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Orthopedic Research Online Journal

The Effectiveness of Core Strength Training to Improve Functional Mobility and Balance in Geriatric Population: A Literature Review

Manjusha K1, Nithya Narayanan Kutty2* and Shilpa Chandran3

1Post Graduate Student MPT, Cooperative Institute of Health Sciences, India

2Associate Professor, Department of Physiotherapy, Cooperative Institute of Health Sciences, India

3Assistant Professor, Department of Physiotherapy, Cooperative Institute of Health Sciences, India

*Corresponding author:Nithya Narayanan Kutty, Associate Professor, Department of Physiotherapy, Cooperative Institute of Health Sciences, India

Submission: September 20, 2021;Published: September 28, 2021

DOI: 10.31031/OPROJ.2021.09.000701

ISSN: 2576-8875
Volume9 Issue1

Abstract

Introduction: Core provides proximal stability for distal mobility. Core strength training has a vital role in the improvement of functional Mobility and balance in geriatric Population.

Objective: To establish or review existing studies evaluating the effectiveness of core strength training to improve functional mobility and dynamic balance in geriatric population.

Design: Review of Literature.

Methodology: Various articles from following databases like PubMed, Google scholar, science Direct, research gate Retrieved through a search by using keywords, core strength training, functional mobility, balance, geriatric Population. Total 20 articles were included in the study and based on their findings a review was made.

Conclusion: The present literature review concludes that core strength training is beneficial to improve functional mobility and balance in geriatric population.

Keywords: Core strength training; Functional mobility; Balance; Geriatric population

Introduction

Core Stability (CS) was introduced for the first time in 1990s by Hodges and Richardson during studying the timing of trunk muscles in patients with chronic low back pain. Core strengthening has become a major trend in rehabilitation. Core stability training targets the muscles deep within the abdomen which connect to the spine, pelvis and shoulders, to assist in the maintenance of good posture and provide the foundation for all arm and leg movements [1].

“Core,” is composed of the lumbar vertebrae, the pelvis, the hip joints, and the active and passive structures that either produce or restrict movement of this Segment. Core stability can be defined as the ability of the lumbopelvic-hip complex to prevent buckling of the vertebral column and return it to equilibrium following perturbation [2].

Functional Mobility is the most studied and most relevant physical ability affecting quality of life with strong prognostic value for disability and survival. Natural selection has built the “engine” of mobility with great robustness, redundancy, and functional reserve. Efficient patterns of mobility can be acquired during development even by children affected by severe impairments [3]. On average, the rate of decline in walking speed and other measures of lower extremity performance accelerates over the seventh decade of life, starting sometime between the ages of 60-70 years, with an extremely heterogeneous time course across. loss of mobility occurs when the ability to compensate for the cumulative effects of impairments is exhausted and normal daily life becomes a challenge. Slower walking speed (most commonly assessed using usual walking speed achieved during a timed walk test over a short distance) and other multisystem performance measures of physical function (such as the time taken to rise from a chair and sit down several times, or tests of balance) are consistently associated with poorer well-being and quality of life in old age, track overall health status, and predict adverse health outcomes, including rising multi morbidity, health care resource utilization, disability in activities of daily living, nursing home admission, and earlier mortality [3].

Balance is considered a key component in many activities of daily living, from simple activities such as quiet standing, to more complex activities such as walking while talking or while changing directions. These different tasks require different components of balance ability, which are usually divided into two types of balance: static and dynamic. Static balance is defined as the ability to maintain an upright posture and to keep the line of gravity within the limits of the base of support (i.e., quiet standing). Dynamic balance is defined as the ability to maintain stability during weight shifting often while changing the base of support. The abdominals serve as a particularly vital component of the core. The transversus abdominis that run horizontal (except for the most inferior fibers, which run parallel to the internal oblique muscle), creating a belt around the abdomen. ‘‘Hollowing in’’ of the abdomen creates isolate activation of the transversus abdominis. The transverses abdominis and multifidi have been shown to contract 30ms before movement of the shoulder and 110ms before movement of the leg in healthy people, theoretically to stabilize the lumbar spine [4].

In 2012 Granacher et al. [5] and colleagues conducted first study that investigated the impact of core instability strength training on measures of trunk muscle strength, spinal and functional mobility as well as on balance in healthy and physically active seniors. Core strength training can reduce the risk of falls by challenging the nervous system to maintain balance and movement coordination. In a 2013 mega-analysis published in “Sports Medicine,” researchers concluded that core strength training can increase strength by an average of 30 percent and balance and functional performance by 23 percent among seniors [5].

The core strengthening exercise was proven that it was effective in improving balance ability of elderly and in preventing getting a bruise from a fall. Aging leads to loss of balance and stability hence Core strengthening program help elderly to independence in life activity & also improve the balance and quality of life [6].

Objective

To establish or review existing studies evaluating the effectiveness of core strength training to improve functional mobility and dynamic balance in geriatric population.

Methodology

Data bases searched

Pubmed, Google Scholar, Research Gate

Queries used

Core strength training, functional mobility, balance, geriatric population

To review the literatures that describes and evaluate the effectiveness of core muscle strengthening program to improve functional mobility and balance in geriatric population. Relevant articles in English were received through search of Pub Med, Google scholar, Research gate. Total 20 articles were taken and studied out of which 11 experimental studies, 3 comparative study, 2 cross sectional study, 2 review literature, 1 uncontrolled study and 1 longitudinal study were included. The inclusion criteria were geriatric population, the effect core strength training given studied and published from 2000 to present, studies published in English language, recent research. Exclusion criteria were studies published before 2000, studies conducted among younger adults, athletes. The purpose of the review was to gain an understanding about the benefits of core strength training in geriatric population in the area of functional mobility and balance to overcome repeated events of falls. The following key words are used in combinations: core strength training, functional mobility, balance, geriatric population.

Result

Total 20 articles were taken and studied. The review study is tabulated in Table 1A. About author, title of the study and final conclusion of the study were described below in the Table 1; [7-24].

Table 1: Porous structure testing of acetabular cups vs. ASTM Standards.

ASTM: American Society of Testing and Materials.


Discussion

The present study demonstrates a correlation between core strength training, functional mobility and balance ability in geriatric population. This analysis support and update the finding of previous reviews and identifies that core strength training is beneficial for the improvement of functional mobility and balance in older adult to achieve a good quality of life. The analysis supports the theory of Hodges and Richardson in 1996 according to him transverse abdominis contract before any Limb movement.

The core musculature is also responsible for generating a variety of movement of trunk in many planes of motion before leg movement. The data suggest that Core muscles are the kinetic link that transfers.

The torques and angular moment between upper and lower extremities during the execution of whole-body movements [25].

Global muscles (Rectus abdominis, external obliques and some parts of the erector spinae) are ideal for creating movement of the trunk and producing torque, because of their large moment arms and long levers as they are attached from the thorax to the pelvis [26]. These muscles are labelled as the prime movers for trunk or hip flexion, extension, and rotation. During whole body movement stability of core associated with Local muscles. [c]Local muscles (Transverses abdominis, multifidus, pelvic floor, diaphragm, and internal obliques are responsible for producing sufficient force for segmental stability of the spine [27]. The coordinated muscle recruitment between the global muscles and the local muscle during functional activities maintains stability of the core spine [28]. Core stabilization exercises helps in improving neuromuscular control, strength, and endurance of the muscles [29]. Core stability training targets the muscles deep within the trunk which are connected to the spine, pelvis and shoulders and it assists in maintaining good posture and provides the foundation for arm and leg movements [30]. Exercises that target core muscles are effective for core stabilization and motor control training and thus are used for maintaining balance. Studies suggested that core muscles play an important role in improving balance and training functional mobility in older adults. Study done by Sure et al. [29] have shown associations between diminished trunk muscle strength, endurance, muscle quality, and poor balance in older adults.

Conclusion

The present literature review concludes that core strength training is beneficial to improve functional mobility and balance in geriatric population.

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© 2021 Nithya Narayanan Kutty. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and build upon your work non-commercially.



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