The Effect of Lower Extremity Strengthening Exercises Versus Trunk Strengthening Exercises

The aim of this study is to investigate the effect of lower extremity strengthening exercises versus trunk strengthening exercises on balance, walking, fall risk and quality of life in elderly individuals. In our study, the participants will be divided into 3 groups consisting of trunk strengthening exercises, lower extremity strengthening exercises and control groups.Body strengthening exercises and lower extremity strengthening exercises group will be included in the exercise program for a total of 40 minutes each session, 3 sessions a week, for a total of 8 weeks. The exercises will be shown and applied by the research physiotherapist in groups of 2-3 to the participants of both groups. No exercise program will be applied to the control group, and appropriate exercise training will be given after the final evaluation.

Those aged 65 and over, residing in Yalova and agreeing to be included in the study, will be included in the study. Volunteers who will participate in the study will be informed about the purpose of the study, its duration, and possible side effects of the treatment to be applied. Their consent will be obtained with an "Informed Consent Form" prepared in accordance with the standards determined by the Clinical Research Ethics Committee of Istanbul University Cerrahpaşa Faculty of Medicine, and the study will be carried out in accordance with the Declaration of Helsinki. In our study, the participants will be divided into 3 groups consisting of trunk strengthening exercises, lower extremity strengthening exercises and control groups.

Body strengthening exercises and lower extremity strengthening exercises group will be included in the exercise program for a total of 40 minutes each session, 3 sessions a week, for a total of 8 weeks. The exercises will be shown and applied by the research physiotherapist in groups of 2-3 to the participants of both groups. No exercise program will be applied to the control group, and appropriate exercise training will be given after the final evaluation.

Evaluation scales will be administered to the participants at the beginning of the study and 8 weeks later.

Body weight, own weight of the extremity and elastic exercise band will be used in strengthening exercises in trunk strengthening exercises and lower extremity strengthening exercises groups.

The weight of the extremity itself, or the number of repetitions in exercises using body weight, will be determined at the initial assessment according to the patient's exercise tolerance for each exercise. For each exercise, the exercise program will be started with the number of repetitions perceived by the participant according to the Modified Borg Scale (MBS), the number of repetitions will be increased, the program will be continued with the number of repetitions, the perceived fatigue severity will be between 4-7, by increasing the number of repetitions weekly. will be.

Appropriate band selection for the exercises to be used with an elastic exercise band will be determined according to the participant's tolerance and muscle strength. Participants will be asked to do the exercise for 15 repetitions with the lowest level of exercise band first, and then the perceived fatigue severity will be questioned by MBS. If the exercise intensity perceived by the participant is between 4 and 7, it will be determined as the correct band. If the participant's perceived severity is lower, the process with the next higher band will be repeated until the correct band is found for the patient. The same process will be applied for the tape to be used in the strengthening training of each region.

Elastic band exercises will be started with 8 repetitions, and the intensity of exercise will be questioned by increasing the number of repetitions by 2 in the first exercise session each week. If the perception of exercise intensity has increased, the number of repetitions will be kept the same, if the exercise intensity does not increase, the number of repetitions will be continued as 10, the next week after the exercise as 12 repetitions, the color of the exercise band will be changed and the exercise intensity will be evaluated by switching to the next band, and if the exercise intensity is appropriate, the previous band will be evaluated.

Eligibility Criteria:
Inclusion Criteria:

* Being 65 years or older
* Having adequate cognitive function ((Mini Mental State Test (MMST) score equal to or greater than 24)
* Functional Ambulation Classification (FAC) level of 3, 4 or 5.

Exclusion Criteria:

* Having cardiac diseases that prevent exercise
* Have had any cardiac event or surgery in the last six months
* Pulmonary embolism and deep vein thrombosis in the last three months
* History of disabling cerebrovascular disease
* Presence of acute retinal hemorrhage or previous ophthalmic surgery
* Presence of active infection, malignancy or multiple organ failure
* Terminal disease status
* Having a history of lower and upper extremity fractures in the last three months
* Severe hearing and vision loss
* Being diagnosed with Parkinson's, dementia, or depression
* Have received exercise training in the last six months
* Multiple drug use
* Having been diagnosed with vestibular disease
* Existence of moderate or severe respiratory system disease that is not under control that interferes with exercise
* Having uncontrolled hypertension
* Having diabetes with diabetes complications such as nephropathy, retinopathy and severe neuropathy, or uncontrolled diabetes.