Physical Therapy Korea (한국전문물리치료학회지)

Korean Research Society of Physical Therapy (한국전문물리치료학회)
권호 표지
DOI QR코드

DOI QR Code

Relationship Between Lower-limb Strength and Y-balance Test in Elderly Women

  • Eun-hye Kim (Department of Physical Therapy, The Graduate School, Yonsei University) ;
  • Sung-hoon Jung (Department of Physical Therapy, Division of Health Science, Baekseok University) ;
  • Hwa-ik Yoo (Department of Physical Therapy, The Graduate School, Yonsei University) ;
  • Yun-jeong Baek (Department of Rehabilitation Medicine, Seoul National University Bundang Hospital) ;
  • Oh-yun Kwon (Kinetic Ergocise Based on Movement Analysis Laboratory)
  • Received : 2023.06.23
  • Accepted : 2023.07.31
  • Published : 2023.08.20
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Falls are a common and serious problem in the elderly population. Muscle strength and balance are important factors in the prevention of falls. The Y-balance test (YBT) is used to assess dynamic postural control and shows excellent test-retest reliability. However, no studies have examined the relationship between lower-limb strength and YBT scores in elderly women. Objects: This study aimed to examine the relationship between lower-limb strength and YBT scores in elderly women. Methods: Thirty community-dwelling elderly women participated in the study. Lower-limb strength including hip flexor, hip extensor, hip abductor (HAB), hip adductor (HAD), knee flexor, knee extensor, ankle dorsiflexor, and ankle plantar flexor (PF) muscles was examined using a smart KEMA strength sensor (KOREATECH Inc.), and the YBT was used to assess dynamic balance. Relationship between lower-limb strength and YBT was demonstrated using a Pearson's correlation coefficient. Results: HAB strength (r = 0.388, p < 0.05), HAD strength (r = 0.362, p < 0.05), and ankle PF strength (r = 0.391, p < 0.05) positively correlated with the YBT-anterior direction distance. Ankle PF strength was positively correlated with the YBT-posteromedial direction distance (r = 0.396, p < 0.05) and composite score (r = 0.376, p < 0.05). Conclusion: The results of this study suggest that HAB, HAD, and ankle PF strengths should be considered for dynamic postural control in elderly women.

Keywords

References

  1. Michael YL, Whitlock EP, Lin JS, Fu R, O'Connor EA, Gold R; US Preventive Services Task Force. Primary care-relevant interventions to prevent falling in older adults: a systematic evidence review for the U.S. Preventive Services Task Force. Ann Intern Med 2010;153(12):815-25.  https://doi.org/10.7326/0003-4819-153-12-201012210-00008
  2. Sipe CL, Ramey KD, Plisky PP, Taylor JD. Y-balance test: a valid and reliable assessment in older adults. J Aging Phys Act 2019;27(5):663-9.  https://doi.org/10.1123/japa.2018-0330
  3. Sartini M, Cristina ML, Spagnolo AM, Cremonesi P, Costaguta C, Monacelli F, et al. The epidemiology of domestic injurious falls in a community dwelling elderly population: an outgrowing economic burden. Eur J Public Health 2010;20(5):604-6.  https://doi.org/10.1093/eurpub/ckp165
  4. Keely Boyle K, Rachala S, Nodzo SR. Centers for Disease Control and Prevention 2017 guidelines for prevention of surgical site infections: review and relevant recommendations. Curr Rev Musculoskelet Med 2018;11(3):357-69.  https://doi.org/10.1007/s12178-018-9498-8
  5. Johansson J, Nordstrom A, Nordstrom P. Greater fall risk in elderly women than in men is associated with increased gait variability during multitasking. J Am Med Dir Assoc 2016;17(6):535-40.  https://doi.org/10.1016/j.jamda.2016.02.009
  6. Deandrea S, Lucenteforte E, Bravi F, Foschi R, La Vecchia C, Negri E. Risk factors for falls in community-dwelling older people: a systematic review and meta-analysis. Epidemiology 2010;21(5):658-68.  https://doi.org/10.1097/EDE.0b013e3181e89905
  7. Stevens JA, Corso PS, Finkelstein EA, Miller TR. The costs of fatal and non-fatal falls among older adults. Inj Prev 2006;12(5):290-5.  https://doi.org/10.1136/ip.2005.011015
  8. Tinetti ME, Kumar C. The patient who falls: "It's always a trade-off". JAMA 2010;303(3):258-66.  https://doi.org/10.1001/jama.2009.2024
  9. Orr R. Contribution of muscle weakness to postural instability in the elderly. A systematic review. Eur J Phys Rehabil Med 2010;46(2):183-220. 
  10. Low Choy NL, Brauer SG, Nitz JC. Age-related changes in strength and somatosensation during midlife: rationale for targeted preventive intervention programs. Ann N Y Acad Sci 2007;1114(1):180-93.  https://doi.org/10.1196/annals.1396.014
  11. Rubenstein LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing 2006;35 Suppl 2:ii37-41.  https://doi.org/10.1093/ageing/afl084
  12. Amor-Dorado JC, Barreira-Fernandez MP, Llorca J, Gonzalez-Gay MA. Oculographic, clinical test of sensory integration and balance and computerized dynamic posturography findings in patients with psoriatic arthritis. Otol Neurotol 2017;38(3):448-53.  https://doi.org/10.1097/MAO.0000000000001296
  13. Pardasaney PK, Latham NK, Jette AM, Wagenaar RC, Ni P, Slavin MD, et al. Sensitivity to change and responsiveness of four balance measures for community-dwelling older adults. Phys Ther 2012;92(3):388-97.  https://doi.org/10.2522/ptj.20100398
  14. Plisky PJ, Gorman PP, Butler RJ, Kiesel KB, Underwood FB, Elkins B. The reliability of an instrumented device for measuring components of the star excursion balance test. N Am J Sports Phys Ther 2009;4(2):92-9. 
  15. Wilson BR, Robertson KE, Burnham JM, Yonz MC, Ireland ML, Noehren B. The relationship between hip strength and the Y balance test. J Sport Rehabil 2018;27(5):445-50.  https://doi.org/10.1123/jsr.2016-0187
  16. DeJong AF, Mangum LC, Hertel J. Ultrasound imaging of the gluteal muscles during the Y-balance test in individuals with or without chronic ankle instability. J Athl Train 2020;55(1):49-57.  https://doi.org/10.4085/1062-6050-363-18
  17. Stockert B, Barakatt E. Test-retest reliability of the star excursion balance test in a geriatric population. J Geriatr Phys Ther 2005;28(3):116. 
  18. Leetun DT, Ireland ML, Willson JD, Ballantyne BT, Davis IM. Core stability measures as risk factors for lower extremity injury in athletes. Med Sci Sports Exerc 2004;36(6):926-34.  https://doi.org/10.1249/01.MSS.0000128145.75199.C3
  19. Nadler SF, Malanga GA, DePrince M, Stitik TP, Feinberg JH. The relationship between lower extremity injury, low back pain, and hip muscle strength in male and female collegiate athletes. Clin J Sport Med 2000;10(2):89-97.  https://doi.org/10.1097/00042752-200004000-00002
  20. Ahn SH, Kwon OY, Hwang UJ, Jung SH, Kim HA, Kim JH. The association between genu recurvatum angle and the strength of the hip and knee muscles in standing workers. Work 2020;66(1):173-81.  https://doi.org/10.3233/WOR-203161
  21. Kim HA, Hwang UJ, Jung SH, Ahn SH, Kim JH, Kwon OY. Comparison of shoulder strength in males with and without myofascial trigger points in the upper trapezius. Clin Biomech (Bristol, Avon) 2017;49:134-8.  https://doi.org/10.1016/j.clinbiomech.2017.09.001
  22. Drusini AG, Eleazer GP, Caiazzo M, Veronese E, Carrara N, Ranzato C, et al. One-leg standing balance and functional status in an elderly community-dwelling population in northeast Italy. Aging Clin Exp Res 2002;14(1):42-6.  https://doi.org/10.1007/BF03324416
  23. Park K, Yang M, Yoo T, Kim S. One-leg standing and y-balance test performance in elderly fallers and nonfallers. Top Geriatr Rehabil 2020;36(2):92-6.  https://doi.org/10.1097/TGR.0000000000000262
  24. Bouillon LE, Baker JL. Dynamic balance differences as measured by the star excursion balance test between adult-aged and middle-aged women. Sports Health 2011;3(5):466-9.  https://doi.org/10.1177/1941738111414127
  25. Lee DK, Kim GM, Ha SM, Oh JS. Correlation of the Y-balance test with lower-limb strength of adult women. J Phys Ther Sci 2014;26(5):641-3.  https://doi.org/10.1589/jpts.26.641
  26. Earl JE, Hertel J. Lower-extremity muscle activation during the star excursion balance tests. J Sport Rehabil 2001;10(2):93-104.  https://doi.org/10.1123/jsr.10.2.93
  27. Liaw MY, Chen CL, Pei YC, Leong CP, Lau YC. Comparison of the static and dynamic balance performance in young, middle-aged, and elderly healthy people. Chang Gung Med J 2009;32(3):297-304. 
  28. Khayambashi K, Ghoddosi N, Straub RK, Powers CM. Hip muscle strength predicts noncontact anterior cruciate ligament injury in male and female athletes: a prospective study. Am J Sports Med 2016;44(2):355-61.  https://doi.org/10.1177/0363546515616237
  29. Karagiannakis DN, Iatridou KI, Mandalidis DG. Ankle muscles activation and postural stability with Star Excursion Balance Test in healthy individuals. Hum Mov Sci 2020;69:102563. 
  30. Laughton CA, Slavin M, Katdare K, Nolan L, Bean JF, Kerrigan DC, et al. Aging, muscle activity, and balance control: physiologic changes associated with balance impairment. Gait Posture 2003;18(2):101-8.  https://doi.org/10.1016/S0966-6362(02)00200-X
  31. Tracy BL. Force control is impaired in the ankle plantarflexors of elderly adults. Eur J Appl Physiol 2007;101(5):629-36.  https://doi.org/10.1007/s00421-007-0538-0
  32. Hubbard TJ, Kramer LC, Denegar CR, Hertel J. Correlations among multiple measures of functional and mechanical instability in subjects with chronic ankle instability. J Athl Train 2007;42(3):361-6.  https://doi.org/10.3113/FAI.2007.0343
  33. Blankevoort CG, van Heuvelen MJ, Boersma F, Luning H, de Jong J, Scherder EJ. Review of effects of physical activity on strength, balance, mobility and ADL performance in elderly subjects with dementia. Dement Geriatr Cogn Disord 2010;30(5):392-402.  https://doi.org/10.1159/000321357
  34. Gribble PA, Hertel J, Denegar CR. Chronic ankle instability and fatigue create proximal joint alterations during performance of the Star Excursion Balance Test. Int J Sports Med 2007;28(3):236-42. https://doi.org/10.1055/s-2006-924289