“Comparison Of Pelvic PNF And Lower Limb Strengthening Protocol For Prevention Of Fall In Post Menopausal Women”

Main Article Content

Roshni Kumari
Vinika Chaudhary
Shweta Sharma

Abstract

Background: One of the most well-known physiological effects of menopause is hormonal changes. Women's hormone levels decrease year by year during menopause, following which they are more likely to experience many changes as a result of this hormonal imbalance. Estrogen reacts directly and indirectly over muscle and results in condition leading to muscle loss, that brings about which in turn results in restrictions in physical abilities, muscle strength, and balance accelerating their risk of falling. Therefore this study
compared fall prevention techniques in postmenopausal women by incorporating proprioceptive neuromuscular facilitation (PNF) and
exercises utilizing elastic bands.
OBJECTIVES - To find out effect of pelvic PNF and lower limb strengthening to improve balance and strength for fall prevention.
METHOD- It is a control group experimental study with a pre-test and post-test design. total no. of 24 postmenopausal women of age 45 to 65 were included in the study, Pelvic PNF along with lower limb PNF was administered to Experimental Group whereas lower limb strengthening was given to Control group. Along with the above intervention, home based exercises was also provided. All the subjects in the study underwent a basic assessment and then they were randomly assigned into one of two groups, the 4-week treatment plan of 3 sessions per week for 30-35 minutes was given.
RESULT: After the 4 week PNF and elastic band exercise, both the experimental group and control groups showed statistically significant differences within the groups, except for POMA in the control group that showed no significant results. FTSTS in
experimental group with p value (0.008*) and in control group with p-value (0.000*). POMA with p value (0.02*) within experimental group showedsignificant results and POMA with p value (0.152) within control group showed no significant results. EFST with p value (0.005*) and (0.005*) showed significant result with in experimental and control group respevtively. There was no significant difference between the two groups in the scores of EFST, POMA and FTSTS (p>0.05).
CONCLUSION: Given the findings of the present study, Pelvic PNF and elastic band exercise should be recommended as a practical approach in order to improve strength, balance and reduce fall in postmenopausal women.

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How to Cite
Roshni Kumari, Vinika Chaudhary, & Shweta Sharma. (2024). “Comparison Of Pelvic PNF And Lower Limb Strengthening Protocol For Prevention Of Fall In Post Menopausal Women”. Journal of Advanced Zoology, 45(1), 624–630. https://doi.org/10.53555/jaz.v45i1.3520
Section
Articles
Author Biographies

Roshni Kumari

Post- Graduation Student (MPT Neurology), Shree Guru Gobind Singh Tricentenary University,
Gurugram, Haryana, India

Vinika Chaudhary

Assistant Professor, Faculty of Physiotherapy, Shree Guru Gobind Singh Tricentenary University,
Gurugram, Haryana, India

Shweta Sharma

Assistant Professor, MMIPR, MMU, Ambala, Haryana, India

References

Abbs, E., Brown, R., Guzman, D., Kaplan, L., & Kushel, M. (2020). Risk Factors for Falls in Older Adults Experiencing Homelessness: Results from the HOPE HOME Cohort Study. Journal of general internal medicine, 35(6), 1813–1820. https://doi.org/10.1007/s11606-020-05637-0

Altaf, S., Aftab, A., & Malik, A. N. (2019). Role of exercise in reducing risk of fall in geriatric population. JPMA. The Journal of the Pakistan Medical Association, 69(10), 1576.

Arnold, C. M., Busch, A. J., Schachter, C. L., Harrison, L., & Olszynski, W. (2005). The relationship of intrinsic fall risk factors to a recent history of falling in older women with osteoporosis. The Journal of orthopaedic and sports physical therapy, 35(7), 452–460. https://doi.org/10.2519/jospt.2005.35.7.452

Austin, N., Devine, A., Dick, I., Prince, R., & Bruce, D. (2007). Fear of falling in older women: a longitudinal study of incidence, persistence, and predictors. Journal of the American Geriatrics Society, 55(10), 1598–1603. https://doi.org/10.1111/j.1532-5415.2007.01317.x

Balance improvement by strength training for the elderly. Journal of physical therapy science, 25(12)

Barrett-Connor, E., Weiss, T. W., McHorney, C. A., Miller, P. D., & Siris, E. S. (2009). Predictors of falls among postmenopausal women: results from the National Osteoporosis Risk Assessment (NORA). Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 20(5), 715–722.

https://doi.org/10.1007/s00198-008-0748-2

Beth Bright, Erica Boerger, Lindsay Grillot, Katie Knous, Megan Lee, Chelsea Selking, Risa Umeno, The Association of Judgment and Related Factors That Affect Fall Risk in Older Adults, Topics in Geriatric Rehabilitation, 10.1097/TGR.0000000000000143, 33, 2, (89-97), (2017).

Bohannon, R. W., Magasi, S. R., Bubela, D. J., Wang, Y. C., & Gershon, R. C. (2012). Grip and knee extension muscle strength reflect a common construct among adults. Muscle & nerve, 46(4), 555–558. https://doi.org/10.1002/mus.23350

Cangussu, L. M., Nahas-Neto, J., Petri Nahas, E. A., Rodrigues Barral, A. B., Buttros, D.deA., & Uemura, G. (2012). Evaluation of postural balance in postmenopausal women and its relationship with bone mineral density--a cross sectional study. BMC musculoskeletal disorders, 13, 2. https://doi.org/10.1186/1471-2474-13-2

Cesário, D. F., Mendes, G. B. da S., Uchôa, É. P. B. L., & Veiga, P. H. A.. (2014). Proprioceptive neuromuscular facilitation and strength training to gain muscle strength in elderly women. Revista Brasileira De Geriatria E Gerontologia, 17(1), 67–77. https://doi.org/10.1590/S1809-98232014000100008

Cummings SR, Melton LJ: Epidemiology and outcomes of osteoporotic fractures. Lancet 2002, 359(9319):1761-1767

Dalal, P. K., & Agarwal, M. (2015). Postmenopausal syndrome. Indian journal of psychiatry, 57(Suppl 2), S222– S232. https://doi.org/10.4103/0019-5545.161483

De Cesar Netto, C., Godoy-Santos, A. L., Saito, G. H., Lintz, F., Siegler, S., O'Malley, M. J., Deland, J. T., & Ellis, S. J. (2019). Subluxation of the Middle Facet of the Subtalar Joint as a Marker of Peritalar Subluxation in Adult Acquired Flatfoot Deformity: A Case-Control Study. The Journal of bone and joint surgery. American volume, 101(20), 1838–1844. https://doi.org/10.2106/JBJS.19.00073

Elliott, K. J., Sale, C., & Cable, N. T. (2002). Effects of resistance training and detraining on muscle strength and blood lipid profiles in postmenopausal women. British journal of sports medicine, 36(5), 340–344. https://doi.org/10.1136/bjsm.36.5.340

Ferrucci, L., Guralnik, J. M., Buchner, D., Kasper, J., Lamb, S. E., Simonsick, E. M., Corti, M. C., Bandeen-Roche, K., & Fried, L. P. (1997). Departures from linearity in the relationship between measures of muscular strength and physical performance of the lower extremities: the Women's Health and Aging Study. The journals of gerontology. Series A, Biological sciences and medical sciences, 52(5), G R Neri, S., S Oliveira,

J., B Dario, A., M Lima, R., & Tiedemann, A. (2020). Does Obesity Increase the Risk and Severity of Falls in People Aged 60 Years and Older? A Systematic Review and Meta-analysis of Observational Studies. The journals of gerontology. Series A, Biological sciences and medical sciences, 75(5), 952–960. https://doi.org/10.1093/gerona/glz272

G., Iolascon, G., de Sire, A., Calafiore, D., Benedetti, M. G., Cisari, C., Letizia Mauro, G., Migliaccio, S., Nuti, R., Resmini, G., Gonnelli, S., & Moretti, A. (2020). Multifactorial Assessment of Risk of Falling in 753 Post-Menopausal Women: A Multicenter Cross-Sectional Study by the Italian Group for the Study of Metabolic Bone Diseases. Clinical interventions in aging, 15, 1077–1084. https://doi.org/10.2147/CIA.S257304

Go, H.-E., & Kim, S.-H. (2012). The Effect of PNF Exercise on Body Functions of Elderly Women. PNF and Movement , 10 (4), 9–23. https://doi.org/10.21598/JKPNFA.2012.10.4.9

Gong W. (2020). Effects of dynamic exercise utilizing PNF patterns on the balance of healthy adults. Journal of physical therapy science, 32(4), 260–264. https://doi.org/10.1589/jpts.32.260

Grabiner, M. D., Crenshaw, J. R., Hurt, C. P., Rosenblatt, N. J., & Troy, K. L. (2014). Exercise-based fall prevention: can you be a bit more specific?. Exercise and sport sciences reviews, 42(4), 161-168.

Granacher, U., Gollhofer, A., Hortobágyi, T., Kressig, R. W., & Muehlbauer, T. (2013). The importance of trunk muscle strength for balance, functional performance, and fall prevention in seniors: a systematic review. Sports medicine (Auckland, N.Z.), 43(7), 627–641. https://doi.org/10.1007/s40279-013-0041-1

Gregorio, L., Brindisi, J., Kleppinger, A., Sullivan, R., Mangano, K. M., Bihuniak, J. D., Kenny, A. M., Kerstetter, J. E., & Insogna, K. L. (2014). Adequate dietary protein is associated with better physical performance among post-menopausal women 60-90 years. The journal of nutrition, health & aging, 18(2), 155–160. https://doi.org/10.1007/s12603-013-0391-2

Hita-Contreras F, Martínez-Amat A, Cruz-Díaz D, Pérez-López FR (2016) Fall prevention in postmenopausal women: the role of Pilates exercise training. Climacteric 19:229– 233. https://doi.org/10.3109/13697137.2016.1139564

Holick MF: Too little vitamin D in premenopausal women: why should we care? Am J Clin Nutr, 2002, 76: 3–4. [Medline]

Joshua, A. M., D'Souza, V., Unnikrishnan, B., Mithra, P., Kamath, A., Acharya, V., & Venugopal, A. (2014). Effectiveness of progressive resistance strength training versus traditional balance exercise in improving balance among the elderly - a randomised controlled trial. Journal of clinical and diagnostic research : JCDR, 8(3), 98–102. https://doi.org/10.7860/JCDR/2014/8217.4119

Kalyani, R. R., Corriere, M., & Ferrucci, L. (2014). Age-related and disease-related muscle loss: the effect of diabetes, obesity, and other diseases. The lancet. Diabetes & endocrinology, 2(10), 819–829. https://doi.org/10.1016/S2213-8587(14)70034-8

KATO, M., IZUMI, K., HIRAMATSU, T. and SHOGENJI, M. (2006), Development of an exercise program for fall prevention for elderly persons in a long-term care facility. Japan Journal of Nursing Science, 3: 107-117. https://doi.org/10.1111/j.1742-7924.2006.00SS057.x

Khadilkar S. S. (2019). Musculoskeletal Disorders and Menopause. Journal of obstetrics and gynaecology of India, 69(2), 99–103. https://doi.org/10.1007/s13224-019-01213-7

Kim, J. W., Han, S. W., & Kim, J. G. (2006). The effects of elastic resistance exercise of lumbo-pelvic region and lower limbs muscle on walking ability and balance ability of the elderly. J Phys Growth Mot Dev, 14, 13-26.

Klein, D. A., Stone, W. J., Phillips, W. T., Gangi, J., & Hartman, S. (2002). PNF Training and Physical Function in Assisted-Living Older Adults, Journal of Aging and Physical Activity, 10(4), 476-488. Retrieved May 1, 2023, from https://doi.org/10.1123/japa.10.4.476

Ko, S. H., & Jung, Y. (2021). Energy Metabolism Changes and Dysregulated Lipid Metabolism in Postmenopausal Women. Nutrients, 13(12), 4556. https://doi.org/10.3390/nu13124556

Lord, S. R., Sambrook, P. N., Gilbert, C., Kelly, P. J., Nguyen, T., Webster, I. W., & Eisman, J. A. (1994). Postural stability, falls and fractures in the elderly: results from the Dubbo Osteoporosis Epidemiology Study. The Medical journal of Australia, 160(11), 684–691.

Mackintosh, S. F., Hill, K., Dodd, K. J., Goldie, P., & Culham, E. (2005). Falls and injury prevention should be part of every stroke rehabilitation plan. Clinical rehabilitation, 19(4), 441–451. https://doi.org/10.1191/0269215505cr796oa

Mesquita, L. S., de Carvalho, F. T., Freire, L. S., Neto, O. P., & Zângaro, R. A. (2015). Effects of two exercise protocols on postural balance of elderly women: a randomized controlled trial. BMC geriatrics, 15, 61. https://doi.org/10.1186/s12877-015-0059-3, de Carvalho, F. T., Freire, L. S., Neto, O. P., & Zângaro, R. A. (2015). Effects of two exercise protocols on postural balance of elderly women: a randomized controlled trial. BMC geriatrics, 15, 61. https://doi.org/10.1186/s12877-015-0059-3

Mesquita, L. S., de Carvalho, F. T., Freire, L. S., Neto, O. P., & Zângaro, R. A. (2015). Effects of two exercise protocols on postural balance of elderly women: a randomized controlled trial. BMC geriatrics, 15, 61. https://doi.org/10.1186/s12877-015-0059-3

Messier, V., Rabasa-Lhoret, R., Barbat-Artigas, S., Elisha, B., Karelis, A. D., & Aubertin-Leheudre, M. (2011). Menopause and sarcopenia: A potential role for sexhormones. Maturitas, 68(4), 331–336. https://doi.org/10.1016/j.maturitas.2011.01.014

Neri, S. G. R., Harvey, L. A., Tiedemann, A., Gadelha, A. B., & Lima, R. M. (2020). Obesity and falls in older women: Mediating effects of muscle quality, foot loads and postural control. Gait & posture, 77, 138–143. https://doi.org/10.1016/j.gaitpost.2020.01.025

Noh, H. J., & Kim, S. H. (2015). Comparative Study on the Effects of Proprioceptive Neuromuscular Facilitation and Elastic Band Exercise on the Physical Function and Blood Lipid Levels of Obese Elderly Women.

Pereira, M. P., & Gonçalves, M. (2012). Proprioceptive neuromuscular facilitation improves balance and knee extensors strength of older fallers. International Scholarly Research Notices, 2012.

Puri, P., Sinha, A., Mahapatra, P., & Pati, S. (2022). Multimorbidity among midlife women in India: wellbeing beyond reproductive age. BMC Women's Health, 22(1), 1-15.

Roberts, C. E., Phillips, L. H., Cooper, C. L., Gray, S., & Allan, J. L. (2017). Effect of different types of physical activity on activities of daily living in older adults: systematic review and meta-analysis. Journal of aging and physical activity, 25(4), 653-670.

Rodrigues, I. B., Ponzano, M., & Giangregorio, L. M. (2019). Practical tips for prescribing exercise for fall prevention. Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 30(10), 1953–1960. https://doi.org/10.1007/s00198-019-05141-0

Rolland, Y. M., Perry, H. M., 3rd, Patrick, P., Banks, W. A., & Morley, J. E. (2007). Loss of appendicular muscle mass and loss of muscle strength in young postmenopausal women. The journals of gerontology. Series A, Biological sciences and medical sciences, 62(3), 330–335.

https://doi.org/10.1093/gerona/62.3.330

Scheffer, A. C., Schuurmans, M. J., van Dijk, N., van der Hooft, T., & de Rooij, S. E. (2008). Fear of falling: measurement strategy, prevalence, risk factors and consequences among older persons. Age and ageing, 37(1), 19–24. https://doi.org/10.1093/ageing/afm169

Sheereen, F., & Kadarkar, K. S. (2022). Community-based appraisal of menopause-specific health problems and quality of life among women of rural Western Maharashtra. Journal of family medicine and primary care, 11(11), 7328–7334. https://doi.org/10.4103/jfmpc.jfmpc_1377_22

Shumway-Cook, A., Brauer, S., & Woollacott, M. (2000). Predicting the probability for falls in communitydwelling older adults using the Timed Up & Go Test. Physical therapy, 80(9), 896–903.

Song, H. S., Park, S. D., & Kim, J. Y. (2014). The effects of proprioceptive neuromuscular facilitation integration pattern exercise program on the fall efficacy and gait ability of the elders with experienced fall. Journal of exercise rehabilitation, 10(4), 236–240. https://doi.org/10.12965/jer.140141

Srivastava, S., & Muhammad, T. (2022). Prevalence and risk factors of fall-related injury among older adults in India: evidence from a cross-sectional observational study. BMC public health, 22(1), 550. https://doi.org/10.1186/s12889-022-12975-7

Sucuoglu, H., Tuzun, S., Akbaba, Y. A., Uludag, M., & Gokpinar, H. H. (2015). Effect of Whole-Body Vibration on Balance Using Posturography and Balance Tests in Postmenopausal Women. American journal of physical medicine & rehabilitation, 94(7), 499–507.

https://doi.org/10.1097/PHM.0000000000000325

Witt, D., Talbott, N., & Kotowski, S. (2011). Electromyographic activity of scapular muscles during diagonal patterns using elastic resistance and free weights. International journal of sports physical therapy, 6(4), 322.

Zhao, J., Liang, G., Huang, H., Zeng, L., Yang, W., Pan, J., & Liu, J. (2020). Identification of risk factors for falls in postmenopausal women: a systematic review and meta-analysis. Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 31(10), 1895–1904. https://doi.org/10.1007/s00198-020-

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