The Effects of Nine-Square Exercise On Balance in the Elderly with Falls Risk
Keywords:
elderly; exercise; balance; fallsAbstract
Background and objective: Presently, “nine-square exercise” is popular among community-dwellers in Thailand. However, evidences in the benefits of nine-square exercise on balance in older persons remained unclear. This study aimed to evaluate the effects of nine-square exercise on balance in the elderly with falls risk.
Methods: Thirty-four older persons (mean age 63.8±2.0 years) were divided into experimental and control groups (17 of each). The experimental group was assigned to practice nine-square exercise for 3 days/week, 30 minutes/day for a total of 5 weeks, while the control group attended health education classes at weeks 2 and 4 of the study. At pre- and post-study, all participants were evaluated for dynamic and static balance by using the Timed Up and Go Test (TUGT) and the One Leg Stance Test (OLST), respectively. Data were analyzed by using the T-tests.
Results: At the end of the study, the experimental group significantly improved their balance (p<0.05). When compared between groups, the experimental group showed significantly less time taken to complete the TUGT than did the control group (p<0.001). No statistically significant difference between groups was found in the OLST (p>0.10).
Conclusions: Nine-square exercise could improve dynamic balance in the elderly with falls risk. Therefore, this exercise is possibly an alternative exercise regimen for improving balance in community-dwelling older persons.
References
2. Mahidol Population Gazette. Thailand population 2017. Bangkok: Mahidol Population Gazette, 2017.
3. Bird ML, Pittaway JK, Cuisick I, Rattray M, Ahuja K. Age-related changes in physical fall risk factors: result from a 3 year follow-up of community dwelling older adults in Tasmania, Australia. Int J Environ Res Public Health 2013; 10: 5989-5997.
4. Dhargave P, Sendhilkumar R. Prevalence of risk factors for falls among elderly people living in long-term care homes. J Clin Gerontol Geriatr 2016; 7: 99-103.
5. Jitapunkul S, Na Songkhla M, Chayovan N, Chitratkul A, Choprapawon C, Kachondham Y, et al. Fall and their associated factor: a nation survey of the Thai elderly. J Med Assoc Thai 1998; 81: 233-242.
6. Rongmuang D, Nakchattri C, Tongdee J, Sombutboon J. Incidence and factors associated with fall among the community-dwelling elderly, Suratthani. J Phrapokklao Nurs College 2016; 27: 123-138.
7. Kwon IH, Song JY, Kim DY, Son JY, Shim YJ, Shin WS. Comparison of rhythmic and non-rhythmic aerobic exercises on depression and balance in the elderly. Phys Ther Rehabil Sci 2017; 6: 146-151.
8. Silsupadol P. Exercise as an intervention for preventing falls in community-dwelling older adults. Thai J Phys Ther 2012; 4: 180-192.
9. Yardley L, Beyer N, Hauer K, McKee K, Ballinger C, Todd C. Recommendations for promoting the engagement of older people in activities to prevent falls. Qual Saf Health Care 2007; 16: 230-234.
10. Krabuanrat C. The 9-square exercise and brain development. Bangkok: Grand Sport Group, 2007.
11. Junprasert S, Toonsiri C, Chalaem T, ChooJun N, Kirdnoil P, Songprasert A, et al. Impact of nine-square Thai dancing on elderly people’s health. Thai J Nurs Coun 2013; 28: 60-80.
12. Ronnarithivichai C, Thaweeboon T, Petchpansri S, Sujijantararat R, Boonchan N, Kridiborworn C. The evaluation of physical fitness before and after 9-square-table aerobic exercise and rubber ring stretching of elders in the health promotion program for the elderly, Faculty of Nursing, Mahidol University. J Nurs Sci 2009; 27: 68-76.
13. Manunyanon S. The effect of different size of the matrix of nine square on agility for badminton [Master Thesis in Sports Science]. Bangkok: Graduate School, Kasetsart University, 2011.
14. Watchiramekakul L, Krabuanrat C, Reungthai R. Effect of specific movement training program on reaction time in taekwondo player. J Sport Sci Tech 2011; 11: 176-191.
15. Cheunsakulpong T, Abthaisong O. The effect of moving the body in the nine squares table with balance and memory in geriatric psychiatric patients who admitted in Prakaisuk ward. J Srithanya Hospita 2012; 13: 16-25.
16. Mangione KK, Craik RL, McCormick AA, Blevins HL, White MB, Sullivan-Marx EM, et al. Detectable changes in physical performance measures in elderly African Americans. Phys Ther 2010; 90: 921-627.
17. Nualnetr N, Aonsri C, Chaipipat N. A comparison of 9-square exercise and conventional balance exercise on balance in older women. Thai J Phys Ther 2016; 38: 93-102.
18. Jalayondeja C. Falls screening by Timed Up and Go (TUG). J Med Tech Phys Ther 2014; 26: 5-16.
19. Prasat Neurological Institute. Clinical practice guidelines: dementia. Bangkok: Tana Press Printing, 2014.
20. Chirawatkul A. Statistics for health science research. Bangkok: Wittayaphat, 2013.
21. Nokham R, Panuthai S, Khampolsin T. Effect of square-stepping exercise on balance among older persons. Nurs J 2016; 43: 58-68.
22. Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991; 39: 142-148.
23. Springer BA, Marin R, Cyhan T, Roberts H, Gill NW. Normative values for the unipedal stance test with eyes open and closed. J Geriatr Phys Ther 2007; 30: 8-15.
24. Bohannon RW. Responsiveness of the single-limb stance test. Gait Posture 2012; 35: 173.
25. Pescatello L, Arena R, Riebe D, Thompson P. ACSM’s guidelines for exercise testing and prescription. 9th ed. Baltimore: Lippincott Williams & Wilkins, 2014.
26. Ritchie C. Rating of perceived exertion (RPE). J Physiother 2012; 58: 62.
27. Farlie MK, Molloy E, Keating JL, Haines PT. Clinical markers of the intensity of balance challenge: observational study of older adult responses to balance tasks. Phys Ther 2016; 96: 313-323.
28. Gschwind YJ, Kressig RW, Lacroix A, Muehlbauer T, Pfenninger B, Granacher U. A best practice fall prevention exercise program to improve balance, strength/power, and psychosocial health in older adults: study protocol for a randomized controlled trial. BMC Geriatr 2013; 13: 1-13.
