낙상위험 여성노인의 요부안정화운동이 장애물 보행에 대한 운동역학적 효과 분석

Abstract

This study was performed to identify the kinetic and kinematic effects of the lumbar stabilization exercise on obstacle gait (5.2cm, 15.2cm) among elderly women with risk of fall. The study subjects were 32 women aged 65 years old and over with risk of fall identified by Tinetti test, who registered from senior citizen centers in 2 districts of G metropolitan city. They were randomly allocated into 2 groups; experimental group and control group. The lumbar stabilization exercise program was given to the experimental group for 12 weeks. The chi-square test and t-test were used to test homogeneity and to compare baseline results of kinetic and kinematic measurements on obstacle gait between experimental group and control group. To identify the effects of lumbar stabilization exercise program among study subjects, repeated measure of analysis of variance (ANOVA) was performed. Statistical analyses were carried out using SPSS 18.0 and for all tests of statistical significance, p<0.05 was used. For kinematic effects, knee angle of the leading limb significantly increased at 5.2cm obstacle gait, and crossing velocity and knee angles of the trailing limb and the leading limb at 15.2cm obstacle gait significantly increased, while foot clearance of the trailing limb and the leading limb significantly decreased. For kinetic effects, there were statistically significantly decreased in the ground reaction force (GRF) of Z axis of the leading limb significantly increased, Y axis in the trailing limb, the GRF of X axis of the leading limb, ankle moment and the loading rate of the trailing limb with 5.2 cm obstacle gate. With 15.2cm obstacle gait, the GRF of Z axis in both limbs, knee moment of the trailing limb and ankle moment of the leading limb significantly increased, while there were significantly decrease in the GRF of Y axis in both limbs, GRF of X axis and the ankle moment in the trailing limb, the loading rate of the leading limb, and muscular activities of gastrocnemius muscle of the trailing limb and rectus femoris of the leading limb. In conclusion, the lumbar stabilization exercise program might be effective method on elderly women to improve the physical balances by recovering the function of back muscles which contribute to their postural control.