Are Static and Dynamic Balance Tests A Criteria Showing Cognitive Impairments In the Elderly?

Study Overview
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Brief Summary
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The aim of our study is to reveal whether static and dynamic balance tests can be an indicator of deterioration in cognitive impairments in geriatric individuals.

Detailed Description
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the static and dynamic balance test will be used to predict cognitive impairments in older adults.

Official Title
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Are Static and Dynamic Balance Tests A Criteria Showing Cognitive Impairments In the Elderly?

Conditions
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Geriatric Population, Balance Problems

Intervention / Treatment
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* Diagnostic Test: Four Square Step Test


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Relative, healthy elderly individuals aged 65-85 years Individuals who do not have neurological / orthopedic problems that will prevent them from performing the test Independent elderly individuals in activities of daily living Men and women living in a nursing home No pre-defined vision and hearing problems No history of lower extremity or lumbar spinal surgery Exclusion Criteria: Hadkinson's Abbreviated Mental Test less than 7 points Presence of defined neurological, orthopedic, systemic (cardiovascular) disease that interferes with walking and mobility Presence of defined psychiatric illness Having a communication problem Presence of using aids for walking Use of prostheses or orthoses associated with the lower extremity Presence of cognitive, visual or auditory impairment Balance-affected individuals with lower extremity disorders

Ages Eligible for Study
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Minimum Age: 65 Years
Maximum Age: 85 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Diagnostic Test: Four Square Step Test|These are standardized test which will be applied to subjects with pencil, paper and time recorder.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Standardized Mini Mental Test | The mini mental test is a test that can be administered by a physician, nurse, psychologist or a healthcare professional with a short training. It is a practical mental test in terms of applicability that can show the cognitive level globally. Evaluates cognitive performance quantitatively. It is important in terms of examining the course of dementia cases and their response to treatment in the clinic. There are 11 items in the test gathered around 5 main headings. These items are; Orientation is register memory, attention and calculation, recall and language. The total score is evaluated out of 30. A score of 25 and above is considered normal. Between 10 and 19 is moderate dementia. Between 19-24 refers to early dementia (13,14). | 5 minutes | 
| Four Step Square Test | The test clinically assesses the ability to change direction while taking a step. At the start of the test, the patient stands in the upper left square (Frame 1) and looks in the direction of Square 2. First, the step sequence is clockwise: Square 1, then Squares 2, 4, and 3. Then the step sequence is counterclockwise: square 3, followed by squares 4, 2, and 1. The physiotherapist demonstrates the test and allows the patient to apply the model to learn the sequence. The test is repeated if the patient fails to complete the sequence successfully or loses balance or touches the cane. Two points are obtained and the better of these two points is recorded. Timed effort begins when the first foot touches the ground at Square 2 and then ends when the patient's second foot touches the ground at Square 1 (15, 16, 17). | 8 minutes | 
| Timed Up and Get Test | The test assesses functional mobility, balance, and performance in adults 65 years and older. Wearing normal shoes and walking aids, the patient begins the test in a standard seat with his back against the chair, his arms resting on the arms of the chair, and both feet flat on the floor. The patient is instructed to stand up and walk to a line on the ground at a distance of 3 m, turn on the line, walk back to the chair and sit on the chair. The test ends when the patient's hip touches the seat. The test is repeated twice; The fastest time is recorded. It is classified as mobile for <10 s, general independent for <20 s, and limited mobility for >30 s (15, 16, 18). | 5 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| One Leg Standing Test (Eyes Open and Eyes Closed): | One leg is lifted without touching the standing leg. Initially, the eyes remain open. The patient is instructed to close their eyes and is asked to maintain their balance for 30 seconds. Balance disorder is suspected if the lifted leg touches the support leg, the lifted leg touches the ground, the patient jumps on the standing leg, or touches something for balance. Inability to balance on one leg for 30 seconds during one-leg stance is an indication of decreased balance function. However, the clinical expectation for the ability to balance on one leg decreases with the age of the patient. Healthy individuals aged 60-69 should be able to stand on one leg with their eyes open for at least 5 seconds (19). | 3 minutes | 
| Functional Reach Test: | The functional reach test, developed by Duncan et al., is a reliable and validated test used in clinical balance measurement. Have the patient raise the right arm 90° while standing in a comfortable position with bare feet and then step with the right arm without stepping and/his balance. During the functional reach test, the physiotherapist observes whether the patient is on the ground with both feet and does not step forward. If one of these behaviors occurs, the patient repeats the test. The Functional Reach Test is repeated three times and the best measurement is recorded. Decreased ability to lie down indicates an increased risk of the patient falling in the future; Values of 15 cm and below indicate a significantly increased risk of falling, and values between 15 and 25 cm indicate a mild fall risk (20). | 4 minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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geriatria, cognitive status, balance test