The effect of diaphragm muscle exercise on dynamic balance amomg post-covid-19 older adults in Klang Valley, Malaysia

Goh, Le Yi (2024) The effect of diaphragm muscle exercise on dynamic balance amomg post-covid-19 older adults in Klang Valley, Malaysia. Final Year Project, UTAR.

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Abstract

Background: The COVID-19 pandemic has disproportionately affected older adults, leading to long-term complications, including diaphragm dysfunction, which may contribute to impaired dynamic balance and increased fall risk. Despite the known impact of diaphragm muscle weakness on respiratory function, its effect on balance in post-COVID-19 older adults has not been thoroughly investigated. Objective: This study aims to evaluate the effectiveness of diaphragm muscle exercises in improving dynamic balance among post-COVID-19 older adults in Klang Valley, Malaysia. Methods: This quasi-experimental study targeted community-dwelling older adults aged 60 and above in Klang Valley, Malaysia, with diaphragm dysfunction post-COVID-19. Participants were randomly assigned to two intervention groups: diaphragm weight training or incentive spirometry. The sample size (39 participants) was calculated using G*Power software. Pre- and post-intervention measures assessed diaphragm dysfunction (MED Scale, CE) and dynamic balance (TUG test, BBS, FTSST). Data were analysed using SPSS, employing paired t-tests, independent t-tests, and hypothesis testing, with a significance threshold of p < 0.05. Results: The total number of participants who completed this research study was 40. This study consisted of two intervention groups: diaphragm weight training (n=20) and incentive spirometry (n=20). The most common age group for diaphragm weight training is 70-74 (n=8), while for incentive spirometry is 75-79 (n=4) and 80-84 (n=4). A significant difference was found in TUG, BBS, and FTSST between the two intervention groups. Paired sample t-tests revealed that diaphragm weight training led to significant changes in TUG (p < 0.001), BBS (p < 0.001), and FTSST (p = 0.005). In the incentive spirometry group, significant improvements were found for BBS and FTSST (p < 0.001), but not for TUG (p = 0.08). Independent sample t-tests confirmed diaphragm weight training's greater effectiveness, with significant differences favouring this intervention in TUG (p = 0.003), BBS (p = 0.011), and FTSST (p = 0.001). Conclusion: This study concludes that diaphragm weight training is significantly more effective than incentive spirometry in improving dynamic balance. Both interventions showed improvements in BBS and FTSST, but only diaphragm weight training demonstrated statistically significant improvement in TUG performance. The findings suggest that diaphragm-focused training interventions may be a more effective strategy for enhancing dynamic balance in participants. Keywords: dynamic balance, post-COVID-19, older adults, fall prevention, respiratory muscle trainin

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