’s general health in addition to finding core problems in
medical and nursing researches (Hekmatpoor et al. 2014; jafarzadeh et al. 2010). A
category which can have significant impacts on individuals’ life quality, especially the
elders, is the ability for performance of daily activities which requires moving the body
while maintaining control and balance. An example of these activities is gaiting
(walking). The ability and quality of gaiting significantly diminishes during the elderly
ages and on the other hand, the reduction of the former and the latter may result in
disorders including shorter pace lengths or even interruption of the normal gaiting
pattern. Ultimately, this disorder can provide the context for injuries which are caused
by losing control or falling down. (Sadeghi et al, 2013). Falling down is one of the major
causes of death among elders in a way that, annually more than 11 thousand people
around the world die as a result of falling down. Nowadays, the spread of falling down
among elders has turned into a major health threat for them. 35 to 45 percent of people
aged over 65, experience falling down at least once a year (Azim Zadeh et al. 2014). In
addition, buy the growth of age, not only the occurrence of falling down increases, but
also the severities of injuries also increase (D. R. Daniel, 2011). Among the serious
injuries caused by falling down, it can be referred to femoral fractures, subdural
hemorrhage and hematoma, bruising, sprain of joints, stretch marks, death,
psychological effects, fear of falling in 20% of patients, loss of confidence and
performance limitations (Hasani et al. 2011).
Studies have revealed that administration of exercises can significantly impede
the process of losing balance and other physical fitness factors among elders.
Administration of exercises, especially balance exercises increase the postural control
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Neda Ghadimi, Mina Bikdeli, Fatemeh Royatvand Ghiasvand, Behnaz Ganji Samin, Elham Shirzad THE IMPACT OF STABILITY RANGE EXERCISES ON GAIT PARAMETER AND QUALITY OF LIFE
AMONG ACTIVE ELDER WOMEN
among elders and therefore, provides the contexts for avoiding certain serious injuries
some of which may even result in death of elders. On this basis, performance of sports
exercises is necessarily crucial for this stratum. One of the goals of such exercises can be
the improvement of elders’ gaiting pattern which results from muscular abilities such as
strength, endurance and flexibility. On the other hand, ability for controlling the body
while moving and gaiting can have a beneficial effect (Sadeghi et al. 2013).
Since during the elderly ages the rates of compensatory postural responses to
disturbances falls, the elder will have less ability for compensating this disturbance and
keeping control over the body. Therefore, improvement of the so-called compensatory
responses can help with reducing the risk of falling down. Previous studies have
indicated that balance and endurance exercises can lead to improvement of strength
and balance and reduce the risk of falling down. However, nowadays it is believed that
these exercises are not merely sufficient for improvement of balance specific
neuromuscular compatibilities (Granacher et al, 2011). Because the so-called
compensatory responses which are activated due to external disturbances are not under
the direct control and that there are different ways of neutrally controlling them
through voluntarily moves, therefore usual and traditional balance exercises which are
focused on voluntarily control of steps, will not improve these so-called compensatory
responses (Shapiro et al, 2010).
On this basis, the present study is aimed at development of a compatibility
between systems and control postural control through administration of specific
balance exercises aimed at displacement of the center of gravity in an individual’s range
of stability through formation of a disturbance in neuromuscular system in an eight
weeks length of time. The aforementioned compatibility can have impacts on the
pattern of gaiting and consequently on life quality.
Therefore with respect to the fact that balance, life quality and kinematics of
gaiting change during the elderly ages, the researcher of this article ran into the
question that if administration of specific balance exercises which are designed aimed at
displacement of the gravity center in an individual’s stability range can lead to
adaptability of systems and Postural control through forming a disturbance in the
neuromuscular system within an 8 weeks length of time?
Methods
This research is performed in a semi-experimental and the design of the research
included a pre-test, a post-test and a control group. The population included 100 elder
women aged between 61 and 88 who inhabited in the nursing home of Karaj, Kahrizak.
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AMONG ACTIVE ELDER WOMEN
40 individuals were identified as a match with research criterions and therefore, these
40 were selected as the sample group of the research. Upon signing the terms of
experiments and the questionnaires regarding life quality, the sample was divided into
two groups of experimental (n= 15) and control (n= 15). The entire subjects had a
previous experience of participating in morning exercises of the facility. The
aforementioned healthy active elder women who aged between 61 and 88, mad
presences at the facility for three times a week and for the length of eight weeks. The
experimental group was administered with a certain protocol of stability range
exercises under the supervision of the researcher and also, the experimental group
participated in morning exercises of the facility under supervision of a coach (the
exercises given to the control group lacked the specific exercises of stability range
exercises).
For the purpose of measurement the demographic information form and the
testimonials signed by the subjects (the testimonial form was concerned with
information about the method of exercising and video capturing in pre and post-test
situations) as well as subjects’ medical information forms (this form includes the
criterions of exclusion from research including diabetes, mental and psychological
problems, blood pressure, dizziness, having severe deformities at under body parts,
severe joint issues, cardinal problems and severe aspiratory problems, addiction to
drugs or painkillers, severe vision problems and hearing issues, surgery record during
the last year and etc.) and the pretest and posttest information collection forms (health
status, pace length, pace speed, pace frequency, pace swing time and pace stance time).
On the other hand, another tool for data collection which was used in this
research was the SF-36 questionnaire. This self-reporting is mainly used for discussion
of health and life quality. This questionnaire is developed by Ware and Sherburne and
includes 36 elements in terms of 8 contexts of physical performance, performance
restriction related to physical health, performance restriction related to mental health,
energy and fatigue, feeling of being good, social performance, pain and general health.
The collected statistical data were subjected to further analyses with the independent
and dependent t tests and also for assuring the normality of data distributions, the
Kolmogorov-Smirnoff test was applied at a confidence level of P= 0.05.
Findings
Table 1, indicates the descriptive data related to the personal characteristics of the
subjects such as height, weight and age for both the experimental and control group.
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AMONG ACTIVE ELDER WOMEN
Table 1: The descriptive data related to the personal characteristics of the subjects for both the
experimental and control group
Height (cm)
151.70±6.32
150.20±4.00
Weight (Kg)
72.16±9.67
65.50±11.85
Age (year)
70.20±7.91
69.53±5.93
group
experimental
control
Hypothesis testing
First hypothesis
Null hypothesis: a single period of stability range exercises does not have an impact on
the life quality of active elder women.
Table 2: Results of correlated t-test for comparison of posttest and pretest levels of life quality
among the groups
Post-test and preChanges level
Post-test
Pre-test
test comparison
t14 = 4.505,
1200±10.32
70.33±18.75
58.33±23.11
sig = 0.000*
t14 = 6.077,
14.67±9.35
74.67±18.06
60.00±19.36
sig = 0.000*
t14 = 2.820,
13.33±31.15
65.00±47.68
51.66±47.68
sig = 0.014*
t14 = 2.882,
30.00±40.31
70.00±41.40
4.00±44.11
sig = 0.012*
t14 = 2.476,
28.89±45.19
88.88±29.99
59.99±47.68
sig = 0.027*
t14 = 2.823,
33.11±45.43
86.44±30.77
53.33±51.64
sig = 0.014*
t14 = 4.183,
11.16±10.80
76.00±17.34
64.33±22.90
sig = 0.001*
t14 = 5.325,
17.00±12.36
75.67±18.16
56.67±17.18
sig = 0.000*
t14 = 2.869,
18.27±11.15
82.40±16.54
64.13±23.80
sig = 0.012*
t14 = 4.955,
21.33±16.68
75.20±20.35
53.87±14.33
sig = 0.000*
t14 = 2.314,
15.83±26.50
86.66±11.68
70.83±27.00
sig = 0.036*
t14 = 3.995,
17.67±17.12
78.33±20.30
60.67±2019
sig = 0.001*
t14 = 3.254,
19.00±22.61
67.67±24.41
48.33±27.64
sig = 0.006*
t14 = 2.467,
10.33±16.22
56.17±17.56
45.83±19.83
sig = 0.027*
t14 = 3.205,
13.33±16.11
78.00±21.3
64.66±20.57
sig = 0.006*
t14 = 3.007,
11.00±14.17
72.33±18.31
61.33±1445
sig = 0.009*
t14 = 4.616,
16.46±12.48
76.83±15.05
61.53±21.63
sig = 0.000*
t14 = 6.321,
19.39±11.88
73.35±16.72
53.69±19.38
sig = 0.000*
*a significant difference between pre-test and post-test in the same group( P < 0.05
Group
experimental
Control
experimental
Control
experimental
Control
experimental
Control
experimental
Control
experimental
Control
variable
Physical
performance
performance
restriction related
to physical health
performance
restriction related
to mental health
Energy and
fatigue
Feeling of being
good
Social
performance
experimental
pain
Control
experimental
General health
Control
experimental
Control
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Sum of life
quality
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AMONG ACTIVE ELDER WOMEN
Results of the correlated t-test for making a comparison between post-test and pre-test
values of physical performance, performance restriction related to physical health,
performance restriction related to mental health, energy and fatigue, a feeling of being
good, social performance and pain and general health and quality of life for control and
experimental groups indicated that in all variables and for both the control and
experimental groups, there exists a significant difference between the pre-test and posttest results. However, the results of implementing the independent t-test for making
comparison between the changes of physical performance, performance restriction
related to physical health, performance restriction related to mental health, energy and
fatigue, a feeling of being good, social performance and pain and general health and
quality of life, did not reveal any significant difference between the control and
experimental groups. Therefore, it can be stated that the stability range exercises are not
impactful on the quality of life among active elder women.
Second hypothesis
Null hypothesis: one period of stability range exercises does not have any influence on
pace length profile and right and left step lengths in right and left paces of active elder
women.
Results of the correlated t-test for making a comparison between the changes of
right and left pace lengths and the length of the left step in right pace and the length of
the right step in both left and right paces of both the experimental and control groups
are summarized in table 3.
Table 3: Results of the correlated t-test for making a comparison between the changes of right
and left pace lengths and the length of the left step in right pace and the length
changes
Independent t-test results
t 14 = -0.686, Sig = 0.504
t 14 = 0.483, Sig = 0.636
Left pace
0.055±0.038
0.031±0.015
Right pace
0.052±0.043
0.026±0.028
t 14 = -0.790, Sig = 0.443
0.024±0.031
0.026±0.024
Compared variables
Left and right paces’ length
Length of left step in right pace
Length of the right step in left
and right paces
With respect to the obtained results, it can be interpreted that stability range exercises
significantly increased both pace lengths. On the other hand, these exercises have
significantly increased the lengths of both and left steps in both the left and right paces.
However, the effect of the aforementioned exercises on the length of right and
left paces and the left and right steps of each pace is not different and the effect of the
exercises is equally significant and increasing for both paces.
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AMONG ACTIVE ELDER WOMEN
Third hypothesis
Null hypothesis: one period of stability range exercises does not have any influence on
pace speed among active elder women.
Results of the correlated t-test for comparing the changes of speed of both the left
and right paces of both the experimental and control groups are summarized in table 4.
Table 4: Results of the correlated t-test for comparing the changes of speed of both the left and
right paces of both the experimental and control groups
changes
Independent t-test results
t 14 = 0.613, Sig = 0.550
Left pace
Right pace
0.027±0.022
0.028±0.021
Compared variables
Pace speed in left and right
paces
With respect to the results it can be inferred that the effect of stability range exercises
have not made a significant change in the pace speed in left and right paces and that the
effect was equal for both paces.
Fourth hypothesis
Null hypothesis: one period of stability range exercises does not have any influence on
gaiting frequency among active elder women.
Results of the correlated t-test for comparing the changes in frequency of both
the left and right paces of both the experimental and control groups are summarized in
table 5.
Table 5: Results of the correlated t-test for comparing the changes in frequency of both the left
and right paces of both the experimental and control groups
changes
Independent t-test results
Left pace
Right pace
t 14 = 1.089, Sig = 0.295
24.51 ±14.35
23.63 ±16.15
Compared variables
Pace frequency in left and right
paces
With respect to the results it can be inferred that the effect of stability range exercises
have not made a significant change in the pace frequency in left and right paces and
that the effect was equal for both paces.
Fifth hypothesis
Null hypothesis: one period of stability range exercises does not have any influence on
swing time of one gaiting cycle among active elder women.
Results of the correlated t-test for comparing the changes in swing time of one
gaiting cycle of both the experimental and control groups are summarized in table 6.
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AMONG ACTIVE ELDER WOMEN
Table 6: Results of the correlated t-test for comparing the changes in swing time of one gaiting
cycle of both the experimental and control groups
changes
Independent t-test results
t 14 = -0.071, Sig = 0.944
Left pace
0.537±2.34
Right pace
0481±2.619
Compared variables
Left and right pace swing time
With respect to the results, it can be inferred that the effect of stability range exercises
have not made a significant change in the swing time of one gaiting cycle in left and
right paces and that the effect was equal for both paces.
Sixth hypothesis
Null hypothesis: one period of stability range exercises does not have any influence on
stance time of one gaiting cycle among active elder women.
Results of the correlated t-test for comparing the changes in stance time of one
gaiting cycle of both the experimental and control groups are summarized in table 7.
Table 7: Results of the correlated t-test for comparing the changes in stance time of one gaiting
cycle of both the experimental and control groups
changes
Results of the independent t-test
t 14 = 0.071, Sig = 0.944
Left pace
Right pace
0.537±2.34
-0481±2.619
Compared variables
Stance time of right and left
paces
With respect to the results it can be inferred that the effect of stability range exercises
have not made a significant change in the stance time of one gaiting cycle in left and
right paces and that the effect was equal for both paces.
Discussion and Conclusions
With respect to the results obtained from the present research, it can be concluded that:
Despite of the type, sports exercises have a significant and beneficial effect on the
quality of life of elders. During the elderly ages, the pace length reduces and an element
which is crucial in this phenomenon, is a reduction is muscular strength. Reduced pace
length as a result of age can be in fact the consequence of firmness of muscles, reduced
ability of muscles of knee, reduced movement range for hip rotation, hip rotation,
flexion and pelvis extension, limitation of motion in the pelvis muscle-skeletal, joint
sedentary and weak muscles.
Possible reasons for improved pace and step lengths:
a) Effect of exercises on the body and under body parts result in strengthening of
the core muscles;
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AMONG ACTIVE ELDER WOMEN
b) Improved performance in under body parts;
c) Improved movement range, improved flexibility and improved strength of leg
muscles.
The aforementioned exercises lead in increased pace length equally for both legs and
also helps avoiding and treating certain gaiting disorders among elders which are
resulted from lack of symmetry in pace lengths. Therefore, perturbation balance
exercises can be used for especially increasing the length of pace and steps.
Stability range exercises significantly increase the length of both paces. On the
other hand, the aforementioned exercises significantly increase the length of both the
left and right steps. However, the effects of these exercises are equally for both steps
and the aforementioned exercises have an equal, significant and increasing effect on
both paces. In other words, these exercises lead to a symmetrical increase in pace length
and therefore, these exercises could be utilized for improving and increasing the pace
length among 61-88 year old women.
Reduction of speed of taking steps during gaiting is due to their reduced levels
of strength. This reduction is a sign of a muscular weakness in under body parts,
flection in hip muscles, and flexibility of the hip joint and the vertical force of the
ground. Increasing the length of speed and obtaining a faster gaiting rhythm can lead to
increased gait speed.
Results indicate the effects of perturbation balance exercises on improvement of
pace frequency and pace speed in both left and right steps of elder women in both
groups. In addition, none of the aforementioned exercise protocols were prioritized
over each other. The exercises administered by the researcher were not aimed at
improving the contraction speed and muscular-strength. Therefore, one of the reasons
for constancy in pace cycle may be that the pace of contraction and muscular strength
have not been changed.
Reduced movement in under body joints, results in shortening of gait swing
phase. Therefore, these people spend a large time of their gait cycle at the double
support phase. A possible reason for these changes lies in neuromuscular changes due
to aging. However, this research has pointed that increased pace length increases the
float time. But the findings of other researchers have shown just the opposite and the
most crucial reason for this lack of consistency may lie in difference in the manner of
imposing the disturbance on the individual. For improving the gait cycle, it is important
to consider for reduction of stance time and increasing the swing time and closure of
the aforementioned times to a normal state. In this research, the stability range exercises
were unable to leave a significant impact.
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AMONG ACTIVE ELDER WOMEN
With respect to the fact that there exists a reverse relation between gait speed and the
length of the deployment phase, a reason which is seemingly the cause of prevention of
changes in stance phases and gait frequency, as it was mentioned earlier; could be
resulted from restriction of performance of balance exercises for elders.
References
1. Azim zadeh, elham, Aslankhani, MA, shojaei, M, Salvati, Mahyar. (2014). the
impact of exercise balance disorders and other disorders static and dynamic
balance in elderly women. Motor Behavior, 13, 108-95.
2. De Noronha Ribeiro Daniel F, de souza Vale RG, Giani TS,et al. (2011).
Correlation between static balance and functional autonomy in elderly women.
Arch Gerontal Geriater. 52(1):111-4.
3. Granacher, U., Muehlbauer T., Zahner, L., Golhofer, A., Kressing, RW. (2011).
Comparison of traditional and recent approaches in the promotion of balance
and strength in older adults. Sports Medicine. 1, 41(5). 377-400.
4. Hassani Mehraban A, Mackenzie M, Byles J. (2011). A self-report home
environment screening tool identified older women at risk of falls. Journal of
Clinical Epidemiology. 64:191-9.
5. Heidari M, Shahbazi S. (2012) Effect of Self-Care Training Program on Quality of
Life of Elders. Iran Journal of Nursing. 25(75): 1-8.
6. Hekmatpoor, Davoodd, Shamsi, M., Zamani, Majid. (2014). the effect on the
quality of life of elderly healthy lifestyle education programs in Arak. Journal of
Medical Sciences, Vol. 16, No. 3 (serial number 72), 11-1.
7. Jadidi, Ali, Farahaninia M, M, Jan Mohammad, Sarah, Haqqani, Hamid. (2012).
The relationship between spiritual health and quality of life of elderly residents
of Kahrizak Charity Foundation. Iran Journal of Nursing, Volume 24, Number
72, 56-48.
8. Sadeghi, Heydar, Yadegari poor, Mohammad, Ghasempour, Hamid, Shojaedin,
Sadr al-Din. (2013). the effect of eight weeks of training, a combination of water land on lower limb strength and walking speed in older men. Journal of Aging,
Vol. 7, No. 27, 66-59.
9. Shapiro, A. and Melzer I. (2010). Balance perturbation system to improve balance
compensatory
responses
during
walking
in
old
persons.
Journal
of
neuroengineering and rehabilitation. 7:32.
European Journal of Physical Education and Sport Science - Volume 1 │ Issue 2 │ 2016
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