Multidimensional Exercise Program Research Articles

Effect Of Incorporating Dexterity Function In A Multi-Dimensional Exercise Program On Functional Performance In Elderly Population.

Effect Of Incorporating Dexterity Function In A Multi-Dimensional Exercise Program On Functional Performance In Elderly Population.

Effectiveness of magnetic therapy versus exercise in elderly patients with chronic mechanical neck pain: A randomized clinical trial

<b>Background:</b> Mechanical neck pain (MNP) affects all age groups, it has a substantial physical, psychological, and economic impact, especially in elderly. This study aimed to evaluate effect of addition of magnetic therapy (MT) to exercise versus exercise therapy alone on neck pain (NP), proprioception, and balance in elderly patients with chronic MNP.<br /> <b>Materials & Methods:</b> 50 elderly patients with chronic MNP were assigned to magnetic group (25 patients who practiced exercise program for 35-40 minutes/session three sessions per week for four weeks in addition exposure to MT for 20 minutes each session three sessions per week for four weeks) and control group (25 patients who practiced only the exercise program). The severity of pain, cervical joint position sense (JPS) and balance performance were measured by using the visual analogue scale (VAS) goniometer and the both single-leg stance time (SLST), and timed up and go (TUG) tests, respectively. ANOVA and Independent t-tests were used to determine significant differences within and between two groups for normal variables, whereas the Mann-Whitney and Kruskal-Wallis tests were used for not normal variables.<br /> <b>Results:</b> The results show significant improvements in VAS, SLST (with open and closed eyes), TUG, and JPS after interventions in both groups, p-value <0.05, while addition of MT to exercise program induced only significant differences in VAS, SLST (with open & closed eyes), TUG, except JPS, p-value = 0.002, 0.047 & 0.037, 0.001, and 0.928 respectively, in favor to the magnetic group.<br /> <b>Conclusions:</b> Multi-dimensional exercise program is effective in relieving NP and improving balance in elderly with MNP, addition of MT to exercise program could induce superior effects only on pain and balance for elderly patients with MNP.

Changes in Selected Cognitive and Motor Skills as Well as the Quality of Life After a 24-Week Multidimensional Music-Based Exercise Program in People With Dementia.

The loss of independence is one of the greatest consequences of dementia. Multidimensional music-based exercise programs could counteract. The present study investigates the effects of such a program on people with dementia and bases on a 24-week intervention with three measurement time points. Sixty-nine people with dementia were randomly assigned to the intervention (n = 43) and control group (n = 26). The following outcome parameters were measured: leg strength, gait, grip strength, balance, reaction time, selected cognitive abilities, and quality of life. A mixed ANOVA with repeated measurement showed significant interaction effects between group and time. After 24-weeks in contrast to the control group the intervention group significantly improved in leg strength (P = .001), balance (P = .001), gait (P = .001), grip strength (right P = .002, left P = .011), reaction time (P = .003), global cognition (P = .039), verbal fluency (P = .002), attention (P = .013) and quality of life (P = .011). In conclusion, the program enhanced selected cognitive and motor skills and quality of life.

Influence of a\xa0multidimensional music-based exercise program on selected cognitive and motor skills in dementia patients\u2014a\xa0pilot study

One of the most common causes of needing care in old age is dementia. In order to enjoy a pleasant retirement for people with dementia, it is essential for them to maintain their independence. Studies have shown that a combination of physical activity and music has positive effects on dementia patients. Therefore, this study aimed to investigate the feasibility of implementing a multidimensional music-based exercise program for dementia patients and the effects on an intervention group (IG) compared to a control group (CG, usual care). The study design was based on a 12-week intervention with two (IG/CG) by two (pretest/posttest) parallel groups and block randomization with unequal group sizes. Participants had to be able to move independently or with a walker and not have severe cardiovascular disease or cardiac arrhythmias. Fifty-three blinded dementia patients (age: 83.63 ± 6.03 years) from inpatient facilities participated in the study and were assigned from the exercise instructors to IG (n = 34) and CG (n = 19). The primary outcomes were feasibility (Observation sheet), modified Chair Rising test, Timed Up and Go test, hand dynamometer test, FICSIT‑4 (Frailty and Injuries: Cooperative Studies of Intervention Techniques), and drop bar test. Secondary endpoints included: verbal fluency (“animals”), the Mini-Mental State Examination, memory, Trail Making Test A, and Qualidem. Forty-nine subjects were analyzed (IG = 32; CG = 17). There were significant differences between the groups in the modified Chair Rising test (p = 0.033), FICSIT‑4 (p = 0.035), and Timed Up and Go test (p = 0.005) at posttest, which showed improved performance of the IG compared to the CG. The IG additionally showed improvements in the modified Chair Rising test (p = 0.000), drop bar test (p = 0.033), hand dynamometer test (p = 0.001), Timed Up and Go test (p = 0.000), verbal fluency (p = 0.002) and Trail Making Test A (p = 0.04) after 12 weeks. There were no adverse events or side effects. The multidimensional music-based exercise program could be performed by the dementia patients and was well received. The improved functional mobility could contribute to a lower risk of falls and thus maintain independence. For the follow-up study, the number of subjects, randomization, and parameters should be considered.

Addendum: MacDonald, A.M., et al. CaRE @ Home: Pilot Study of an Online Multidimensional Cancer Rehabilitation and Exercise Program for Cancer Survivors. J. Clin. Med. 2020, 9, 3092

The authors wish to make the following corrections to this paper [...]

CaRE @ Home: Pilot Study of an Online Multidimensional Cancer Rehabilitation and Exercise Program for Cancer Survivors.

Background: Although facility-based cancer rehabilitation and exercise programs exist, patients are often unable to attend due to distance, cost, and other competing obligations. There is a need for scalable remote interventions that can reach and serve a larger population. Methods: We conducted a mixed methods pilot study to assess the feasibility, acceptability and impact of CaRE@Home: an 8-week online multidimensional cancer rehabilitation and exercise program. Feasibility and acceptability data were captured by attendance and adherence metrics and through qualitative interviews. Preliminary estimates of the effects of CaRE@Home on patient-reported and physically measured outcomes were calculated. Results: A total of n = 35 participated in the study. Recruitment (64%), retention (83%), and adherence (80%) rates, along with qualitative findings, support the feasibility of the CaRE@Home intervention. Acceptability was also high, and participants provided useful feedback for program improvements. Disability (WHODAS 2.0) scores significantly decreased from baseline (T1) to immediately post-intervention (T2) and three months post-intervention (T3) (p = 0.03 and p = 0.008). Physical activity (GSLTPAQ) levels significantly increased for both Total LSI (p = 0.007 and p = 0.0002) and moderate to strenuous LSI (p = 0.003 and p = 0.002) from baseline to T2 and T3. Work productivity (iPCQ) increased from T1 to T3 (p = 0.026). There was a significant increase in six minute walk distance from baseline to T2 and T3 (p < 0.001 and p = 0.010) and in grip strength from baseline to T2 and T3 (p = 0.003 and p < 0.001). Conclusions: Results indicate that the CaRE@Home program is a feasible and acceptable cancer rehabilitation program that may help cancer survivors regain functional ability and decrease disability. In order to confirm these findings, a controlled trial is required.

Effect of Multidimensional Exercise Program for Improving Balance in Traumatic Brain Injury Patients

Background- Balance disorder is a common problem in post-TBI patients. In many research’s done before treatment is given mainly on motor component to improve balance in TBI patients. In this study we are going to give multidimensional protocol - sensory stimulations along with motor components. Balance is a main component of a patient for his mobility, many therapist concentrate on balance in chronic stage of TBI patients, in this study we are going to give treatment in acute stage of TBI patients which will help them to recover fast. There is lack of research’s done on acute post TBI patients with multidimensional exercise program for balance disorder. Indeed this made us to study the effect of multidimensional exercise program on balance disorder in TBI patients. Objectives- To find out the effectiveness of multidimensional exercise program for improving balance control in mild TBI patients. To find out the effectiveness of multidimensional exercise program for improving balance control in moderate TBI patients. To find out the effectiveness of multidimensional exercise program for improving balance control in severe TBI patient. METHOD- In this study total 20 candidates were taken having impaired balance secondary to TBI from hospitals in karad. Their balance were assessed by berg balance scale and community balance and mobility scale. They were divided into mild, moderate and severe TBI. A multidimensional exercise protocol of 6 week was given for improving balance and their balance was checked at 2nd, 4th, and 6th week by same BBS and CBMS score. Later evaluation and interpretation of data was done. Result- The 20.8% improvement is seen in pre and post treatment BBS score and 8.82% improvement is seen in pre and post treatment CBMS score in post TBI patients with balance impairment. Conclusion- On the basis of result it can be concluded that multidimensional exercise program is effective for improving balance in TBI patients.

The Effects of a Multidimensional Exercise Program on Health Behavior and Biopsychological Factors in Mexican Older Adults.

Background: The population of older adults is increasing worldwide, which brings attention to the importance of healthy aging. Adoption of healthy lifestyle activities such as participating in physical activity on a daily basis is key to maintaining physical and mental health. The aim of this study was to investigate the effects of participation in a 12-week multidimensional exercise program on health behavior and biopsychological factors of older adults living in Northeastern Mexico.Methods: A quasi-experimental study was conducted with 45 older adults (35 females and 10 males; M = 67.24 ± 5.73 years). The participants were assigned to an experimental group (EG; n = 23) that participated in a 12-week exercise program and a control group (CG; n = 22). Pre- and post-analyses of the exercise intervention data were carried out to investigate the participants’ health-related variables including physical activity levels, blood pressure, self-esteem, depressive symptoms, and blood lipids profiles.Results: The results indicated that the exercise intervention contributed to significant improvements in the older adults’ health-related variables for the EG when contrasted with the control group. For instance, the EG significantly improved systolic (p < 0.001) and diastolic (p < 0.027) blood pressure, blood lipids [e.g., cholesterol (p < 0.05)], triglycerides (p < 0.05), self-esteem (p < 0.005), and depressive symptoms (p < 0.002) as well as physical activity (p < 0.001) levels. The results also demonstrated that only those individuals in the EG diagnosed with disease benefited from improved self-esteem and physical activity levels when contrasted with their healthy counterparts.

A Multidimensional Exercise Program in the Home for Older Adults Designed to Improve Function

The purpose of this study was to determine whether there was difference in the OASIS (Outcome and Assessment Information Set) activities of daily living (ADL) items scores between the Safe Strides program and Safe Strides plus Zōntago program. Eight home care offices were selected for this prospective randomized quality improvement study where Safe Strides versus Safe Strides plus Zōntago were compared. Rehabilitation outcome OASIS ADL change scores were analyzed for 112 total patient care episodes. The Safe Strides + Zōntago mean total ADL score change and ADL change per visit were higher than the Safe Strides group. Differences in ADL outcomes in older adults undergoing home care provided by physical therapists and physical therapist assistants in the Safe Strides exercise program versus the Safe Strides plus Zōntago program were noted. The Safe Strides + Zōntago compared with Safe Strides alone improved patient functional outcomes as measured by the OASIS.

Impacts of Multidimensional Exercise Program for Older Adults on Mild Cognitive Impairment

Impacts of Multidimensional Exercise Program for Older Adults on Mild Cognitive Impairment

Home-Based Exercise Supported by General Practitioner Practices: Ineffective in a Sample of Chronically Ill, Mobility-Limited Older Adults (the HOMEfit Randomized Controlled Trial).

To evaluate the effects a home-based exercise program delivered to ill and mobility-limited elderly individuals on physical function, physical activity, quality of life, fall-related self-efficacy, and exercise self-efficacy. Randomized controlled trial (ISRCTN Registry, Reg.-No. ISRCTN17727272). Fifteen general practitioner (GP) practices and participants' homes. Chronically ill and mobility-limited individuals aged 70 and older (N = 209). An exercise therapist delivered the experimental intervention-a 12-week multidimensional home-based exercise program integrating behavioral strategies-in individual counseling sessions at the GPs' practices and over the telephone. The control intervention focused on promoting light-intensity activities of daily living. Interventions took place between February 2012 and March 2013. The primary outcome was functional lower body strength (chair-rise test). Secondary outcomes were physical function (battery of motor tests), physical activity (step count), health-related quality of life (Medical Outcomes Study 8-item Short-Form Survey), fall-related (Falls Efficacy Scale-International Version), and exercise self-efficacy (Selbstwirksamkeit zur sportlichen Aktivitaet (SSA) scale). Postintervention differences between the groups were tested using analysis of covariance (intention to treat; adjusted for baseline value and GP practice; significance level P ≤ .05). Participants had a mean age ± standard deviation of 80 ± 5, 74% were female, 87% had three or more chronic diseases, and 54% used a walking aid. The difference (intention to treat; experimental minus control) between adjusted postintervention chair-rise times was -0.1 (95% confidence interval = -1.8-1.7). Differences for all secondary outcomes were also nonsignificant. The program was ineffective in the target population. Possibilities for improving the concept will have to be evaluated.

Investigating the effects of a multidimensional exercise program on symptoms and antiinflammatory status in female patients with ankylosing spondylitis

ObjectiveThe purpose of this study is to investigate the effects of a multidimensional exercise program on symptoms and antiinflammatory status in female patients with ankylosing spondylitis (AS). MethodsThe BATH Indexes, Dougados Functional Index (DFI), Health Assessment Questionnaire in Spondyloarthopathies (HAQ-S), Ankylosing Spondylitis Quality of Life (ASQoL) and Beck Depression Inventory (BDI) were used to evaluate twenty-four female AS patients. ESR, CRP, TNF-α and IL-6 were also analyzed. All patients were assessed at baseline and with 3 weeks intervals till 12 week. A multidimensional exercise program was applied for three times a week. ResultsThere were significant differences in Bath Ankylosing Spondylitis Global Index (BAS-G) and Disease Activity Index (BASDAI), HAQ-S, ASQoL and BDI scores (p < 0.05). The level of the ESR, CRP and IL-6 fluctuated slightly. There was only significant difference at 3 and 12 weeks as compared to baseline levels in TNF-α values (p = 0.048, p < 0.001). ConclusionWe concluded that multidimensional exercise program should be taken into consideration for AS patients due to its positive effects on symptoms and antiinflammatory effects.

Adverse events in mobility-limited and chronically ill elderly adults participating in an exercise intervention study supported by general practitioner practices.

To present detailed adverse event (AE) data from a randomized controlled trial (RCT) of a home-based exercise program delivered to an elderly high-risk population by an exercise therapist after medical clearance from a general practitioner (GP). Randomized controlled trial. General practitioner practices and participant homes. Community-dwelling, chronically ill, mobility-limited individuals aged 70 and older (mean 80 ± 5) participating in a RCT of an exercise program (HOMEfit; ISRCTN17727272) (N = 209; n = 106 experimental, n = 103 control; 74% female). A 12-week multidimensional home-based exercise program (experimental) versus baseline physical activity counseling (control). An exercise therapist delivered both interventions to participants during counseling sessions at the GP's practice and on the telephone. Adverse events were documented at least at every counseling session and assessed by the GP and an AE manager. One hundred fifty-one AEs were reported in 47% (n = 99) of all participants. Twenty-one (14%) events were classified as serious. In six events (4%; n = 4 experimental, n = 2 control), participation in the study had to be discontinued immediately. In 25 events (17%; n = 9 experimental, n = 16 control), the intervention had to be suspended. The intervention was determined to have caused two events (both nonserious and in the experimental group). Even though the program appears to be safe, high morbidity unrelated to exercise can constitute a critical challenge for sustained exercise participation.

The Effects of a Short Term Novel Aquatic Exercise Program on Functional Strength and Performance of Older Adults

The purpose of this study was to determine the effects of a short-term novel multidimensional aquatic exercise program on functional abilities of healthy older adults. Twenty-six men and women (mean age 76.33 + 5.55 years) were recruited and assigned to an aquatic- (n = 15) or land-based (n = 11) training group. The aquatic training group completed a multidimensional water exercise program that incorporated resistance training, functional exercise movements and rudimentary aquatic plyometric activities. The active control group participated in a supervised land-based fitness program. Each exercise intervention was conducted over an 8-week period (16 sessions of 30 - 40 minutes) with the training load progression adjusted equally between groups using the 6 - 20 Rating of Perceived Exertion Scale (RPE). Prior to and immediately following the intervention, both groups were evaluated with select components of the Senior Fitness Test. The 30-second chair stand, 30-second arm curl, and 8 foot up and go were selected as measures of strength and functional abilities. The results of an independent t-test indicated that the control and experimental groups were matched for functional abilities prior to the intervention. A 2 (group) x 2 (time) analysis of covariance (ANCOVA) with repeated measures revealed significant differences in the pre- to post-testing measures for the aquatic training program for the arm curl (p &lt; 0.01) and the 8 foot up and go (p = 0.02). Analysis of the active control revealed no pre-post differences for any measure. Thus, a short-term aquatic exercise program with multidimensional intervention strategies will significantly enhance functional abilities in older adults when compared to a functionally matched active control group.

The effects of a home-based exercise program on physical function in frail older adults.

Exercise has been shown to improve physical function in frail older adults; however, the effects of exercise may vary with degree of frailty, the format and intensity of the exercise intervention, and level of supervision. This cohort study describes the effects of participation in a 6-week home-based exercise program on measures of physical function as well as exercise-related beliefs, including exercise self-efficacy and outcomes expectation, in frail older adults. Participants were 72 frail older adults who participated in a 6-week home-based exercise program supervised by graduate physical therapy students. Individualized home-based exercises targeted strength, flexibility, balance, gait, and cardiovascular fitness. Physical function was measured at baseline and after completion of the 6-week exercise program using the Functional Fitness Test (Biceps Curl, Chair Stand, 8-Foot Up and Go) and velocity on a 4-m walk. Measures of exercise-related beliefs included the Self-Rated Abilities for Health Practices Scale and Exercise Outcome Expectations. Participation in the 6-week home-based exercise program was associated with improvements in measures of physical function, including an average increase of 3 repetitions (35%) on the biceps curl, 2.4 repetitions (59%) on the chair stand, and an average increase of 0.17 m/s (33%) in gait velocity. Average decrease in Timed Up and Go test scores was 5.7 seconds (26%). Scores for exercise-related beliefs also improved (self-efficacy average increase was 7 points [40%], and average increase in outcome expectations was 3 [47%]). A supervised 6-week, multidimensional home-based exercise program was safe and associated with improvements in physical and exercise-related belief outcome measures in this cohort study of frail older adults.

Stability of Kyphosis, Strength, and Physical Performance Gains 1 Year After a Group Exercise Program in Community-Dwelling Hyperkyphotic Older Women

Pawlowsky SB, Hamel KA, Katzman WB. Stability of kyphosis, strength, and physical performance gains 1 year after a group exercise program in community-dwelling hyperkyphotic older women. Objective To determine if subjects maintained improvements in kyphosis, spinal extensor strength, and physical performance 1 year after a 12-week multidimensional group exercise program. Design Follow-up data compared with posttest outcome measures. Setting Outpatient academic medical center. Participants Nineteen of the initial 21 women, ages 65 to 80, with thoracic kyphosis of 50° or greater at the onset of the study completed follow-up testing. Interventions Initial intervention included multidimensional group exercise performed 2 times a week for 12 weeks, consisting of spinal extensor strengthening, flexibility exercises, and integrated spinal proprioception training. Subjects exercised independently during the following year. Main Outcome Measures Primary measures at the 1-year follow-up were usual and best kyphosis. Secondary measures included spinal extensor strength, modified Physical Performance Test (PPT), and the Jug Test. Results Subjects maintained gains at the 1-year follow-up ( P>.05). Best kyphosis improved by 3° during the follow-up year ( P=.022). There were no significant declines in usual kyphosis ( P=.302), spinal extensor strength ( P=.999), PPT ( P=.087), and the Jug Test ( P=.999) at follow-up. Conclusions Hyperkyphotic women maintained gains in usual kyphosis, spinal extensor strength, and physical performance 1 year after a group exercise program. Improvement in best kyphosis in the year after the intervention was also observed. Detraining effects may be minimized by multidimensional exercises.

Determinants of improvement in walking capacity among individuals with chronic stroke following a multi-dimensional exercise program

To identify the determinants of improvement in walking capacity following therapeutic exercise in chronic stroke survivors. A secondary analysis of data obtained from a prospective, single-blind, randomized controlled intervention trial. Sixty-three community-dwelling individuals (mean age = 65 years, age range = 50-87 years) with a chronic stroke (post-stroke duration: mean = 5.5 years, range = 1-28 years). Subjects were randomized into a leg exercise group (n = 32) or an arm exercise group (n = 31). Subjects in each group underwent 3 1-hour exercise sessions per week for 19 weeks. Walking capacity, cardiorespiratory fitness, isometric knee extensor muscle strength, balance ability, and balance confidence were evaluated before and after the interventions. Multiple regression analysis was performed to identify the determinants of improvement in walking capacity. After controlling for age, gender, post-stroke duration, and baseline walking capacity, gain in paretic leg muscle strength and peak oxygen consumption remained independently associated with gain in walking capacity (R2 = 0.229). Enhancement of cardiorespiratory fitness and paretic leg muscle strength are both significant determinants in improving walking capacity among chronic stroke survivors. However, the rather weak relationship (R2 = 0.229) indicates that other factors not measured in this study may also contribute to the improvement in walking capacity.

Home Balance Training Intervention for People With Multiple Sclerosis

This study investigated the effects of a home balance training intervention on people with multiple sclerosis (MS). This quasi-experimental repeated-measures study involved 14 ambulatory community-dwelling individuals with MS. Subjects were assessed on three separate occasions: before and after a 6-week control period and after a 6-week home exercise program. After the intervention, subjects demonstrated significant improvement in measures of balance, including the Berg Balance Scale and specific components of the Sensory Organization and Limits of Stability Tests. In conclusion, a multidimensional home exercise program can improve certain measures of balance in individuals with MS who have mild to moderate disability. Whether these improvements lead to improved quality of life or a reduction in fall risk is yet to be determined.

Maximum physical capacity testing in cancer patients undergoing chemotherapy: qualitative findings from an exercise program

Over the past few years there has been a growing interest in the field of physical exercise in rehabilitation of cancer patients, leading to requirements for objective maximum physical capacity measurement (maximum oxygen uptake (VO(2max)) and one-repetition maximum (1RM)) to determine dose-response levels in different cancer diagnoses. To explore the patients' experiences of maximum physical capacity testing while concurrently undergoing chemotherapy and participating in a 6-week, 9 h weekly multidimensional exercise program. Prospective, exploratory study using semi-structured qualitative interviews conducted prior to and at termination of the program. The study included 100 patients (18-65 years, median 42 years) with or without residual disease and with mixed diagnoses. Following the intervention, cancer patients felt significantly safer in performing maximum physical capacity tests as these motivated them through self-perceived competitiveness and set a standard that served to encourage peak performance. The positive attitudes in this sample towards maximum physical capacity open the possibility of introducing physical testing early in the treatment process. However, the patients were self-referred and thus highly motivated and as such are not necessarily representative of the whole population of cancer patients treated with chemotherapy.

The impact of a multidimensional exercise program on self-reported anxiety and depression in cancer patients undergoing chemotherapy: A phase II study

Little is known about the role of exercise in improving cancer patients' mood while undergoing chemotherapy. In this phase II study changes in self-reported anxiety and depression and fitness (VO2max) are reported in relation to a 6-week, 9 h weekly, multidimensional exercise program. A total of 91 patients receiving chemotherapy, between 18 and 65 years old, completed a Hospital Anxiety and Depression Scale Questionnaire (HADS; response rate 91%, adherence rate 78%). Anxiety (p < 0.001) and depression (p = 0.042) was significantly reduced. The mean +/- SD of the change was -1.14 +/- 2.91 for anxiety and -0.44 +/- 2.77 for depression. Improvements in fitness were correlated with improvements in depression, chi2(1) = 3.966, p = 0.046, but not with improvements in anxiety, chi2(1) = 0.540, p = 0.462. The research suggests that exercise intervention may have a beneficial impact on psychological distress for cancer patients receiving chemotherapy with low to moderate levels of baseline psychomorbidity. The study furthermore indicates that changes in distress may be associated with disease status and levels of physical activity undertaken during disease. The study is followed up by an ongoing randomized clinical controlled trial to evaluate potential causal effects of exercise intervention on psychological distress and fitness in cancer patients undergoing chemotherapy.