Preliminary effects of a modified Otago Exercise Program on metabolic, cellular, and epigenetic biomarkers in people living with dementia: A pilot randomized controlled trial.

The aim of this study was to investigate the effects of a moderate-intensity multicomponent training (MCT) program on body composition, physical function, glycaemic control and lipid profiles in overweight and obese older people. This single-arm quasi-experimental study included 48 male (n = 10) and female (n = 38) overweight (n = 27) and obese (n = 21) older individuals (69.2 ± 4.3 years; 76.4 ± 12.3 kg; 1.60 ± 0.1 m; 30.3 ± 4.7 kg·m2) who were subjected to a 36-week moderate-intensity MCT intervention, including strength, stretching, endurance and balance exercises, twice a week, along with nutritional counselling and psychoeducation. Body composition, physical function (upper- and lower-body strength endurance, lower-body flexibility and dynamic balance), fasting plasma glucose, total cholesterol (TC), low-density lipoprotein (LDL-c) and high-density lipoprotein (HDL-c) levels were assessed before and after 12, 24 and 36 weeks of intervention. Food consumption was evaluated at baseline and after 36 weeks. Except for TC (p = 0.58; W = 0.014), a significant improvement was detected in LDL-c (p < 0.001; W = 0.132) and HDL-c (p < 0.001; W = 0.195), as well as in fasting glucose (p < 0.001; W = 0.556). Upper- and lower-body strength endurance (both p < 0.0001, W = 0.447 and W = 0.175, respectively), lower-body flexibility (p = 0.02; W = 0.068) and dynamic balance (p = 0.04; W = 0.060) also improved in response to MCT. However, all body composition outcomes remained unchanged throughout the MCT intervention (all p > 0.05). Similarly, no significant differences were identified in the food intake variables (all p > 0.05). Our moderate-intensity MCT program effectively improved physical function, glycaemic control and lipid profile, but not body composition, in overweight and obese older adults.

Comparative effects of cognitive training with whole-body vibration vs. traditional physiotherapy on balance and plantar sensation in diabetic neuropathy.

BackgroundOlder adults who have fallen are at an increased risk of future falls. Training cognitive and physical functions simultaneously, known as dual-task (DT) training, has been shown to improve mobility and reduce fall risks. With appropriate digital tools, such as smartphones and mobile apps, it is possible to deliver DT training in unsupervised, home-based settings, thereby increasing accessibility beyond the clinical environment.ObjectiveThis study aimed to evaluate the feasibility and acceptability of a technology-based DT training program delivered through a blended model of supervised and self-directed sessions for older adults with a history of falls. Perspectives of health care professionals working in fall-prevention services were also explored.MethodsA single-arm, nonrandomized feasibility study was conducted with 45 community-dwelling adults aged 65 years or older with a history of falls. Participants were recruited through primary care practices, secondary care fall-prevention services, and community outreach. The 24-week DT program, which integrated balance and strength exercises with cognitive training using a mobile app, was delivered in two phases: (1) for12 weeks, weekly 50-minute physiotherapist-led group classes in the community, and 2 additional 50-minute self-directed sessions at home, and (2) for 12 weeks, 3 weekly 50-minute self-directed sessions at home. Feasibility and acceptability were assessed through recruitment and retention rates, adherence, app usage, and self-reported satisfaction. Qualitative data were obtained from focus groups with 28 participants who completed the program and 16 health care professionals. Quantitative data were analyzed descriptively, and qualitative data were analyzed thematically.ResultsWe recruited 45 of the target 50 participants, with most participants (n=41) recruited through community pathways; 4 were recruited via National Health Service (NHS) pathways. Adherence was 64%, with higher adherence during phase 1 (81%) than phase 2 (50%). App usage was high (95%), and self-reported program satisfaction was moderate to high. Retention at 24 weeks was 76%, and no adverse events occurred. The qualitative findings supported the program’s feasibility and acceptability, emphasizing social connection and tailored exercises as key to adherence—especially in home-based sessions. Health care professionals identified community organizations and referral pathways as the most practical routes for implementation.ConclusionsA blended, technology-based DT training program is both feasible and acceptable for older adults at risk of falling and can be effectively delivered beyond clinical settings. Community-based recruitment outperformed NHS pathways, highlighting the value of community engagement. These findings support the feasibility and acceptability of a full-scale trial, with targeted refinements to recruitment, support structures, and delivery to maximize scalability and impact.

Falls among older adults are a major public health concern, but evidence on Thai boxing dance interventions for prevention remains inconclusive. This study aimed to evaluate the effectiveness of a 6-month Thai boxing dance (TBD) program in reducing fall incidence and improving physical performance, fear of falling, and cognitive function among community-dwelling older adults at risk of falling. This study was a 3-arm parallel-group, assessor-blinded randomized controlled trial. The study was conducted at 3 primary health care centers in Chiang Rai, Thailand. Among the 123 participants enrolled, 115 older adults aged ≥60years were identified as being at risk of falling and completed the study. Participants were randomly allocated to 1 of 3 groups: Thai boxing dance (TBD), conventional balance exercise (CBE), or a control group (CG). All groups participated in biweekly sessions over a 24-week period. Falls were monitored over a 180-day period, whereas physical performance, fear of falling, and cognitive function were assessed at baseline and at the 6-month intervention period. Of the 123 participants, 115 completed the trial. Incident rates of falls in the TBD and CBE group (0.18 and 0.17 per person-month, respectively) were lower than the rate of 0.62 in the CG. The TBD group showed a 76% reduction in fall rate compared to CG. TBD also led to significantly greater improvements in physical performance, including postural sway, gait parameters, and lower-limb strength, compared with the CG after the 6-month intervention. The CBE group showed greater improvements in gait parameters only. No significant between-group differences were observed in fear of falling or cognitive function. A 6-month TBD and CBE program reduced falls. TBD improved physical performance more broadly, whereas CBE yielded targeted gait improvements in community-dwelling older adults at risk of falling.

Effect of Aquatic Proprioception Training, Strengthening, and Balance Exercises on Knee Joint Stability and Functional Performance in Anterior Cruciate Ligament Injury

This study examined how standing violinists regulate postural balance when several conditions are varied, including playing posture, weight of the instrument, technical and physical difficulty of the musical piece, and presence or absence of a musical score. It also examined whether imagining playing an easy or difficult piece affects their postural control. This observational study included 16 violin students from a music university (age 21 yrs, SD 4). Postural control was assessed using two stabilometric platforms (frequency 100 Hz). Nine conditions were tested: standard standing; violin posture without/with instrument; motor imagery of an easy and a difficult piece without/with instrument; playing of an easy and a difficult piece, with/without a music stand. Center of pressure (CoP) parameters were extracted, and weight distribution asymmetry was calculated. Depending on data characteristics, either parametric or non-parametric statistical tests were conducted to compare conditions. Compared with the standard standing position, the violin posture without the instrument and the posture with violin and bow showed a significant decrease in CoP sway area (p ≤ 0.010). All violin playing conditions induced a significant increase in CoP parameters (sway area, total, anteroposterior, and mediolateral displacements) compared with the other conditions (p ≤ 0.036). Postural demand was greater for the difficult piece than for the easy one. Motor imagery of violin playing did not increase postural control demands compared with non-playing conditions. Playing the violin, whether performing an easy or a difficult piece, places substantial demands on postural control. Preventive standing balance exercises for violinists may help reduce the risk of early fatigue and playing-related pain. In the presence of injury, motor imagery can be safely employed to maintain violin training, as it does not impose high demands on postural control.

Background“Keep On Keep Up” (KOKU) is a tablet-based digital program based on the well-validated Otago and Fitness and Mobility Exercise programs for older adults to decrease the risk of falling.ObjectiveThis substudy involved a process evaluation in order to analyze the usage patterns of the KOKU digital program, specifically training frequency, volume, and intensity among older adults over a 3-month self-managed training period. Pre-post changes in physical capacity and real-world walking were examined.MethodsThis study is a nested cohort study within the three-armed randomized controlled SMART-AGE trial conducted in Germany (German Clinical Trials Register ID: DRKS00034316). Participants aged 67 years or older with basic digital literacy were included. KOKU provided guided but unsupervised progressive strength and balance training for 3 months. The data on training adherence, engagement, and progression were collected. Instrumented assessments included the Timed Up and Go Test, the 30-Second Chair Rise Test, and real-world walking monitoring using wearable sensors.ResultsA total of 113 participants (n=63, 56% female; mean age 74.02, SD 5.36 y) were included in the analysis. During the 3-month period, participants used KOKU for 24 (SD 15) days, that is, 2 to 3 times per week. Over the entire study period, no falls or other adverse events were reported due to KOKU usage. The number of exercises performed per participant ranged from 2 to 213, with a median value of 70. The instrumented Timed Up and Go Test results revealed a prolonged total duration (d=0.26; P=.009). In the instrumented 30-Second Chair Rise Test, improvements were observed in the number of completed repetitions (d=0.21; P=.04) and frequency of repetitions (d=0.23; P=.03). This was mainly due to a reduction in inactive time (d=−0.60; P<.001). Real-world walking parameters remained unchanged, except for a slower walking speed during walking bouts of less than 30 seconds (d=0.49; P<.001). All changes did not meet the criteria for minimally important differences.ConclusionsKOKU is a novel digital intervention for older adults, promoting balance and strength exercises. Physical capacity improvements were small. However, the use of instrumented assessments provided further insights into participants’ capacity and mobility that would not have been identifiable with conventional assessments. Future improvements to the program should focus on incorporating more challenging exercises for individuals with varying levels of physical capacity.

PurposeGiven the high prevalence of low back pain in this demographic group, effective management strategies are essential. This study aimed to compare the effects of EMG biofeedback-assisted core training using Bosu versus Swiss balls on mechanical low back pain in collegiate students.MethodsA randomized controlled trial was implemented with 36 participants aged 18–25, randomly assigned to either the Bosu or Swiss ball group. Over four weeks, both groups engaged in specific core strengthening exercises three times a week. Pain intensity, core strength, and functional ability were assessed using the Numeric Pain Rating Scale, Oswestry Disability Index, and EMG analysis, respectively.ResultsBoth groups demonstrated significant improvements in pain, functional disability, core strength, and muscle activation following the intervention (p < 0.05). No statistically significant differences were observed between the Bosu ball and Swiss ball groups in the primary outcome measures, however, some enhancements were noted in range of motion, muscle activation and functional disability in the Bosu ball group.ConclusionEMG biofeedback-assisted core training with Bosu balls is more effective than Swiss balls in managing mechanical low back pain in collegiate students. These findings suggest that incorporating Bosu ball exercises can enhance therapeutic outcomes, underscoring the need for tailored rehabilitation strategies to improve quality of life for young adults suffering from low back pain.

Creatine monohydrate is a widely used supplement to improve physical performance and strength. Recent studies suggest it may also benefit cognitive function and depression treatment. However, data on its effects in older adults are scarce, highlighting the need for further research in this population. This study is a randomized, double-blind, placebo-controlled trial assessing five weeks of creatine monohydrate (CrM) supplementation combined with physical training in older adults (≥75 years). Participants will be divided into four groups: placebo (PL), placebo with multicomponent training (PL + MT), creatine monohydrate supplementation (CrM), and creatine monohydrate with multicomponent training (CrM + MT). Evaluations will be conducted before, during, and after the intervention, and again after a five-week washout period. The training program includes supervised sessions twice a week over four weeks, focusing on resistance, cardiovascular, balance, reaction, and agility exercises. Functional capacity and fall risk will be measured, alongside physical tests such as handgrip strength and one-repetition maximum (1RM) tests for leg press, bench press, seated row, and leg extension. Cognitive and emotional assessments will also be conducted during the intervention. The results of this study aim to increase our understanding of the effects of CrM supplementation in older adults. This study is expected to generate valuable information on the impact and safety of this nutrition and exercise strategy, and its application can be extended to a variety of health conditions.

The Effects Of 6-week Balance Training on Corticospinal Excitability, Spinal Reflexive Excitability Modulation, and Balance Performance in Individuals with Chronic Ankle Instability: Randomized Controlled Trial.

Introduction:Badminton is an overhead sport which requires concurrent upper limb strength, explosive power, coordination, and fast reflexes. The repetitive nature of overhead activities places high mechanical demand on the shoulder complex, leading to the potential for developing neuromuscular deficits and overuse injuries. The Federation of International Football Association (FIFA 11+) FIFA 11 shoulder (FIFA 11+ S) warm-up and injury prevention program (originally developed for upper extremity injury prevention in soccer players), consisting of strengthening, balance, core stabilization and plyometric exercises, has not been studied in amateur badminton players.Materials and Methods:A pilot study was conducted on amateur badminton players of 18–30 years who met the inclusion criteria, and baseline measures were taken. Handheld dynamometer was used to measure the strength of shoulder internal and external rotators. Upper limb explosive power was assessed by the Seated Medicine Ball Throw Test (2 kg). Coordination and reaction time of the upper limbs were examined using the Alternate Hand Wall Toss Test and Ruler Drop Test, respectively. Participants completed the FIFA 11+ S training protocol for eight weeks, and post-intervention scores were statistically analysed using paired t-test.Results:Shoulder internal and external rotators strength on the dominant and non-dominant side considerably increased following the 8-week rotator cuff-specific resistance training (P < 0.05). Explosive power, coordination, and reaction time of the upper limb also considerably improved following training (P < 0.05). All outcome measures improved, showing an improvement in the neuromuscular control and functional performance of the upper limb.Conclusion:An 8-week FIFA 11+ Shoulder program effectively improves upper limb strength, power, coordination and reaction time in amateur college-level badminton players. These findings indicate that the FIFA 11+ Shoulder program is statistically and clinically effective in improving the performance of Amateur college level badminton players.

Effects of adding balance training to pulmonary rehabilitation in individuals with COPD: A systematic review and meta-analysis of randomized controlled trials.

Modified Constraint-Induced Movement Therapy (mCIMT) has demonstrated significant potential in rehabilitating lower extremity motor impairments following stroke. However, mCIMT's application is often limited by the need for specialized devices to constrain the non-affected extremity and longer training duration. Constraint Standing Training (CST) is a novel variation of mCIMT that addresses these limitations by eliminating the need for constraining devices and reducing training time, thereby enhancing its feasibility for clinical implementation. Despite these advantages, the specific effects of CST on balance and gait in stroke patients remain underexplored. This study will use a randomized, controlled, single-blinded design. Fifty stroke patients in the chronic phase, with gait disabilities and the ability to stand independently, will be randomly assigned to either the CST group or a control group using a computer-generated randomization sequence. Exclusion criteria include physiological or cognitive impairments that may hinder evaluation or training. Both groups will undergo daily 1-h training sessions, five times per week, for 8weeks. The CST group will undergo sequential standing training using shaping strategies from a single plane to multiple planes, while the control group will receive conventional intensive training, which includes balance and gait exercises commonly used in clinical practice. Assessments will be carried out at baseline (T0), mid-intervention (T1), post-intervention (T2), and 1 month follow-up (T3). The primary outcome of this trial is the Timed Up and Go (TUG) test. Secondary outcomes include the 10-Meter Walk Test, 6-Minute Walk Test, Berg Balance Scale, three-dimensional gait analysis, and surface electromyography. Missing data will be handled using multiple imputation by chained equations. Data will be analyzed using two-way repeated measures ANOVA or generalized estimating equations to determine differences and identify clinically relevant changes. This protocol provides detailed CST methods to guide future research and clinical application. The study employs a randomized controlled trial design to robustly evaluate CST's effects on balance and gait in hemiparetic stroke patients. CST's sequential, multi-plane exercises offer a potentially practical alternative. However, larger, multi-center trials are recommended for future validation. This trial is registered at www.chictr.org.cn. ChiCTR2400086282. Date of registration: 27 June 2024.

Dynamics and stability analysis of a novel automatic ball balancer

Introduction: The aging process involves various conditions affecting the body, leading to a progressive decline in physical abilities. Objective: To determine the effect of a multimodal physical exercise program on sarcopenia parameters, dynamic balance, strength, and endurance in older adults. Methodology: A pre-experimental study was conducted with nine individuals aged 60 to 79 years, active healthcare professionals working in a public hospital for state workers in Baja California, Mexico. Sarcopenia was assessed using the SARC-F, while dynamic balance, strength, and endurance were evaluated using the Senior Fitness Test battery. A multimodal physical exercise program was implemented consisting of three sessions per week, 40 minutes per session, for 10 weeks. The exercises were organized in circuits that included three strength exercises, one endurance exercise, and one dynamic balance exercise per session. Results: The mean initial SARC-F score was 4.7 ± 0.6, and post-intervention it was 2.5 ± 0.5 (p=0.01). The mean initial strength was 10.5 ± 1.2 repetitions, and post-intervention it was 14.2 ± 2.0 (p=0.01). Although dynamic balance and endurance showed improved post-intervention scores, these were not statistically significant. Conclusion: Multimodal physical exercise significantly reduced SARC-F scores indicating sarcopenia and increased lower limb strength, suggesting that in this population, it represents a non-pharmacological strategy that supports prevention and treatment.

With increasing age, changes occur in the muscles, bones, and joints, leading to a decline in strength, elasticity, and flexibility. These conditions result in reduced balance ability and an increased risk of falls among older adults. Limited knowledge regarding balance disorders and insufficient community-based education remain challenges in preventing fall risks. This community service activity aimed to improve the knowledge and skills of older adults through education and demonstration of balance exercises in Dusun Dawung. The methods included health education on balance disorders, their causes, impacts, and management, followed by direct practice of balance exercises. The results showed an improvement in participants’ understanding, from 61% with low understanding, 29% moderate understanding, and 10% good understanding to 6% low understanding, 13% moderate understanding, and 81% good understanding after the intervention. Participants were also able to perform the exercises independently in a proper and correct manner. This activity was effective in enhancing knowledge and balance ability among older adults and has the potential to reduce the risk of falls.

Radiologic technologists are frequently exposed to occupational stressors that heighten the risk of burnout, compromising well-being and job performance. Workplace exercise programs have been identified as promising strategies to enhance physical and mental health across occupational groups; however, robust experimental evidence among radiologic technologists remains limited. This study aimed to evaluate the effects of a structured workplace exercise program on perceived stress, burnout, and quality of life among radiologic technologists. A small-scale randomized controlled experimental study was conducted with 19 radiologic technologists from the Local Health Unit of Castelo Branco, Portugal. Participants were randomly assigned to an experimental group (n = 10, age mean = 43.8 ± 9.92 years old) or a control group (n = 9, age mean = 48.2 ± 7.86 years old). The intervention consisted of a six-week workplace exercise program conducted during work hours, comprising sessions three times per week, twice per day. Each session lasted approximately 15-20 min and included balance, stretching, and light resistance exercises. Outcomes were assessed pre- and post-intervention using the Perceived Stress Scale, the Copenhagen Burnout Inventory, and the WHOQOL-BREF. The experimental group showed significant reductions in perceived stress (p = 0.013, d = -0.697 (-1.6-0.206) [moderate]) and in personal (p = 0.004, d = -0.834 (-1.748-0.08) [moderate]) and work-related burnout (p = 0.026, d = -0.756 (-1.664-0.151) [moderate]), as well as improvements in the physical (p = 0.046, d = 0.592 (-0.303-1.488) [small]) and environmental (p = 0.032, d = 0.991 (0.062-1.92) [moderate]) domains of quality of life. No significant changes occurred in the control group. These preliminary findings suggest that a brief, low-cost workplace exercise program may reduce stress and burnout and improve quality of life among radiologic technologists. These findings support the integration of structured physical activity into healthcare work settings as a feasible, preventive, and health-promoting strategy.

Adolescent idiopathic scoliosis (AIS) is reported as the most common type of scoliosis. The aim of this study is to evaluate the effect of scoliosis-specific exercises on the Cobb angle and muscle strength in AIS, comparing the outcomes between both gender groups. This study was conducted with a total of 34 individuals (17 girls, 17 boys) aged 10 to 14 years, all diagnosed with AIS of the S-type, and Cobb angles ranging from 15° to 30°. The Cobb angle was measured before and after the intervention; additionally, the patients were evaluated using the Modified Push-up, Sit-up, Lateral Bridge, Trunk Flexor Endurance, and Sorensen tests. Scoliosis-specific exercises based on the Barcelona Scoliosis Physical Therapy School (BSPTS) approach were performed in front of a mirror, on a scoliosis bar, and using an exercise ball, in four sessions over an eight-week period. Improvement in both the thoracic and lumbar Cobb angle was observed in both groups, with a more significant correction found in males (p &lt; .001). In all muscle strength tests, improvements in test durations were noted in both the male and female groups. However, the times recorded in the Sorensen test and the Modified Push-up test were significantly longer in males than in females (p &lt; .001). These results highlight gender differences in muscle strength and scoliosis severity. BSPTS exercises led to improvements in both Cobb angle and muscle strength in both groups. Additional interventions may be beneficial for achieving further improvements in the treatment of girls with AIS. Cite this article as: Okur Dündar, Ş., Çağlar, İ., &amp; Apaydın, Z. (2026). Comparison of the effectiveness of scoliosis-specific exercises in girls and boys with adolescent idiopathic scoliosis. Research in Sports Science, 16, 0082, doi:10.5152/rss.2026.25082

Background: Complications developing in individuals with Type 2 Diabetes Mellitus (T2DM) lead to functional impairments and losses in postural balance; however, changes in cognitive functions are also observed and are often overlooked. Dual-task exercises allow simultaneous engagement of balance and cognitive functions. Therefore, this study aimed to investigate the effects of dual-task exercise training on cognitive functions, balance, and functional status in individuals with T2DM. Methods: In this study, 40 individuals diagnosed with T2DM were randomly assigned to three groups: the dual-task exercise group (DTEG, n = 13), the single-task exercise group (STEG, n = 13), and the control group (CG, n = 14). Over eight weeks, balance exercises were administered to the STEG, while simultaneous balance and cognitive exercises were applied to the DTEG, twice weekly under the supervision of a physiotherapist. Participants in the control group received no intervention. Dual-task performance, cognitive functions, balance, and functional status were assessed at baseline and at the end of eight weeks. Dual-task performance was defined as the primary outcome. Results: After the intervention, for the primary outcome, dual-task performance (TUG single-task condition and TUG dual-task condition), both exercise groups showed greater improvements than controls. Both exercise groups also demonstrated significant improvements in balance, functional status, and cognitive outcomes compared to the control group. In the between-group comparisons, both exercise groups showed significant improvements in several cognitive functions compared with the control group (p < 0.05). In addition, the MoCA total score was significantly higher in the DTEG compared with the other groups. Conclusions: Both dual-task and single-task exercises improve cognitive function, balance, and functional status in individuals with T2DM.