ÖZET

Amaç:

Bu çalışmada postmenopozal kadınlarda proprioseptif nöromusküler fasilitasyon ve Frenkel egzersizlerinin denge, düşme riski ve yaşam kalitesi üzerine etkinliğinin araştırılması amaçlanmıştır.

Gereç ve Yöntem:

Kırk sekiz postmenopozal kadın proprioseptif nöromusküler fasilitasyon (n=24) ve Frenkel (n=24) (ev egzersiz programı şeklinde) egzersiz gruplarına randomize edildiler. Tüm katılımcıların çalışma öncesi ve çalışma sonrası 4. haftada el sıkma kas gücü, yaşam kalitesi, düşme riski ve denge (fonksiyonel uzanma testi, tek ayak üzerinde durma testi, timed up and go testi ve Berg denge testi) değerlendirmeleri yapıldı.

Bulgular:

Proprioseptif nöromusküler fasilitasyon grubunda tüm değerlendirme parametrelerinde anlamlı şekilde gelişme elde edildi (p<0,05). Frenkel grubunda, tek ayak üzerinde durma testi (p=0,064) ve kısa form-36 mental sağlık skoru (p=0,057) dışında tüm değerlendirme parametrelerinde anlamlı bir gelişme elde edildi (p<0,05). Gruplar arası karşılaştırmalarda ise el sıkma kas gücü, fonksiyonel uzanma testi ve timed up and go testi skorlarında iki grup arasında anlamlı bir fark olmadığı görüldü (p>0,05).

Sonuç:

Proprioseptif nöromusküler fasilitasyon ve Frenkel egzersizlerinin postmenopozal kadınlarda denge parametreleri, düşme riski ve yaşam kalitesi üzerine önemli etkileri olmuştur. Frenkel egzersiz programı daha ucuzdur ve daha az insan gücü gerektirir, bu nedenle postmenopozal kadınlarda dengenin iyileştirilmesi ve düşme riskinin azaltılması açısından daha tercih edilebilir olabileceğini düşünüyoruz.

References

Young KJ, Je CW, Hwa ST. Effect of proprioceptive neuromuscular facilitation integration pattern and swiss ball training on pain and balance in elderly patients with chronic back pain. J Phys Ther Sci 2015;27:3237-40.

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

Wolfson L, Whipple R, Derby CA, Amerman P, Murphy T, Tobin JN, et al. A dynamic posturography study of balance in healthy elderly. Neurology 1992;42:2069-75.

Rodrigues Barral AB, Nahas EA, Nahas-Neto J, Cangussu LM, Buttros Dde A. Effect of hormone therapy on postural balance in postmenopausal women. Menopause 2012;19:768-75.

Shepherd JE. Effects of estrogen on cognition, mood, and degenerative brain diseases. J Am Pharm Assoc (Wash) 2001;41:221-8.

Lowe DA, Baltgalvis KA, Greising SM. Mechanisms behind estrogen‟s beneficial effect on muscle strength in females. Exerc Sport Sci Rev 2010;38:61-7.

Cangussu LM, Nahas-Neto J, Petri Nahas EA, Rodrigues Barral AB, Buttros Dde A, Uemura G, et al. Evaluation of postural balance in postmenopausal women and its relationship with bone mineral density--a cross sectional study. BMC Musculoskelet Disord 2012;16:13:2.

Seo K, Park SH, Park K. The effects of stair gait training using proprioceptive neuromuscular facilitation on stroke patient’s dynamic balance ability. J Phys Ther Sci 2015;27:1459-62.

Afrasiabifar A, Karami F, Najafi Doulatabad S. Comparing the effect of Cawthorne-Cooksey and Frenkel exercises on balance in patients with multiple sclerosis: a randomized controlled trial. Clin Rehabil 2018;32:57-65.

Marsden J, Harris C. Cerebellar ataxia: pathophysiology and rehabilitation. Clin Rehabil 2011;25:195-216.

Hita-Contreras F, Martínez-Amat A, Cruz-Díaz D, Pérez-López FR. Fall prevention in postmenopausal women: the role of Pilates exercise training. Climacteric 2016;19:229-33.

Sucuoglu H, Tuzun S, Akbaba YA, Uludag M, Gokpinar HH. Effect of Whole-Body Vibration on Balance Using Posturography and Balance Tests in Postmenopausal Women. Am J Phys Med Rehabil 2015;94:499-507.

von Stengel S, Kemmler W, Engelke K, Kalender WA. Effects of whole body vibration on bone mineral density and falls: results of the randomized controlled ELVIS study with postmenopausal women. Osteoporos Int 2011;22:317-25.

Pluchino A, Lee SY, Asfour S, Roos BA, Signorile JF. Pilot study comparing changes in postural control after training using a video game balance board program and 2 standard activity-based balance intervention programs. Arch Phys Med Rehabil 2012;93:1138-46.

Russell MA, Hill KD, Blackberry I, Day LM, Dharmage SC. The reliability and predictive accuracy of the falls risk for older people in the community assessment (FROP-Com) tool. Age Ageing 2008;37:634-9.

Kılınç M, Avcu F, Onursal O, Ayvat E, Savcun Demirci C, Aksu Yildirim S. The effects of Bobath-based trunk exercises on trunk control , functional capacity , balance , and gait: a pilot randomized controlled trial. Top Stroke Rehabil 2016;23:50-8.

Jonsson E, Seiger Å, Hirschfeld H. One-leg stance in healthy young and elderly adults: A measure of postural steadiness? Clin Biomech (Bristol, Avon) 2004;19:688-94.

Barry E, Galvin R, Keogh C, Horgan F, Fahey T. Is the Timed Up and Go test a useful predictor of risk of falls in community dwelling older adults: A systematic review and meta- analysis. BMC Geriatr 2014;14:14.

Blum L, Korner-Bitensky N. Usefulness of the Berg Balance Scale in Stroke Rehabilitation: A Systematic Review. Phys Ther 2008;88:559-66.

Neumann S, Kwisda S, Krettek C, Gaulke R. Comparison of the grip strength using the martin-vigorimeter and the JAMAR-dynamometer: Establishment of normal values. In Vivo 2017;31:917-24.

Strand CV, Russell AS . WHO/ILAR Taskforce on quality of life. J Rheumatol 1997;24:1630-2.

Lord SR, Sambrook PN, Gilbert C, Kelly PJ, Nguyen T, Webster IW, et al. Postural stability, falls and fractures in the elderly: results from Dubbo osteoporosis epidemiology study. Med J Aust 1994;160:684-91.

Cilento MBR, Nóbrega ACL, Araújo AQC. Evaluation of the efficacy of training protocols of the sit-to stand activity in elderly women. Fisioter Bras 2005;6:412-8.

Kim Y, Kim E, Gong W. The effects of trunk stability exercise using PNF on the functional reach test and muscle activities of stroke patients. J Phys Ther Sci 2011;23:699-702.

Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther 2000;80:896-903.

Mesquita LS, de Carvalho FT, Freire LS, Neto OP, Zângaro RA. Effects of two exercise protocols on postural balance of elderly women: A randomized controlled trial. BMC Geriatr 2015;15:1-9.

Seo KC, Kim HA. The effects of ramp gait exercise with PNF on stroke patients’ dynamic balance. J Phys Ther Sci 2015;27:1747-9.

Rojhani-Shirazi Z, Barzintaj F, Salimifard MR. Comparison the effects of two types of therapeutic exercises Frenkele vs. Swiss ball on the clinical balance measures in patients with type II diabetic neuropathy. Diabetes Metab Syndr 2017;11:29-32.

Bohannon RW, Magasi SR, Bubela DJ, Wang YC, Gershon RC. Grip and Knee Extension Muscle Strength Reflect a Common Construct among Adults. Muscle Nerve 2012;46:555-8.

Teixeira de Carvalho F, de Andrade Mesquita LS, Pereira R, Neto OP, Amaro Zangaro R. Pilates and Proprioceptive Neuromuscular Facilitation Methods Induce Similar Strength Gains but Different Neuromuscular Adaptations in Elderly Women. Exp Aging Res 2017;43:440-52.

Ko EJ, Chun MH, Kim DY, Kang Y, Lee SK, Yi JH, et al. Frenkel’s exercise on lower limb sensation and balance in subacute ischemic stroke patients with impaired proprioception. Neurology Asia 2018;23:217-24.

Park KY, Seo KC. The effects on the pain index and lumbar flexibility of obese patients with low back pain after PNF scapular and PNF pelvic patterns. J Phys Ther Sci 2014;26:1571-4.

Postmenopozal Kadınlarda Denge Egzersizlerinin Denge, Düşme Riski ve Yaşam Kalitesi Üzerine Etkisi

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References