Balance Exercises Research Articles

Physical Exercise and Health, 2: Benefits Associated With Different Levels and Patterns of Activity.

Physical activity and leisure time exercise are associated with well-documented health benefits. Cohort studies and meta-analyses of such studies show that the benefits of physical activity are dose-dependent, arise at even low levels of activity, improve sharply from low to higher levels of activity, peak at very high levels of activity, and plateau thereafter. The benefits are apparent regardless of how the activity is accrued, from vigorous movements in very short intervals during everyday activities across the course of a day to vigorous, "weekend warrior" exercise, accumulated mostly during 1-2 days in a week. An earlier article in this column discussed terminology, guidance, benefits, and risks in the context of exercise and health. This article states and explains the guidance about exercise for adults and for special populations such as the elderly, discusses general limitations of cohort studies, examines how many steps of walking a day suffice to improve health outcomes and at what level a ceiling is reached, considers at what speed these steps need to accrue, examines the benefits of exercise patterns such as vigorous intermittent lifestyle physical activity and weekend warrior workouts, discusses a study that examined different combinations of exercise, and explains the reasons behind the paradox that fitter persons need to perform apparently harder workouts to meet the exercise guidance. Some niche issues are also discussed, such as a role for isometric exercise, the use of caffeinated and energy beverages before exercise, the use of target heart rate as a measure of exercise intensity, how to grade an exercise session that varies in intensity, and the importance of load-bearing, stability, balancing, and flexibility exercises. It must be understood that exercise is a lifetime commitment that provides benefits that pills cannot. Health care professionals need to recommend activity and discourage sedentariness in all patients whom they see.

Influence of Respiratory Muscle Training and Balance Exercise in Children with Cerebral Palsy: A Randomized Controlled Trial

The study's objective was to ascertain the effects of inspiratory muscle and balance training on children with hemiplegic cerebral palsy's (CP) pulmonary function, respiratory muscle strength (RMS), functional ability, and balance.

Effects of Elastic Band Exercise Combined with Swiss Ball Exercise on Lower Extremity Muscle Strength, Balance, and Pain in Middle-Aged Women with Osteoarthritis

Effects of Elastic Band Exercise Combined with Swiss Ball Exercise on Lower Extremity Muscle Strength, Balance, and Pain in Middle-Aged Women with Osteoarthritis

Do Bosu Ball Exercises Affect Countermovement Jump and Squad Jump Performance in Basketball Players?

Bu araştırma, basketbolcularda sekiz haftalık bosu ball egzersizlerinin dikey sıçrama ve kuvvet performansına etkisini incelemek amacıyla yapıldı. Araştırmanın örneklem grubunu Bingöl ili, Gençlik ve Spor İl Müdürlüğünde, en az iki yıl lisanslı olarak basketbol oynayan 20 deney 20 kontrol olmak üzere toplam 40 erkek basketbolcudan oluşturuldu. Sporculara haftanın 3 günü olacak şekilde 60 dakika basketbol antrenmanları uygulandı ve 8 hafta boyunca devam etti. Deney grubuna ek olarak 30 dakika bosu ball egzersizleri uygulandı. Sırasıyla antropometrik, dikey sıçrama ve kuvvet ölçümleri alındı. Test sonuçlarına göre grup içi bağımlı değişkenlerin karşılaştırılmasında bağımlı iki örneklem testi yapıldı. Ayrıca gruplar arası karşılaştırmalar tekrarlı ölçümler ile yapıldı. Yapılan değerlendirme sonucuna göre dikey sıçrama Countermovement Jump (CMJ) değerlerinde deney ve kontrol grubunun ön test ve son test gruplar arası karşılaştırmasında istatistiksel olarak anlamlı fark olduğu tespit edildi (p<0.05). Sırt kuvveti değerlerinde deney ve kontrol grubunun ön test ve son test gruplar arası karşılaştırmasında anlamlı farklılık tespit edilmedi (p>0.05). Bacak kuvveti değerlerinde deney ve kontrol grubunun ön test ve son test gruplar arası karşılaştırmasında istatistiksel olarak anlamlı farklılık tespit edildi (p>0.05). Sonuç olarak, bosu ball egzersizlerinin bacak bölgesinde bulunan kasların gücü etkilediği bu sayade sporcuların dikey sıçrama ve kuvvet performansına önemli oranda etkileyebileceğini düşünmekteyiz.

Effects of task-oriented balance training with sensory integration in post stroke patients

Background: Balance and functional mobility is greatly affected in stroke patients. Balance training integrated with sensory input is more beneficial for improving balance and mobility in stroke patients. Objective: To determine the effects of task-oriented balance training with and without sensory integration on balance, postural stability, and mobility in post-stroke patients. Methods: A randomized control trial was conducted at RHS Rehabilitation Centre, Islamabad. A total of n=60 post-stroke patients were included in the study through a non-probability purposive sampling technique. Male and female stroke patients above 40 years of age, having the ability to maintain a standing position without aid for at least 5 minutes, and patients on Grades II, III, IV on the Functional Mobility Scale were included in this study. They were randomly allocated into Group A (n=30) and Group B (n=30). Both groups received Task oriented balance training while group B was treated with additional sensory integration. The Berg Balance Scale, Dynamic Gait Index, Activities Specific Balance Confidence Scale, and Balance Error Scoring system were used for balance assessment. The assessment was done at baseline and after 6th week. Results: The mean age of the participants was 54.47 years. After 6 weeks of intervention, a significant difference was found in group A as compared to group B for Dynamic mobility measured by Dynamic gait index with p-value (p=0.06) and for balance measured by BBS with p-value (p=0.05). Conclusion: The task-oriented balance training with sensory integration is effective in improving dynamic balance and mobility in stroke patients. Keywords: balance training; Sensory Integration; stroke rehabilitation; task-oriented balance exercises.

Effect of Balance Exercises with Smart Phone Based Virtual Reality Programme on Balance in Stroke Patients

Background and objectives: A stroke is a neurological deficit, caused due to vascular changes. Impaired postural control and balance impairments in post-stroke patients are associated with a high risk of falls among stroke patients. The perturbation-based balance training is mainly used in older adults and balance impairment. Virtual reality (VR) as a novel technology is rapidly becoming a popular intervention for improving balance. VR can visualize computer-generated environments with a full field of view through Head-mounted displays (HMD-VR). This study was conducted to assess and investigate the effect of balance exercises with smartphone-based virtual reality programs on balance in stroke patients. Methods: This was a randomized single-group pre and post-test study design. 30 subjects met the inclusion criteria and were enrolled, assigned, and received intervention. Subjects were given perturbation-based balance exercises and smartphone-based virtual reality along with conventional physiotherapy. The intervention protocol was for 6 days/week for 4 weeks period. Results: Following 4 weeks of intervention showed improvement in postural control and balance which was assessed using BBS, TUG, VR BESS, BESTest, and SIS 3.0. Paired t-test was used to differentiate the mean significance. The mean pre to post-intervention difference is 12.6 with a p - value < 0.05. TUG score improved from pre to post-intervention difference is 1.443 with a p - value < 0.05. VR BESS score improved from pre to post-intervention difference is 10.266 with a p value < 0.05. The mean BESTest pre to post-intervention difference is 11.467 with a p - value < 0.05. SIS 3.0 score improved from a pre to post-intervention difference is 20.33 with p - value < 0.05. The result of this study showed a highly significant difference in pre and post-treatment. Conclusion: The study concludes that perturbation-based balance exercises with smartphone-based virtual reality programs are a useful adjunct to improving balance in stroke patients along with conventional physiotherapy.

The Effectiveness of the Birthing Ball (Gym Ball) on the Progress of Opening the First Stage of Labor in the Working Area of Muka Health Center, Purwakarta District, Purwakarta Regency, Indonesia

The birthing ball allows gravity to help the baby descend into the pelvis, which can speed up the opening of the cervix. Apart from that, the Birthing Ball also provides extra comfort and support to pregnant women, which can reduce pain and anxiety during the birthing process. This study aimed to determine the effectiveness of the birthing ball (gym ball) on the progress of the opening the first stage of labor in the Muka Health Center Working Area, Purwakarta District, Purwakarta Regency, Indonesia. This study is experimental research with a post-test approach with the control group and uses primary data, namely measuring the length of the first stage of labor. A total of 30 research subjects took part in this study. The birth ball showed the potential to increase the speed of duration of the first stage of labor statistically significantly, p<0.05. The duration of the first stage of labor in the intervention group was around 195.83 ± 16.76 minutes, while the duration of labor in the control group was 345.83 ± 26.76 minutes. In conclusion, there is the effectiveness of the birthing ball (gym ball) in the progress of the opening the first stage of labor in the Muka Health Center Working Area, Purwakarta District, Purwakarta Regency, Indonesia.

A Systematic Review of the Long-Term Effects of Using Smartphone- and Tablet-Based Rehabilitation Technology for Balance and Gait Training and Exercise Programs.

Recent advances in wearable motion sensors, mobile devices, the Internet of Things, and telecommunications have created new potential for telerehabilitation. Recognizing that there is no systematic review of smartphone- or tablet-based balance and gait telerehabilitation technology for long-term use (i.e., four weeks or more), this systematic review summarizes the effects of smartphone- or tablet-based rehabilitation technology on balance and gait exercise and training in balance and gait disorders. The review examined studies written in English published from 2013 to 2023 in Web of Science, Pubmed, Scopus, and Google Scholar. Of the 806 studies identified, 14 were selected, and the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-sectional Studies was applied to evaluate methodological quality. The systematic review concluded that all 14 studies found balance and gait performance improvement after four weeks or more of balance and gait telerehabilitation. Ten of the 14 studies found that carry-over effects (improved functional movements, muscle strength, motor capacity, cognition, and reduced fear of falling and anxiety levels) were maintained for weeks to months. The results of the systematic review have positive technical and clinical implications for the next-generation design of rehabilitation technology in balance and gait training and exercise programs.

OA05 Cycling: a tool for cardiovascular exercise in patients with established ankylosing spondyloarthritis

OA05 Cycling: a tool for cardiovascular exercise in patients with established ankylosing spondyloarthritis

Ageing, sport and physical activity participation in Scotland.

As sport and physical activity are vital to support extended health spans, this study aimed to analyse the current trends in sports participation and physical activity rates among individuals aged 65 years and older in Scotland. Data were compared with the Chief Medical Officer (CMO) guidelines and analysed the influence of key factors on participation rates. The study used data from the Scottish Health Survey and the Scottish Household Survey (2019) to investigate self-reported participation in physical activity and sports across different age groups. Descriptive statistics and cross-tabulations were used to analyse the relationships between participation rates and influencing factors. Participation data for Parkrun events in Scotland were also analysed for the years 2008-2018. The study found a clear decline in sports participation with age, with a steep decline after the age of 65, particularly in women. The majority of participation among individuals aged 65+ was in walking, with a sport participation rate of only 31.2% when walking was excluded. Physical activity and sport participation was lower in women across all age ranges but particularly so in the 75+ age group. The most popular sporting activities in the older age group were keep fit/aerobics, swimming and golf. Additionally, the study found that social deprivation had a major impact on sports participation rates, with the most deprived households exhibiting the lowest participation levels irrespective of age. The prevalence of loneliness was lower among individuals who participated in sports or adhered to the CMO guidelines for moderate/vigorous physical activity and strength-building exercises. The findings of this study have implications for promoting physical activity and sports participation among older adults, particularly in deprived communities. This study highlights the importance of balance exercises within sport and the need for more targeted efforts to increase participation rates among older adults. The study also emphasizes the positive impact of sports participation on reducing loneliness among older adults. Overall, the findings suggest the need for ongoing efforts to promote physical activity and sports participation among older adults to improve their overall health and well-being.

Unleashing potential and optimizing adolescent roller skating performance through a structured exercise program – a randomized controlled trial

BackgroundThe intricate nature of an athlete's abilities evolves dynamically with the enhancement of motor skills. Hence the study sought to investigate the impact of a tailored four-week exercise program`encompassing exercises focused on balance, agility, and speed. The primary objective was to determine how this exercise program influences both the roller skating talent and overall physical fitness proficiency in young male roller skaters.MethodsThirty male participants (age 11–14 years) enrolled in the school skating team were recruited. The participants were randomized into either an experimental group [n = 15], performing a short-term exercise program, or a control group [n = 15], involved in the physical education classes for eight sessions over four weeks. The primary outcome measure, the skating performance, was measured by the linear speed test (LST). The secondary outcomes, i.e., balance, agility, and speed, were evaluated using the star excursion balance test (SEBT), agility t-test (ATT), and arrowhead change of direction speed test (ACDT). SEBT was assessed in 8 directions. The study was registered with the Clinical Trials Registry India (TRN: CTRI/2018/09/015713) before the recruitment of the participants on 14/09/2018.ResultsThe results showed that LST, ATT, and ACDT improved significantly (p < 0.05) in both groups, however, greater (p < 0.05) improvement was observed in the experimental group (Cohen’s d 0.8 to 1.3). Regarding SEBT, improvement was observed in a few directions only in both groups. However, no significant difference was observed between both groups in SEBT measurements.ConclusionsA short-term structured exercise program consisting of balance, agility, and speed exercises significantly improved the talent of skating, agility, and speed compared to physical education classes activities in young male roller skaters. The study highlights the potential of targeted training interventions to enhance athletic performance in this population.

PHYSICAL EDUCATION OF STUDENTS WITH ORTHOPEDIC DISABILITIES AND THE EVALUATION OF EXPENDITURES ON THESE STUDENTS

Introduction: Physical education of students with orthopedic disabilities includes a special program aimed at improving their physical and motor skills. This program takes into account the individual needs and abilities of students while encouraging their participation in physical activities. Physical education of students with orthopedic disabilities is usually guided by a specialist physiotherapist, sports trainer or special educator. The program is customized taking into account the student's current situation and the type of disability. The physical education program includes various exercises to increase the student's mobility, improve balance and coordination skills, and increase muscle strength and flexibility. A variety of activities may take place, such as physical therapy sessions, muscle strengthening exercises, balance exercises, stretching and sports activities. In addition, suitable sports and games for students with orthopedic disabilities also play an important role. This helps students develop their teamwork, competitive and social skills. Some sports that students can participate in include wheelchair basketball, paralympic swimming, wheelchair tennis and athletics. Technological tools are also used in physical education. Special equipment such as prostheses, wheelchairs or walking devices support students' participation in physical activities. Method and Analysis: Panel data analysis was used in this study. Frequency, regression and statistical mean were used in the analysis. Conclusion: Physical education of students with orthopedic disabilities is important in terms of improving their physical and motor skills. It seems to be an important program to encourage participation in physical activities and increase their self-confidence. By adopting an approach tailored to their individual needs, these students should be supported to lead a healthy life and maximize their physical potential. For this reason, providing the expenditure expenses of the students in need of orthopedic and physical education by the public will support the achievement of effective results on participation and success.

Exercise treatments for lumbar spinal stenosis: A systematic review and intervention component analysis of randomised controlled trials

Objective To analyse the components used in exercise interventions for people with symptoms of neurogenic claudication due to lumbar spinal stenosis and identify components associated with successful interventions. Data sources Eligible papers published up to April 2023 from MEDLINE, EMBASE, CINAHL, PEDro, CENTRAL, Web of Science, and trial registry websites. Review methods Literature searches were performed by an Information Specialist. We searched for randomised trials evaluating exercise interventions for people with neurogenic claudication symptoms (the primary symptom of lumbar spinal stenosis). Two authors independently performed study selection, data extraction, and quality assessments using the Cochrane Risk of Bias tool Version 2 and the TIDieR checklist for intervention reporting. Details of intervention components were extracted, tabulated, and synthesised using an intervention component analysis approach. Results We found thirteen trials reporting 23 exercise interventions delivered to 1440 participants. These featured 60 different components. Most exercise interventions included supervision and flexion-based exercises. Balance exercises were rarely included. Exercise components featured more frequently in successful interventions included stretches, strength or trunk muscle exercises, fitness exercises, especially cycling, and psychologically informed approaches. Interpretation is limited by low study numbers and heterogeneity. No conclusions could be drawn about exercise supervision or dose. Discussion Exercise interventions for people with neurogenic claudication typically feature multiple components. Common features such as supervision, lumbar flexion, and aerobic fitness exercises and also less common features such as stretches, strengthening exercises, and psychologically informed approaches warrant consideration for inclusion when designing and optimising exercise interventions for people with lumbar spinal stenosis.

Effectiveness of an online multicomponent physical exercise intervention on the physical performance of community-dwelling older adults: A randomized controlled trial

This study aimed to assess the effectiveness of an online multicomponent physical exercise intervention (MPE) on the physical performance (PP) of older adults. A randomized controlled trial was conducted, with 110 participants assigned to either the MPE group or the control group. The MPE group engaged in endurance, strength, balance, and flexibility exercises for at least three days per week, while the control group received educational sessions. PP was evaluated using the Short Physical Performance Battery (SPPB) at baseline and after three months. The intervention group showed a mean increase over control group of 0.81 points on the SPPB scale (95% confidence interval [CI] 0.23-1.40; p=0.000) and in the tandem balance test with 1.26 more seconds (95% CI 0.21-2.31; p=0.019). These findings suggest that the online MPE intervention is effective in enhancing the PP of community-dwelling older adults, which may contribute to a reduction in functional dependence among this population.

O.4.1-10 The FITT guidelines for multicomponent fall prevention programmes for community-dwelling older adults

Abstract Purpose The most commonly proposed intervention for fall prevention in community-dwelling older adults is a multicomponent exercise programme. This is a structured form of exercise that improves muscle performance, balance, proprioception, coordination, mobility, and gait. It usually includes balance and functional exercises versus control. Although it has been suggested that exercise programmes for fall prevention should be performed three or more times per week, no precise guidelines for frequency (F), intensity (I), T(time), and T(type) of a multicomponent exercise programme have been proposed. It has already been pointed out that frequency, type, and time of a multicomponent exercise programme do not explain the effects of balance exercises in older adults. The aim of this systematic review was to evaluate the reporting of FITT guidelines for a multicomponent exercise programme for fall prevention in community-dwelling older adults, with a focus on intensity. Methods Systematic reviews of randomised control trials comparing the effectiveness of structured, multicomponent fall prevention programmes in community-dwelling older adults were included. Studies that focused on a specific condition, such as stroke, were excluded. We included only studies that compared fall rates before and after the multicomponent programme. PubMed, PEDro, EMBASE, Scopus were searched until January 2023. Results Preliminary results showed that FITT guidelines for multicomponent exercise were not consistently reported across studies. In particular, exercise intensity was often not reported. Without a valid and reliable measure of exercise intensity, the dose-response relationship for a multicomponent exercise programme should be further investigated. Conclusions Limitations of this systematic review include variability in the design of multicomponent interventions and incomplete reporting of FITT in reported studies. Support/Funding Source The study is founded from Next Generation EU Recovery and Resilience Facility and resources from National institute of public health Slovenia.

S6-4 How to engage community-dwelling older adults in fall prevention programs? – a qualitative study into potential strategies

Abstract Aim Fall rates and fall-related injuries among community-dwelling older adults (≥65 years) will likely increase due to the rapidly aging population worldwide. Therefore, fall prevention has become an international priority. Fall prevention programs (FPPs), consisting of strength and balance exercises, have been proven effective in reducing the number of falls among older adults. However, in practice, professionals find it difficult to enroll participants for FPPs. Therefore, this study aims to identify effective strategies that promote engagement in FPPs among older adults. Methods Based on previously identified barriers and facilitators for participation in FPPs by older adults, six strategies were designed using Intervention Mapping: 1) reframing; 2) informing about benefits; 3) raising awareness of risks; 4) involving social environment; 5) offering tailored intervention; 6) arranging practicalities. Strategies were presented and validated during semi-structured interviews with older adults (n = 12) at risk of falling. Interviews were recorded, transcribed and analyzed following a hybrid qualitative thematic method. Results Analysis showed that reframing 'aging’ and 'fall prevention' is important. Within this strategy, themes emerged related to respondents’ preference to be approached differently, taking a ‘life course’ perspective about falls, and avoiding confronting terms. Furthermore, the strategy 'informing about benefits' (e.g. ‘living independently for longer') could contribute to understanding the relevance of participating in FPPs. Other strategies were considered important to take into account too, but were less emphasized. Conclusion This study provides insight into possible strategies to stimulate older adults to participate in FPPs. Reframing ‘aging’ and 'fall prevention' may facilitate the conversation about fall prevention, which can be achieved by communicating differently about the topic, for example ‘staying fit and healthy’, while focusing on the benefits of participating in an FPP. Developing practical recommendations about how to apply the strategies, is an area for future research, as this could help health and social care professionals to enhance older adults’ participation in FPPs. Currently, the strategies are further developed to be applied and evaluated for effectiveness in multiple field labs in a central Dutch region (Utrecht). Funding source This research was co-funded by Regieorgaan SIA, part of the Netherlands Organization for Scientific Research (NWO).

The Effectiveness of Video-Based Game Exercise Therapy Applications in Pes Planus Rehabilitation: Protocol for a Randomized Controlled Trial.

Pes planus is one of the most common foot deformities. Although there are many studies on the effectiveness of various exercise methods in pes planus rehabilitation, the number of studies on video-based game exercise therapy applications is very limited. This study aims to evaluate the effectiveness of 2 video-based game exercise therapies and structured exercise practices in pes planus rehabilitation. This study is a 3-arm, parallel-group, single-blinded randomized controlled trial. The study will include 69 patients with flexible pes planus aged between 18 and 25 years who attend the orthopedics and traumatology clinic and meet the inclusion criteria. The primary outcomes are measures of navicular drop and pedobarographic analysis before and after the intervention, and the secondary outcomes include balance, femoral anteversion, and lower extremity muscle strength. Participants will be evaluated with a navicular drop test for medial longitudinal arch height, a pedobarographic analysis system for plantar pressure analysis, a Craig test for femoral anteversion, the Becure Balance System for balance measurement, and a myometer device for lower extremity muscle strength measurement. Participants will be randomly assigned to a structured exercise group, an exergame group, or a serious game group according to their order of arrival. The structured exercise group will use a short foot exercise, a towel-picking exercise, and various walking and balance exercises. Patients in the serious play group will play the lower extremity games in the Becure Balance System. Patients in the exergame group will play balance games on the Nintendo Wii game console. All participants will participate in 18 exercise sessions (3 days a week for 6 weeks). After the treatment, the initial measurements will be repeated. The study started in January 2023. It is expected to be completed in June 2024. This study will be the first randomized controlled study to evaluate the effectiveness of 2 different video-based game exercise therapy applications in pes planus rehabilitation. Through this study, the use of video-based game exercise therapy in pes planus rehabilitation, together with the developing technology, will be a guide. In addition, a new exercise protocol, including serious game exercises, will be added to the literature. In the future, it is expected that our study on the development of different game systems, especially for the ankle, will provide pioneering feedback. ClinicalTrials.gov NCT05679219; https://clinicaltrials.gov/study/NCT05679219. DERR1-10.2196/51772.

O.1.2-5 How to make physical activity part of daily life for elderly using the IPitup activity bench: CrossCare research

Abstract Purpose The main goal of IPitup is to lower the threshold to physical activity and to encourage people to become more active in public spaces. To do so IPitup (npo) offers a package that is built around the activity bench, an urban sitting furniture that provides a wide range of strength, balance and cardiovascular exercises. An app and training courses for coaches complete the offer. They provide the possibility to easily put into practice the WHO guidelines for physical activity. Within the CrossCare project, IPitup focussed specifically on prevention among elderly to allow them to remain physically active in their own living environment. Project description At first the market demand was mapped and stakeholders were identified. An extensive survey (n = 229) then provided insights into the movement patterns of the primary end-users and illustrated among others the interest in the existing IPitup package. 93% was found to be convinced of the importance of physical activity and 92% considered the activity bench suitable for use by elderly. Thanks to input of secondary and tertiary users and with the help of live tests and co-creation sessions, it became clear which adjustments should be made to the activity bench and the accompanying services. Input from elderly, caregivers, local residents, healthcare professionals and local governments made clear the importance of a comprehensive approach. Getting seniors to become more physically active requires more than just creating an movement-friendly environment (hardware). This only makes sense if sufficient attention goes to an adapted offer (software), which must be organized in a way that people get motivated to actively engage (orgware). In the end the concept was successfully implemented in various environments. Post-research practice suggested the project is replicable in other countries. Conclusions In elderly there is a clear acknowledgment and conviction about the importance of physical activity. Based on input from various stakeholders, specific adjustments were made to the activity bench and its supporting services. This seems to make the IPitup concept a valuable tool to lower the threshold for older people to become more active in daily life. Interreg project supported by four healthcare research institutes.

Balance rehabilitation for patients with Multiple Sclerosis using a Kinect®-based virtual training program

BackgroundPatients with multiple sclerosis (MS) often experience balance issues during physical activities. Traditional rehabilitation exercises such as stretching, resistance, and aerobic training have been found to be effective, but can be repetitive and tedious, leading to reduced patient motivation and adherence. Furthermore, direct supervision by a therapist is not always possible. MethodsThe aim of this study was to develop and evaluate the effectiveness of a virtual training program incorporating visual feedback from the Kinect® sensor in male patients with multiple sclerosis. Forty-five participants, with an age range of 22–56 years (mean age = 39), were randomly assigned to one of three equal groups, including two experimental groups and one control group. The experimental groups participated in eight-week exercise interventions, with each session lasting 20 to 30 min and occurring three times per week. In contrast, the control group received no interventions. Within the experimental groups, one was exposed to conventional balance exercises, whereas the other engaged in the proposed virtual training program. Both of these groups undertook three balance exercises, namely the single-foot stance, lunge maneuvers, and arm/leg stretching routines. The assessment encompassed diverse facets of balance, including parameters of 10 Meter Walk Time, Berg Balance Scale, Static Balance Score, and Time-Up and Go Scale, as well as the quality of life, gauged through the Multiple Sclerosis Quality of Life (MSQOL)-54 Questionnaire. The effect of test variables was investigated using analysis of covariance (ANCOVA), while the independent samples t-test was used to check for significant differences among the groups. The effects of the groups were compared using a paired samples t-test. ResultsThe findings revealed that both rehabilitation programs positively affected the dependent variables compared to the control group. However, the significant difference between the pre-test and post-test scores of the experimental groups indicated the effectiveness of the proposed program compared to the traditional method. ConclusionsEntertaining virtual training programs utilizing visual feedback can be effective for rehabilitating patients with MS. The proposed method enables patients to perform rehabilitation exercises at home with high motivation, while accurate information about the treatment process are provided to the therapist.

Restoring walking ability in older adults with arm-in-arm gait training: study protocol for the AAGaTT randomized controlled trial

ContextFalls are a significant problem among older adults. While balance and functional exercises have been shown to be effective, it remains unclear whether regular walking has specific effects on reducing the risk of falls.RationaleOlder people who fall frequently have impaired gait patterns. Recent studies have suggested using interpersonal synchronization: while walking arm-in-arm, an older person synchronizes steps with a younger person to reinstate a better gait pattern. This method of gait training may reduce the risk of falls.ObjectiveThe aim is to assess the efficacy of an arm-in-arm gait-training program in older people.DesignThe arm-in-arm gait training trial (AAGaTT) is a single-site, open label, two-arm, randomized controlled trial.ParticipantsWe will enroll 66 dyads of older people and their younger “gait instructors”. The older participants must be > 70 years old with adequate walking ability. They must have experienced a fall in the year prior to study entry.InterventionDyads will walk an indoor course for 30 min either side-by-side without contact (control group) or arm-in-arm while synchronizing their gait (intervention group). The gait training will be repeated three times a week for four weeks.OutcomesThe main outcome will be the walking speed measured in five-minute walking trials performed at baseline and at the end of each intervention week (week 1 – week 4), and at week 7. Gait quality will be assessed using accelerometers. We will also assess perceived physical activity and health using questionnaires. Finally, we will monitor fall incidence over 18 months. We will evaluate whether outcomes are more improved in the intervention group compared to the control group. In addition, interviews will be conducted to assess the perception of the gait training.Expected resultsRecent advances in the neurophysiology of motor control have shown that synchronizing gait to external cues or to a human partner can increase the efficiency of gait training. The expected benefits of arm-in-arm gait training are: reduced risk of falls, safe treatment with no adverse effects, and high adherence. This gait training program could be a low-cost intervention with positive effects on the health and well-being of seniors.Trial registrationClinicalTrials.gov NCT05627453. Date of registration: 11.25.2022.