Trunk Muscle Attributes Are Associated With Balance and Mobility in Older Adults: A Pilot Study

Abstract

Objective To determine if trunk muscle attributes are associated with balance and mobility performance among mobility-limited older adults. Design Cross-sectional analysis of data from a randomized clinical trial. Setting Outpatient rehabilitation research center. Participants Community-dwelling older adults (N=70; mean age 75.9 y) with mobility limitations as defined by the Short Physical Performance Battery (SPPB). Methods Independent variables included physiologic measures of trunk extension strength, trunk flexion strength, trunk extension endurance, trunk extension endurance and leg press strength. All measures were well tolerated by the study subjects without the occurrence of any associated injuries or adverse events. The association of each physiologic measure with each outcome was examined, using separate multivariate models to calculate the partial variance (R2) of each trunk and extremity measure. Main Outcome Measurements Balance measured by the Berg Balance Scale (BBS) and Unipedal Stance Test (UST), and mobility performance as measured by the SPPB. Results Trunk extension endurance (partial R2=.14, p=.02), and leg press strength (partial R2=.14, p=.003) accounted for the greatest amount of the variance in SPPB performance. Trunk extension endurance (partial R2=.17, p=.007), accounted for the greatest amount of the variance in BBS performance. Trunk extension strength (R2=.09, p=.03), accounted for the greatest amount of the variance in UST performance. The variance explained by trunk extension endurance equaled or exceeded the variance explained by limb strength across all three performance outcomes. Conclusions Trunk endurance and strength can be safely measured in mobility-limited older adults, and are associated with both balance and mobility performance. Trunk endurance and trunk strength are physiologic attributes worthy of targeting in the rehabilitative care of mobility-limited older adults.

Effects of Core Instability Strength Training on Trunk Muscle Strength, Spinal Mobility, Dynamic Balance and Functional Mobility in Older Adults

“…Kibler et al [12] argued that the core is especially important in everyday and sports-related activities because it provides proximal stability for distal mobility. Preliminary studies reinforce and extend these hypotheses by showing that there is an association between trunk muscle strength (trunk extensor strength) and balance (unipedal stance test) as well as functional mobility (Short Physical Performance Battery, Berg Balance Scale) in community-dwelling older adults with a mean age of 76 years [13]. Further, Hicks et al [14] investigated whether trunk muscle composition is a predictor of functional mobility in community-dwelling older adults (age range 70-79 years).…”

“…The authors concluded that improving trunk muscle composition may be an important approach to maintain function and potentially reduce balance and functional mobility impairments. Given these findings [5,13,14], it seems plausible to argue that core strength training may have the potential to improve trunk muscle strength, postural alignment, balance and functional mobility in older adults. …”

Prediction of Dynamic Postural Stability During Single-Leg Jump Landings by Ankle and Knee Flexibility and Strength

“…20 In addition, knee-extensor strength has been found to be a significant predictor of static and dynamic balance in the elderly. 21 Literature on trunk strength indicates that trunkextensor-muscle performance (strength and endurance) is associated with static-balance scores in elderly individuals with limited mobility, 22 and that core-strengthening programs improve static postural stability, 23 as well as dynamic postural stability measured with the SEBT.…”

Development of Core Strength Training Equipment and Its Effect on the Performance and Stability of the Elderly in Activities of Daily Living

“…Several prior studies on enhancing core strength in the elderly have been conducted. In particular, Suri, Kiely, Leveille, Frontera, & Bean (2009) verified that an association among increased trunk muscle strength, balance, and daily functions. Hicks et al (2005) reported that trunk muscle composition is a predictor of functional stability of the elderly.…”

“…In addition, many scholars believe that core strength training has the potential of strengthening trunk muscles, controlling posture, and improving balance, and functional stability in the elderly (Hicks et al, 2005;Katzman, Vittinghoff, & Kado, 2011;Suri et al, 2009). …”