The Effect of Gluteus Medius Strengthening on Balance Ability in Asymptomatic Older Adults
Rachel Gross, SPT; Kyle Haake, SPT; Lindsay Norton, SPT; Abby Seider, SPT; Jacob Stuhlsatz, SPT
Faculty Mentor: Jim Dronberger, Pt, DPT, OCS, MBA
PURPOSE/HYPOTHESIS: Falls are a major source of injury affecting the older adult population, and imbalance has been cited as a potential contributor. Previous studies concerning balance have focused on causal factors such as ankle strength, metabolic diseases, and core muscle fatigue. Although the effect of hip strength on balance has also been cited, the relationship between gluteus medius strength and balance has not been explored. The aim of this study was to evaluate the effect of gluteus medius strengthening on balance in the asymptomatic older adult utilizing the Mini-Balance Evaluation Systems Test (Mini-BESTest). We hypothesized that strengthening the gluteus medius would improve Mini-BESTest scores. SUBJECTS: Sixteen asymptomatic adults (ages 63-88) completed this six week study. METHODS AND MATERIALS: Subjects were recruited from community centers and fitness facilities in the Kansas City area and randomly assigned to control (n=9) or experimental groups ( n=7). The balance of all subjects was measured using the Mini-BESTest to provide a balance performance baseline. Subjects in the experimental group were then instructed to perform one gluteus medius strengthening exercise daily using a 30 second hold-20 second relax isometric for 10 repetitions. Written instructions were provided by the researchers after subjects demonstrated exercise proficiency. Subjects in the control group (n=9) were not instructed in this exercise but were allowed to continue their routine exercise program. After six weeks, all subjects were re-measured using the Mini-BESTest. RESULTS: Multi-way ANOVA analysis of Mini-BESTest scores revealed a significant interaction between pre- and post-tests: the control group improved in overall scores while the experimental group declined in overall scores. Further statistical analyses of pre-test and post-test scores for each sub-section of the Mini-BESTest were included in the study; however, these results were not significant. CONCLUSIONS: Contrary to our expectations, the control group improved their balance scores while the experimental group did not. A noteworthy finding revealed that the experimental group had higher initial balance scores compared to the control group: since their scores were already higher, the chances to improve may have been lessened. Other potential reasons for these results include (1) most of those subjects who completed the study were recruited from fitness facilities and may have been exercising regularly. Thus, the impact of one exercise may have been small; (2) the same researcher did not always perform both pre-test and post-test on subjects, (3) the Mini-BESTest includes components that do not directly require gluteus medius activity. In terms of clinical relevance, we cannot conclude that strengthening the gluteus medius has an effect on balance in the asymptomatic older adult. Further study may be needed to more conclusively demonstrate a relationship between gluteus medius strength and balance.
Faculty Mentor: Jim Dronberger, Pt, DPT, OCS, MBA
PURPOSE/HYPOTHESIS: Falls are a major source of injury affecting the older adult population, and imbalance has been cited as a potential contributor. Previous studies concerning balance have focused on causal factors such as ankle strength, metabolic diseases, and core muscle fatigue. Although the effect of hip strength on balance has also been cited, the relationship between gluteus medius strength and balance has not been explored. The aim of this study was to evaluate the effect of gluteus medius strengthening on balance in the asymptomatic older adult utilizing the Mini-Balance Evaluation Systems Test (Mini-BESTest). We hypothesized that strengthening the gluteus medius would improve Mini-BESTest scores. SUBJECTS: Sixteen asymptomatic adults (ages 63-88) completed this six week study. METHODS AND MATERIALS: Subjects were recruited from community centers and fitness facilities in the Kansas City area and randomly assigned to control (n=9) or experimental groups ( n=7). The balance of all subjects was measured using the Mini-BESTest to provide a balance performance baseline. Subjects in the experimental group were then instructed to perform one gluteus medius strengthening exercise daily using a 30 second hold-20 second relax isometric for 10 repetitions. Written instructions were provided by the researchers after subjects demonstrated exercise proficiency. Subjects in the control group (n=9) were not instructed in this exercise but were allowed to continue their routine exercise program. After six weeks, all subjects were re-measured using the Mini-BESTest. RESULTS: Multi-way ANOVA analysis of Mini-BESTest scores revealed a significant interaction between pre- and post-tests: the control group improved in overall scores while the experimental group declined in overall scores. Further statistical analyses of pre-test and post-test scores for each sub-section of the Mini-BESTest were included in the study; however, these results were not significant. CONCLUSIONS: Contrary to our expectations, the control group improved their balance scores while the experimental group did not. A noteworthy finding revealed that the experimental group had higher initial balance scores compared to the control group: since their scores were already higher, the chances to improve may have been lessened. Other potential reasons for these results include (1) most of those subjects who completed the study were recruited from fitness facilities and may have been exercising regularly. Thus, the impact of one exercise may have been small; (2) the same researcher did not always perform both pre-test and post-test on subjects, (3) the Mini-BESTest includes components that do not directly require gluteus medius activity. In terms of clinical relevance, we cannot conclude that strengthening the gluteus medius has an effect on balance in the asymptomatic older adult. Further study may be needed to more conclusively demonstrate a relationship between gluteus medius strength and balance.