Difference Influence of Core Stability Exercise and Ankle

Proprioceptive Exercise toward Dynamic Balance on Young Adult

Overweight

Anita Faradilla Rahim

*, Gadis Meinar Sari

, Purwo Sri Rejeki

Department of

Physiotherapy,Faculty of Health Science, University of Muhammadiyah Malang, Jalan Bandung No. 1

Malang 65113

2,3

Department of Physiology, Sport Health Science Program, Faculty of Medicine, Airlangga University,

Jalan Prof Dr Moestopo No. 47, Surabaya

Keywords: Core stability exercise, ankle proprioceptive exercise, dynamic balance, overweight.

Abstract: Overweight is excess weight gain abnormal fat or excessive that can divert health, which occurs due to energy

imbalance while the energy comes in is greater than the energy expended (WHO, 2017) that resulting in a

build up of energy reserves stored in adipose tissue (Sherwood, 2016). Adipose tissue accumulation and an

increase in excess body mass can cause a decrease in muscle mass, resulting in impaired muscle response and

loss of body stability mechanism (Greve et al., 2008). The purpose of this study was to determine the

differences in core stability exercise and ankle proprioceptive exercise in improving the dynamic balance of

overweight young adult women. The results obtained before practice in first group (K1) is 58,9±9,46 and

second group (K2) is 58,2±4,18,. The average after exercise on first group (K1) is 92, 1±4, 15 and second

group (K2) is 91,0±3,47. The conclusion of this study is that there is no difference between Core stability

exercise and Ankle proprioceptive exercise in increasing the dynamic balance of overweight young adult.

1 INTRODUCTION

World Health Organization (WHO) reports that in

2016, around 1.9 billion adults aged 18 and over were

overweight with a prevalence of 39% men and 40%

women (WHO, 2016). The highest prevalence still

occurs in developed countries such as America and

Europe which are overweight was 62%, while for the

prevalence of overweight in Southeast Asia reached

14% (WHO, 2016), and for the prevalence of

overweight in Indonesia shows 13,5 % (Kementrian

Kesehatan Republik Indonesia, 2019). A person with

an overweight condition experiences morphological

and functional changes in the muscles that cause a

decrease in strength muscle and muscle contraction, a

decrease in muscle flexibility and muscle elasticity,

as well as a proprioceptive decrease that will

eventually lead to a decrease in the body's balance

system (Suadnyana, I.A, Nurmawan, Sutha, Muliarta,

2015).

Balance is the body's ability to control the center

of gravity of the fulcrum (Yuliana I Putu; Irfan,

Muhammad; Fadhil Dzil Ikrom Al Hazmi, Dhofirul,

2014). Balance is the ability to maintain equilibrium

both static and dynamic when placed in various

positions (Shumway-Cook et al., 2011). Static

balance is the body's ability to maintain a position

where the center of gravity (COG) is at rest or not

moving (Abrahamova and Hlavacka, 2008). Dynamic

balance is the ability to maintain body stability when

moving or when body movements or body parts occur

from one point to another (Miller, 2006). To improve

the balance, physical training is needed to

strengthening the muscles involved, increase postural

stability and exercise the somatosensory system.

Physical exercise carried out regularly, systematically

and continuously, all outlined in an exercise program

can significantly improve physical abilities (Dias and

Armstrong, 2004).

In improving body balance, we need an exercise

that is to strengthen the muscles involved, increase

postural stability and somatosensory system training.

One study states that propioceptive training is

effective in increasing students' static balance and

core stability exercise is effective in increasing the

dynamic balance of students (Karakaya et al., 2015).

Rahim, A., Sari, G. and Rejeki, P.

Difference Inﬂuence of Core Stability Exercise and Ankle Proprioceptive Exercise toward Dynamic Balance on Young Adult Overweight.

DOI: 10.5220/0009120100270030

In Proceedings of the 2nd Health Science International Conference (HSIC 2019), pages 27-30

ISBN: 978-989-758-462-6

On the other research found that there is a significant

relationship between dynamic balance and body mass

index (BMI), where overweight students have a lower

dynamic balance compared to students with normal

BMI. However, the comparison of core stability

exercise and ankle propioceptive exercise in

improving the dynamic balance of overweight

adolescents is still not explained (Habut et al., 2015).

Core stability exercise is an exercise that uses the

ability of the trunk, lumbar spine, pelvic, hip,

abdominal muscles and muscles along the spine to

work together to form strength that aims to maintain

the spine according to the body's symmetry alignment

and become more stable and prevent injury(Berrigan

et al., 2006). Core stability exercise is targeted at the

abdominal muscles that connect the pelvis, spine and

shoulders, which helps in maintaining good posture

and provides the basis for all arm and leg movements.

Akuthota et al., (2008) says that the techniques of

core stability exercise are crunch, dynamic leg and

back, Superman, static straight legs, and hundreads.

Ankle proprioceptive exercise is a simple exercise

to train sensorimotor that controls postural stability.

This exercise will send proprioceptive afferent input

to the central nervous system thereby changing the

efferent nerve response by increasing neuromuscular

control of muscles and joints and balance control. The

types of training techniques in ankle proprioceptive

exercise are stretching, strengthening, and standing

on the balance board (Karakaya et al., 2015). The

purpose of ankle proprioceptive exercise is to

gradually train the lower limbs such as ankle, knee

and hip to be strong and reactive to improve function,

reduce knee pain, slow down the degenerative

process of the joints, improve balance so as to reduce

the risk of falls and injuries.

2 METHODS

This study uses a Randomized Pre-Test and Post-Test

Group Design research design consisting of two

groups: a group given core stability exercise (K1) and

a group given ankle proprioceptive exercise (K2) with

each group totaling 5 people who meet the inclusion

criterias are women aged 19-22 years, has a body

mass index of 23-24.9 kg / m2, and is physically and

mentally healthy, and exclusion criteria are active

exercise, undergoing a weight loss program,

dysminore, and taking drugs that have an effect on

balance. The research was carried out for 6 weeks at

the Bhakti Wiyata Kediri Institute of Health Sciences,

from April to May 2018, which had previously been

approved by the subject through informed consent.

Pre test and post test dynamic balance is measured

using the Y Balance Test with one foot in the center

of the grid, and the other foot reaches three

measurement angles (anterior, posteromedial,

posterolateral) as far as possible without using

footwear in centimeters (cm) (Fullam et al., 2014).

This study was approved by the ethics committee

of the Faculty of Dentistry, Airlangga University. The

data collection technique in this research is

quantitative which is done by numerical calculation.

The collected data is processed and analyzed through

a computer using SPSS, with the significance level of

0.05. The statistical tests used were data normality

test with Shapiro Wilk test, data homogeneity test

with Levene's test, paired sample t-test to determine

differences in the balance value between before and

after treatment in each group, and Mann Whitney test

to determine differences in results increasing balance

between groups.

3 RESULTS AND DISCUSSION

Based on the results of data analysis using paired

sample t test, the p value in group one (K1) is 0.001,

and group two (K2) is 0,000 so it can be concluded

that there is an effect of core stability exercise and

ankle proprioceptive exercise on the dynamic balance

of young adult overweight. However, to test the

difference in effect using the Mann Whitney test p

value = 0.994 so that it can be concluded that there is

no difference between core stability exercise and

ankle proprioceptive exercise in improving the

dynamic balance of young adult overweight.

Core stability exercise can improve balance by

having an effect on muscle and joint tissue (Yuliana I

Putu; Irfan, Muhammad; Fadhil Dzil Ikrom Al

Hazmi, Dhofirul, 2014). The mechanism of change

that results in an increase in the level of tension in the

muscles, is a result of the work of muscle contraction.

Muscle contraction is accompanied by an increase in

motor recuitment which will further produce energy

output from increased muscle contraction. Increased

deposited motor unit receptors during training, which

is a neuralmechanism that occurs for two to six

weeks. When exercise increases the amount of

tension that causes muscle changes during

contractions which is then followed by an increase in

muscle size, the greater the diameter of the muscle

fibers, the greater the muscle contraction. The joint is

one of the passive stabilizers that is bound by

ligaments. In balance defense, the need for a joint

condition that is stable and without pain will reduce

the joint's ability to make a move. Movement that

HSIC 2019 - The Health Science International Conference

made by the joint is obtained through proprioceptive

stimulus to the position and motion to be performed.

With the proprioceptive nature of the joints, when

doing joint exercises it will be more stable because it

is supported by the strength of the muscles as movers

and the stability of the ligaments that direct and limit

joint motion (Yuliana I Putu; Irfan, Muhammad;

Fadhil Dzil Ikrom Al Hazmi, Dhofirul, 2014).

Ankle proprioceptive exercise is an exercise that

gradually exercises the lower limbs such as ankle,

knee and hip to be strong and reactive to improve

function, reduce knee pain, inhibit the degenerative

process of the joints, improve balance so as to reduce

the risk of falls and injuries, there are three

techniques: stretching, strengthening dan berdiri

diatas balance board (Basavanthappa and

Basavanthappa, 2011).

Stretching is a form of physical exercise where the

skeletal muscles are consciously extended. Stretching

is a general term used to describe a therapeutic

maneuver. This maneuver is intended to extend the

soft tissue structure that is pathologically or non

pathologically shortened so as to increase tissue

flexibility. Stretching is given to maintain or increase

the elasticity of muscle tissue, tendons, fascia,

ligaments and joint motion (McHugh and Cosgrave,

2010).

Strengthening exercise by using this therapy aims

to increase the strength of leg muscles and lower

limbs. All movements produced are the result of an

increase in muscle tension as a motor response.

Muscle strength can be described as the ability of

muscles to withstand both external and internal

forces. Muscle strength is closely related to the

neuromuscular system that is how much the nervous

system's ability to activate muscles to contract. The

more muscle fibers that are activated, the greater the

strength the muscles produce (Dias and Armstrong,

2004; Suadnyana, I.A, Nurmawan, Sutha, Muliarta,

2015). Muscle strength of the legs, legs and hips is

very instrumental in maintaining body balance when

there is external force. Muscle strength is directly

related to the ability of muscles to fight the forces of

garvitation and other external loads that continuously

affect body position (Dias and Armstrong, 2004).

Balance board is used to train balance with the

aim of increasing proprioceptive joints, coordination

of motor skills and core muscle strength to avoid

falling and injury especially at the ankles and knees

(Reynolds, 2010). This exercise will send

proprioceptive afferent input to the central nervous

system thereby changing the efferent nerve response

by increasing neuromuscular control of muscles and

joints and balance control (Karakaya et al., 2015). By

improving proprioceptive, one can get the balance

needed to maintain stability and can quickly change

direction when needed (Swandari, 2015). Not only

does it increase proprioception, the balance board

also trains vestibular abilities. When the body is

above the balance board, the receptors will be forced

to provide information to the cerebellum and ganglia

wards to issue compensatory movements so that the

body stays balanced.

4 CONCLUSIONS

Based on the results of research that has been done, it

can be concluded that there is no difference between

core stability exercise and ankle proprioceptive

exercise in increasing the dynamic balance of young

adult overweight. Based on the results and

conclusions above, the researcher conveys the

suggestion that further research be carried out with a

greater number of subjects, so that it can show the

results of the exercise of increasing balance and

differences in the value of balance between groups.

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HSIC 2019 - The Health Science International Conference