Kang Shuho, Park Ilbong
Department of Sports Rehabilitation, Busan University of Foreign Studies, Busan 46234, Republic of Korea.
J Funct Morphol Kinesiol. 2024 Mar 13;9(1):50. doi: 10.3390/jfmk9010050.
The reflexive responses to resist external forces and maintain posture result from the coordination between the vestibular system, muscle, tendon, and joint proprioceptors, and vision. Aging deteriorates these crucial functions, increasing the risk of falls. This study aimed to verify whether a training program with water bags, an Instability Neuromuscular training (INT) using the inertial load of water, could positively impact balance ability and dynamic stability. This study was conducted with twenty-two healthy older women aged ≥ 65 (mean age: 74.82 ± 7.00 years, height: 154.20 ± 5.49 cm, weight: 55.84 ± 7.46 kg, BMI: 23.55 ± 3.58 kg/m). The participants were randomly allocated into two groups: a group that used water bags and a control group performing bodyweight exercises. The intervention training lasted 12 weeks, with 2 sessions per week totaling 24 sessions, each lasting 60 min. The pre- and post-tests were compared using -tests to examine within- and-between-group differences. The effect size was examined based on the interaction between group and time using a two-way repeated measures ANOVA. The Modified Timed Up and Go manual (TUG manual), Sharpened Romberg Test (SRT), and Y-balance test (YBT) were conducted to assess dynamic stability, including gait function, static stability, and reactive ability. In comparison between groups, the waterbag training group showed a decrease in task completion time associated with an increase in walking speed in the TUG manual test ( < 0.05), and an increase in static stability and reaction time in the Sharpened Romberg test with eyes closed ( < 0.05), and an increase in single-leg stance ability in both legs in the Y-balance test ( < 0.05). All statistical confidence interval levels were set 95%. INT using the inertial load of water enhanced the somatosensory system and gait related to dynamic stability in older women. Therefore, the clinical application of this training program is expected to reduce the risk of falls in healthy older women, improving dynamic stability related to gait.
对外部力量作出抵抗并维持姿势的反射性反应源于前庭系统、肌肉、肌腱、关节本体感受器以及视觉之间的协调。衰老会使这些关键功能退化，增加跌倒风险。本研究旨在验证使用水袋的训练计划，即利用水的惯性负荷进行的不稳定神经肌肉训练（INT），是否能对平衡能力和动态稳定性产生积极影响。本研究针对22名年龄≥65岁的健康老年女性开展（平均年龄：74.82±7.00岁，身高：154.20±5.49厘米，体重：55.84±7.46千克，体重指数：23.55±3.58千克/平方米）。参与者被随机分为两组：一组使用水袋，另一组进行体重训练作为对照组。干预训练持续12周，每周2次，共24次，每次持续60分钟。使用t检验比较前后测试结果，以检验组内和组间差异。基于组与时间之间的交互作用，使用双向重复测量方差分析来检验效应大小。进行改良计时起立步行测试（TUG测试）、锐化罗姆伯格测试（SRT）和Y平衡测试（YBT），以评估动态稳定性，包括步态功能、静态稳定性和反应能力。在组间比较中，水袋训练组在TUG测试中任务完成时间减少，步行速度增加（P<0.05），在闭眼锐化罗姆伯格测试中静态稳定性和反应时间增加（P<0.05），在Y平衡测试中双腿单腿站立能力增加（P<0.05）。所有统计置信区间水平设定为95%。利用水的惯性负荷进行的INT增强了老年女性与动态稳定性相关的体感系统和步态。因此，预计该训练计划的临床应用可降低健康老年女性的跌倒风险，改善与步态相关的动态稳定性。
