Journal of Gerontology
سالمندشناسی
joge
Medical Sciences
http://joge.ir
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2476-7301
2476-7301
10.22034/joge
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jalali
1405
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gregorian
2026
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ارتباط تعادل عملکردی و قدرت عضلات مچ پا با سابقه افتادن سالمندان ساکن جامعه: مطالعه مقطعی
Association of Functional Balance and Ankle Muscle Strength with Fall History Among Community-Dwelling Older Adults: A Cross-Sectional Study
مسائل جسمی سالمندان
elderly physical issues
پژوهشي اصیل
Original research
<span style="font-size:11pt"><span style="line-height:115%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"><strong>مقدمه</strong>: افتادن از مهم‌ترین دغدغه‌های سلامت عمومی در سالمندان با پیامدهای جسمی و روانی شدید است. در حالی که تعادل و قدرت عضلات مچ پا به‌عنوان عوامل کلیدی در خطر افتادن شناخته می‌شوند، نقش ترکیبی آن‌ها در سابقه افتادن سالمندان ساکن جامعه مشخص نیست. این مطالعه با هدف بررسی ارتباط تعادل عملکردی و قدرت عضلات مچ پا با سابقه افتادن انجام شد</span></span></span><span dir="LTR" style="font-size:12.0pt"><span style="line-height:115%">.</span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="line-height:115%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">روش‌ها: </span></span></span></b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">این مطالعه مقطعی بر روی </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">۱۹۶</span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"> سالمند ساکن جامعه (میانگین سنی </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">۸/۷۰ </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%">±</span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"> ۱/۵</span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"> سال؛ </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">۵۰</span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"> درصد مرد) در ایران انجام شد. تعادل عملکردی با مقیاس تعادل برگ و آزمون دسترسی عملکردی ارزیابی شد. قدرت ایزومتریک عضلات مچ پا (پلانتار فلکسور و دورسی فلکسور) به‌صورت دوطرفه با دینامومتر دستی اندازه‌گیری شد. سابقه افتادن از طریق خودگزارشی در </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">۱۲</span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"> ماه گذشته به دست آمد. داده‌ها با آزمون</span></span></span><span dir="LTR" style="font-size:12.0pt"><span style="line-height:115%"> t </span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">مستقل و رگرسیون لجستیک دوحالته تحلیل شدند</span></span></span><span dir="LTR" style="font-size:12.0pt"><span style="line-height:115%">.</span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="line-height:115%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">یافته‌ها: </span></span></span></b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">سالمندان با سابقه افتادن در مقایسه با گروه غیرافتاده، تعادل عملکردی به‌طور معناداری ضعیف‌تر </span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"><span style="color:#0f1115">(</span></span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"><span style="color:#0f1115">2/4</span></span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span cambria="" style="font-family:"><span style="color:#0f1115">±</span></span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"><span style="color:#0f1115"> 7/44</span></span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"><span style="color:#0f1115"> در مقابل </span></span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"><span style="color:#0f1115">1/3 </span></span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span cambria="" style="font-family:"><span style="color:#0f1115">±</span></span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"><span style="color:#0f1115"> 8/51</span></span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"><span style="color:#0f1115">؛ </span></span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"><span style="color:#0f1115">001/0 ></span></span></span></span><span dir="LTR" style="font-size:12.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><span style="color:#0f1115">P</span></span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"><span style="color:#0f1115">) </span></span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">و قدرت پلانتار فلکسور راست کمتری (1/9 </span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span cambria="" style="font-family:">±</span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"> 5/36 نیوتن در مقابل 5/8 </span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span cambria="" style="font-family:">±</span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"> 3/45 نیوتن؛ 001/0 ></span></span></span><span dir="LTR" style="font-size:12.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">P</span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">) داشتند. تحلیل رگرسیون لجستیک نشان داد که تعادل عملکردی، قوی‌ترین همبسته مستقل سابقه افتادن است </span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"><span style="color:#0f1115">(نسبت شانس = </span></span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"><span style="color:#0f1115">85/0</span></span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"><span style="color:#0f1115">؛ فاصله اطمینان </span></span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"><span style="color:#0f1115">۹۵</span></span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><span style="color:#0f1115">٪</span></span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"><span style="color:#0f1115">: 78/0</span></span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"><span style="color:#0f1115"> تا </span></span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"><span style="color:#0f1115">92/0</span></span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"><span style="color:#0f1115">؛ </span></span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"><span style="color:#0f1115">۰01/0></span></span></span></span><span dir="LTR" style="font-size:12.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><span style="color:#0f1115">P</span></span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"><span style="color:#0f1115">). </span></span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">و پس از آن، قدرت پلانتار فلکسور راست قرار دارد </span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"><span style="color:#0f1115">(نسبت شانس = </span></span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"><span style="color:#0f1115">94/0</span></span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"><span style="color:#0f1115">؛ فاصله اطمینان </span></span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"><span style="color:#0f1115">۹۵</span></span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><span style="color:#0f1115">٪</span></span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"><span style="color:#0f1115">: 91/0</span></span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"><span style="color:#0f1115"> تا </span></span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"><span style="color:#0f1115">98/0</span></span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"><span style="color:#0f1115">؛ </span></span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"><span style="color:#0f1115">003/0=</span></span></span></span><span dir="LTR" style="font-size:12.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><span style="color:#0f1115">P</span></span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:"><span style="color:#0f1115">). </span></span></span></span><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">با این حال، قدرت دورسی فلکسور و پلانتار فلکسور چپ به سطح معنی‌داری آماری نرسیدند.</span></span></span><b><span dir="LTR" style="font-size:12.0pt"><span style="line-height:115%"></span></span></b></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="line-height:115%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">نتیجه‌گیری: </span></span></span></b><span lang="AR-SA" style="font-size:12.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">تعادل عملکردی و قدرت عضله پلانتار فلکسور مچ پا، همبسته‌های مستقل مهمی برای سابقه افتادن در سالمندان ساکن جامعه هستند و تعادل عملکردی، قوی‌ترین همبسته محسوب می‌شود. این یافته‌ها بر اهمیت ارزیابی جامع تعادل و قدرت عضلات مچ پا در برنامه‌های غربالگری و طراحی مداخلات توانبخشی هدفمند برای پیشگیری از افتادن تأکید می‌کنند.</span></span></span></span></span></span></span></span>
<span style="font-size:11pt"><span style="background:white"><span style="line-height:150%"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:12.0pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times=""><span style="color:#0f1115">Introduction:</span></span></span></span></b><span style="font-size:12.0pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times=""><span style="color:#0f1115"> Falls are a major public health concern among older adults, with severe physical and psychological consequences. While balance and ankle muscle strength are recognized as critical factors in fall risk, their combined role in fall history among community-dwelling older adults remains unclear. This study aimed to investigate the association of functional balance and ankle muscle strength with fall history.</span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="background:white"><span style="line-height:150%"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:12.0pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times=""><span style="color:#0f1115">Methods:</span></span></span></span></b><span style="font-size:12.0pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times=""><span style="color:#0f1115"> A cross-sectional study was conducted with 196 community-dwelling older adults (mean age: 70.8 ± 5.1 years; 50% male) in Iran. Functional balance was assessed using the Berg Balance Scale and the Functional Reach Test. Isometric ankle muscle strength (plantarflexion and dorsiflexion) was measured bilaterally using a handheld dynamometer. Fall history was obtained through self-report over the preceding 12 months. Data were analyzed using independent t-tests and binary logistic regression.</span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="background:white"><span style="line-height:150%"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:12.0pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times=""><span style="color:#0f1115">Results:</span></span></span></span></b><span style="font-size:12.0pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times=""><span style="color:#0f1115"> Older adults with a history of falls demonstrated significantly poorer functional balance (BBS: 44.7 ± 4.2 vs. 51.8 ± 3.1; p < 0.001) and lower right ankle plantarflexor strength (36.5 ± 9.1 N vs. 45.3 ± 8.5 N; p < 0.001) compared to non-fallers. Binary logistic regression revealed that functional balance was the strongest independent correlate of fall history (OR = 0.85; 95% CI: 0.78–0.92; p < 0.001), followed by right ankle plantarflexor strength (OR = 0.94; 95% CI: 0.91–0.98; p = 0.003). However, left ankle plantarflexor strength and dorsiflexor strength did not reach statistical significance.</span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="background:white"><span style="line-height:150%"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:12.0pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times=""><span style="color:#0f1115">Conclusion:</span></span></span></span></b><span style="font-size:12.0pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times=""><span style="color:#0f1115"> Functional balance and ankle plantarflexor strength are significant independent correlates of fall history in community-dwelling older adults, with functional balance emerging as the strongest correlate. These findings highlight the importance of comprehensive balance and ankle strength assessments in fall risk screening and targeted rehabilitation programs.</span></span></span></span></span></span></span></span>
افتادن تصادفی؛ تعادل وضعیتی؛ قدرت عضلانی؛ سالمند؛ مطالعه مقطعی
Accidental Falls, Postural Balance, Muscle Strength, Aged, Cross-Sectional Studies.
84
93
http://joge.ir/browse.php?a_code=A-10-843-4&slc_lang=fa&sid=1
Safoora
Sabbaghian Rad
صفورا
صباغیان راد
safoora_rad@yahoo.com