The aim of this observational study is to reveal the effect of sarcopenia on cervical proprioception, kinesiophobia and pressure pain threshold in geriatric individuals living in a nursing home. The main questions it aims to answer are as follows: The presence of sarcopenia in geriatric individuals living in a nursing home is effective/not effective on cervical proprioception. The presence of sarcopenia in geriatric individuals living in a nursing home is effective/not effective on kinesiophobia. The presence of sarcopenia in geriatric individuals living in a nursing home is effective/not effective on pressure pain threshold. As a result of the evaluations, we will obtain the answers to the above questions with the surveys and measurements conducted with the participants divided into two groups as control and sarcopenia groups.
Aging, which is a physiological process, is a period that reduces or limits the activity level and functionality of individuals, making them socially, physically and emotionally dependent to different degrees. With increasing age, changes may occur in physiological, psychological, cognitive and social areas, while the individual's cognitive and functional capacity decreases, an increase in the incidence of chronic diseases is observed. In light of today's scientific, medical, technological and economic developments, the population of both our country and the world is increasing. The 'geriatric syndrome concept' that we encounter due to the increasing elderly population has brought with it a series of sub-concepts. The most important of these concepts is the concept of sarcopenia, which has been the subject of many studies in recent years. Sarcopenia is defined as a progressive and widespread loss of muscle mass, function and strength. The EWGSOP, known as the European Working Group on Sarcopenia in the Elderly, defined sarcopenia in 2010 as a syndrome characterized by progressive and widespread loss of skeletal muscle mass and function, associated with risks such as physical disability, poor quality of life and death. Sarcopenia, which is the most common among geriatric syndromes, significantly affects the physical, social and psychological life of the individual, while visibly restricting daily life activities. The presence of sarcopenia increases the risk and duration of hospitalization due to the loss of strength, falls and fragility it brings, and significantly increases the cost of care. Determining the parameters affected by sarcopenia in the geriatric population is essential for the establishment of preventive treatment algorithms and providing clinicians with a comprehensive perspective on sarcopenia. The first factor that the presence of sarcopenia can affect may be proprioception. It is thought that the impairments in proprioception may be due to a decrease in the dynamic response of muscle spindles and axonal atrophy leading to impaired processing of sensory information. The cervical region is especially critical in terms of proprioception. The suboccipital muscles in the cervical region contain a large number of mechanoreceptors for proprioception, and this region is defined as the main source of proprioceptive information. However, there is no study in the literature investigating the relationship between sarcopenia and cervical proprioception or the effect of sarcopenia on cervical proprioception. Another issue that needs to be addressed in the presence of sarcopenia is kinesiophobia. In a study conducted in 2024, the relationship between sarcopenia risk and kinesiophobia in geriatric individuals was evaluated and it was observed that sarcopenia risk increased the risk of kinesiophobia. Finally, another issue that we want to evaluate in the presence of sarcopenia is the pressure pain threshold. No study investigating the relationship between sarcopenia and pressure pain threshold was found in the literature. In light of the above information, the aim of the current study is to reveal the effect of sarcopenia on cervical proprioception, kinesiophobia and pressure pain threshold in geriatric individuals living in a nursing home. Purpose: To reveal the effect of sarcopenia on cervical proprioception, kinesiophobia and pressure pain threshold in geriatric individuals living in a nursing home. The current study was planned as a prospective, controlled study at the Private Nevia Oran Nursing Home and Elderly Care Center. Universe and sample of the study: The study will be conducted with the participation of individuals living in the Private Nevia Oran Nursing Home and Elderly Care Center located in the city center of Ankara. Data collection: Data will be collected by the researcher using a face-to-face interview technique . To determine the sarcopenia classification, hand grip strength will be measured with the Jamar hand dynamometer, and physical performance will be evaluated with the the 4 m walking test . Bioimpedance Analysis (BIA) and anthropometric measurement methods will be used to measure muscle mass. Based on the results obtained, individuals will be divided into 2 groups as those with sarcopenia and those without sarcopenia. Those with no decrease in muscle mass, grip strength and muscle performance will form the asymptomatic control group, while those with decreased muscle mass, grip strength and/or performance will be included in the sarcopenic group (experimental group). Joint position error test will be used to assess cervical proprioception. An algometer will be used to assess the pressure pain threshold. The kinesiophobia causes scale and pain catastrophizing scale will be used to assess fear of movement and pain catastrophizing.
Study Type
OBSERVATIONAL
Enrollment
31
Nevia Oran Nursing Home
Ankara, çankaya, Turkey (Türkiye)
Assessment of cervical proprioception
Cervical proprioception was assessed using joint position error test . While seated, the participant faced a board positioned 90 cm away at head level, consisting of concentric circles (40 cm diameter, 1-cm increments), and wore a cap with a mounted laser pointer The participant first aligned the laser with the central point to establish the neutral position, then-with eyes open-was guided through flexion, extension, right/left rotation, and right/left lateral flexion, returning to neutral after each movement. The same six movements were then actively performed with eyes closed . Six repetitions were completed for each direction, and the point at which the laser stopped was marked on the board after every trial . The mean of these points was calculated, and angular deviation from the target was determined using the arctan method based on the fixed distance to the board. A deviation of more than 4 degrees was considered to indicate impaired proprioception.
Time frame: 0-8 months
Assessment of kinesiophobia
Kinesiophobia was assessed using the Kinesiophobia Causes Scale (KCS) . Developed by Kocjan and Knapik, the scale identifies the biological and psychological sources of fear of movement and contributes to understanding the underlying causes of reduced motor activity. It comprises two domains: biological and psychological. The biological domain includes morphological factors, movement requirements, energy resources, biological drives, negative experiences, motor competence, and beliefs related to body care, while the psychological domain assesses factors such as confidence, self-efficacy, and social interaction that contribute to avoidance behavior . The Turkish validity and reliability study was conducted by Çayır et al. The greater this value in the range of 0-5, the more valid the person's level of kinesiophobia.
Time frame: 0-8 months
Assessment of pressure pain threshold
A pressure algometer (Baseline Force Gauge Model 12-0304; Baseline, NY, USA) will be used to assess the pressure pain threshold. The patient will be seated, and pressure will be applied perpendicularly and bilaterally using the algometer to different points in the cervical region (2 cm lateral to the C2 and C7spinous processes, at the midpoint of the upper part of the trapezius muscle) at a rate of approximately 3 N/s over an area of 0.5 cm² . The participant will be asked to report the moment they first felt discomfort and the pressure value at this moment will be recorded as the "pressure pain threshold". A second measurement will be taken at each region after an interval, the average of the two measurements will be noted.
Time frame: 0-8months
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