The primary aim of this study is to investigate the effects of easily applicable somatic-based chair exercises on balance and pain in the elderly. Additionally, the study aims to reveal the impact of exercise on functionality and cognitive level, and the resulting changes in quality of life. The main research questions addressed in this study are: * What are the most suitable exercise models that can be applied to improve pain control and balance in the elderly? * How do the results of different approaches aimed at improving the quality of life in the elderly differ?
Somatic education refers to a process of sensory-motor learning that enables individuals to develop greater conscious control over their physiological functions. In this study, Thomas Hanna's definition of somatics and Hanna Somatic Education will be used. Thomas Hanna (1976) introduced the term "somatics" to describe the discipline of movement reeducation (somatic education/somatic movement), which aims to promote inner awareness of an individual's body. The practice of somatic movement involves pandiculation. Pandiculation is a process that starts with deliberate muscle activation and transitions into a slow and controlled eccentric release. This is done with ongoing sensory focus, and the movements remain gentle, unforced, and require little effort. The study design involves comparing the effects of structured somatic-based chair exercises with the effects of a conventional exercise method consisting of basic range of motion exercises combined with static stretching.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
70
The intervention includes a structured somatic-based chair exercise program (SSCE) developed in accordance with Thomas Hanna's somatic education approach. The program consists of gentle, slow, and controlled movements incorporating pandiculation techniques to improve body awareness and movement control. Exercises target multiple body regions, including the neck, trunk, pelvis, shoulders, upper and lower extremities, wrists, hips, and ankles. Sessions will be performed twice weekly for 8 weeks, with each session lasting approximately 35-40 minutes. A total of 35 volunteers will be enrolled in the SSCE.
A total of 35 volunteers will be enrolled in the conventional exercise program, which combines range of motion (ROM) exercises and passive stretching of the same body regions and muscle groups as those addressed in the somatic exercise group.
Pain Assessment
Pain will be assessed via the Brief Pain Inventory (BPI). BPI measures two objectives: the subjective severity of pain and the causal effect of pain. The questions include numerical rating scales from 0 to 10 (0: none; 1-4: mild; 5-6: moderate, and 7-10: severe).
Time frame: 1 week before the study (T0); at week 4 (T1) and at week 8 (T2)
Balance Ability Assessment
Balance ability will be assessed by using the Berg Balance Test (BBT). The BBT measures balance ability (static and dynamic) among older adults. It is a qualitative measure that assesses balance by performing functional activities such as reaching, bending, transferring, and standing, including most components of postural control. The test contains 14 items. A higher score indicates better balance and a lower risk of falling.
Time frame: 1 week before the study (T0); at week 4 (T1) and at week 8 (T2)
Objective Balance Assessment via Becure Balance System
Objective balance performance will be assessed using the Becure Balance System. The system utilizes the Nintendo WiiFit balance board integrated with computer-based software to evaluate static standing balance, center of gravity distribution, and postural oscillations. The validity and reliability of the system have previously been established.
Time frame: 1 week before the study (T0); at week 4 (T1) and at week 8 (T2)
Cognitive Assessment
The Montreal Cognitive Assessment Scale (MoCA) will be used to assess changes in cognitive levels after the exercise program. The scale is scored between 0 and 30, and includes 6 cognitive functions (memory, visual-spatial skills, executive functions, attention, concentration and working memory tasks, language, and orientation). Higher scores indicate better cognitive performance.
Time frame: 1 week before the study (T0); at week 4 (T1) and at week 8 (T2)
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Quality of Life Assessment
The Quality of Life Scale in the Elderly (CASP-19) will be used to determine changes in the volunteers' quality of life after the exercise program. CASP-19 consists of 19 items and 4 sub-dimensions as 'Control', 'Autonomy', 'Enjoyment', and 'Self-actualization'. Each item of the scale is rated on a 4-point Likert scale (0-3). Higher scores indicate better perceived quality of life and well-being in older adults.
Time frame: 1 week before the study (T0); at week 4 (T1) and at week 8 (T2)
Assessment of Mobility
The Timed Up and Go test (TUG) will be used to assess mobility along with fall risk. TUG correlates well with balance, gait speed, and functional capacity. In this test, participants are instructed to stand up from a standard chair, walk 3 meters at a comfortable, safe pace, turn around, walk back to the chair, and sit down again. The total time required to complete the task is recorded in seconds. Shorter completion times indicate better functional mobility and dynamic balance, whereas longer times indicate poorer mobility and increased fall risk.
Time frame: 1 week before the study (T0); at week 4 (T1) and at week 8 (T2)
Upper Extremity Muscle Strength Assessment
The Weight Lifting Test (Arm Curl Test) will be used to assess upper extremity muscle strength. Participants perform as many arm curls as possible within 30 seconds while holding a standardized weight \[5 lbs (2.3 kg) for women and 8 lbs (3.6 kg) for men\]. Higher repetition counts indicate better upper extremity muscle strength.
Time frame: 1 week before the study (T0); at week 4 (T1) and at week 8 (T2)
Upper Extremity Flexibility Assessment
Upper extremity flexibility will be assessed using the Back Scratch Test (Apley Scratch Test). The test measures the distance between or the overlap of the middle fingers behind the back. An overlap between the fingers is recorded as a positive value, whereas a gap between the fingers is recorded as a negative value. Higher positive values indicate better upper extremity flexibility.
Time frame: 1 week before the study (T0); at week 4 (T1) and at week 8 (T2)
Lower Extremity Muscle Strength Assessment
Lower extremity muscle strength will be assessed using the 30-Second Sit-to-Stand Test. Participants perform as many sit-to-stand repetitions as possible within 30 seconds. Higher repetition counts indicate better lower extremity muscle strength.
Time frame: 1 week before the study (T0); at week 4 (T1) and at week 8 (T2)
Lower Extremity Flexibility Assessment
Lower extremity flexibility will be assessed using the Chair Sit-and-Reach Test. The test measures the distance between the fingertips and toes while reaching toward the foot from a seated position. The distance between the fingertips and the toes is measured in centimeters. Reaching beyond the toes is recorded as a positive value, whereas the inability to reach the toes is recorded as a negative value. Higher positive values indicate better lower extremity flexibility.
Time frame: 1 week before the study (T0); at week 4 (T1) and at week 8 (T2)