Abstract
Background & Objectives: Falling is one of the most common geriatric syndromes, threatening the independence of older people. One of the most effective fall prevention strategies is strengthening exercises, along with balance training. Exercise in older people prevents disease, poor performance, and cognitive decline. It also improves motor performance in older people with physical disorders. In recent years, with advances in science and technology and new sports methods, including electrical muscle stimulation, high–intensity training programs have been developed for older adults, which have been associated with increased strength and resistance. The favorable effect of local muscle stimulation on muscle–neural parameters has already been seen in athletes. Some researchers demonstrated the positive effects of electrical muscle stimulation on muscle strength and dynamic balance in postmenopausal women. The present study investigated the effect of electrical muscle stimulation on dynamic balance and fear of falling in 65– to 70–year–old women.
Methods: The current study was quasi–experimental, with a pretest and posttest and two training and control groups. The statistical population of this research comprised older women aged 65 to 70 years living in Mashhad City, Iran. From this community, 20 older women voluntarily, in line with the study's objectives, entered the study in a purposeful and accessible manner. Participants were randomly assigned to two groups: electrical muscle stimulation and a control group. The inclusion criteria for participation in the study were as follows: participants' informed consent; absence of diseases such as epilepsy, cancer, cardiovascular disorders, and psychiatric illnesses; no history of neurological conditions such as Alzheimer disease or Parkinson disease; and not receiving pharmacological interventions during the course of the study. The exclusion criteria included withdrawal from the sessions, absence from more than 2 sessions, and inadequate physical condition to complete the intervention period. To collect data, the Falls Efficacy Scale–International (FES–I) (Yardley et al., 2005) and dynamic balance tests, including the Timed Up and Go (TUG) (Mathias et al., 1986) and Fullerton Advanced Balance Scale (FAB) (Rose et al., 2006), were used in the pretest and posttest phases. Electrical stimulation exercises were performed for 8 weeks, with two 20–minute sessions per week in the training group. This training course was conducted in three phases: adaptation (2 weeks), initial training (2 weeks), and main training (4 weeks). The control group did not receive any intervention during this period. Ethical considerations observed in the study included voluntary participation of members in program meetings, completion of questionnaires willingly by members, appropriate planning for conducting meetings, confidentiality of information and names of individuals, and obtaining written consent from research participants. Data analysis was performed at two levels: descriptive (mean and standard deviation) and inferential (analysis of covariance). Also, an independent t test was used to compare the training and control groups on demographic variables (age, height, and weight). All data were analyzed in SPSS statistical software version 24. The significance level for all statistical tests was set at α=0.05.
Results: The findings showed that electrical muscle stimulation exercises had a significant effect on improving the dynamic balance (Fullerton Advanced Balance Scale) (p<0.001) and dynamic balance (TUG test) (p=0.025) of the older people. Also, the findings showed that the electrical muscle stimulation exercises had no significant effect on older people's fear of falling (p=0.081).
Conclusion: According to the findings, electrical stimulation of muscles is effective for dynamic balance in older women aged 65 to 70, but it did not significantly reduce their fear of falling. It is suggested that trainers and counselors use electrical muscle stimulation as a safe and effective method to improve dynamic balance in older women.
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