Effects of a physical activity program in manual dexterity and manual proprioceptive sensibility in two different institutionalized age groups of elderly people
Effects of a physical activity program in manual dexterity and manual proprioceptive sensibility in two different institutionalized age groups of elderly people
Abstract
Several studies (e.g. Carmeli, 2003; Mesquita, 2003) refer that the functioning of the manual proprioceptive sensibility and of the manual dexterity is essential for the accurate control in the manipulation of small objects and for the needs of many daily activities. This study intends to investigate the variation in the manual dexterity and manual proprioceptive sensibility, through the application of a regular physical activity program to a group of institutionalized elderly. The sample comprises 24 institutionalized elderly, aged 70 – 90 years old. These were divided into two age groups: 70 to 80 and 81 to 90 years old. The Minnesota Manual Dexterity Test was applied to evaluate the manual dexterity – batteries of Placing and Turning Tests. The Discrimination Weights Test was applied to evaluate the manual proprioceptive sensibility. The statistic procedures included: descriptive statistic (mean and standard deviation) and inferential statistic (Mann-Whitney test and the Wilcoxon test). Significance level was fixed on p?0,05. The main results showed that (i) in the Placing test and in the turning test, there was a significant improvement in the manual dexterity after the end of the program, in the total sample and in both age groups; (ii) in the manual proprioceptive sensibility, there were significant improvements after the end of the program, in the total sample and in the 70 to 80 age group. The physical activity program improved the manual dexterity skills and the manual proprioceptive sensibility in these two age groups. The Portuguese society should give special attention to the regular physical activity of the elderly, because it seems to improve their life quality, especially to what concerns the manual activities showed by this study.
1. Introduction
It´s interesting to notice that the human population has been going through a revolution in its structure (that is occurring all over the world), that is to say, a clear tendency towards aging and long life. Carvalho (2006) calls our attention to the fact that, in spite of all the medical and scientific efforts to extend the elderly people’s lives, this increase in longevity is not always synonymous of a healthy autonomous life. According to the same author, it´s important to find ways to revert this situation.
2. Aim of the study
This study intends to investigate, in two different age groups of institutionalized elderly people, the changes in the manual dexterity and the manual proprioceptive sensibility, through the application of a regular physical activity program.
3. Methods
The sample was constituted by 24 institutionalized elderly, aged between 70 and 90 years old. These were divided into two age groups: 70 to 80 and 81 to 90 years old. The elderly were selected through a medical declaration confirming that, in spite of having several moderate pathologies, their general health condition allows them to practice regular physical activity. A first evaluation was made in terms of manual dexterity and manual proprioceptive sensibility. After twenty seven sessions of regular physical activity (two times a week, 45’ each), a new evaluation was made. The manual dexterity was evaluated through the Minnesota Manual Dexterity Test – Placing Test and Turning Test. The manual proprioceptive sensibility was evaluated by the Discrimination Weights Test. The statistic procedures included the descriptive statistic (average and standard variation) and the inferential statistic (the Mann-Whitney test and the Wilcoxon test). The significance level was fixed on p?0,05.
4. Results
4.1. Manual dexterity for the total sample in the two moments of observation
In Tables 1 and 2 we present the values of manual dexterity concerning the comparisons between the first and the second moments of observation for the total sample.
Table 1. Total sample. Comparison between the 1st and the 2nd moments of observation. Placing Test. Values in seconds. Mean, standard deviation, and values of mean rank, z and p.
Tabla 1. Effects of a physical activity program in manual dexterity and manual proprioceptive sensibility in two different institutionalized age groups of elderly people
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Table 2. Total sample Comparison between the 1st and the 2nd moments of observation. Turning Test. Values in seconds. Mean, standard deviation, and values of mean rank, z and p.
Tabla 2. Effects of a physical activity program in manual dexterity and manual proprioceptive sensibility in two different institutionalized age groups of elderly people
Contenido disponible en el CD Colección Congresos nº 8
Analyzing the results in the two tables, when we compare the two moments of observation, we notice that the values of manual dexterity show statistically significant differences in all attempts. There is coherence in the results, as the elderly in the total sample reached higher values of manual performance in the second moment of observation.
4.2. Manual dexterity for each age group in the two moments of observation
In Tables 3 and 4 we describe the results of manual dexterity to what concerns the comparison between the first and the second moment of observation for the elderly aged between 70 to 80 years old. Table 3. Elderly aged between 70 to 80. Comparison between the 1st and the 2nd moments of observation. Placing Test. Values in seconds. Mean, standard deviation, and values of mean rank, z and p.
Tabla 3. Effects of a physical activity program in manual dexterity and manual proprioceptive sensibility in two different institutionalized age groups of elderly people
Contenido disponible en el CD Colección Congresos nº 8
Table 4. Subjects aged between 70 and 80. Comparison between the 1st and the 2nd moments of observation. Turning Test. Values in seconds. Mean, standard deviation, and values of mean rank, z and p.
Tabla 4. Effects of a physical activity program in manual dexterity and manual proprioceptive sensibility in two different institutionalized age groups of elderly people
Contenido disponible en el CD Colección Congresos nº 8
When we compare the two moments of observation in Tables 3 and 4, we can notice that the values of manual dexterity show significant differences in all attempts. It is shown that the elderly aged between 70 to 80, reached higher values of manual performance in the second moment of observation. Tables 5 and 6 describe the results of manual dexterity to what concerns the comparison between the first and the second moment of observation for the elderly aged between 81 to 90 years old.
Table 5. Subjects aged between 81 and 90 years old. Comparison between the 1st and the 2nd moments of observation. Placing Test. Values in seconds. Mean, standard deviation, and values of mean rank, z and p.
Tabla 5. Effects of a physical activity program in manual dexterity and manual proprioceptive sensibility in two different institutionalized age groups of elderly people
Contenido disponible en el CD Colección Congresos nº 8
Table 6. Subjects aged betwen 81 and 90 years old. Comparison between the 1st and the 2nd moments of observation. Turning Test. Values in seconds. Mean, standard deviation, and values of mean rank, z and p.
Tabla 6. Effects of a physical activity program in manual dexterity and manual proprioceptive sensibility in two different institutionalized age groups of elderly people
Contenido disponible en el CD Colección Congresos nº 8
Through the results shown in Tables 5 and 6, when we compare the two moments of observation, we can notice that the values of manual dexterity showed statistically significant differences in all attempts. To what concerns the elderly aged between 81 and 90 years old, in spite of needing more time to perform the batteries of the Placing and Turning Tests in relation to the other age group (Tables 3, 4, 5 and 6), we observed that they improved that they improved their manual performances after the regular physical activity program. 4.3. Manual proprioceptive sensibility for the total sample in the two moments of observation In Table 7 we describe the results of the manual proprioceptive sensibility, concerning the comparison between the first and the second moment of observation for the total sample.
Table 7. Total sample. Comparison between the 1st and the 2nd moments of observation. Weights Discrimination Test. Values in percentage. Mean, standard deviation, and values of mean rank, z and p.
Tabla 7. Effects of a physical activity program in manual dexterity and manual proprioceptive sensibility in two different institutionalized age groups of elderly people
Contenido disponible en el CD Colección Congresos nº 8
Analyzing this table, when we compare the moments of observation, we can notice that the values of manual proprioceptive sensibility only showed significant differences in the second (p=0,020), the fourth (p=0,024), the fifth (p=0,033) and in the average of the five arrangements (p=0,031). Though not all the differences being significant, in the second moment of observation, the percentages of the manual proprioceptive sensibility were always higher than the ones in the first moment in all the arrangements. 4.4. Manual proprioceptive sensibility for the total sample in the second moment of observation In Table 8 we describe the results of the manual proprioceptive sensibility, concerning the comparison between the first and second moment of observation for subjects belonging to the age group of 70 to 80 years old.
Table 8. Subjects aged between 70 and 80 years old. Comparison between the 1st and the 2nd moments of observation. Weights Discrimination Test. Values in percentage. Mean, standard deviation, and values of mean rank, z and p.
Tabla 8. Effects of a physical activity program in manual dexterity and manual proprioceptive sensibility in two different institutionalized age groups of elderly people
Contenido disponible en el CD Colección Congresos nº 8
Analyzing Table 8, when we compare the two moments of observation, we can notice that the values of manual proprioceptive sensibility only showed significant differences in the second arrangement (p=0,018) and in the average of the five arrangements (p=0,041). It’s also important to say that, in the end of the regular physical activity program, we observed higher percentages in almost all the arrangements. However, it’s interesting to see that the first arrangement showed identical percentages both in the beginning and in the end of the program. In Table 9 we show the results of the manual proprioceptive sensibility, to what concerns the comparison between the first and the second moment of observation for the elderly belonging to the age group from 81 to 90 years old. Table 9. Subjects aged from 81 to 90 years old. Comparison between the 1st and the 2nd moments of observation. Weights Discrimination Test. Values in percentage. Mean, standard deviation, and values of mean rank, z and p.
Tabla 9. Effects of a physical activity program in manual dexterity and manual proprioceptive sensibility in two different institutionalized age groups of elderly people
Contenido disponible en el CD Colección Congresos nº 8
In Table 9 we analyzed the comparison between the two moments of observation, we can notice that the values of the manual proprioceptive sensibility didn’t show significant differences in all the arrangements. However, after the program, the elderly improved the values of the manual proprioceptive sensibility in almost all the arrangements. By observing the Tables 8 and 9, the elderly aged from 70 to 80 years old got higher percentages than the other age group, both in the beginning and in the end of the program, in the average of the five arrangements. In general, in both age groups and in almost all the arrangements, we notice that the elderly improved their manual proprioceptive sensibility after the program.
5. Discussion of the results
Several studies have described that it’s possible to fight the decline of the manual dexterity with the practice of regular physical activity (e.g. Desrosiers et al., 1997; Ranganathan et al., 2001; Carmeli, 2003). Our studies are supported by several studies (e.g. Desrosiers et al., 1994). Mesquita (2002), carried out a study about the multidimensional evaluation of elderly people (manual preference and proficiency), with a sample of 113 subjects, distributed into three age groups: G1) from 65 to 74 years old; G2) from 75 to 84 years old and G3) from 85 to 99 years old. The author observed that, to what concerns the age, there weren’t any statistically significant differences among the three age groups and in the multidimensional evaluation. However, it’s important to note that, in this study, it was possible to observe a decline in the manual function in the G3) age group (from 85 to 99 years old). Ranganathan et al. (2001) stated that a training program that provides adequate stimulus to the sensorial and motor systems, will possibly reduce the debilities related to age, including the manual function. The more stimulated are the sensorial and proprioceptive organs (responsible for the gathering of information), the more accurate and precise they will become (Moreira, 2000). Smith et al. (1999) carried out a study that intended to determine the decline of the manual performance related to age, through a sensitive research. These authors used an instrument with four different motor tasks of increasing difficulty. The sample was constituted by two groups of healthy subjects: young adults aged 18 to 58 years old and old adults aged 69 to 94 years old. The most important result was that the old adults’ group needed more time to complete the motor tasks of increased difficulty, showing significant differences when compared to the other group. Through the experience lived among the elderly of both age groups and through the analysis of the reports and the monthly accounts of the classes, it was interesting to observe that these people rediscovered the “body” again. We noticed that, through these new experiences, they were able to recall times gone by. There was a rebirth of the pleasure for movement, for “feeling” their own body, in believing that everyone is able to accomplish and, basically, to reach the joy and succeed in living a life with better quality.
6. Conclusions
According to the results obtained in this study, the manual dexterity in the batteries of the Placing and Turning Tests, showed statistically significant improvements after the program, both in general and for each age group. In turn, the manual proprioceptive sensibility showed improvements after the program, both in general and for each age group. In spite of the differences between the two moments, these were only statistically significant in the age group from 70 to 80 years old.
7. References
Carmeli, E.; Patish, H. & Coleman, R. (2003). The aging hand. Journal of Gerontology: medical sciences, 58A (2): 146-152.
Carvalho, M. J. (2006). A actividade física na terceira idade e relações intergeracionais. Revista Brasileira de Educação Física e Desporto, 20 (supl. 5), 71-72.
Carvalho, J. & Mota, J. (2002). A actividade física no idoso. Justificação e prática. Edição: Câmara Municipal de Oeiras. Divisão do Desporto. Portugal.
Desrosiers, J.; Bravo, G. ; Hébert, R.; Dutil, E. & Mercier, L. (1994). Validation of the Box and Block Test as a measure of dexterity of elderly people: reliability, validity, and norms studies. Archives of Physical Medicine and Rehabilitation, 75: 751-755.
Desrosiers, J.; Rochette, A.; Hébert, R. & Bravo, G. (1997). The Minnesota Manual Dexterity Test: reliability, validity and reference values studies with healthy elderly people. Canadian Journal of Occupational Therapy, 5 (64): 270-277.
Discrimination Weights Test. (2004). Discrimination Weights Test – User Instructions, Model 16015: Lafayette Instrument.
Mesquita, C. (2002). Avaliação funcional multidimensional de idosos. Estudos em idosos institucionalizados avaliando a preferência e proficiência manuais. Dissertação de Mestrado não publicada. Faculdade de Ciências do Desporto e de Educação Física – Universidade do Porto. Portugal.
Minnesota Manual Dexterity Test. (1998). Test administrator’s manual, n.º 32023. Revised Edition: Lafayette Instrument.
Moreira, M. (2000). A coordenação. Revista Ludends, 16, (4): 25-28. Ranganathan, V.; Siemionow, V.; Sahgal, V.; Liu, J. & Yue, G. (2001). Skilled finger movement exercise improves hand function. Journal of Gerontology: medical sciences, 56A, (8): 518-522.
Sardinha, L. & Baptista, F. (1999). Programas de actividade física no Concelho de Oeiras. In: Jorge Mota e Joana Carvalho (org.), Actas do Seminário – A qualidade de vida no idoso: o papel da actividade física, pp. 54-64. Gabinete de Desporto de Recreação e Tempos Livres da Faculdade de Ciências do Desporto e de Educação Física – Universidade do Porto. Portugal.
Smith, C.; Umberger, G.; Manning, E.; Slevin, J.; Wekstein, D.; Schmitt, F.; Markesbery, W.; Zhang, Z.; Gerhardt, G.; Kryscio, R. & Gash, D. (1999). Critical decline in the fine motor hand movements in humans aging. The American Academy of Neurology, 53, (7): 1458-1461.
