Functional Reach Test Research Articles

The effects of single leg stance during daily toothbrushing on the balance skills of elderly adults

Background and Study Aim. It was aimed to measure the effects of single-leg stance on measuring the individual postural limits and balance skills of elderly adults.
 Material and Methods. The present study involved a total of 360 elderly adults aged between 70 and 80 years. The participants were divided into two groups as 187 individuals in experiment group (99 women / 88 men) and 173 individuals in control (94 women / 79 men). In measuring the risk of fall and balance skills, the Functional Reach Test, Timed up and go Test, and Single Leg Stance Test were used. The participants in experiment group were asked to stand on one foot for a total of 4 minutes (2 minutes in morning and 2 minutes in evening) every day while brushing their teeth for 50 weeks. Since the data showed normal distribution, the independent samples t-test was used in determining the intergroup difference, whereas the dependent sample t-test was used in determining the intragroup pretest-posttest difference.
 Results. It was determined that there was a significant relationship between elderly adults’ balance skills and 4-min/day single-leg stance practice (p<0.05). In all the tests, it was found that the balance skills of women and men have improved and men had better values in comparison to women.
 Conclusion. It is thought that, via simple procedures such as lifting up one foot while brushing the teeth, the balance skills of elderly adults can be improved, the risk of fall can be reduced. They can be supported in terms of living an independent life.

The effect of pilates on body awareness, activity level, aerobic capacity and balance in healthy young adults

Aim: In this study, it was aimed to investigate the effects of Reformer Pilates on body awareness, activity level, aerobic capacity and balance in young adults.Materials and Methods: Participants were consisted of Reformer Pilates (individuals who received a program of muscle strengthening and flexibility exercises; n=82) and sedentary groups (n=87). Body Awareness Questionnaire (BAQ), International Physical Activity Questionnaire Short Form (IPAQ-SF), YMCA 3-Minute Step Test, Single-Limb Stance Test (SLST), and Functional Reach Test (FRT) were used in the evaluations of the participants.Results: A statistically significant difference was found in favor of the Reformer Pilates group in the scores of BAQ, IPAQ-SF mild level activity, YMCA 3-Minute Steps Test, SLST with eyes closed, and lateral FRT scores (p<0.05). In the sedentary group, heart rate change after the YMCA 3 min Step Test was statistically significantly higher (p=0.001).Conclusion: Body awareness, aerobic performance, and balance scores were found to be better in individuals who practiced Reformer Pilates than in sedentary individuals.

The effectiveness of traditional Chinese medicine-based exercise on physical performance, balance and muscle strength among older adults: a systematic review with meta-analysis.

Traditional Chinese medicine (TCM) based exercises have been widely used in the prevention and treatment of balance, cardiopulmonary, and other related diseases in older adults. However, there seems to be no consensus on the improvement and comparison of physical performance, balance, and muscle strength in the elderly population. To systematically examine the impact of different TCM-based exercises on physical performance, balance, and muscle strength outcomes in the elderly. We searched PubMed, EMBASE, Scopus, and Cochrane Center, CNKI and Wan Fang between their date of inception and March 2021. This meta-analysis was performed using RevMan5.3 software. Only randomized controlled trials (RCT) or controlled clinical trials (CCT) were considered in TCM-based exercises (Tai Chi, Ba Duan Jin, Qigong). The overall mean difference (MD) or standardized mean difference (SMD), and its 95% confidence interval (CI) were calculated. A total of 27 studies with 2580 older adults met the inclusion criteria. The pooled analysis indicated that Tai Chi could be more effective in Times up and go (TUG) (MD = - 2.62, 95% CI - 4.00 to - 1.24, P = 0.0002), 5 times sit-stand (MD = - 1.89; 95%CI - 3.38 to - 0.40; P = 0.01), and handgrip strength outcomes (SMD = 0.69; 95%CI 0.52-0.86; P < 0.0001) compared to Ba Duan Jin and Qigong. The older adults performing Qigong could have a better benefit in Single-bed balance (SLB) with eyes closed compared to Tai Chi and Ba Duan Jin (MD = 3.42; 95%CI 1.55 to 5.29; P = 0.0003). Tai Chi also had benefits in terms of balance outcomes compared to those in the control group: Berg Balance scale (BBS) (MD = 1.41; 95% CI 0.03-2.85; P = 0.05), Functional reach test (FRT) (MD = 1.57; 95%CI 1.22-1.93; P < 0.0001). The Tai Chi study meta-analysis demonstrated significant effects on lower limb strength: knee extension (SMD = 0.56; 95%CI 0.26-0.86; P = 0.0003), ankle dorsiflexion (SMD = 0.67; 95%CI 0.02-1.31; P = 0.04) compared to the controls. This systematic review reveals that TCM-based exercises can effectively improve physical performance outcomes, balance outcomes, and muscle strength in the elderly population. While there is limited evidence on the efficacy of other TCM-based lifestyle interventions, more high-quality clinical trials on this topic are warranted.

Functional Reach Test, Single-Leg Stance Test, and Tinetti Performance-Oriented Mobility Assessment for the Prediction of Falls in Older Adults: A Systematic Review.

The authors sought to systematically review the existing literature on the falls-related diagnostic test properties of the Functional Reach Test (FRT), single-leg stance test (SLST), and Tinetti Performance-Oriented Mobility Assessment (POMA) in older adults across settings and patient populations. The PubMed, EMBASE, and CINAHL databases were searched (inception-July 2020). Inclusion criteria were participants aged 60years or more, prospectively recorded falls, and the reporting of falls-related predictive validity. Manuscripts not published in English were excluded. Methodological quality of reporting was assessed using the Tooth Scale. Of 1071 studies reviewed, 21 met the inclusion criteria (12 POMA, 8 FRT, 6 SLST). Seven studies (58.3%) used a modified version of the POMA, and 3 (37.5%) used a modified FRT. For the outcome of any fall, the respective ranges of sensitivity and specificity were 0.076 to 0.615 and 0.695 to 0.97 for the POMA, 0.27 to 0.70 and 0.52 to 0.83 for the modified POMA, 0.73 and 0.88 for the FRT, 0.47 to 0.682 and 0.59 to 0.788 for the modified FRT, and 0.51 and 0.61 for the SLST in community-dwelling older adults. For the SLST, the sensitivity and specificity for recurrent falls in the community-dwelling setting were 0.33 and 0.712, respectively. All the clinical tests of balance demonstrated an overall low diagnostic accuracy and a consistent inability to correctly identify fallers. None of these tests individually are able to predict future falls in older adults. Future research should develop a better understanding of the role that clinical tests of balance play in the comprehensive assessment of falls risk in older adults. Neither the FRT, SLST, nor POMA alone shows consistent evidence of being able to correctly identify fallers across fall types, settings, or older adult subpopulations. These clinical tests of balance cannot substitute a comprehensive falls risk assessment and thus should be incorporated in practice solely to identify and track balance impairment in older adults.

Correlation of Lumbar Core Strength with Functional Mobility in Community-Dwelling Elderly Adults

Context: Aging results in changes in individual cells and organs of the body which consequently result in changes in function and appearance. These changes imply a negative influence on functional performance interfering with activities of daily living. The core muscles form an important mechanical linkage providing proximal stability and distal mobility. With age, due to fat infiltration, the core muscle strength is found to decrease. Aims: The study aimed to find if a correlation exists between core muscle strength and functional mobility in community-dwelling elderly individuals. Settings and Design: The study was an analytical cross-sectional study conducted in an urban setup in Pune. Subjects and Methods: A total of 103 community-dwelling elderly individuals were assessed for lumbar core strength using the Supine test of Pressure biofeedback and functional mobility using the timed up and go (TUG) test as well as the functional reach test (FRT). Statistical Analysis Used: Spearman correlation test was used in this study. Results: The study showed a significant correlation between core strength and TUG test as well as with the FRT scores (r[TUG] = −0.75, r[FRT] = 0.72). Conclusions: Individuals with a stronger core require lesser duration to complete the TUG test, and can reach a greater distance in the FRT.

Balance Measurement Using Microsoft Kinect v2: Towards Remote Evaluation of Patient with the Functional Reach Test

To prevent falls, it is important to measure periodically the balance ability of an individual using reliable clinical tests. As Red Green Blue Depth (RGBD) devices have been increasingly used for balance rehabilitation at home, they may also be used to assess objectively the balance ability and determine the effectiveness of a therapy. For this, we developed a system based on the Microsoft Kinect v2 for measuring the Functional Reach Test (FRT); one of the most used balance clinical tools to predict falls. Two experiments were conducted to compare the FRT measures computed by our system using the Microsoft Kinect v2 with those obtained by the standard method, i.e., manually. In terms of validity, we found a very strong correlation between the two methods (r = 0.97 and r = 0.99 (p &lt; 0.05), for experiments 1 and 2, respectively). However, we needed to correct the measurements using a linear model to fit the data obtained by the Kinect system. Consequently, a linear regression model has been applied and examining the regression assumptions showed that the model works well for the data. Applying the paired t-test to the data after correction indicated that there is no statistically significant difference between the measurements obtained by both methods. As for the reliability of the test, we obtained good to excellent within repeatability of the FRT measurements tracked by Kinect (ICC = 0.86 and ICC = 0.99, for experiments 1 and 2, respectively). These results suggested that the Microsoft Kinect v2 device is reliable and adequate to calculate the standard FRT.

Age suit simulation replicates in healthy young adults the functional challenges to balance experienced by older adults: an observational study

BackgroundAge simulation can have a positive effect on empathic understanding and perception of ageing. However, there is limited evidence for its ability to replicate objectively the physical and functional challenges...

Six weeks of Pilates improved functional mobility, postural balance and spatiotemporal parameters of gait to decrease the risk of falls in healthy older adults

ObjectiveTo determine the effectiveness of Pilates exercises on falls risk factors. DesignProspective cohort, pre-test post-test study. Participants were selected using convenience and snowballing sampling. Pilates classes were held twice weekly for six weeks (1-h sessions) with a supplementary home programme. MethodsA test of cognitive function, the Montreal Cognitive Assessment (MOCA), was employed to determine eligibility for inclusion. The following fall-predictor variable measures were employed: the 16 item Falls Efficacy Scale (FES), the short International Physical Activity Questionnaire (IPAQ), the Functional Reach Test (FRT), the Timed Up and Go (TUG), the GAITRite® system, Platform FOOTWORKpro. Multivariate analysis ANOVA with time as within subject factor was used to test for differences between pre and post-test scores adjusted for the factor Pilates. Resultstwenty-seven participants completed the study, mean age = 70.4 (SD = 4.5). After adjusting for the effect of the factor Pilates “previous experience or no previous experience of Pilates”, statistically significant differences were identified in the following domains: The TUG (p < 0.001), FRT (p < 0.001), velocity, swing and stance time and the Mediolateral sway (p < 0.05). A significant difference was found between pre and post-test for anteroposterior sway in those with experience of Pilates (p < 0.05) and interaction between time and Pilates experience in Physical Activity (p < 0.05). ConclusionFindings suggest that functional mobility, mobility, spatiotemporal parameters of gait, postural balance and physical activity improved in healthy older adults after 6 weeks of Pilates with a supplementary home programme.

Myofascial Release of the Hamstrings Improves Physical Performance-A Study of Young Adults.

Physical performance is mainly assessed in terms of gait speed, chair rise capacity, and balance skills, and assessments are often carried out on the lower limbs. Such physical performance is largely influenced by the strength of the quadriceps and hamstrings muscles. Flexibility of the hamstrings is important because quadriceps muscle activity influences the hip flexion angle. Therefore, hamstring flexibility is essential to improve physical performance. In this study, Myofascial Release (MFR) was applied to the hamstrings to evaluate its effects. MFR on the hamstrings was performed on 17 young adults. Physical function and physical performance were measured before, immediately after, and 5 days after the MFR intervention: finger floor distance (FFD), range of motion (ROM) of the straight leg raising test (SLR), standing long jump (SLJ), squat jump (SJ), functional reach test (FRT), comfortable walking speeds (C-walking speed), and maximum walking speeds (M-walking speed). The results of the analysis show a significant increase in FFD (−2.6 ± 8.9 vs. 0.4 ± 9.4 vs. 2.4 ± 8.9, p < 0.01), SLJ (185.6 ± 44.5 vs. 185.0 ± 41.8 vs. 196.6 ± 40.1, p < 0.01), and M-walking speed (2.9 ± 0.6 vs. 3.0 ± 0.6 vs. 3.3 ± 0.6, p < 0.01). This study has shown that MFR for hamstrings not only improves flexibility but also increases M-walking speed and physical performance of the SLJ. As MFR is safe and does not involve joint movement, it may be useful for maintaining and improving performance and flexibility during inactivity and for stretching before exercise.

Diagnostic tests to assess balance in patients with spinal cord injury: a systematic review of their validity and reliability.

Sophisticated biomechanical instruments can assess balance in patients with spinal cord injury (SCI) with accuracy and precision; however, they are costly and time consuming to use. Clinical diagnostic tests to assess balance in patients with SCI are less costly and easier to use, but there is limited literature available regarding their reliability and validity. To review systematically articles reporting the validity and reliability of diagnostic tests used to assess balance function in patients with SCI. We searched for articles in the English language from the earliest record to December 15, 2020, which reported validity or reliability of any clinical instrument or diagnostic test used to assess balance in patients with SCI. Articles assessing balance in paraplegic patients with causes other than SCI were excluded. Databases included MEDLINE, AMED, EMBASE, HMIC, PsycINFO, CINAHL, Scopus, and Google Scholar. The COSMIN Risk of Bias checklist was used to assess the studies included and PRISMA-DTA guidelines were applied. We included 16 articles that assessed the validity or reliability of 10 diagnostic tests. The Functional Reach Test (FRT), Berg Balance Scale (BBS), and Mini-Balance Evaluation Systems Test (Mini-BESTest) were assessed by more than 1 study, while the remaining 7 diagnostic tests including the Function in Sitting Test, T-Shirt Test, Motor Assessment Scale item 3, Sitting Balance Score, 5 Times Sit-to-Stand Test, Tinetti scale, and Sitting Balance Measure were assessed by 1 study each. The FRT has good-to-excellent test-retest reliability, excellent inter-rater reliability, and good construct, concurrent, and convergent validity. The BBS has excellent inter-rater and intra-rater reliability, high internal consistency, and good concurrent and construct validity. The Mini-BESTest has excellent test-retest reliability, excellent inter-rater reliability, high internal consistency, and good concurrent, convergent, and construct validity. The FRT, BBS, and Mini-BESTest appear to be valid and reliable clinical instruments to assess balance function in patients with SCI.

Reliability and Validity of a Modified Version of the Community Balance and Mobility Scale (CBMS-Home) for Use in Home Assessment.

The Community Balance and Mobility Scale (CBMS) has been shown to be a valid and reliable outcome measure for evaluating balance and mobility among older adults; however, some items cannot be conducted in all home environments, limiting its use in home-based assessments. The purpose of this study was to evaluate the accuracy and selected measurement properties of a modified 12-item CBMS-Home (8 original items and 4 modified items of the CBMS) feasible for use within the constraints of home assessments for older adults. Fifty-five people (mean [SD] age = 77.2 [6.0] years) were recruited for this validation study. Participants completed the full original CBMS, CBMS-Home (the modified items of the CBMS), the Functional Reach Test, and Step Test. Principal components analysis, internal consistency, test-retest and intermethod reliability, agreements within and between methods, and criterion validity were calculated. Principal components analysis of CBMS and CBMS-Home both revealed 3 similar components and loadings. Bland-Altman and weighted κ analyses revealed that the CBMS-Home demonstrated moderate to almost perfect agreement (weighted κ = 0.45-0.84) with CBMS. The distribution of scores of CBMS-Home were satisfactory, and other results showed excellent test-retest (intraclass correlation coefficient [ICC] = 0.95) and intermethod reliability (ICC = 0.94) and internal consistency (Cronbach α = 0.94). There were no ceiling effects (0%) or floor (1.8%) effects. CBMS-Home demonstrated a low (Spearman ρ = 0.39) and moderate positive (Spearman ρ = 0.63) relationship with the Functional Reach Test and Step Test, respectively. The CBMS-Home has good psychometric properties and provides a useful multidimensional assessment tool. A modified version of the CBMS (CBMS-Home) can be confidently used to assess older adults-within their own home-who might have mild balance impairments.

Limits of stability among patients with Chronic Maxillary Sinusitis: A Cross-sectional Comparative study

Background: Sinusitis also known as Rhino sinusitis is the inflammation of sinuses that involves one or more cavities that could be due to bacterial or viral infection or even due to allergies. The patients may experience pain and tenderness around eyes, cheeks, nose and forehead, facial swelling, headache may be severe with nasal congestion. The secretions could have an impact on the vestibular apparatus which possibly may cause balance impairment. This study is intended to analyze the effect of chronic maxillary sinusitis (CMS) on balance. Objective: The aim of the study is to analyze the impact of CMS on the limits of stability. Materials and Methods: Thirty participants within the age group 20-40 were selected. Group A consisted of 15 patients with chronic maxillary sinusitis (CMS). Group B were matched controls (n=15) with the same age group, as that of the sinusitis group. Both male and female subjects within the age group of 20-40 years were included. Subjects with any other illness like trigeminal neuralgia, tension type headache, cervicogenic headache and other types of sinusitis were excluded. Functional Reach Test (FRT) between two groups were analysed Results: The mean FRT in patient with CS is 32.5 ± 9.5 cm. While in matched controls is 36.8 ± 7.9 cm. There exists significance difference (p=0.002) between them. Conclusion: Patient with chronic maxillary sinusitis has less functional reaching capability and thereby decreased limits of stability when compared to the matched peers.

Daily living activities, exercise capacity, cognition, and balance in COPD patients with and without frailty.

Information on the interaction between frailty and chronic obstructive pulmonary disease (COPD) is limited. This study aimed to compare activities of daily living (ADL), exercise capacity, balance, and cognition in COPD patients with and without frailty. Twenty frail and 28 non-frail COPD patients aged 55 years and over were included. Frailty was determined according to Fried et al. Dyspnea was evaluated using the modified Medical Research Council (mMRC) dyspnea scale. Respiratory and peripheral muscle strength were measured. Functional capacity was assessed using a 6-min walk test (6MWT); ADL performance was evaluated using the Glittre ADL test. The balance was evaluated using the functional reach test (FRT). Cognitive function was assessed using the Montreal Cognitive Evaluation (MoCA) Test. Quality of life was measured using the COPD Assessment Test (CAT). The mMRC and CAT scores were higher in the frail patients as compared with the non-frail patients (p < 0.05). The maximal inspiratory pressure, handgrip strength, 6MWT distance, and FRT score were lower in the frail patients as compared with the non-frail patients (p < 0.05). The duration for the Glittre ADL test was longer in the frail patients than the non-frail patients (p < 0.05). There was no significant difference between MoCA scores between groups (p > 0.05). Frail COPD patients have increased dyspnea perception, impaired muscle strength, and functional capacity, ADL performance, balance, and quality of life. Whether pulmonary rehabilitation programs for patients with frail COPD need to be adapted with new rehabilitation strategies, including components of frailty, needs further investigation.

The Effects of a 10-Week Home-Based Exercise Programme in Individuals with Parkinson’s Disease during the COVID-19 Pandemic: A Pilot Study

Current restrictions on clinical visits as a consequence of the COVID-19 pandemic has increased the need for home-based exercise regimes to facilitate useful, long term patterns of behaviour in individuals with Parkinson’s disease (PD). This study aimed to evaluate the effectiveness of a 10-week home-based exercise program designed to target improvements in axial rigidity and gait. The Movement Disorders Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), motor scale and rigidity items, Functional axial rotation–physical (FAR-p), functional reach test (FRT), and time up and go (TUG) test were recorded. In addition, the 10-metre walk test, the fall efficacy scale international (FES-I) and the global rating of change score (GROC) were also recorded. Eighteen individuals were divided randomly into two groups: a home-based exercise group (n = 10) and a traditional physiotherapy control group (n = 8). Participants in the 10-week home-based exercise group showed significant improvements (p &lt; 0.05) in the MDS-UPDRS rigidity item, FAR-p, step length, gait velocity, FRT and FES-I when compared with the control group. This study supports the use of home-based exercises in individuals with PD. These preliminary results also support the hypothesis that targeting axial deficits may be an effective approach for improving gait and reducing falls.

The Effect of Trunk Stability Training Based on Visual Feedback on Trunk Stability, Balance, and Upper Limb Function in Stroke Patients: A Randomized Control Trial.

This study aimed to investigate the effects of trunk stability training based on visual feedback on trunk stability, balance, and upper limb function in patients with stroke. Twenty-eight patients with chronic stroke were randomly assigned to either a trunk support group (n = 14) or a trunk restraint group (n = 14) that practiced upper limb training with trunk support and trunk restraint, respectively, based on visual feedback for 30 min per day, three times per week, for 4 weeks. The postural assessment scale for stroke (PASS) was used to assess the stability of patients, and the functional reaching test (FRT) was performed to assess balance. To assess upper extremity function, a range of motion (ROM) test, manual muscle testing (MMT), and Fugl–Meyer assessment-upper limb (FMA-upper limb) were performed. Consequently, both groups showed significant differences before and after training in the PASS, FRT, shoulder flexion ROM, triceps brachii MMT, and FMA-upper limb (p < 0.05), while the trunk support group showed more significant improvements than the trunk restraint group in the PASS, FRT, and FMA-upper limb (p < 0.05). Trunk support-based upper limb training effectively improved trunk stability, balance, and upper limb function and is beneficial as an upper limb training method. Providing trunk support is more effective than restricting the trunk; trunk support-based upper limb training is expected to promote voluntary participation when combined with visual feedback.

Matter of Balance Classes Through Physical Therapist Fall Risk Assessment.

Falls remain the leading cause of injury-related death for 65 years and older. Matter of Balance is a well-documented community-based program designed to reduce participants' fear of falling. However, Matter of Balance classes' effect on physical measures remains less well studied. The objective of this study was to evaluate the effects of the Matter of Balance program on balance, strength, and fall risk. This is a single-group pretest-posttest evaluation of balance and strength in community participants enrolled in 8-week Matter of Balance classes. Physical therapist assessments of the Functional Reach Test and five times sit-to-stand test at week 1 and week 8 were compared. A total of 33 class participants were studied. The average improvement in the Functional Reach Test was M = 1.33 (SD = 1.6) inches and the five times sit-to-stand test was M = -3.24 (SD = 3.42) seconds; p < .05. Matter of Balance classes resulted in improvement in both balance and strength. This study's findings support Matter of Balance classes' efficacy as a community-based program that can reduce a participant's physical risk for falls.

Effects of orthopedic insoles on postural balance in patients with chronic stroke: A randomized crossover study.

Orthopedic insoles (OIs) with medial arch support and heel cushion are widely used to manage lower extremity injuries, but their effects on postural balance in patients with chronic stroke have not been adequately explored. Design: Double-blinded, sham-controlled, randomized crossover trial. A total of 32 ambulatory patients (20 men and 12 women, aged between 30 and 76 years) with more than 6 months since stroke onset. All participants received one assessment session wearing OIs and one session wearing sham insole (SI) in a random order with a 1-day interval. Our primary outcome was the Berg Balance Scale score. Secondary outcomes included the Functional Reach Test, Timed Up and Go test, and computerized posturography. All were performed in both sessions. Subgroup analyses regarding demographic and functional variables were conducted to identify potential responders. Significant between-insole differences favoring OIs were seen in all clinical tests (P < 0.05), but were seen only in the static medial-lateral sway in computerized posturography assessment (P = 0.04). An approximate 2-point difference in the BBS score favoring OIs was observed in all subgroups, not reaching the minimal clinically important difference. The use of OIs generated small but significant positive effects on improving postural balance among patients with chronic stroke. Additional biomechanical and clinical studies are required to evaluate their potential for routine clinical use. NCT03194282.

Constraint Induced Movement Therapy Increases Functionality and Quality of Life after Stroke

This blind randomized clinical trial evaluated the effect of CIMT on the functionality and quality of life (QOL) of chronic hemiparetics. Thirty volunteers were divided into two groups: Control (CG) and CIMT (CIMTG); evaluated before and after 12 and 24 intervention sessions. The scales used were: adapted Fugl-Meyer Motor Assessment (FMA), Modified Ashworth, Stroke Specific Quality Of Life (SS-QOL) and the Functional Reach Test (FRT). The scores for all FMA variables in the CIMTG increased until the 24th session, differing from the pre-treatment. In the CG, the scores increased for pain, coordination/ speed and sensitivity. In the FRT there was an increase in the scores in both groups; after the 12th and 24th sessions, the result of the CIMTG was superior to the CG. For the SS-QOL in the CIMTG, the general score and most of the variables increased, as well as in the CG. Muscle tone in CIMTG was lower compared to CG after 24 sessions. Both protocols used in the study were effective, the CIMT protocol showed benefits in recovering the functionality of the paretic upper limb, in the functional range and in reducing muscle tone, with a consequent improvement in quality of life.

THE IMPACT OF NON-SPECIFIC LOW BACK PAIN ON POSTURAL CONTROL, BALANCE, FALL, MOBILITY AND PHYSICAL ACTIVITY IN ELDERLY INDIVIDUALS: A COMPARATIVE STUDY

Purpose: Studies investigating the effects of non-specific low back pain (NSLBP) on elderly individuals are limited in the literature. The study aimed to compare postural control, balance, physical activity and related factors in elderly individuals with and without the NSLBP.Methods: The study was designed as a cross-sectional. A total of 67 elderly individuals (NSLBP group n=33 and control group n=34) were included in the study. Patients' pain intensity and disability levels were evaluated using Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI), respectively. Postural control and fall risk were measured using the Biodex Balance System. Participants' balance performance, mobility, fear of falling and physical activity levels were evaluated using functional reach test (FRT), timed up and go test (TUG), Falls Efficacy Scale International (FES-I) and International Physical Activity Questionnaire (IPAQ)-Short Form, respectively.Results: While there was a significant difference between the two groups in all parameters of static postural stability test (p&amp;lt;0.05), no difference was found in dynamic postural stability, modified clinical sensory integration test, and fall risk index (p&amp;gt;0.05). The FES-I score (p=0.003) and the TUG time (p=0.001) were significantly higher in the NSLBP group than in the control group. The FRT distance (p=0.001) and the IPAQ score (p=0.029) were significantly lower in the NSLBP group than in the control group.Conclusion: This study suggests that static postural control, balance, mobility, and physical activity are impaired in elderly individuals with NSLBP. Clinicians should take into account these disadvantages in planning rehabilitation programs in elderly individuals with the NSLBP.

Motor Control and Ergonomic Intervention Home-Based Program: A Pilot Trial Performed in the Framework of the Motor Control Home Ergonomics Elderlies' Prevention of Falls (McHeELP) Project.

ObjectivesFalls are a serious problem that can reduce living autonomy and health-related quality of life of older adults. A decrease in the muscular strength of the lower limbs and the deterioration of balance or motor performance deficits may lead to falls. "Motor Control Home Ergonomics Elderlies' Prevention of Falls" (McHeELP) is a novel motor control exercise program combined with ergonomic arrangements of the home environment. This pilot trial is conducted in order to examine the feasibility and acceptability of the McHeELP program, the selection of the most appropriate outcome measures, and the exact sample size calculation that should be used for the randomized controlled trial (RCT) with Clinical Trial Identifier: ISRCTN15936467.Patients and methodsTwenty older adults (aged ≥65 years) who had experienced at least one fall-incident in the past 12 months have participated in the trial; they were randomized in a 1:1 ratio to the McHeELP group (McHeELP-G) and the Control group (CG). The McHeELP-G received a personalized therapeutic motor control and learning exercise program performed three times per week for 12 weeks. Regarding McHeELP - home modification, a booklet that contained basic advice and tips on the modification for their inside and outside home environment was provided to the participants. Objective and self-reported outcome measures, collected at baseline and post-intervention (end of the third month), included functional, fear of falling, and quality of life measurements.ResultsThe McHeELP intervention was very feasible and acceptable to the participants, and the adherence was excellent (100%). The majority of outcome measures seemed appropriate and significant differences were also revealed between the two groups. Specifically, post-intervention statistically significant improvement was found in the 4 meters walking test, Timed Up and Go test, Sit to Stand test, Tandem Stance test, Functional Reach test, Foot tapping test, EuroQoL-5D-5L - visual analog scale (VAS), Lower Extremity Functional Scale, Falls Self-Efficacy International Scale, and Home Falls and Accidents Screening Tool (HOMEFAST) questionnaire of McHeELP-G (all p-values ≤0.002). No statistically significant difference was observed in the mobility, self-care, usual activities, pain/discomfort subscales of Euro QoL-5D-5L (all p-values >0.05), except the anxiety/depression subscale of McHeELP-G (p=0.008). Moreover, no statistically significant improvement was found regarding McHeELP participants' knee flexion/extension restriction and ankle dorsiflexion/plantar-flexion restrictions. Regarding CG, no statistically significant difference was found (p>0.05), except the Tandem Stance test (p=0.003) and HOMEFAST (p<0.001). Referring to the future McHeELP RCT, it was estimated that a sample size of 25 evaluable patients per group is required.ConclusionsThis pilot trial's findings suggest that it is feasible to deliver an RCT of the McHeLP program to this population. Exercise programs that are easy to administer need to be developed and implemented to reduce the burden of falls in older adults.