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“THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION”
Submitted by:
Krishna Dhamecha (12sptpt11023)
Hiral Dholariya (12sptpt11024)
6Th semester July, 2015
Guide BY:
Dr. Nilesh Telaiya
Lecturer school of physiotherapy, RKU
CERTIFICATE
This is to certify that the project work entitled “The effect of strengthening and balance exercise training on geriatric population. “has been undertaken and written under my supervision and it describes the original research work carried out by Ms. Krishna Dhamecha and Ms. Hiral Dholariya registered at RK University in 6th semester Bachelors of Physiotherapy.
Signature of Guide Name: Dr.Nilesh Telaiya Degree: MPT (peridritric) Designation: Assistant professor
DECLARATION
We hereby certify that we are the authors of this project work. We certify to the best of
our knowledge, our project does not infringe upon anyone’s copyright nor violate any
proprietary rights and that any ideas, techniques, quotations, or any other material from
the work of other people included in our project published or otherwise, are fully
acknowledged in accordance with the standard referencing practices. We declare that
this is a true copy of our project, including any final revisions, as approved by my project
review committee.
Signature of candidate Signature of candidate
Dhamecha Krishna Dipakbhai Dholariya Hiral Nileshbhai
Enrolment no: 12sptpt11023 Enrolment no: 12sptpt11024
Date: 16/07/2015 Date: 16/07/2015
Place: Rajkot Place: Rajkot
ACKNOWLEGEMENT
First and foremost we would like to thank ours parents Dipakbhai,Ritaben and
Nileshbhai, Jyoshnaben_who who who are my living Gods and our brother Sumit and Akhil
for their valuable support and encouragement, blessing and love which has always been a
source of inspiration and strength in accomplishing this academic task.
our heartfelt gratitude to almighty God who has guided us this far and to whom goes all the
honor and glory for the successful completion of this study.
we wish to express our regards to our Director Dr. priyanshu Rathod School of Physiotherapy,
R.K.University for his whole hearted guidance and meticulous suggestions in the completion of
this work and for all the facilities and support extended to us during this study. We are extremely
thankful for his constant encouragement and inspiration during the course of this study.
With due respect, we would like to express our sincere thanks to our guide Dr. Nilesh Telaiya
Senior lecturer of School of Physiotherapy, R.K.University, for his judicious information, expert
suggestions, valuable guidance, continuous support, incessant reassurance during every stage of
this work and interest shown in this dissertation without which this work would not have been
possible.
we would like to extend our heartfelt thanks to assistant lecturer, Dr. Kajal Mam for their
valuable guidance, constant help and support throughout this study and all the lecturers of our
college who have taught us and gave their valuable suggestions during the course of the study.
we sincere thanks to colleagues and friends for taking keen interest in our study, guiding us
through the path, giving me support and motivation during the course of study.
We wish to express our thanks to Mr. Harshal Anjariya our librarian for their timely help in
lending us books and journals for our reference all the time.
We shall fail our duties if we don’t acknowledge our Colleagues and Friends for their
suggestions and criticism while assisting us in this study.
Last but not the least we would like to thanks all the Individuals in our study without whom this
task would not have been possible.
we sincere thanks to all the contributors whose names we may have missed but who truly deserve
our gratitude.
We would like to thank once again to all who have helped us all the while.
Signature Signature
Name: Krishna Dhamecha Name: Hiral Dholariya
ABSTRACT
“THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON
GERIATRIC POPULATION”
SUBMITTED BY: Krishna Dhamecha, Hiral Dholariya
Key word:- Time up and go test, MMT, Balance, Strengthening exercise, fall risk,
Geriatric
Background: - Ageing leads to musculoskeletal, cardiovascular, respiratory problem
along with balance impairment and increase in fall incidence. Exercise training is used
as fall prevention intervention and can decrease risk factors associated with falls
including reduced muscle strength and impaired balance. The need of study is there are
very few studies which are testing both muscle strength and balance of an older
individual following balance training and strengthening exercise.
AIM: To find out the effect of strengthening exercise and balance training in elderly
people.
Methodology: This study includes 30 subject elderly people more than 65 year age.
This people were screened for the inclusion and exclusion criteria. An informed consent
was taken from the participants prior to study. TUG and MMT is outcome measured.
Study same was taken from RKU campus and near by trumba village using
convenience sampling method study is experimental and comparative study.
Result: There is significant difference in TUG and MMT after giving balance and
strengthening exercise.
I
DISCUSSION: This study evaluated the effect of exercises on balance and muscle
strength by TUG test and MMT.
CONCLUSION: There is significant difference in pre and post TUG test and MMT.
This result shows that effect of balance and strengthening exercise training (2 weeks)
leads to improve balance and muscle strength.
II
TABLE OF CONTENTS
SR NO. TITLE PAGE NO.
1 List of tables III 2 List of figures IV 3 List of chart V 4 Structured Abstract I 5 Introduction 1 6 Need of study 5 7 Aim & objective of the study 7 8 Hypothesis 9 9 Review of literature 11
10 Methodology 14 11 Results 22 12 Discussion 28 13 Conclusion 32 14 Summary 34 15 Rererence 36
III
LIST OF TABLES
SR NO.
TABLE PAGE NO
11.1 MEAN AND STANDARD DEVIATION OF PRE AND POST QUADRICEPS MUSCLE STRENTH
24
11.2 MEAN AND STANDARD DEVIATION OF PRE AND POST CALF MUSCLE STRENGTH
25
11.3 MEAN AND STANDARD DEVIATION OF TUG TEST 26
IV
LIST OF FIGURES
SR NO FIGURE PAGE NO
10.1 MATERIAL USED IN STUDY 17
10.2 STRECHING OF HAMSTRING AND CALF MUSCLE
20
10.3 STRENGTHENING OF KNEE EXTENSION 20
10.4 STRENGTHENING OF PLANTER FLEXION 20
10.5 ONE LEG STANDING 21
10.6 REACH OUT 21
V
LIST OF CHART
SR NO CHART PAGE NO
11.1 MEAN OF PRE AND POST QUADERICEPS MUSCLE STRENGTH
24
11.2 MEAN OF PRE AND POST CALF MUSCLE STRENGTH 25
11.3 MEAN OF PRE AND POST TUG TEST 26
VI
THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION 2
INTRODUCTION
Physical fitness is a general state of health and well being and more specifically,
the ability to perform aspect of sports or occupation. Physical fitness is generally
achieved through correct nutrition, exercise, hygiene and rest (1).
With aging older people facing more problem associated with impaired vestibular
function, cardiovascular problem, neuromuscular problem, musculoskeletal problem, etc
(1)
1. Impaired muscle strength
2. Impaired balance
3. Impaired gait
4. Impaired vision
5. Impaired cognitive function
The most common risk factors for falls include muscle weakness, arthritis,
history of falls, limited gait, balance or vision problem use of assistive device, limited
of daily living depression cognitive impairment and elderly people. (1)
Exercise training is used as fall prevention intervention and can decrease risk
factor associated with falls including reduced muscle strength and impaired balance.
(2)
Balance disorder in the geriatric population are a multifactorial condition ,
weakness in the muscle strength, altered muscle activation patters, loss of
THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION 3
proprioception and inability to control normal posture sway can all result in
decreased balance in elderly. (3)
Routine group of exercise
1. Balance exercise
2. Strength training (resistance training)
Balance exercise as part of prevention program , you should follow an exercise
program designed to address your need for improved skill in walking balance,
coordination and increase muscle strength and less and feet. Exercise program and ask
programs can very from once 4 week to there or more times per week and session vary
in length.
Component:-
• Muscular power
• Muscular strength
• Flexibility
• Balance
• Speed
• Agility
• Reaction time
• Co-ordination (4)
Geriatric is a specially that focus on health care of older people. The age of
geriatric is >65 year. (5)
Strengthening exercise program 8 to 12 repetition of a resistance training
exercise for each major group at an intensity of 40% to 80% of one repetition (RM)
two–three minutes of rest is recommended between exercise sets to allow for proper
THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION 4
recovery. Two to four set are recommend for each muscle group, 3 to 4 time per
week. (6)
Benefit of strength training includes increase muscle strength, tendon and
ligament strength, bone density, flexibility, tone metabolic rate and postural support.
(6)
Balance exercise is effective in improving functional and static balance,
mobility and falling in geriatric people. Balance training shown beneficial result with
diminished risk of fall and balance exercise increased the confidence in geriatric and
give a positive well have and decreased fear of fall. (7)
TUG test is sensitive (87%) of specific measure for identifying older person
who are prone to falls. It is quicker and easy to perform. (8)
THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION 5
NEED OF THE STUDY
THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION 6
NEED OF THE STUDY
The need of study is there will be increase in balance and muscle strength in old
age people. There is no study by using TUG test and MMT to improve balance and
muscle strength. So using both the TUG and MMT and find that there is improve or not
in balance and muscle strength.
THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION 7
AIM AND OBJECTIVES
THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION 8
AIM & OBJECTIVES
AIMS:-
• To find out the effect of strengthening exercise and balance training in
geriatric person.
OBJECTIVE:-
• To study the effectiveness of 2 weeks of balance training on balance
performance in geriatric person.
• To study the effectiveness of 2 weeks of strengthening exercise on muscle
strength in geriatric person.
THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION 10
HYPOTHESIS Null hypothesis:
There will no significant difference in strength and balance in elderly people after exercise training.
Alternative hypothesis:
There will significant difference in strength and balance in elderly people after exercise
training.
THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION 11
REVIEW OF LITERATURE
THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION 12
REVIEW OF LITERATURE
Nishad Abdul L Atheef Majida 2015 has done study with the objective with
effect of core strength training on functional mobility in community dwelling people. 48
community dwelling elderly males taken in that studies with the age group of 55-70.
After giving a balance training(2 week-thrice a day) there was improvement in gait
performance and increase a gait velocity ,speed, and endurance .after giving a balance
training there was activation of propioception as before study. There is also
improvement in their quadriceps, knee flexors muscle strength. As result of above
study. (8)
Barbara l. Fischer, psy n 1 William T. Hoyt, PhD ; 2 Lawrence maucieri, phD3
Amy j. kind MD, PhD 1.4; etc all (volume 51, number 2, 2014 page -263 – 274).
Dr. John zettel volume 1, issue 2, winte r 2014, is used as fall preventive
intervention and decrease falls including balance and strength. Department of human
health and nutritional science, college of biological science, university of Guelph on
Canada.
Eduro .L.cadore et al. 2013 has done study with the objective to effects of
multicomponent training on muscle power output, muscle mass and functional
outcomes in frail nonagenarians. In that study Twenty four elderly were randomized into
intervention or control group. The intervention group performed a twice-weekly, 12-week
multicomponent exercise program composed of muscle power training (8-10 repetition)
combined with balance and gait training. Outcome measure for that research was TUG
test and barthel index. After giving balance training there was induced a positive
stimulus to promote the muscle hypertrophy enhance leg muscle power and functional
capacity and decrease incidence of fall and our study is correlate to that study.
THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION 13
American age American geriatrics society falls – risk guidelines 2010 has
done study with objective was to assist health care professionals in their management
of older adults who have fallen or are at a risk of falling and to optimize assessment and
interventions for reducing the number of falls in older adults. Target population was >65
years, cognitive impairments and long term care facilities. Screening and assessment
taken.
Broolce sal2amv, MD. Thomas Jefferson University 2010 JUL; 82(1):61.68.
M.M. Mureira. L.takayma. A. L. Galliano V. F. Caparbo R. A. Costa R. M. R.
Pereira [osteoporosis Into (2007) 18: 419–425 DO1 10.1007/5. 00198–006– 0.252.5]
15/haskowski, (2006 – 07 – 08) “strength training: How many set for best result”
myo clinic Retrieved (2013 – 01 -24).
Age Bamett A, Smith B, lord s, Williams M, Baumand A: ageing 2003 ; 32;
407 – 414 Sterling M, Jull G, Wright A. the effect of musculoskeletal pain on motor
activity and control. J pain 2001: 2 (3): (135 – 45) community based group exercise
improves balance and reduces fall in at risk older people a randomized controlled trial.
President council on physical fitness & sports definition for health, fitness &
physical activity.
THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION 15
METHODOLOGY
Study Design:
Experimental study
Study Setting:
RKU campus and near by trumba village
Sampling Technique:
Convenience sampling
Study Population:
Elderly people (>65 years age) male and female
Study Sample:
30 subjects
Study Duration:
Training duration – 2 weeks
Total Study duration:
14 weeks
THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION 16
CRITERIA FOR SELECTION
INCLUSION CRITERIA
Healthy older adults (male and female) >65 years of age
EXCLUSION CRITERIA
Other individuals have coronary heart disease
Uncontrolled hypertension and diabetes
Asthma
Any other severe cardio-pulmonary disorder, any other cerebro vascular disorder which
may affect their walking performance.
MATERIALS USED IN THE STUDY Stop watch
Measure tape
Chair
Pen
Chalk
Consent form
Assessment form
THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION 17
Material used in study 10.1
METHOD
MMT and TUG test can be use for the balance and muscle strength. The test has
been used as part of muscle strength and balance testing for more than 65 year age of
both male and female.
Present study was conducted on 30 older people in the age group of more than
65 year, of the r.k university campus and near by trumba village.High blood pressure,
dizziness, any musculoskeletal disorder, diabetes person were excluded from the study.
Informed consent was taken from all the older person. They were explained with the
whole test to be performed.
Subject was measured and subject was asked to perform the two test:
1. Time up and go test
2. Manual muscle testing
3. Treatment description
THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION 18
The experimental group was submitted to strengthening and balance training
thrice a week for 40 minutes, over 2 weeks, exercise innervations in the form of
strengthening and balance training program are now recognized as new strategy to
improve balance and muscle strength.
Participant were instructed to report any symptoms or feeling of falling during
training session, the therapist stood beside the participants to guarantee physical safety
in case of loss of balance.
A 5 minute warm up before the activity included head rotation, shoulder rotation,
upper limb stretching, lower limb stretching.(hamstring and calf stretching ) participants
were asked to walk sideways (4*/-minute), tendom walking (3minute), backward walking
(4minute), toe-walking (2minute), one leg standing (2minute) and reach out (5minute)
with eye open. Knee extension (Quadriceps muscle), and ankle planter flexion (calf
muscle) strengthening exercise with therabend and last 5 minute cool down phase
included-deep breathing in supine.
Time up and go test (TUG test)
The time up and go test is an effective method for assessing mobility and
quantifying locomotors performance, including a sequences of functional maneuvers
used in everyday life, basic mobility skills are tested, such as rising from a chair, walking
3 meters, turning and sitting down on the same chair A stopwatch is used to time the
test(seconds).the test is convenient in clinical as it is quick, requires no special
+equipment or training.TUG was proven to have a good interrater reliability(ICC-
0.99)(Steffen et al,2002) good test retest reliability(ICC-0.97-0.99)and spearman’s=0.93
have been demonstrated many studies.
Manual muscle testing:
Before starting the MMT must care the person as free as possible form
discomfort or pain during test. The environment is quiet and no distracting. The patient
is a lying on met or plinth as testing muscle and gives a proper instruction after that
check the
THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION 19
The flow chart of procedure
THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION 20
Stretching of hamstring and calf strengthening of knee extension 10.3
Muscle 10.2
Strengthening of planter flexion 10.4
THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION 21
One leg standing 10.5
Reach out 10.6
THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION 23
RESULT
A comparative study was performed in which TUG and MANUAL MUSCLE
TESTING was assessed in elderly people. The value of TUG and MMT were collected
for the elderly people
Statistics was performed using paired t-test individual TUG and wilcoxon signed
rank test individual MAUNAL MUSCLE TESTING
• Paired t-test and Wilcoxon signed rank test taken subjects
• Calculate t-value of elderly people for MMT and TUG
• The two tailed P-value is 0.05
• The data was analyze by using Paired t-test and Wilcoxon signed rank
test and results were obtained
• There is significance difference between pre and post in subjects with
taken
THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION 24
Table 11.1: DIFFERNT BETWEEN QUDERICEPS MUSCLE STRE NGTH PRE AND POST BOTH THE LOWER LIMB
VARIABLE
(OUTCOME)
MEAN
SD
P-VALUE
PRE POST PRE POST
Quadriceps right 4.76 4.83 0.4302 0.3790
<0.0001
Quadriceps left 4.86 4.90 0.3457 0.3051
INTERPRETATION: The above table shows the mean of quadriceps muscle strength
score right i.e.: 4.76±0.4302 (pre) and post 4.83±0.3790 and left pre 4.86±0.3457 and
post 4.90±0.3051 result shows significant difference for quadriceps muscle strength (P<
0.05, p-value= <0.0001).
11.1: mean of pre and post quadriceps muscle streng th
THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION 25
Above graph shows pre and post quadriceps muscle strength of elderly people.
mean for pre and post quadriceps muscle strength of elderly people is pre (rt) 4.76 and
post (rt) 4.83 and pre (lt) 4.86 and post (lt) 4.90 respectively statistical analysis of the
data shows there is significant (p<0.0001 ) difference in quadriceps muscle strength.
Table 11.2: DIFFERENT BETWEEN CALF MUSCLE STRENGTH PRE AND POST BOTH THE LOWER LIMB
VARIABLE
(OUTCOME)
MEAN
SD
P-VALUE
PRE POST PRE POST
Calf right 4.33 4.43 0.5467 0.5683
Calf left 4.26 4.50 0.5208 0.5085 <0.0001
INTERPRETATION: The above table shows the mean of calf muscle strength score
right i.e.: 4.33±0.5467 (pre) and post 4.43±0.5683 and left pre 4.26±0.5208 and post
4.50±0.5085 result shows significant difference for calf muscle strength (P<0.05, p-
value=<0.0001).
11.2: mean of pre and post calf muscle strength
THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION 26
Above graph shows pre and post Calf muscle strength of elderly people. Mean for
pre and post calf muscle strength of elderly people is pre (RT) 4.33 and post (RT) 4.43
and pre (lt) 4.26 and post (lt) 4.50 respectively. Statistical analysis of the data shows
there is significant (p<0.0001) difference in muscle calf strength.
Table 11.3: DIFFERENT BETWEEN TUG TEST PRE AND POST
Variable
(Outcome)
MEAN SD N t
Value
P
Value
PRE POST PRE POST
TUG 10.36 9.16 2.1412 1.7436 30 10
<0.0001
INTERPRETATION: The above table shows the mean of TUG test score
i.e.:10.36±2.1412 pre and post 9.16±1.7436 post result shows significant difference for
TUG test (t=10, p-value=<0.0001).
11.3: mean of pre and post TUG test
THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION 27
Above graph shows pre and post TUG test of elderly people. Mean for pre and
post TUG test of elderly people is pre 10.36 and post 9.16 respectively. Statistical
analysis of the data shows there is significant (p<0.0001) difference in TUG test.
THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION 29
DISCUSSION
Aim of study is to effective the balance and Strength performance in geriatric
person. The component of outcome measure was taken is TUG and manual muscle
testing. The results show that there is statistically significant difference in TUG score
(mean: -1.200 sec) before and after exercise Balance Training. There is significant
difference in MANUAL MUSCLE TESTING (Mean: 65.50) performance before and after
Strengthening training program.
Nishad Abdul Latheef Majida*1 (2015) which supports the study After giving a
balance training (2 week) there is improvement in increase speed and endurance. After
giving a Strength exercise and balance training there is activation of propioception as
before study. Which support the study there is also improvement in their quadriceps,
and Calf muscle strength. As result of above study (10)
Nizar Abdul Majeed kutty*(vol 24 no.2 (2013) which support the study after giving
balance exercise (2 week). There is improve speed and endurance because Wayne et
al (2004) reported that the activation of propioreceptor, because there is correlation
between sensory and motor process. The loss of sensory information can bring about
change in use of ankle and hip strategies. This suggests that selection of posture
movement strategies appears to be an automatic protective process dependent upon
accurate multisensory information.
Eduardo L. Cardore. Etc @ American Aging Association (2013) which support the
study after giving balance training there is induced a positive stimulus to promote the
muscle hypertrophy enhance leg muscle power and functional capacity and decrease
incidence of fall ( as above study (11))and our study is correlate to this study.
THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION 30
Scholar research library (2011) which supported study after giving balance
exercise, there is change in neuromuscular performance and balance. This training
improve balance and walking ability.
THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION 31
LIMITATIONS OF THE STUDY:
• Age group between > 65 year old age people
• Duration of timing 2 weeks
• Sample size 30 subject only
FURTHER RECOMMENDATIONS:
• Large sample size should be taken.
• This study can be further done with longer treatment duration
THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION 33
CONCLUSION
This result shows that effect of balance training and Strengthening exercise (2 weeks)
thrice a day per week. Leads to improve Balance and Functional Mobility in older adults.
Strengthening and Balance training Program could be successfully to improve Balance,
Mobility and potentially reduce the risk of falls.
THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION 35
SUMMARY
30 elderly people were included for study. Outcome measure was TUG and MANUAL
MUSCLE TESTING.
The data was then tabulated and subjected to statistical analysis by paired t- test for
TUG and wilcoxon signed rank test for MANUAL MUSCLE TESTING outcome
measure. After Analysis the data the following inference were drawn:
1. There was significant difference in TUG test (t= 10, P<0.05) among elderly
people after strengthening exercise.
2. There was significant difference in MANUAL MUSCLE TESTING (p<0.05, P-
value=<0.0001) among elderly people after strengthening exercise..
Form the result of present study it was concluded that there was elderly people
which lead to increase in balance and strengthening exercise program to
reduced fear of fall risk and improve physical function (lower limb strength and
balance.
THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION 37
BIBLIOGRAPHY
1. Balance training program is highly effective in improving functional status and
reducing the risk of fall in elderly a randomized controlled trial.
M.M.Madureria.L.takaynama.A.L.gallinar Osteoporoses int (2007)18:419-425
2. Balance training and exercise in geriatric patients. M.Runge, G.Rehfeld,.esnicek
Aerpah-klinik Esslingen,Germany 2000;1:61-65
3. Training exercises helps to manage fall risk in American geriatrics society fall risk
guidelines. www.americangeriatrics.org
4. Dhebar F et al have structured balance, co-ordination and strength older
individuals.2014
5. .ahmad Ali akbari kamarani (MD University of social welfare
6. .Nishad Abdul L Atheef Majida 2015.
7. Brooke sazamv md Thomas Jefferson university Jul ;( 1):61-68. 2010
THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION 40
ANNEXURE 10.2
Assessment Form
Date: No:
Name: Age and sex:
Address:
M: _________________
Occupation:
Chief complaints:
History:
1. History of fall: 2. Medication history: 3. History of any other medical condition:
On observation:
1. Posture:____________________________________________________ 2. Deformity:_______________________________________________________
THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION 41
EXAMINATION
1. Strength testing(MMT) of lower limb
Muscle Pre-strength data Post strength data
right Left right Left
Quadriceps muscle
Calf muscle
2. Balance examination: TUG Test
Remark :______________________________________________
____________________________________________________
____________________________________________________
__________________________________________________
Outcome measure Pre-training data Po st-training data
TUG (in second) (in second)
THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION 42
MASTER CHART
SR NO GENDER AGE TUG PRE TUG POST
1 Female 62 11 9
2 Female 67 10 9
3 Female 65 14 12
4 Female 70 10 9
5 Female 75 12 11
6 Female 68 11 10
7 Female 65 10 9
8 Female 80 13 11
9 Male 64 8 7
10 Male 58 9 8
11 Male 60 12 11
12 Male 68 13 12
13 Male 71 12 10
14 Male 65 9 9
15 Male 68 12 10
16 Female 70 12 10
17 Male 70 15 13
18 Female 70 9 8
19 Female 80 14 12
20 Male 60 9 8
21 Male 55 10 8
22 Female 65 8 7
23 Male 65 8 7
24 Female 65 9 8
25 Female 60 8 7
26 Female 55 10 9
27 Male 58 7 7
28 Male 56 7 7
29 Female 65 9 8
30 Female 65 10 9
THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION 43
SE. NO
QUADRICEP MUSCLE
CALF MUSCLE
Pre-
Grade
Post-
Grade
Pre-
grade
Post- grade
rt Lt Rt Lt rt lt Rt Lt
1 5 5 5 5 4 4 4 5
2 5 5 5 5 4 4 5 4
3 4 5 4 5 4 4 4 4
4 5 5 5 5 4 4 4 4
5 5 5 5 5 4 4 5 4
6 5 5 5 5 4 4 4 4
7 4 5 5 5 5 5 5 5
8 4 5 4 5 4 4 4 5
9 5 5 5 5 5 5 5 5
10 5 5 5 5 4 4 4 4
11 5 5 5 5 4 4 4 4
12 4 5 4 5 4 4 4 5
13 5 5 5 5 4 5 4 5
14 5 5 5 5 5 5 5 5
15 4 5 5 5 4 4 5 4
16 5 5 5 5 4 4 4 4
17 4 4 4 5 4 4 4 4
18 5 4 5 4 4 4 4 5
19 4 4 4 4 3 3 3 4
20 5 5 5 5 5 5 5 5
THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION 44
21 5 5 5 5 5 5 5 5
22 5 5 5 5 5 4 5 4
23 5 4 5 4 5 4 5 5
24 5 5 5 5 5 5 5 5
25 5 5 5 5 4 4 4 5
26 5 5 5 5 5 5 5 5
27 5 5 5 5 5 5 5 5
28 5 5 5 5 4 4 4 4
29 5 5 5 5 4 4 4 4
30 5 5 5 5 5 4 5 4
THE EFFECT OF STRENGTHENING AND BALANCE EXERCISE TRAINING ON GERIATRIC POPULATION 45
ANNEXURE 10.3
MESUREMENT TOOLS
Time up and go test (TUG test)
The time up and go test is an effective method for assessing mobility and
quantifying locomotors performance, including a sequences of functional maneuvers
used in everyday life, basic mobility skills are tested, such as rising from a chair, walking
3 meters, turning and sitting down on the same chair A stopwatch is used to time the
test(seconds).the test is convenient in clinical as it is quick, requires no special
+equipment or training.TUG was proven to have a good interrater reliability(ICC-
0.99)(Steffen et al,2002) good test retest reliability(ICC-0.97-0.99)and spearman’s=0.93
have been demonstrated many studies.
Manual muscle testing:
Before starting the MMT must care the person as free as possible form
discomfort or pain during test. The environment is quiet and no distracting. The patient
is a lying on met or plinth as testing muscle and gives a proper instruction after that
check the muscle power by manual resistance.