Lower Extremity Strength Research Articles

EFEITO DO TREINAMENTO FUNCIONAL NA SAÚDE DO ADOLESCENTE

ABSTRACT Introduction The high rate of obesity caused by the modern sedentary lifestyle associated with bad eating habits and the high intellectual demand at school generates a physical and psychological deficit in contemporary youth. The damage caused in this growth phase is irrecoverable, and the habits acquired during this period are crucial to individual health. The urgency of this problem has generated research on methods to reverse this situation, among them functional training. Objective To study the effect of functional training on adolescent health. Methods 30 boys and 30 girls were recruited as study subjects. The experiment lasted one semester, including two weekly physical education classes focused on functional training. Data on body indexes, fitness, and physical test results were collected before and after the intervention. The results of the experiment were integrated and compared. Results The selection of functional training can optimize adolescents’ biochemical indexes, making adolescents’ orthostatic posture more balanced, and significantly improve muscle strength, body flexibility, explosive strength of upper and lower extremities, motor coordination, body flexibility, muscular endurance, cardiopulmonary function, etc. Conclusion Functional training can effectively improve the physical health of adolescents. Participants have increased their interest in sports, and this intervention can potentially promote the development of adolescents’ physical and mental health if replicated nationwide. Studies are needed to popularize functional training in adolescents. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

The Relationship Between Lower and Upper Extremity Strength Performance and Body Image Perception in Adolescent Athletes

The Relationship Between Lower and Upper Extremity Strength Performance and Body Image Perception in Adolescent Athletes

Accurate COP Trajectory Estimation in Healthy and Pathological Gait Using Multimodal Instrumented Insoles and Deep Learning Models.

Measuring center-of-pressure (COP) trajectories in out-of-the-lab environments may provide valuable information about changes in gait and balance function related to natural disease progression or treatment in neurological disorders. Traditional equipment to acquire COP trajectories includes stationary force plates, instrumented treadmills, electronic walkways, and insoles featuring high-density force sensing arrays, all of which are expensive and not widely accessible. This study introduces novel deep recurrent neural networks that can accurately estimate dynamic COP trajectories by fusing data from affordable and heterogeneous insole-embedded sensors (namely, an eight-cell array of force sensitive resistors (FSRs) and an inertial measurement unit (IMU)). The method was validated against gold-standard equipment during out-of-the-lab ambulatory tasks that simulated real-world walking. Root-mean-square errors (RMSE) in the mediolateral (ML) and anteroposterior (AP) directions obtained from healthy individuals (ML: 0.51 cm, AP: 1.44 cm) and individuals with neuromuscular conditions (ML: 0.59 cm, AP: 1.53 cm) indicated technical validity. In individuals with neuromuscular conditions, COP-derived metrics showed significant correlations with validated clinical measures of ambulatory function and lower-extremity muscle strength, providing proof-of-concept evidence of the convergent validity of the proposed method for clinical applications.

Cervical Spondylodiscitis Revealed by Tracheostomy Infected: A Rare Case Report Management and Outcome

Background: Spondylodiscitis is a spinal infection rare affecting primarily the intervertebral disk and the adjacent vertebral bodies. His diagnosis is difficult and often delayed or missed due to the rarity of the disease. Cervical spondylodiscitis has quite rare findings regarding the common location of spinal abscesses in the lumbar and thoracic regions. To obtain the best patient outcomes, these spinal infections require prompt diagnosis and appropriate treatment. Case description: A 44-year-old boy was admitted to the neurosurgery department of our hospital for heaviness in 4 limbs without gait disorders in context infected tracheostomy after staying in intensive care. MRI spine showed a spine deformity with lyse C4C5 epiduritis and spinal cord compressed. Antibiotics intravenous were started for 1 month the patient benefited from a corpectomy with an iliac graft and anterior cervical plate. The anatomopathological examination revealed an inflammation not specific. He was therefore put on antibiotics for 6 weeks. Three months later the neck pain and limb pain resolved after treatment and a complete return of lower extremity strength. Conclusion: Cervical spondylodiscitis has increased and become more aggressive. While radical surgical debridement, stable reconstruction together with antibiotic therapy remained a reliable approach to achieve complete healing of the inflammation, anterior alone surgery became more applicable.

EFEITOS DO TREINAMENTO DE FORÇA SOBRE A ESTABILIDADE FÍSICA DOS DANÇARINOS

ABSTRACT Introduction: Ballroom dance has evolved from a simple self-taught part of folklore to a technical, performative, and artistic competitive dance called the International Standard Dance. Objective: Study the effects of special lower limb strength training on the physical stability of dancers. Methods: 20 volunteers, students of a university specialized in dance, were divided into experimental and control groups, undergoing training of 30 minutes daily, 3 times a week, for 3 months. The control group followed the daily training, while the experimental group received special lower limb strength training. The relevant physical data measured before and after the intervention were statistically analyzed. Results: Compared to the control group, there was a significant difference in the athletes of the experimental group (P<0.05). The experimental group's lower limb strength and special skills were significantly improved. Conclusion: The lower extremity strength training protocol significantly improved the dancers’ muscle strength, proportionally increasing the stability of the sports skills. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

중증 COVID-19 환자에서 호흡재활프로그램의 종합적 효과: 단일사례연구

Purpose: This study was designed to determine the comprehensive effects of a respiratory rehabilitation program on the immune system, pulmonary function, motor ability, and activities of daily living (ADLs) in a patient with severe coronavirus disease 2019 (COVID-19).
 Methods: A 73-year-old female patient diagnosed with severe COVID-19 was recruited at OO university hospital. The respiratory rehabilitation program was conducted for 8 weeks, 5 days per week, for 120 min per day, and consisted of aerobic and strength exercises. We assessed the changes in the immune system-related cells and inflammatory markers, dyspnea, coughing ability, respiratory muscle strength, pulmonary functions, upper and lower extremity strength, balance, walking speed, and ADLs.
 Results: The lymphocytes showed a meaningful increase after the intervention, whereas the level of C-reactive protein and erythrocyte sedimentation rate decreased, suggesting the setting down of inflammation. COVID-19-related dyspnea was reduced, and the coughing ability of the patient was improved. Finally, there were remarkable increases in the upper and lower extremity strength, balance, walking speed, and ADL assessments.
 Conclusion: Hence, we suggest that the respiratory rehabilitation program, which includes aerobic and strength exercises, helps patients with COVID-19 relieve the main symptoms, such as dyspnea and cough, and improve the immune system and pulmonary function, motor ability, and ADLs.

The investigation of isokinetic knee strength and muscle balance of taekwondo and wrestling athletes

Taekwondo and wrestling are two different Olympic combat sports that need lower extremity strength in different ways. During the training process that lasts for many years, the harmony in the leg muscles may be dissimilar. This study aims to determine (1) the knee extension and flexion strength values of elite taekwondo and wrestling athletes with similar physical and demographic characteristics and (2) the muscle balances formed after long-term taekwondo and wrestling training. This study was conducted with the voluntary participation of 20 elite taekwondo and wrestling athletes (age: 20.4±1.27 years; experience: 10.6±1.98 years; height 176.65±5.86 cm; weight 72.96±6, 96 kg; BMI 23.35±1.47 kg/m2). Following the determination of the demographic and physical characteristics of the athletes, their isokinetic knee strengths were examined at an angular velocity of 600/s and compared between taekwondo and wrestling. Accordingly, the differences between the extension relative and average peak torque strengths of the athletes were significant in favour of the taekwondo players in the extension strength. On the other hand, the hamstring/quadriceps strength ratios of the taekwondo athletes were lower (p0.05). The study results showed that taekwondo players have higher extension strength. In the observed groups, it was determined that the muscular asymmetry occurred at different levels because of the adaptation specific to the sport type. Taekwondo trainings allows more balanced hamstring/quadriceps muscle harmony than wrestling. It is recommended to develop training programs in which the flexor muscles are trained against muscular imbalances in wrestling.

Epidural Spinal Cord Stimulation Helps Restore Locomotion in an Individual with Subacute Combined Degeneration: A Case Report

Background: Subacute combined degeneration (SCD) of the spinal cord with corticospinal tract involvement can impair motor functions below the level of the lesion. Case Report: A 63-year-old man developed progressive bilateral lower extremity weakness marked by difficulty standing for more than a second and the inability to ambulate, causing him to become wheelchair-bound. He was diagnosed with SCD. His vitamin B12 level was corrected and he underwent physical therapy. Despite these interventions, he experienced an overall deterioration in his strength examination. He later underwent an epidural spinal cord stimulator trial with pulsed electrical stimulation. With this, he experienced improvement in his lower extremity strength and regained the ability to ambulate independently. Permanent leads were placed with the retained faculty to ambulate with the stimulator turned on. Conclusion: Epidural spinal cord stimulation (SCS) has the potential to improve motor function and restore locomotion in individuals with spinal cord injury from SCD. Key words: Case report, epidural spinal cord stimulation, spinal cord injury, subacute combined degeneration

Primary meningeal central nervous system lymphoma: A case report and literature review

Primary central nervous system lymphoma (PCNSL) is a rare extranodal non-Hodgkin lymphoma, and isolated meningeal PCNSL, without evidence of parenchymal involvement, is even less common, occurring in only 10% to 15% of cases. A 65-years-old female presented to our hospital with progressive lower extremity motor dysfunction and blurred vision. The initial neurological examination revealed decreased muscle strength in both lower extremities and sensory dysfunction of lower extremities, saddle area, and buttocks. Brain magnetic resonance imaging showed no abnormalities. Lumbar enhanced magnetic resonance imaging showed T11 to L3 horizontal meningeal enhancement. Cerebrospinal fluid (CSF) cytology revealed lymphoma cells. Immunohistochemistry and flow cytometry of the CSF were performed as auxiliary methods to establish the diagnosis of lymphoma. The patient was diagnosed primary meningeal central nervous system lymphoma. During hospitalization, the patient was treated with 2 courses of high-dose intrathecal methotrexate and rituximab combined with intrathecal chemotherapy and supportive treatment. After 2 years of follow-up, the patient was able to walk and take care of herself. Cases of PCNSL involving only the meninges are rare. Multimodal analysis of the CSF comprises an important component of the diagnostic work-up for patients with primary meningeal central nervous system lymphoma.

Variability in lower extremity motor function in spina bifida only partially associated with spinal motor level.

Previous studies have found motor function to correlate with spinal motor level and, accordingly, individuals with spina bifida are frequently categorized clinically in this manner. The aim of the current study was to describe how lower extremity functions including strength, selective motor control, and mirror movements vary by motor level in children and young adults with spina bifida. A single center, retrospective, cross-sectional, descriptive study using data collected in the National Spina Bifida Patient Registry and by a gait laboratory was performed. Seventy-seven individuals with spina bifida were included with the majority having myelomeningocele (59 lumbar, 18 sacral motor level). Lower extremity strength and selective motor control varied to a certain extent with motor level. However, 90% of individuals showed strength or weakness in at least one muscle group that was unexpected based on their motor level. Mirror movements did not clearly vary with motor level. Lower extremity strength, selective motor control, and mirror movements in individuals with spina bifida were not entirely predicted by motor level. This highlights the possible need for an improved spina bifida classification system that describes not only spinal motor level but more clearly defines a particular individual's functional motor abilities.

SAĞLIKLI GENÇ YETİŞKİNLERDE HALAT VE KÜREK EGZERSİZLERİNİN FİZİKSEL PERFORMANS ÜZERİNE ETKİLERİNİN KARŞILAŞTIRILMASI

Amaç
 Halat egzersizleri, fiziksel performansı artırmak için
 geniş çaplı ve ağır halatların kullanıldığı pliyometrik
 egzersiz yaklaşımıdır. Kürek egzersizleri ise genel vücut
 kuvvetini artıran, kapalı ortamda kürek çekme aletiyle
 yapılan bir egzersiz türüdür. Çalışmanın amacı,
 bu iki egzersiz yaklaşımının omzun internal rotasyon/
 eksternal rotasyon (IR/ER) kas kuvvetine, propriyosepsiyonuna,
 üst ekstremite dengesine, alt ekstremite
 kuvveti ve gövde stabilizasyonuna etkilerinin karşılaştırılmasıdır.
 Gereç ve Yöntem
 Araştırmaya, 18-25 yaşları aralığında sağlıklı 22 birey
 dahil edilmiştir. Çalışma başlangıcında ve sonunda;
 60°/sn açısal hızdaki izokinetik dinamometre ile IR/
 ER omuz kas kuvvet testi, izokinetik dinamometre ile
 15°, 45° ve 75° hedef açılarda aktif IR/ER omuz propriyosepsiyon
 ölçümü, üst ekstremite için Y denge testi
 ve kapalı kinetik zincir alt ekstremite stabilite testi gerçekleştirilmiştir.
 Katılımcılar randomize olarak kürek
 (n=10) ve halat (n=12) egzersiz gruplarına ayrılmıştır.
 Her iki gruba da 6 hafta boyunca, haftada 3 gün, gün
 aşırı, 6 set egzersiz ve setler arasında 30 sn dinlenmeyle
 egzersizler yapılmıştır. Egzersizler sırasındaki
 ritmi takip edebilmek için halat egzersiz grubunda 60
 bpm, kürek grubunda 30 bpm metronom hızı belirlenmiştir.
 Bulgular
 Egzersiz programlarından sonra; her iki grubun da
 (Kürek; n=9 / Halat; n=10) başlangıca göre kapalı kinetik
 zincir alt ekstremite stabilite testi ve IR total iş
 sonucunda anlamlı artış bulunmuş (p˂0,05), Üst Ekstremite
 Y Denge Testi ve propriyosepsiyon testi sonuçlarında
 fark olmadığı görülmüştür (p˃0,05). Halat
 egzersizi grubunun; dominant omzunun 60˚/s hızındaki
 IR zirve torku (p=0,048) ve vücut ağırlığına oranı
 (p=0,045) egzersiz programının sonunda, başlangıca
 göre anlamlı olarak artmıştır. Egzersiz programı-
 nın başlangıcına göre egzersiz programı sonrasında
 belirlenen değişim miktarlarının karşılaştırılmasında
 iki grup arasında birbirine üstünlük gözlenmemiştir
 (p>0,05).
 Sonuç
 Mevcut sonuçlar ışığında iki egzersiz protokolünün de
 sağlık bireylerde antrenman programlarının bir parçası
 haline getirilebileceğini düşünmekteyiz.

Aerobic exercise and dual-task training combination is the best combination for improving cognitive status, mobility and physical performance in older adults with mild cognitive impairment.

The aim of the present study was to investigate the effects of different exercise combinations on cognitive status, muscle strength of lower extremities, mobility, physical performance, mood and quality of life in older adults with mild cognitive impairment (MCI). A total of 48 older adults with MCI were randomly assigned to four groups: (1) aerobic plus lower extremity strengthening exercises (AG), (2) dual-task training plus lower extremity strengthening exercises (DG), (3) aerobic exercise, dual-task training and lower extremity strengthening exercises (ADG), (4) solely lower extremity strengthening exercises (CG). Patients' cognitive status, lower extremity muscle strength, balance, mobility, activities-specific balance confidence, functional exercise capacity, physical performance, mood and quality of life were evaluated. In all three intervention groups, there was a significant improvement in cognitive status, balance, mobility, activities-specific balance confidence, physical performance, mood and quality of life (p < 0.05). The most remarkable change was observed in the ADG on cognitive status, mobility and physical performance parameters (p < 0.05). In addition, the most significant improvement in balance parameters was recorded both in the DG and ADG (p < 0.05). Besides, the highest increase in functional exercise capacity was detected both in the AG and ADG (p < 0.05). On the other hand, both exercise combinations were superior to the control group in terms of improving mood and quality of life (p < 0.05). The trial results proved that aerobic exercise and dual-task training is the best combination for improving cognitive status, mobility and physical performance in older adults with MCI.

Arnis-based Exercise Program for Balance Control in Community-Dwelling Older Adults: Study Protocol for a Pilot Randomized Controlled Trial

Background: Aging causes impairment in balance and increases the prevalence of falls in older adults. Martial arts are now incorporated into exercise programs to improve balance. Arnis, a Filipino Martial Art, can improve the balance control of older adults. Objectives: This study primarily aims to determine the effects of an Arnis-based exercise program on balance control of healthy community-dwelling older adults. This study also aims to describe its effect on older adults’ concerns about falling and lower limb functional strength. Methods: This will be a single-blind, pilot randomized controlled trial. Participants will be randomly allocated to either the intervention or control group. The intervention group will perform an Arnis-based exercise program for 40-60 minutes per session thrice a week for 12 weeks. The control group will continue to do their usual activities for the duration of the study. Participants will be measured at baseline and 12 weeks after for balance, concern for falling, and lower limb strength using the Berg Balance Scale, Timed-Up and Go Test, Falls Efficacy Scale-International Filipino, and the 30-second Chair Sit-to-stand Test, respectively. Data will be analysed through independent and paired t-tests. A p-value Expected Results: Significant improvements in the balance scores in the intervention group are expected after 12 weeks of the Arnis-based exercise program, along with its effects on concerns for falling and lower extremity strength. The pilot study will provide data on the effectiveness of Arnis as a reference for future larger experimental studies.

CLINICAL TRIAL OF METFORMIN FOR FRAILTY PREVENTION IN COMMUNITY-DWELLING OLDER ADULTS WITH PRE-DIABETES

Abstract Background Metformin may reduce frailty through improving insulin resistance and inflammation, aging mechanisms known to increase frailty risk. We describe a randomized clinical trial of metformin for frailty prevention in community-dwelling older adults with pre-diabetes and provide baseline characteristics of randomized participants. Methods Older adults (65+ years) are studied in this randomized, double-blind, placebo-controlled trial of metformin (max 2,000 mg/day). Pre-diabetes, required for inclusion, is assessed by 2-hour oral glucose tolerance test (OGTT). Individuals with glomerular filtration rate &amp;lt; 45 mL/min and frail individuals (Fried criteria) are excluded. The primary outcome, frailty, is assessed by both Fried criteria and frailty index. Secondary outcomes are physical function (short physical performance battery), lower extremity strength (Biodex), 6-minute walk, inflammation (systemic and skeletal muscle tissue), muscle insulin signaling, insulin sensitivity (insulin clamp), glucose tolerance (OGTT), and body composition (dual-energy x-ray absorptiometry). Subjects are followed for 2 years with safety assessments every 3 months and frailty assessment and OGTT every 6 months. Results 145 participants (49% female, 35% Hispanic) are randomized. Mean age is 71.8 ± 5.4 years (range: 65-88), body mass index is 30.8 ±6 kg/m2, and Hemoglobin A1c is 5.6 ±0.4%. Using Fried criteria, 63.4% have frailty score of 0, 30.3% a score of 1, and 6.2% a score of 2. Conclusion Metformin is being examined as a potential therapeutic agent to prevent frailty in older adults with pre-diabetes. Findings from this trial may have future implications for screening and treatment of pre-diabetes in older adults for the prevention of frailty.

Telehealth For Individuals with Parkinson's Disease During Covid-19 In Brazil: A Prospective Case Series.

To implement a telerehabilitation prevention, treatment, and follow-up physical therapy protocol for monitoring individuals with Parkinson's disease (PD) and to verify its effectiveness in minimizing the deleterious effects of the COVID-19 pandemic. Prospective case series, involving 40 participants with mild to moderate PD recruited from a specialized neurorehabilitation group. The study was divided into four parts: (1) Phone calls to assess the feasibility of participating in remote physical therapy. (2) Social media training. (3) Baseline and post-intervention assessment for functional lower extremity strength, fear of falling, quality of life, depression, anxiety, activities of daily living, verbal fluency. (4) Intervention protocol consisting of 20 remote weekly physical therapy sessions, graphic material for physical and cognitive training, social activities, and education. The telerehabilitation protocol was viable and effective for patients with PD as an alternative to in-person treatment during the COVID-19 pandemic.

Sağlıklı kadınlarda klinik Pilates egzersizlerinin fiziksel uygunluk ve psikososyal parametreler üzerine etkilerinin incelenmesi

Purpose: The aim of this study was to examine the effect of supervised and home-based clinical Pilates exercises on physical fitness, psychosocial status, and exercise beliefs in healthy women. Methods: Thirty-eight healthy women (mean age=29.95±7.16 years) were divided into two groups: supervised group (N=19) and home-based group (N=19). Physical fitness was assessed with modified push-up, sit-up, sit to stand, anterior plank, lateral plank, Biering-Sorensen, trunk flexors endurance, timed up and go and 6-min walking tests. Body composition was assessed with body mass index and waist to hip ratio. Psychosocial status was assessed with Social Appearance Anxiety Scale (SAAS), Rosenberg Self-Esteem Scale (RSES), Body Image Scale and Exercise Beliefs Questionnaire. Both groups completed a 24-session exercise program for 8 weeks, 3 days a week. Results: After the program, a significant improvement was seen in the modified push-up, sit-up, sit to stand, anterior plank, lateral plank, Biering-Sorensen, trunk flexors endurance tests with SAAS, RSES and Exercise Beliefs Questionnaire scores in the supervised group (p&amp;lt;0.05). In the home-based group, significant improvement was achieved in the modified push-up, sit-up, anterior plank, trunk flexors endurance tests with Exercise Beliefs Questionnaire scores (p&amp;lt;0.05). Comparing delta values, it was observed that there was a significant difference in the sit to stand and anterior plank tests with the Exercise Beliefs Questionnaire scores in favor of the supervised group (p&amp;lt;0.05). Conclusion: It was seen that clinical Pilates exercises, both supervised and home-based, similarly increased endurance and muscle strength, as well as positively affected participants’ perspectives on exercise in healthy women. In addition, clinical Pilates exercises performed under supervision made a difference in both lower extremity strength evaluated by sit to stand test and endurance results evaluated by anterior plank test.

Effect of Exercise Using an Exoskeletal Hip-Assist Robot on Physical Function and Walking Efficiency in Older Adults.

Robotic technology has developed rapidly in recent years, and several robotic devices have been applied to improve physical, sensory, intellectual, psychological, and social functioning in the elderly and people with disabilities. In this study, we investigated the effects of EX1-assisted exercise in various environments on physical function, muscle strength, and walking efficiency in older adults. We designated four experimental conditions and randomly assigned participants to one of four groups: A (overground walking without an EX1), B (overground walking using the resistance mode of EX1), C (stair ascent using the assistance mode of EX1), and Group D (inclined treadmill walking using the assistance mode of EX1). A total of 60 community-dwelling elderly persons participated in 10 exercise intervention sessions for 4 weeks, and all participants were assessed before and after the exercise intervention. Physical function was measured by the 10-meter walk test for self-selected velocity (10MWT-SSV), short physical performance battery (SPPB), Berg balance scale (BBS), timed up and go (TUG), functional reach test (FRT), geriatric depression scale-short form (GDS-SF), and muscle strength of trunk and lower extremity. Cardiopulmonary metabolic energy efficiency was measured using a portable telemetric gas analyzer system. A significant increase in the 10MWT-SSV and TUG test was observed in groups B, C, and D. A statistically significant improvement in the SPPB and FRT was seen only in group D, and GDS-SF scores decreased significantly after exercise with an EX1 in groups B and D. Trunk and lower limb muscle strength increased more in the groups that exercised with EX1 assistance than those without an EX1, particularly in group B. The net metabolic energy costs and energy expenditure measurement during walking significantly improved in exercise groups C and D. The findings in this study support the application of the EX1 to physical activity and exercise to improve age-related changes in physical function, muscle strength, and walking efficiency among older adults. In addition, personalized exercise programs using different modes and training environments with an EX1 can enhance physical performance and walking efficiency in the elderly.

The Effect of Combination of Core Stability Training and Lower Extremity Strength Training on Static Standing Balance Ability in a Child with Down Syndrome

Balance is the ability to stay in one position with good control. Children with a diagnosis of Down syndrome usually have decreased muscle tone (hypotonia) or muscle weakness, so that their balance is disturbed and they are more prone to falling when standing. Core stability and lower extremity strength exercise are expected to improve the ability of static standing balance in children with a diagnosis of Down syndrome. The aim of the study is to determine the effect of giving a combination of core stability and lower extremity strength exercises on the static standing balance ability in children with Down syndrome. This study uses a single subject research on a child with a diagnosis of Down syndrome who is given core stability and lower extremity strength exercise for 4 weeks to improve the ability of static standing balance. The ability of static standing balance in this study was measured using Gross Motor Function Measure (GMFM). Measurements were taken before exercise was given (A1), follow-up (B) and final evaluation (A2). After being given exercise twice for four weeks, there was no increase in the GMFM score, so it was concluded that there was no increase in the ability of static standing balance in children with Down syndrome in this study. In conclusions, giving core stability exercise and lower extremity strength exercise twice for four weeks is considered not to be able to improve the ability of static standing balance in children with Down syndrome.

A randomized controlled trial on impact of group exercise programme on fall risk, balance, strength, fear of fall and quality of life of older adults

Introduction. A parallel group Randomized Controlled Trial was aimed to determine the impact of a group exercise programme on fall risk and its modifiable risk factors in older adults. Methods. 86 older adults having increased fall risk were assigned to group exercise programme or individualized exercise programme. Intervention consisted of warm up, balance retraining exercises and cooldown and lower limb strengthening exercises derived from Otago Exercise Programme (OEP) forming the core program for 2 times in a week for the period of 10 weeks. Demographic data, Timed Up and Go test, 5-times sit to stand test, sway index and dynamic postural stability, fear of fall and physical and mental components of Quality of Life were assessed before and after 10 weeks and after 6 months of intervention. Results. A significant intra-group effect was demonstrated for both groups at post-intervention in all the outcomes, (p &lt; 0.005). No differences were observed between groups for any outcome (p &gt; 0.005) except SF 12 score which was improved more in experimental group (p &gt; 0.005). Conclusions. Group exercise program was effective in reducing fall risk and fear of fall, improving balance and lower extremity strength and enhancing the quality of life of older adults.

Evaluating and Characterizing an Individually-Tailored Community Exercise Program for Older Adults With Chronic Neurological Conditions: A Mixed-Methods Study.

A mixed-methods approach was used to study an individually-tailored community exercise program for people with a range of chronic neurological conditions (e.g.,stroke, spinal cord injury, brain injury, multiple sclerosis, Parkinson's disease) and abilities. The program was delivered to older adults (mean age: 62 ± 9years) with chronic neurological conditions across a 12-week and an 8-week term. Participants attended 88% of sessions and completed 89% of prescribed exercises in those sessions. There were no adverse events. Clinically important improvements were achieved by all evaluated participants (n = 8) in at least one testing domain (grip strength, lower-extremity strength, aerobic endurance, and balance). Interviews with participants identified key program elements as support through supervision, social connection, individualized programming, and experiential learning. Findings provide insight into elements that enable a community exercise program to meet the needs of a complex and varied group. Further study will support positive long-term outcomes for people aging with neurological conditions.