Influence of the strength of the ankle plantar flexors on dynamic balance in 55-65-year-old women

Authors

  • Antonio Cejudo
  • Miguel Ángel Esparza Montero

Keywords:

Triceps surae, Coordination, Falls risk, Older adults

Abstract

Objectives: The loss of strength of the plantar flexors of the ankle associated with aging may limit the performance of balance in the functional activities of daily life in older adults. The deficit of strength of this musculature and an inadequate dynamic balance have been correlated with an increased risk of falls in older adults. Therefore, the main objective of the present study is to analyse the association between the strength of the plantar flexors and the dynamic balance in older women.

Methods: A total of 79 older women, between the ages of 55 and 65, participated in the present study. Subjects participated in a systematic program of physical exercise in a private fitness center of the Region of Murcia during the year 2019. A cross-sectional correlational study was designed to correlate the dynamic balance, assessed with the Y-balance Test (YB) and the Timed Up and Go Test (TUG), with the strength of the ankle plantar flexors, assessed with the Calf-raise test (CR). A Wilcoxon test was carried out to evaluate the differences between the values of the dominant and non-dominant sides in the balance test Y-Balance test. A Spearman correlation analysis was applied to observe if the strength of the plantar flexors of the ankle was associated with the two tests of dynamic balance.

Findings: A significant "small" correlation between the strength of the plantar flexors of the ankle and the postero-lateral dynamic balance "Y-Balance" (p = 0.023, r = 0.256) was found in the subjects of the present study.

Conclusions: The main finding of the present study was that 55-65-year-old women need to train the strength of the plantar flexors of the ankle to improve the unipodal dynamic balance and minimize the possible risk of falling.

References

Moreno González A. Incidencia de la actividad física en el adulto mayor. Rev Int Med Cienc Act Fís. 2005;5(20):222-236.

Izquierdo I, Del Río O, Rodríguez A. Tiempo dedicado a la práctica del deporte. La desigualdad de las mujeres en el uso del tiempo. Madrid: Ministerio Asuntos Sociales. Instituto de la mujer. Serie Debate 20. 1988;101-111.

Sarmiento Ramos ML. Envejecimiento y actividad físico-deportiva (AFD). Int J Educ Dev. 2016;1(2):135-142. https://doi.org/10.17060/ijodaep.2016.n2.v1.579

Schlüssel MM, Dos Anjos LA, de Vasconcellos MTL, Kac G. Reference values of handgrip dynamometry of healthy adults: A population-based study. Clin Nutr. 2008;27(4):601-607. https://doi.org/10.1016/j.clnu.2008.04.004

Brach JS, VanSwearingen JM. Physical impairment and disability: relationship to performance of activities of daily living in community-dwelling older men. Phys Ther. 2002;82(8):752–761. https://doi.org/10.1093/ptj/82.8.752

Visser M, Goodpaster BH, Kritchevsky SB, et al. Muscle mass, muscle strength, and muscle fat infiltration as predictors of incident mobility limitations in well-functioning older persons. J Gerontol A Biol Sci Med Sci. 2005;60(3):324–333. https://doi.org/10.1093/gerona/60.3.324

Rantanen T, Era P, Heikkinen E. Maximal isometric strength and mobility among 75-year-old men and women. Age Ageing. 1994;23(2):123-127. https://doi.org/10.1093/ageing/23.2.132

Jung H, Yamasaki M. Association of lower extremity range of motion and muscle strength with physical performance of community-dwelling older women. J Physiol Anthropol. 2016;35(30). https://doi.org/10.1186/s40101-016-0120-8

Timonen L, Rantanen T, Timonen TE, Sulkava R. Effects of a group?based exercise program on the mood state of frail older women after discharge from hospital. Int J Geriatr Psychiatry. 2002;17(12):1106-1111. https://doi.org/10.1002/gps.757

Zhang L, Guo L, Wu H, Gong, X, Lv J, Yang Y. Role of physical performance measures for identifying functional disability among Chinese older adults: Data from the China Health and Retirement Longitudinal Study. Plos One. 2019;14(4):e0215693. https://doi.org/10.1371/journal.pone.0215693

Ding L, Yang F. Muscle weakness is related to slip-initiated falls among community-dwelling older adults. J Biomech. 2016;49(2):238–243. https://doi.org/10.1016/j.jbiomech.2015.12.009

Silva-Fhon JR, Partezani-Rodrigues R, Miyamura K, Fuentes-Neira W. Causas y factores asociados a las caídas del adulto mayor. Enfermería universitaria. 2019;16(1):31-40. https://doi.org/10.22201/eneo.23958421e.2019.1.576

Vikberg S, Sörlén N, Brandén L, Johansson J, Nordström A, Hult A, Y Nordström P. Effects of Resistance Training on Functional Strength and Muscle Mass in 70-Year-Old Individuals with Pre-sarcopenia: A Randomized Controlled Trial. J Am Med Dir Assoc. 2018;20(1):28-34. https://doi.org/10.1016/j.jamda.2018.09.011

Menz HB, Morris ME, Lord SR. Foot and ankle characteristics associated with impaired balance and functional ability in older people. J Gerontol A Biol Sci Med Sci. 2005;60(12):1546-1552. https://doi.org/10.1093/gerona/60.12.1546

Mickle KJ, Caputi P, Potter JM, Steele JR. Efficacy of a progressive resistance exercise program to increase toe flexor strength in older people. Clin Biomech. 2016;40:14-19. https://doi.org/10.1016/j.clinbiomech.2016.10.005

Lee SM, Cynn HS, Yoon TL, Lee JH. Effects of different heel-raise-lower exercise interventions on the strength of plantarflexion, balance, and gait parameters in stroke survivors. Physiother Theory Pract. 2017;33(9):706–715. https://doi.org/10.1080/09593985.2017.1346024

André H, Carnide F, Borja E, Ramalho F, Santos-Rocha R, Veloso A. Calf-raise senior: a new test for assessment of plantar flexor muscle strength in older adults: protocol, validity, and reliability. Clin Interv Aging. 2016;11:1661–1674. https://doi.org/10.2147/CIA.S115304

Jan M-H, Chai H-M, Lin Y-F, et al. Effects of age and sex on the results of an ankle plantar-flexor manual muscle test. Phys Ther. 2005;85(10):1078–1084. https://doi.org/10.1093/ptj/85.10.1078

Jung H, Yamasaki M. Association of lower extremity range of motion and muscle strength with physical performance of community-dwelling older women. J Physiol Anthropol. 2016;35(30). https://doi.org/10.1186/s40101-016-0120-8

Rantanen T, Avlund k, Suominen H, Schroll M, Frändin K, Pertti E. Muscle strength as a predictor of onset of ADL dependence in people aged 75 years. Aging Clin Exp Res. 2002;14(3):10-15.

Hébert-Losier K, Newsham-West RJ, Schneiders AG, Sullivan SJ. Raising the standards of the calf-raise test: A systematic review. J Sci Med Sport.2009;12(6):594–602. https://doi.org/10.1016/j.jsams.2008.12.628

Hashish R, Samarawickrame SD, Wang MY, Salem GJ. The association between unilateral heel-rise performance with static and dynamic balance in community dwelling older adults. Geriatr Nurs. 2015;36(1):30–34. https://doi.org/10.1016/j.gerinurse.2014.09.003

Lee DK, Kang MH, Lee TS. Relationships among the Y balance test, Berg Balance Scale, and lower limb strength in middle-aged and older females. Braz J Phys Ther. 2015;19(3):227-234. http://dx.doi.org/10.1590/bjpt-rbf.2014.0096

Podsiadlo D, Richardson S. The timed "Up & Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142–148. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x

Lan TY, Melzer D, Tom BD, Guralnik JM. Performance tests and disability: developing an objective index of mobility-related limitation in older populations. J Gerontol A Biol Sci Med Sci. 2002;57(5):M294–301. https://doi.org/10.1093/gerona/57.5.M294

Thrane G, Joakimsen RM, Thornquist E. The association between timed up and go test and history of falls: the tromso study. BMC Geriatr. 2007;7(1):1. https://doi.org/10.1186/1471-2318-7-1

Chtara M, Rouissi M, Bragazzi NL, Owen AL, Haddad M, Chamari K. Dynamic balance ability in young elite soccer players: implication of isometric strength. J Sports Med Phys Fitness. 2018;58(4):414-420. https://doi.org/10.23736/S0022-4707.16.06724-4

Muehlbauer T, Gollhofer A, Granacher U. Associations Between Measures of Balance and Lower-Extremity Muscle Strength/Power in Healthy Individuals Across the Lifespan: A Systematic Review and Meta-Analysis. Sports Med.2015;45(12):1671–1692. https://doi.org/10.1007/s40279-015-0390-z

Wang SS, Whitney SL, Burdett RG, Janosky JE. Lower extremity muscular flexibility in long distance runners. J Orthop Sports Phys Ther. 1993;17(2):102-107. https://doi.org/10.2519/jospt.1993.17.2.102

Varela S, Ayán C, Cancela JM. Batteries assessing health related fitness in the elderly: a brief review. Eur Rev Aging Phys. Act. 2008;5(2):97–105. https://doi.org/10.1007/s11556-008-0037-2

Atkinson G, Nevill AM. Statistical methods for assessing measurement error (reliability) in variables relevant to sport medicine. Sports Med. 1998;4:217-238. https://doi.org/10.2165/00007256-199826040-00002

Hopkins WG. A Scale of Magnitudes for Effect Statistics. Sports Med.2019;41(5):377-400.

Gribble P, Hertel J. Considerations for normalizing measures of the Star Excursion Balance Test. Meas Phys Educ Exerc Sci.2003;7:89-100. https://doi.org/10.1207/S15327841MPEE0702_3

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(9):896–903. https://doi.org/10.1093/ptj/80.9.896

Pohl MB, Kendall KD, Patel C, et al. Experimentally reduced hip-abductor muscle strength and frontal-plane biomechanics during walking. J Athl Train. 2015;50(4):385–391. https://doi.org/10.4085/1062-6050-49.5.07

Tazawa M, Kurosaki M, Inoue T, et al. Superior migration of the femoral head in patients with severe hip osteoarthritis influences the gait patterns of the coronal plane. HIP Int. 2019;29(4):446-451. https://doi.org/10.1177/1120700019827250

Foucher KC, Hurwitz DE, Wimmer MA. Preoperative gait adaptations persist one year after surgery in clinically well-functioning total hip replacement patients. J Biomech. 2007;40(15):3432–3437. https://doi.org/10.1016/j.jbiomech.2007.05.020

Justine M, Ruzali D, Hazidin E, Said A, Bukry SA, Manaf H. Range of motion, muscle length, and balance performance in older adults with normal, pronated, and supinated feet. J Phys Ther Sci. 2016;28(3):916–922. https://doi.org/10.1589/jpts.28.916

Mecagni C, Pulliam-Smith J, Roberts K, O’Sullivan SB. Balance and Ankle Range of Motion in Community-Dwelling Women Aged 64 to 87 Years: A Correlational Study. Phys Ther. 2016;80(10):1004-1011. https://doi.org/10.1093/ptj/80.10.1004

Thrane G, Joakimsen RM, Thornquist E. The association between timed up and go test and history of falls: The Tromsø study. BMC Geriatr. 2007;7(1). https://doi.org/10.1186/1471-2318-7-1

Chalapud-Narváez LM, Escobar-Almario A. Actividad física para mejorar fuerza y equilibrio en el adulto mayor. Universidad y salud. 2017;19(1):94-101. https://doi.org/10.22267/rus.171901.73

Landi F, Calvani R, Tosato M, et al. Age-Related Variations of Muscle Mass, Strength, and Physical Performance in Community-Dwellers: Results From the Milan EXPO Survey. J Am Med Dir Assoc. 2017;18(1):88.e17–88.e24. https://doi.org/10.1016/j.jamda.2016.10.007

Harris-Love MO, Benson K, Leasure E, Adams B, McIntosh V. The Influence of Upper and Lower Extremity Strength on Performance-Based Sarcopenia Assessment Tests. J Funct Morphol Kinesiol. 2018;3(4):53. https://doi.org/10.3390/jfmk3040053

Vaquero-Cristóbal R, González-Moro IM, Cárceles FA, Simón ER. Valoración de la fuerza, la flexibilidad, el equilibrio, la resistencia y la agilidad en función del índice de masa corporal en mujeres mayores activas. Rev Esp Geriatr Gerontol. 2013;48(4):171-176. https://doi.org/10.1016/j.regg.2012.11.003

Lee SM, Cynn HS, Yoon TL, Lee JH. Effects of different heel-raise-lower exercise interventions on the strength of plantarflexion, balance, and gait parameters in stroke survivors. Physiother Theory Pract. 2017;33(9):706–715. https://doi.org/10.1080/09593985.2017.1346024

Guillén-Rogel, P, San Emeterio C, Marín PJ. Associations between ankle dorsiflexion range of motion and foot and ankle strength in young adults. J Phys Ther Sci.2017;29(8):1363–1367. https://doi.org/10.1589/jpts.29.1363

Downloads

Published

2021-02-07

How to Cite

Cejudo, A., & Esparza Montero, M. Ángel. (2021). Influence of the strength of the ankle plantar flexors on dynamic balance in 55-65-year-old women. Atena Journal of Public Health, 3, 3. Retrieved from https://www.atenajournals.com/index.php/ajph/article/view/36

Issue

Section

Articles