The Effect of Big Amplitude Calisthenic Group Exercises With Music on Balance and Dual Task Performance in Elderly Individuals

Old age represents the final stage of human life, an inevitable process of aging that leads to functional and physical impairments. The World Health Organization (WHO) defines old age as "a decrease in the capacity to adapt to environmental factors." Aging is characterized by a decline in fertility, increased mortality, and disability, alongside progressive loss of function. Balance problems are common among the elderly. During motor activities, there is a limited support area that can cause changes in the body's center of gravity. As long as the center of gravity remains within this area, movement can be maintained without disruption. Reduced sensory input and sensitivity in the elderly affect movement clarity and postural stability. This condition necessitates the development of movement strategies that limit the support area to a narrower space and require more accurate control of the center of gravity position. As the center of gravity shifts toward the limits, the likelihood of balance loss increases. Therefore, in order to maintain a safe balance area, circular and forward-backward swing amplitudes decrease in the elderly. During these swings, the elderly must keep the center of pressure on the feet close to stability limits. It is reported that physically active elderly individuals exhibit less anxiety and stress compared to sedentary individuals, and have higher quality of life.Physiotherapy methods focus on improving reaction speed to unexpected perturbations through ankle, hip, and stepping strategies in balance training. Dual task exercises are one of the physiotherapy methods used in balance training. Dual Task In daily life, we rarely perform only one task at a time. Rather, our daily activities often involve performing two or more tasks simultaneously. This is referred to as dual-tasking, for example, searching for something in a pocket while walking, or walking while talking involves dual-task performance. Dual-tasking is based on dividing attention between two simultaneous tasks. Given that attention is a limited resource, dividing attention between two concurrent tasks can lead to a decrease in performance in either or both tasks, especially when the demands of one task are high. The relative change in performance associated with dual tasking is called dual task interference or dual task effect. There are some paradigms that explain dual tasking. The complex nature of processes related to dual tasking is evaluated using these paradigms; here, there are two tasks that are simultaneously performed without any manipulation of task variables, and no instruction is given regarding task priority. It is generally used to investigate dual tasking in each of the two simultaneous tasks. In older individuals, there is a decrease in walking speed during dual tasking due to impairment in executive functions and working memory. The decrease in walking speed during dual tasking in older adults has been shown to be more often associated with cognitive function impairment compared to young adults. In a case study, it was shown that balance exercises performed with dual tasking yielded better results in balance parameters compared to balance exercises performed with single tasking, and longer-lasting results were achieved. Music therapy, defined as "the clinical and evidence-based use of music interventions in a therapeutic relationship to achieve personalized goals completed by a certified professional who has completed an approved music therapy program," can be an effective non-pharmacological treatment method. De Witte and colleagues' meta-analysis found that music interventions had a significant impact on reducing both physiological and psychological stress in 104 RCT music intervention studies involving 9617 participants. To our knowledge, there is no study investigating the effect of high amplitude calisthenic group exercises with music on balance and dual task performance in elderly individuals. Therefore, the study will investigate the effectiveness of an exercise program with music applied in groups, comparing the results between groups.

Scientific studies conducted on the elderly indicate that dual task training has benefits in improving walking, balance, and mobility performance in healthy elderly individuals. In rehabilitation, dual task training has been concluded to be included in preventive physiotherapy approaches for preventing falls and supporting a more active lifestyle.