Elderly is an age group that has a high risk of experiencing health problems. One risk that can be experienced by the elderly is the risk of falling. One of the risk factors for falling in the elderly is decreasing in postural balance of the elderly. One of the non-pharmacological therapies developed to reduce the risk of falling in the elderly is to improve the ability of the elderly, especially in controlling postural balance. The purpose of this study was to determine the effectiveness of 12 balance exercises to improve postural balance in the elderly. This type of research is quasi experiments with static group comparison. The research data are obtained by researchers using observation sheet, then the data are tabulated. This study involved two research groups namely the control group (the group not given the intervention) and the treatment group (the group that was given the 12 balance exercise intervention). From the results of Paired samples, t-test with significance level α = 0.05 is obtained by the significance value (p) of 0.025. This study shows that the provision of 12 balance therapy exercise strategy is effective to improve postural balance in the elderly as a preventive effort from the risk of falling.
Elderly is a condition which is an advanced stage of the life process characterized by a decrease in the body’s ability to adapt to environmental stress. Decreasing the ability of various organs, functions and systems of this body is physiological [
The Central Bureau of Statistics Indonesia report the life expectancy increased in 2010, the elderly population was 7.56% and in 2011 it was 7.58%. Meanwhile, the Indonesian Health Profile Source in 2012 illustrates the proportion of elderly in Indonesia of 7.6% or around 18.5 million people. The United Nations, World Population Prospect stated that in 2013 the number of elderly people in Indonesia had increased to 8.9%. About 30% - 50% of the elderly population (aged 65 years) and above experience falls every year [
The risk of falling during an activity can be experienced by all ages. The older a person is, the more risk of falling incidents will be. One of the causes of falls in the elderly is the occurrence of postural disorders caused by the aging process, the disease experienced, and a decrease in bodily functions. Falling incidents experienced by the elderly can result in fractures, muscle disorders and the most fatal risk is death [
Various therapeutic treatments both pharmacological and non-pharmacological began to be developed to reduce the risk of falls in the elderly. To reduce the risk of falling in old age, the Ministry of Health of the Republic of Indonesia through aging, healthy and active program. This aims to improve the quality of life of the elderly and reduce the rate of dependence on the elderly in the family. One of the efforts made is to avoid the elderly from the risk of degenerative diseases and various other disorders including the risk of falling. The non pharmacology method developed to reduce the risk of falling in the elderly is to use the 12 balance strategy exercise technique. The 12 balance strategy exercise has benefits for increasing functional stability limits, improving motor systems, improving postural control, and increasing dynamic stability. But this technique also has a negative impact on the elderly when applied so that the implementation is needed by the supervisor [
The purpose of this study was to determine the effectiveness of 12 balance exercises to improve postural balance in the elderly.
This type of research is quasi experiments with static group comparison study design which in practice is used two groups: Treatment using 12 balance exercise strategy and without exercises. Respondents involved in this research activity must meet the research criteria determined by the researcher, namely: 1) is an elderly group, 2) has fallen during an activity, 3) has no physical problems such as a disability in the body or visual impairment, 4) can communicate well. The instrument of data collection used is the observation sheet adopted from Berg Balance Scale. This measurement consists of 14 types of static balance tests or dynamic on a scale of 0 - 4 (scale based on quality and time) required to complete the test) [
This study was approved by the local ethics commissions are derived from hospital institutions Wahidin Sudiro Husodo Mojokerto. This study was approved by the local ethics commissions are derived from hospital institutions Wahidin Sudiro Husodo Mojokerto (033/RSU/EC/IV/2018). For the determination of the area used as a study was approved by the Research Commission Mojokerto.
1) Sociodemographic and clinical characteristics of the participants.
The results of research conducted for social demographics and respondent characteristics of the research are presented in
2) Effectiveness of 12 balance exercise on postural balance in the elderly.
Data that has been collected using Berg Balance Scale, it can be concluded that the group of respondents given the 12 balance exercise intervention experienced an increase in postural balance of 1.53770. This result is higher when compared to changes in postural balance experienced by groups of respondents who were not given intervention with a result of 0.17264. From the Paired samples t-test analysis obtained significance value of 0.025 so the research hypothesis is accepted which means intervention 12 balance exercise effective to improve the postural balance in the elderly (
No | Characteristic | Group with treatment | Group without treatment | ||
---|---|---|---|---|---|
N | % | N | % | ||
1 | Age · Middle age (45 - 59 years old) · Elderly (60 - 74 years old) · Old (75 - 90 years old) | 3 25 6 | 8.8% 73.5% 17.6% | 4 22 8 | 11.8% 64.7% 23.5% |
2 | Sex · Man · Women | 16 18 | 47.1% 52.9% | 20 14 | 58.8% 41.2% |
3 | Work activities · Active work · Not actively working | 24 10 | 70.6% 29.4% | 22 12 | 64.7% 35.3% |
4 | Blood pressure · Pre-hypertension · First degree hypertension · Second degree hypertension | 6 24 4 | 17.6% 70.6% 11.8% | 8 20 6 | 23.5% 58.8% 17.6% |
Group with treatment | Group without treatment | |||
---|---|---|---|---|
Pre-test | Post-test | Pre-test | Post-test | |
Mean | 26.1176 | 26.7353 | 25.9706 | 26.2941 |
Std. Deviation | 6.23171 | 6.64379 | 6.31250 | 6.06795 |
Std Error Mean | 1.06873 | 1.13940 | 1.08258 | 1.04064 |
Group with treatment | Group without treatment | |
---|---|---|
Mean | −0.61765 | 1.00666 |
Std. Deviation | 1.53770 | 0.17264 |
Lower | −1.15418 | −0.67477 |
Upper | −0.08112 | 0.02771 |
---|---|---|
t | −2.342 | −1.874 |
df | 33 | 33 |
Sig. (2-tailed) | 0.025 | 0.070 |
From the results of the study, it was found that the elderly group of respondents given the 12 balance exercise intervention experienced an increase in postural balance with a significance value of 0.025.
The provision of 12 balance exercise intervention has the same mechanism in improving dynamic balance in the elderly by maintaining the limit of stability, activating the system feedback on movement strategies, and increasing dynamic stability. The 12 balance exercise training has the advantage of improving dynamic balance, making this training more effective. The 12 balance exercise training activates the feedforward mechanism in movement strategies and enhances sensory strategies in the form of sensory integration and sensory re-weighting [
The vestibulocerebellum (cerebellum) system is useful for regulating the balance between the contraction of agonist muscles and antagonistic muscles in the back, pelvis, and shoulders when the body’s position changes rapidly thus needed by the vestibular apparatus. In the stepping exercise training in the 12 balance exercise, it activates the vestibulocerebellum function which acts to calculate the speed of the next movement and the direction in which various body parts will be for the next few milliseconds. The results of this calculation are the key to the brain’s progress for the next sequence of motion [
Sensory integration in the 12 balance exercise training is achieved through eye tracking, dynamic walking, and stepping exercise training [
In an effort to improve health of the elderly, participation from various parties is needed to provide support to the elderly in their efforts to achieve the goal of improving health. The risk of falling during an activity in the elderly is a natural condition to occur in the elderly considering that at the age of the elderly, the organs of the body begin to experience a decline in function and ability. The provision of a 12 balance exercise intervention is a preventive effort that can be done to improve postural balance in the elderly which in turn will trigger elderly independence in carrying out activities.
The results of the research conducted to prove that the provision of 12 balance exercise interventions in the elderly is effective in helping the elderly to improve their postural balance and reduce the risk of falling in the elderly while doing activities.
This research was supported by the Republic of Indonesia Ministry of Research, Technology and Higher Education.
The authors declare no conflicts of interest regarding the publication of this paper.
Murtiyani, N. and Suidah, H. (2019) The Effect of Giving Intervention 12 Balance Exercise on Postural Balance in Elderly. Open Journal of Nursing, 9, 534-540. https://doi.org/10.4236/ojn.2019.95045