The effect of circuit hydraulic resistance training on postural stabilityin elderly, chronically ill patients

• Main Authors: Ming-Shu Chen, 陳銘樹
• Other Authors: Chi-Kuang Chen
• Format: Others
• Language: zh-TW
• Online Access: http://ndltd.ncl.edu.tw/handle/04590130699823178181

博士 === 元智大學 === 工業工程與管理學系 === 103 === As the global population ages rapidly, maintaining and increasing the activities of daily living and reducing the cost of medical care for elderly people are critical for holistic health care worldwide. With the increase of age, lower limb muscle degeneration reduces balance ability, which can easily lead to person falls. Studies have suggested that falling and its sequelae can substantially influence elderly people. This study aimed to develop an effective exercise training program for enhancing the gait function of chronically ill (including cardiovascular disease, diabetes, and osteoporosis) patients to avoid falls and to determine the relationship between regular hydraulic resistance training with aerobic exercise intervention and postural stability in elderly people. In addition, the complexity index (CI), which is based on a multiscale entropy (MSE) algorithm, has been applied in recent studies to demonstrate a person’s adaptability to intrinsic and external perturbations, and has been widely used to measure postural sway or stability. Multivariate multiscale entropy (MMSE) is an advanced algorithm used to calculate the CI values of the center of pressure (COP) data. In this study, we used traditional clinical study indicators to measure postural stability (e.g., timed up and go, single-leg stance with eyes open) and applied the MSE and MMSE algorithms to calculate the postural sway of indicators to assess the differences before and after the intervention exercise program. In addition, we examined whether the MMSE algorithm is superior to the MSE algorithm, whether it can replace traditional clinical indicators, and whether it is more widely used. The participants were chronically ill patients older than 45 years (47–89 years old); 25 participants in the exercise group completed the 12-week training regimen and assessment, and 29 participants in the control group completed a self-exercise at home. The average age of the participants in the intervention group was 67.56 ± 10.70 years. All patients in this study signed institutional review board (IRB) agreements before participating (IRB approval no.: FEMH-IRB-101029-E, v. 02, date: 20120429). This study involved a circuit exercise that combined the use of hydraulic resistance training equipment and aerobic stepping. The participants completed the exercise three times a week for a total of 12 weeks. In addition, the present study recruited a matched age and gender group as the control group. The assessment of balance was conducted four times: pre-exercise, post-Week-6, post-Week-12, and during detraining (post-Week-4 after the exercise training was completed). All data were analyzed using repeated measurements in a paired t test or analysis of variance. The significance level was 0.05. The results revealed the beneficial effects of regular aerobic and resistance training, which improved postural stability in elderly and chronically ill patients. According to our data, most of the postural stability measurements exhibited significant differences between the exercise group and control group. The duration of the timed up and go test decreased from 7.67 s to 6.76 s (p = 0.00013), and the CI of the MMSE increased from 13.87 to 14.83 (p = 0.0094). Women exhibited more significant differences than did men in the exercise and control groups (p = 0.0008). We also found that the MMSE method was superior in COP detection because its discriminatory ability was superior to that of the MSE method as well as other postural stability indicators and traditional balance and gait indices. We concluded that regular exercise regimens such as aerobic, resistance, and combination exercise training enhance the gait function and postural stability in elderly and chronically ill patients. Younger patients attained more positive results than did older patients, and women attained more positive results than did men. Regular exercise might prevent falls; thus, the government and hospitals should increase related promotional measures in aging communities to encourage regular exercise among elderly and chronically ill outpatients.