Prevention Exercise Program Research Articles

Electromyographic activity of shoulder muscles on two preventive exercise programmes for swimmer’s shoulder: elastic band versus weight

ABSTRACT Strength programmes have shown good results in preventing swimmer’s shoulder. However, there aren’t studies based on electromyographic (EMG) analysis in these programmes. This study aims to compare an EMG activity of the middle trapezius (MT), lower trapezius (LT), infraspinatus (IS), serratus anterior (SA), and pectoralis major (PM) in two swimmer’s shoulder preventive programmes – one performed with elastic band and the other with weights. Twenty competitive swimmers performed two strength programmes consisting of five exercises each, while the analysis of EMG activity in MT, LT, IS, SA, and PM for each exercise was recorded. The superficial EMG was used to collect data at a sampling frequency of 1000 hz. The Paired Sample T-test or the Wilcoxon test was applied to compare EMG activity between programmes. The internal rotation at 90º (p < 0.001) and external rotation at 90º (p ≤ 0.01) exercises produced high myoelectric shoulder muscle activity with an elastic band. Conversely, scapular punches (p < 0.001) exercise has high shoulder EMG activity when performed with weights. Performing the same preventive exercise programme with two different instruments produces great variability in the myoelectric activity of the shoulder muscles.

Understanding “Fear Of Falling” And How It Impacts Older Persons Motivation To Engage In Fall Prevention Exercise Interventions

Abstract Background Fear of falling can cause older persons to restrict their activities, which drives reduced strength and balance and increases their falls risk. Falls can have a significant effect on older persons in terms of loss of confidence, ongoing falls risk and ultimately, a poorer quality of life (Oliver et al, 2010). Fall prevention exercise interventions can help reduce the risk of falling in older adults by up to 34% (Sherrington et al, 2020). This study aims to explore the prevalence of fear of falling in older adults both before and after attending a community-based fall prevention exercise programme. The programme consisted of an evidence-based Physiotherapy led 10-week strength and balance class, followed by a 16-week exercise instructor led strength and balance class. Methods A 2-part qualitative study. Part 1: Prior to commencing the class each participant completed a rating of their fear of falling measured by ConfBal (a validated 10 item Balance Confidence scale). Part 2: Questionnaire assessing their experience of the classes and corresponding change in balance scores. Results 17 older adults completed the programme. Surveys were returned by 8/17 to date (47%). Mean pre-intervention ConfBal score of 20, mean post intervention score of 15 (8/17 participants to date), average 4-point improvement after intervention was statistically significant (p=0.008). Reported benefits of falls prevention exercise classes include peer-peer discussion of functional ability, gaining confidence by exercising in a group environment, practising functional exercises relating to day-to-day tasks, and building social relationships. Conclusion Fear of falling amongst community dwelling older adults is common but group exercise improves confidence as well as boosting social interactions. Participation in fall prevention exercise programmes can help to better support older people as they age which may influence better health outcomes in our communities.

Exercise for fall prevention in older adults

Background: Global population aging has significantly increased fall-related incidents among older adults, which is associated with major health risks and challenges for healthcare systems. Falls are a leading cause of injury, disability, and mortality in South Korea, which has shown rapid expansion of the elderly population. Development of effective fall-prevention strategies, including exercise-based interventions is important to address this issue.Current Concepts: Exercise-based fall prevention programs include several key types such as strength and functional movement training and balance exercises. Strength training includes resistance exercises and weightbearing activities to enhance muscle strength, which is essential for stability and fall prevention. Balance exercises improve stability and coordination, including standing on one leg and heel-to-toe walking. Functional movement training includes exercises that simulate daily activities and help individuals to improve their ability to safely perform routine tasks. Programs such as the Otago Exercise Program integrate these elements and offer a comprehensive approach to fall prevention. Such regimens combined with training in safe falling techniques are important to reduce fall risk and improve outcomes. Assessment tools, including the timed up-and-go and senior fitness tests, are useful to identify at-risk individuals and tailor interventions accordingly.Discussion and Conclusion: An effective fall prevention exercise program requires a multifaceted approach that combines various exercise types and focuses on improving muscle strength, balance, flexibility, and functional skills, as well as safe falling and floor recovery techniques. Tailoring these interventions to individual needs and regular risk assessments can enhance their usefulness.

Health And Performance Promotion in Youth (HAPPY) hybrid effectiveness-implementation cluster randomised trial: comparison of two strategies to implement an injury prevention exercise programme in Danish youth handball

ObjectiveTo investigate if a combination of an online and onsite implementation strategy was superior to an online-only strategy in enhancing the use of an injury prevention exercise programme (IPEP) and...

“I’d rather do that (Knee Control) than be injured and not able to play”: a qualitative study on youth floorball players’ and coaches’ perspectives of how to overcome barriers for injury prevention exercise programme use

This study explored youth floorball players’ and coaches’ perspectives on using the injury prevention exercise programmes (IPEPs) Knee Control or Knee Control+ (Knee Control programmes) and how to overcome barriers...

Factors influencing older adult community fall prevention exercise implementation: a scoping review.

Exercise that challenges balance is the most effective fall prevention intervention in community-dwelling older adults. Identifying factors influencing implementation of community fall prevention exercise programs is a critical step in developing strategies to support program delivery. To identify implementation facilitators, barriers, and details reported in peer-reviewed publications on community fall prevention exercise for older adults. Scoping review. We searched multiple databases up to July 2023 for English-language publications that reported facilitators and/or barriers to implementing an evidence-based fall prevention exercise program in adults aged 50+ years living independently. At least two reviewers independently identified publications and extracted article, implementation, and exercise program characteristics and coded barriers and facilitators using the Consolidated Framework for Implementation Research (CFIR). We included 22 publications between 2001 and July 2023 that reported factors influencing implementation of 10 exercise programs. 293 factors were reported: 183 facilitators, 91 barriers, 6 described as both a facilitator and barrier, and 13 unspecified factors. Factors represented 33 CFIR constructs across all five CFIR domains: implementation inner setting (n = 95 factors); innovation (exercise program) characteristics (n = 84); individuals involved (n = 54); implementation process (n = 40) and outer setting (n = 20). Eight publications reported implementation strategies used; 6 reported using a conceptual framework; and 13 reported implementation outcomes. The high number of factors reflects the complexity of fall prevention exercise implementation. The low reporting of implementation strategies, frameworks and outcomes highlight the ongoing need for work to implement and sustain community fall prevention exercise programs.

‘We may need some help; we are just parents who have chosen to engage in football’: a qualitative study on amateur coaches’ experiences of use of and support for injury prevention training in Sweden

IntroductionAchieving sufficient adherence with injury prevention exercise programmes is a challenge. The aim was to explore how amateur football coaches experience the use of and support for injury prevention training...

Acceptability, feasibility, and effectiveness of WE-SURF™: a virtual supervised group-based fall prevention exercise program among older adults

Conducted physically, supervised group-based falls prevention exercise programs have demonstrated effectiveness in reducing the risk of falls among older adults. In this study, we aimed to assess the acceptability, feasibility, and effectiveness of a virtual supervised group-based falls prevention exercise program (WE-SURF™) for community-dwelling older adults at risk of falls.MethodA preliminary study utilizing virtual discussions was conducted to assess the acceptability of the program among six older adults. Effectiveness was evaluated in a randomized controlled feasibility study design, comprising 52 participants (mean age: 66.54; SD: 5.16), divided into experimental (n = 26) and control (n = 26) groups. The experimental group engaged in a 6-month WE-SURF™ program, while the control group received standard care along with a fall’s prevention education session. Feasibility of the intervention was measured using attendance records, engagement rates from recorded videos, dropouts, attrition reasons, and adverse events.ResultsPreliminary findings suggested that WE-SURF™ was acceptable, with further refinements. The study revealed significant intervention effects on timed up and go (TUG) (η2p:0.08; p < 0.05), single leg stance (SLS) (η2p:0.10; p < 0.05), and lower limb muscle strength (η2p:0.09; p < 0.05) tests. No adverse events occurred during the program sessions, and both attendance and engagement rates were high (> 80% and 8/10, respectively) with minimal dropouts (4%). The WE-SURF™ program demonstrated effectiveness in reducing the risk of falls while enhancing muscle strength and balance.ConclusionIn conclusion, WE-SURF™ was demonstrated to be an acceptable, feasible, and effective virtual supervised group-based exercise program for fall prevention in community-dwelling older adults at risk of falls. With positive outcomes and favourable participant engagement, WE-SURF™ holds the potential for wider implementation. Further research and scaling-up efforts are recommended to explore its broader applicability.(Registration number: ACTRN 12621001620819).

Players are positive regarding injury prevention exercise programmes, but coaches need ongoing support: a survey-based evaluation using the Health Action Process Approach model across one season in amateur and youth football

ObjectivesImplementation of injury prevention exercise programmes (IPEPs) in sports is challenging, and behaviour change among players and coaches is essential for success. The aim was to describe players’ and coaches’...

Effective fall prevention exercise in residential aged care: an intervention component analysis from an updated systematic review

ObjectiveThe effect of fall prevention exercise programmes in residential aged care (RAC) is uncertain. This paper reports on an intervention component analysis (ICA) of randomised controlled trials (RCTs), from an...

Health Literacy of Japanese Elderly who Participated in A Long-term Care Prevention Exercise Program by Household Composition

Objectives: With the development of services to improve the daily lives of older adults and the use of Internet of Things technology in healthcare in Japan, there is a growing need to address health literacy, especially among older adults living alone. The current study aims to fill this research gap by assessing the current state of health literacy in this population, and potentially providing guidance for future support strategies.Methods: In this study, 22 older female participants in long-term care preventive services were assessed for health literacy, cognitive function, and activities of daily living using the Household Composition and Basic Demographic Information, the Health Literacy Scale, the Japanese version of the Montreal Cognitive Assessment, and the Occupational Self-Assessment-Short Form.Results: The household composition was 13 older adults living alone and nine living with others. Older adults living alone had significantly lower functional health literacy than those living with others, which affected their ability to understand and apply health information. Difficulties reading health materials were also prevalent in this group, suggesting that visual impairment or a lack of assistive devices may affect their understanding of health information. Considering these specific needs through tailored strategies is essential for helping older adults to adapt to an increasingly digital society.Conclusions: Understanding the current state of functional health literacy among older adults living alone in the community is essential for developing strategies to improve their well-being, prevent isolation, and enable them to make informed decisions about their health.

Human-Centered Design and Development of a Fall Prevention Exercise App for Older Adults in Primary Care Settings.

Falls in older adults are a serious public health problem that can lead to reduced quality of life or death. Patients often do not receive fall prevention guidance from primary care providers (PCPs), despite evidence that falls can be prevented. Mobile health technologies may help to address this disparity and promote evidence-based fall prevention. Our main objective was to use human-centered design to develop a user-friendly, fall prevention exercise app using validated user requirements. The app features evidence-based behavior change strategies and exercise content to support older people initiating and adhering to a progressive fall prevention exercise program. We organized our multistage, iterative design process into three phases: gathering user requirements, usability evaluation, and refining app features. Our methods include focus groups, usability testing, and subject-matter expert meetings. Focus groups (total n = 6), usability testing (n = 30) including a posttest questionnaire [Health-ITUES score: mean (standard deviation [SD]) = 4.2 (0.9)], and subject-matter expert meetings demonstrate participant satisfaction with the app concept and design. Overall, participants saw value in receiving exercise prescriptions from the app that would be recommended by their PCP and reported satisfaction with the content of the app. This study demonstrates the development, refinement, and usability testing of a fall prevention exercise app and corresponding tools that PCPs may use to prescribe tailored exercise recommendations to their older patients as an evidence-based fall prevention strategy accessible in the context of busy clinical workflows.

Factors Influencing the Implementation of a Fall Prevention Exercise Program for Community-Dwelling Older Adults: A Qualitative Study Guided by the PRECEDE-PROCEED Model.

Multiple falls preventions exercise programs have been rolled out globally, however, few studies have explored the factors necessary for their implementation. This study aimed to investigate the factors influencing the implementation of "Steady Feet" (SF), a 12-week community fall prevention exercise intervention, for older adults living in Singapore. This study utilized purposive sampling to recruit two participant groups: (i) older adults who declined or withdrew from the program and (ii) providers of the program (eg, instructors). We conducted 22 semi-structured interviews, recordings were transcribed and translated, followed by thematic analysis. Data collection and analysis were informed by the PRECEDE-PROCEED framework, focusing on predisposing, enabling, and reinforcing factors. Findings revealed two predisposing, four enabling, and two reinforcing themes. Predisposing themes encompassed (i) knowledge, attitudes, and practices of older adults towards exercises and falls prevention, and (ii) perceptions and attitudes of providers towards SF. Both older adults and providers identified several enabling elements in implementing SF, emphasizing the significance of (i) accessibility, availability, and affordability. Providers highlighted (ii) tools and structural support for continual engagement, (iii) minimizing variations in capabilities through a competency development program, and (iv) fostering synergistic partnerships. Positive reinforcement included (i) the role of providers in engaging and promoting participation, (ii) family support, social networks, and (iii) incentives for older adults. Conversely, both groups highlighted negative reinforcements, including (iv) communication issues and (v) repetitive exercises, while providers specifically identified (vi) labor constraints as a deterrent for implementation. Findings indicate that effective implementation necessitates a multifaceted approach. Promoting participation involves engaging instructors, emphasizing social bonds and family involvement, offering incentives, and providing subsidized or free classes. A competency development program proved effective in reducing variations in providers' capabilities. Strengthening community partnerships, with management support, was crucial for ensuring the availability and accessibility of falls prevention programs.

Effects of a fall prevention exercise regimen on physical and psychosocial outcomes in elderly community dwellers: a randomized comparative study.

There is a need for comprehensive programs that address both the physical and psychosocial aspects of fall prevention for the elderly. This study assessed the efficacy of the exercise regimen on various health metrics for elderly community dwellers. Forty-four participants were divided into experimental and control groups. The experimental group adhered to a 9-step core exercise regimen for fall prevention, practicing three times a week for 30 minutes across 10 weeks, while the control group maintained their regular daily activities without any specific exercise program. Before and after the intervention, participants underwent the timed up-and-go t est to evaluate the physical function, the berg balance scale (BBS) and one-legged stance test (OLST) for balance assessment, the activity-specific balance confidence scale for fall-related self-efficacy, and measures for health-related quality of life. Participants in the experimental group showed significant improvements in physical function (p = .04, Cohen's effect size (d) = 0.2). and balance ability on BBS (p < .01, d = 0.2) and OLST (p < .01, d = 1.3) compared to the control group. Furthermore, there was a notable enhancement in the quality of life indicators for this group, especially in areas such as physical function (p = .04, d = 0.2), physical-role limitation (p = .04, d = 0.2), mental health (p = .01, d = 0.3), vitality (p = .02, d = 0.4), body pain (p = .04, d = 0.5), and general health (p = .04, d = 0.4). These findings highlight the potential of the fall prevention exercise program in improving physical health aspects, but its influence on specific psychosocial elements remains to be determined.

An 8-week injury prevention exercise program combined with change-of-direction technique training limits movement patterns associated with anterior cruciate ligament injury risk

Knee ligament sprains are common during change-of-direction (COD) maneuvers in multidirectional team sports. This study aimed to compare the effects of an 8-week injury prevention exercise program containing COD-specific exercises and a similar program containing linear sprint exercises on injury- and performance-related variables during a 135° COD task. We hypothesized that the COD-specific training would lead to (H1) stronger reductions in biomechanical variables associated with anterior cruciate ligament (ACL) injury risk during COD, i.e. knee abduction moment and angle, hip internal rotation angle and lateral trunk lean, and (H2) more effective improvements in COD performance according to the COD completion time, executed angle, ground contact time, and approach speed. Twenty-two sports science students (40% female) completed biomechanical assessments of COD movement strategies before and after participating in two supervised 25-min training sessions per week over 8 weeks. We observed significant ‘training x group’ interaction effects in support of H1: the COD-specific training but not the linear sprint training led to reduced peak knee abduction moments (interaction, p = 0.027), initial knee abduction (interaction, p < 0.001), and initial lateral trunk lean angles (interaction, p < 0.001) compared to baseline. Although the COD-specific training resulted in sharper executed angles (interaction, p < 0.001), the sprint-specific training group showed reduced COD completion (interaction, p = 0.037) and ground contact times (interaction, p < 0.001). In conclusion, a combination of generic and COD-specific injury prevention training resulted in COD technique adaptations that can help to avoid ACL injury-prone COD movements but may negatively affect COD speed.

Multiple Myeloma.

Multiple myeloma (MM) is a cancer that arises from plasma cells in bone marrow. Approximately 35,730 Americans received a new diagnosis and MM will claim the lives of an estimated 12,590 people in 2023. Complications of the disease process include anemia, leukopenia, thrombocytopenia, renal failure, severe pain, bone loss, and hypercalcemia. Patients with MM have a high risk for pathological fractures. For most forms of MM there are effective treatments that may result in long-term remission using multi-drug regimens. Although the medications approved in the United States to treat MM generally produce good outcomes, they have serious, and potentially life-threatening adverse effects. In addition, patients with specific genetic variations are at high risk for relapse. Communication with the oncology team and early intervention in the event of adverse effects of medications, complications of the disease process, or evidence of relapse are important to obtain the best possible outcome. Patients are easily overwhelmed with a three- to four-drug treatment regimen with some drugs given intravenously and/or subcutaneously at the clinic, and others taken orally at home on specific days of each 28-day cycle. Home care nursing is needed to assess for tolerance, adverse effects, and to address patient concerns. Medication management and teaching are very important in guiding patients to safely manage a schedule that changes daily. In addition, the high risk of pathological fractures and serious injury if the patient should fall supports the need for physical and occupational therapy fall prevention and safety education and exercise programs to help avert decline in functional status and combat cancer-related fatigue.

Comparing Online and In-Person Delivery of a Fall Prevention Exercise Program for Older Adults.

Exercise is the single most effective strategy to reduce the risk of falls. Online classes have grown in popularity, but the benefits of online classes remain unknown. Zoomers on the Go is a peer-led 12-week exercise program offered twice weekly to adults 50+years old. The main outcome was lower body strength measured by the 30-s chair stand test. Other outcomes included dropout, attendance, balance, cardiorespiratory fitness, and perceived health. A total of 74 participants (age 66.3 ± 7.1years) in the online group and 84 participants in the in-person group (age 67.3 ± 7.2years) completed the program, with attendance for the online group. Both groups significantly improved their 30-s chair stand, cardiorespiratory fitness, and balance (p < .001) with no difference in functional benefits between groups. The in-person group improved their perceived health and significantly reduced levels of stress and depression, while no such changes were observed in the online group.

Proprioceptive and Strength Exercise Guidelines to Prevent Falls in the Elderly Related to Biomechanical Movement Characteristics.

Falls are a major concern in the elderly and walking is an important daily activity in which falls occur, with tripping and slipping being the most frequent causes. Gait biomechanical parameters have been related to the occurrence of falls in the elderly. Moreover, there is evidence that falls can be prevented through exercise programs, which have been shown to be also effective in improving gait biomechanical parameters. However, a question remains: "What types of exercises must be included in exercise programs to prevent falls?". The purpose of this manuscript was to present guidelines for a fall prevention exercise program for the elderly, which was created with the aim of improving the gait biomechanical parameters related to falls. The critical review performed during the preparation of this manuscript collected important evidence and knowledge in order to create a structural basis for the development of a fall prevention exercise program. This type of program should last 6 or more weeks and be prescribed based on four movement pillars (locomotion, level changes, pulling and pushing, and rotations); however, the locomotion pillar must be the focus of the program. Proprioceptive and functional strength exercises should be included in this program. Based on the theoretical rationale, a proposal for a fall prevention exercise program is presented.

Importance of muscle strength to maintain mobility, but not to maintain postural balance in older women: Cross-sectional study

BackgroundAcknowledging the relationship between postural control and muscle strength in lower limbs is important to find persons with high fall risk and to design fall prevention exercise programs. ObjectiveTo investigate the connection between knee muscle strength, semi-static postural balance, and functional mobility in irregularly active older women. MethodsOne hundred and ten older women aged 60 to 85 years underwent a semi-static postural balance test in a force and functional mobility measured by Timed Up & Go (TUG) with and without Cognitive Tasks (CT). Muscle strength of the knee was assessed by isokinetic dynamometry at 60°/s. ResultsA negative correlation between the functional mobility (TUG with and without CT) and the muscular strength of the knee was observed. Regarding semi-static balance, there was a low negative correlation with peak torque corrected for body weight of the extensors with the following variables with eyes open: Mean Velocity Dominant limb (D) (r = -0.19; p = 0.03); and anteroposterior range Non-Dominant limb (ND) (r = -0.19; p = 0.04); with eyes closed: mediolateral range ND limb (r = -0.21; p = 0.02) and Mean Velocity ND limb (r = -0.18; p = 0.05). ConclusionsThis study found that better functional mobility was associated with greater muscle strength in the knee in elderly women. There were weak negative correlations between knee extensor strength and some measures of semi-static postural balance, suggesting that different motor control actions are required to maintain semi-static balance and mobility. In the case of semi-static balance, a lower level of muscle response is required than in functional mobility.

A QUALITATIVE ANALYSIS OF A DIGITAL FALL PREVENTION EXERCISE PROGRAM FOR OLDER ADULTS WITH INCREASED FALL RISK

Abstract Falls are a significant public health problem; one third of individuals aged 65 years or older fall each year. Strength and balance exercises reduce fall risk, but most older adults are inactive. Individuals at risk of falls need clear guidance to ensure exercises performed at home are safe and provide adequate challenge. The aim of this qualitative study was to investigate the experiences and perceptions of older adults with increased fall risk enrolled in a 3-month digitally delivered home-based fall prevention exercise program (DFP). Semi-structured interviews were conducted by an interview specialist on a sample of 16 participants (81% female, age 77.3±5.8 years). Interviews were transcribed, imported, and coded into Dedoose, a tool for qualitative analysis. Codes were refined with each interview and themes were generated from the final codes. Three themes were identified: adherence to a home-based digitally delivered fall prevention exercise program, impact of fall prevention exercises on activities of daily living (ADL), and benefits of home-balance exercises. Participants attributed adherence to the home exercise program with minimal in-person visits. Participants reported fear of falling increased as they aged; upon completion, participants felt reduced fear of falling in their ADL. Balance exercises were the most appealing due to the level of difficulty and motivation to improve balance. Participants recommended changes to improve the DFP exercise program, with majority wanting to continue the program. This qualitative analysis provides guidance to health professionals about the acceptability and recommended changes for a digitally delivered home fall prevention exercise program.