Traditional Exercise Program Research Articles

A weight-loss program adapted to the menstrual cycle increases weight loss in healthy, overweight, premenopausal women: a 6-mo randomized controlled trial

Hormonal fluctuations during the menstrual cycle influence energy intake and expenditure as well as eating preferences and behavior. We examined the effect in healthy, overweight, premenopausal women of a diet and exercise weight-loss program that was designed to target and moderate the effects of the menstrual cycle compared with the effect of simple energy restriction. A total of 60 healthy, overweight, premenopausal women were included in a 6-mo weight-loss program in which each subject consumed a diet of 1600 kcal/d. Subjects were randomly assigned to either a combined diet and exercise program that was tailored to metabolic changes of the menstrual cycle (Menstralean) or to undergo simple energy restriction (control). Thirty-one women (19 Menstralean and 12 control women) completed the study [mean ± SD body mass index (in kg/m(2)): 32.0 ± 5.2]. Both groups lost weight during the study. In an intention-to-treat analysis, the Menstralean group did not achieve a clinically significant weight loss compared with that of the control group (P = 0.61). In per-protocol analyses, a more-pronounced weight loss of 4.3 ± 1.4 kg (P = 0.002) was shown in adherent Menstralean subjects than in the control group. A differentiated diet and exercise program that is tailored to counteract food cravings and metabolic changes throughout the menstrual cycle may increase weight loss above that achieved with a traditional diet and exercise program in women who can comply with the program. This trial was registered at clinicaltrials.gov as NCT01622114.

Two Different Types of High-Frequency Physical Therapy Promote Improvements in the Balance and Mobility of Persons With Multiple Sclerosis

ObjectiveTo evaluate the mobility and postural balance improvements that could be achieved in a cohort of persons with multiple sclerosis (MS) who participated in a motor adaptation protocol and a cohort of persons with MS who participated in a therapeutic exercise protocol. DesignA cohort design, where subjects were evaluated before and after a 6-week intervention period. SettingClinical laboratory setting. ParticipantsIndividuals (N=42) with relapsing-remitting or secondary progressive MS (Expanded Disability Status Scale [EDSS] scores, 3.0–6.5) were initially screened for eligibility for participation in the study, from which those who fit the inclusion criteria (n=32) were enrolled in the study. Subjects were pseudorandomly assigned to a treatment group and matched based on EDSS scores. Fourteen individuals in the motor adaptation cohort (MAC) (mean age ± SD, 52.6±9y; mean EDSS score ± SD, 5.5±0.9) and 13 individuals in the therapeutic exercise cohort (TEC) (mean age ± SD, 54.0±9y; mean EDSS score ± SD, 5.3±0.9) completed the entire duration of their respective programs. InterventionsBoth cohorts completed their therapy twice a day, 5 days each week, for 6 weeks. Each session of the MAC program consisted of balance and gait training that encouraged new ways to adapt to challenging task demands. The TEC program was similar to a traditional exercise program. Main Outcome MeasuresThe Sensory Organization Test, 6-minute walk test, and gait spatiotemporal kinematics. ResultsCollectively, both treatment groups had improvements in postural balance (P=.001), walking endurance (P=.002), walking speed (P=.004), and step length (P<.001) after therapy. However, there were no statistical differences between the 2 treatment groups for any of the outcome variables (P values >.01). ConclusionsOur exploratory results suggest that a high frequency of physical therapy rather than a specific activity focus might be an important parameter for persons with MS.

Remotely Delivered Exercise-Based Cardiac Rehabilitation: Design and Content Development of a Novel mHealth Platform.

BackgroundParticipation in traditional center-based cardiac rehabilitation exercise programs (exCR) is limited by accessibility barriers. Mobile health (mHealth) technologies can overcome these barriers while preserving critical attributes of center-based exCR monitoring and coaching, but these opportunities have not yet been capitalized on.ObjectiveWe aimed to design and develop an evidence- and theory-based mHealth platform for remote delivery of exCR to any geographical location.MethodsAn iterative process was used to design and develop an evidence- and theory-based mHealth platform (REMOTE-CR) that provides real-time remote exercise monitoring and coaching, behavior change education, and social support.ResultsThe REMOTE-CR platform comprises a commercially available smartphone and wearable sensor, custom smartphone and Web-based applications (apps), and a custom middleware. The platform allows exCR specialists to monitor patients’ exercise and provide individualized coaching in real-time, from almost any location, and provide behavior change education and social support. Intervention content incorporates Social Cognitive Theory, Self-determination Theory, and a taxonomy of behavior change techniques. Exercise components are based on guidelines for clinical exercise prescription.ConclusionsThe REMOTE-CR platform extends the capabilities of previous telehealth exCR platforms and narrows the gap between existing center- and home-based exCR services. REMOTE-CR can complement center-based exCR by providing an alternative option for patients whose needs are not being met. Remotely monitored exCR may be more cost-effective than establishing additional center-based programs. The effectiveness and acceptability of REMOTE-CR are now being evaluated in a noninferiority randomized controlled trial.

Review of Therapeutic Exercise for Upper Lymphedema Patients Following Mastectomy

PURPOSE: The purpose of this review was to summarize some of traditional and recent rehabilitation exercise program to provide basic data and effective treatment guidelines that are applicable to evidence-based clinical practice. METHODS: The abnormal accumulation of tissue proteins due to lymphedema causes the lack of muscle flexibility and weakness, which subsequently causes limitations in performing exercises. However, exercise therapy, which is recommended as a combination therapy, not only overlooks the accompaniment of upper-extremity exercise disorders by the nature of breast cancer, but also does not take into account the pain occurring during exercises. Thus, we reviewed previous studies as many as on therapeutic exercise in upper- limb lymphedema patient at MEDLINE, PubMed, KISS, and RISS. RESULTS: We introduced brief etiology on upper limb lymphedema following mastectomy in breast cancer with general symptoms and characteristics. We also summarized detail therapeutic exercise programs on the exercise intensity, frequency, and time to suggest effective treatment guidelines. CONCLUSIONS: The appropriate exercise rehabilitation programs are effective to recovery from upperlimb lymphedema, and beside it resulted in elevation of functional abilities.

Revisional Bariatric/Metabolic Surgery: What Dictates Its Indications?

Bariatric/metabolic surgery is currently the only effective long-term treatment for morbid obesity- and obesity-related diseases such as diabetes, heart disease, hypertension, obstructive sleep apnea, and dyslipidemia. In addition, bariatric/metabolic surgery has been shown to significantly reduce the incidence of diabetes and cancer and prolong life when compared to non-surgical therapies. However, as obesity is a chronic disease, recidivism of weight and comorbid conditions can occur. In addition, the surgical construct can lead to long-term consequences such as marginal ulceration, bowel obstruction, reflux, and nutritional deficiencies. Despite these drawbacks, prospective randomized controlled studies and long-term longitudinal population-based comparative studies greatly favor surgical intervention as opposed to traditional lifestyle, diet, and exercise programs. Revisional surgery can be quite complex and technically challenging and may offer the patient a wide variety of solutions for treatment of weight recidivism and complications after primary operations. Given the paucity of high quality published data, we have endeavored to provide indications for revisions after bariatric surgery.

Active Video Games for Improving Physical Performance Measures in Older People: A Meta-analysis

Background and Purpose:Participation in regular physical activity is associated with better physical function in older people (>65 years); however, older people are the least active of all age groups. Exercise-based active video games (AVGs) offer an alternative to traditional exercise programs aimed at maintaining or enhancing physical performance measures in older people. This review systematically evaluated whether AVGs could improve measures of physical performance in older people. Secondary measures of safety, game appeal, and usability were also considered.Methods:Electronic databases were searched for randomized controlled trials published up to April 2015. Included were trials with 2 or more arms that evaluated the effect of AVGs on outcome measures of physical performance in older people.Results:Eighteen randomized controlled trials (n = 765) were included. Most trials limited inclusion to healthy community-dwelling older people. With the exception of 1 trial, all AVG programs were supervised. Using meta-analyses, AVGs were found to be more effective than conventional exercise (mean difference [MD], 4.33; 95% confidence intervals [CIs], 2.93-5.73) or no intervention (MD, 0.73; 95% CI, 0.17-1.29) for improving Berg Balance scores in community-dwelling older people. Active video games were also more effective than control for improving 30-second sit-to-stand scores (MD, 3.99; 95% CI, 1.92-6.05). No significant differences in Timed Up and Go scores were found when AVGs were compared with no intervention or with conventional exercise.Conclusions:Active video games can improve measures of mobility and balance in older people when used either on their own or as part of an exercise program. It is not yet clear whether AVGs are equally suitable for older people with significant cognitive impairments or balance or mobility limitations. Given the positive findings to date, consideration could be given to further development of age-appropriate AVGs for use by older people with balance or mobility limitations.

Neuromuscular Electrical Stimulation for Early Recovery of Motor Control of Ankle along with Spasticity in Stroke Patients A Prospective Randomized Controlled Study

Abstract Background and Purpose Effect of neuromuscular electrical stimulation in acute stroke patients while stimulating only single muscle is not known. The purpose of the study is to find the influence of early neuromuscular electrical stimulation to the motor point of tibialis anterior muscle of the affected limb in achieving early motor control of the ankle with reduction in spasticity in poststroke patients. Methods One hundred and thirty-two subjects were selected between 45and 65 years of age and within 2 weeks of the first attack of stroke. They were randomly divided into study and control groups comprising 66 subjects in each group. Study group received neuromuscular electrical stimulation to tibialis anterior muscle of the affected limb, 15 minutes twice daily, 5 days a week up to 3 weeks along with conventional exercise therapy whereas control group received only exercise therapy for that period. Outcome measures include Modified Ashworth Scale for spasticity of ankle plantar flexors, motor power of ankle dorsiflexors and plantar flexors, motor control of ankle joint. They were recorded before starting treatment, after 3 weeks and at 7 weeks following starting the treatment. Results Significant improvement of spasticity was noticed after 7 weeks follow-up (p=0.014). Significant improvement also noticed in ankle dorsiflexor motor power (p&lt;0.001), ankle motor control (p=0.007). Conclusions Neuromuscular electrical stimulation along with traditional exercise programme is superior to exercise alone for early recovery of ankle motor control, plantar-flexor spasticity and ankle dorsiflexor motor strength.

Translation of a Motor Learning Walking Rehabilitation Program Into a Group-Based Exercise Program for Community-Dwelling Older Adults

BackgroundTraditional exercise programs for older adults, which focus on aerobic and strength training, have had only modest effects on walking. Recently, a motor learning exercise program was shown to have greater effects on walking compared with a traditional exercise program. Translating this novel motor learning exercise program into a group exercise program would allow it to be offered as an evidence-based, community-based program for older adults. ObjectiveTo translate a walking rehabilitation program based on motor learning theory from one-on-one to group delivery (On the Move) and evaluate multiple aspects of implementation in older adults with impaired mobility. DesignThe translation process involved multiple iterations, including meetings of experts in the field (Phase I), focus groups (Phase II), and implementation of the newly developed program (Phase III). Phase III was based on a one-group model of intervention development for feasibility, safety, potential effects, and acceptability. SettingCommunity sites, including 2 independent living facilities, an apartment building, and a community center. ParticipantsAdults 65 years of age or older who could ambulate independently and who were medically stable. Thirty-one adults, mean age 82.3 ± 5.6 years, were eligible to participate. MethodsThe group exercise program was held twice a week for 12 weeks. Main Outcome MeasurementsAcceptability of the program was determined by retention and adherence rates and a satisfaction survey. Risk was measured by adverse events and questions on perceived challenge and safety. Mobility was assessed pre- and postintervention by gait speed, Figure of 8 Walk Test, and 6-minute walk test. ResultsModifications to the program included adjustments to format/length, music, education, and group interaction. The 12-week program was completed by 24 of 31 entrants (77%). Adherence was high, with participants attending on average 83% of the classes. Safety was excellent, with only 1 subject experiencing a controlled, noninjurious fall. There was preliminary evidence for improved mobility after the intervention: gait speed improved from 0.76 ± 0.21 to 0.81 ± 0.22 m/s, P = .06; Figure of 8 Walk Test from 13.0 ± 3.9 to 12.0 ± 3.9 seconds, P = .07; and 6-minute walk test from 246 ± 75 to 281 ± 67 m, P = .02. ConclusionsThe group-based program was safe and acceptable to older adults with impaired mobility and resulted in potentially clinically meaningful improvements in mobility.

Balance improvement after physical therapy training using specially developed serious games for cerebral palsy children: preliminary results

Purpose: Cerebral palsy (CP) leads to various clinical signs mainly induced by muscle spasticity and muscle weakness. Among these ones impaired balance and posture are very common. Traditional physical therapy exercise programs are focusing on this aspect, but it is difficult to motivate patients to regularly perform these exercises, especially at home without therapist supervision. Specially developed serious games (SG) could therefore be an interesting option to motivate children to perform specific exercise for balance improvement. Method: Ten CP children participated in this study. Patients received four sessions of SG included into conventional therapy (1 session of 30 min a week during 4 weeks). Trunk control and balance were assessed using Trunk Control Motor Scale (TCMS) before and after interventions. Results: Children presented a significant improvement in TCMS global score after interventions [37.6 (8.7) and 39.6 (9.5) before and after interventions, respectively, p = 0.04]. Conclusion: SG could therefore be an interesting option to integrate in the conventional treatment of CP children.Implication for RehabilitationCerebral palsy (CP) leads to balance issues.Rehabilitation exercises are not performed (enough) at home.Serious games (SG) could increase patients’ motivation.SG increase balance control of CP children.

A Comparison Study of Short Duration High Intensity Training and Traditional Exercise in Post-Menopausal Women.

The mode and duration of exercise necessary to change body composition and reduce weight remains debatable. Menopause results in hormonal changes that may further impede weight loss. PURPOSE: To compare the effects of short duration, high intensity training (HIT) and traditional methods of exercise (walking) on anthropometric, body composition and body weight changes over a 12-week period. METHODS: Subjects (N=18) were post-menopausal, sedentary female volunteers, randomly assigned into one of two exercise groups. Both groups exercised five out of seven days for 12 weeks. The HIT group (N=8) (54.3±7.3yr; 161.4±13.5lb body wt; BMI=28.0±2.1 kg/m2; mean± SD) exercised for (15.0±3.5 min) which consisted of five different exercise routines including upper and lower extremity, a cardio segment, yoga and abdominal exercises. The walkers (N=10) (56.6±5.2yr; 171.2±15.5lb body wt; BMI=29.2±2.6 kg/m2; mean± SD) exercised for (40.0±5.0 min) at 65% of their age-predicted maximum heart rate. Relative (%) body fat was measured via DEXA scan, along with five anthropometric measurements prior to and after 12 weeks. Independent samples t tests for change were used to probe for significant differences at the p<0.05 level. Values are expressed as mean±standard deviation. RESULTS: No significant changes were determined between the HIT and walking groups for the pre-post anthropometric measurements: biceps, waist, abdomen, hips and thigh (11.9±0.8,12.3±0.8 vs. 12.2±1.2,12.5±0.9; 33.1±3.2,33.6±3.2 vs. 33.2±3.7, 33.2±2.8; 36.4±2.7,37.2±2.2 vs. 36.9±2.8,36.7±2.9; 41.3+1.9,42.2+1.8 vs. 41.1±1.7,41.9±2.3; 25.0±1.4,24.8±1.7 vs. 24.4±1.5, 24.2±1.5 in, respectively). Pre-post relative fat measurements and body weight changes were not significantly different between the HIT and walking groups (45.2±3.3, 43.8±4.7 vs. 44.3±3.7, 43.1±4.8 %fat; 161.6±13.6, 171.2±15.5 vs.159.9±14.8, 168.6±15.2 lb, respectively). CONCLUSION: No differences were observed between short duration HIT exercise group and the traditional exercise group (walking) on anthropometric measures, relative percent body fat and body weight over a 12-week period. This work is suggestive that the mode of exercise did not impact pre-post measures for change between a HIT program and a traditional walking exercise program.

Efficacy of Brain Gym Training on the Cognitive Performance and Fitness Level of Active Older Adults: A Preliminary Study.

This study evaluates the impact of Brain Gym (BG) training in active older adults. Eighty-five participants were assigned to four training groups: BG (n = 18), BG plus water-based exercise (n = 18), land-based exercise (n = 30), and land plus water-based exercise (n = 19). The effects of the programs on the attention and memory functions were assessed by means of the symbol digit modality test. The two-min step and the eight-foot up-and-go tests were used to evaluate their impact on fitness level. No program had a significant influence on the participant's cognitive performance, while different effects on the sample' fitness levels were observed. These findings suggest that the effects of BG on the cognitive performance and fitness level of active older adults are similar to those obtained after the practice of a traditional exercise program. Whether BG is performed in isolation or combined with other exercise programs seems to have no influence on such effects.

The Role of Antigravity Treadmill in Haemophilic Children Aged 8 to 11 Years with Unilateral Knee Haemarthrosis without Radiological Involvement

Background: Recurrent joint bleeding in children with hemophilia leads to joint damage with pain, loss of range of motion and function. Antigravity treadmill (AGT) allows unloading of the lower extremities during exercise in a pressurized treadmill chamber. Aim: To investigate the effect of AGT on muscle strength and functional balance in children with hemophilic knee arthritis. Study Design: Prospective, randomized controlled study. Place and Duration of Study: The outpatient clinic, Medical rehabilitation hospital, and King Fahd Hospital, Almadinah Almonawarah, Kingdom of Saudi Arabia, between January 2015 and Mars 2015. Methods: Thirty hemophilic male children with unilateral knee heamarthrosis in the age ranged from 8 to 11 years old were randomly allocated into two equal groups. The control group (group A) received traditional exercise program, while the study group (group B) received AGT gait training added to the same exercise program of group A. Training was applied three times per week for twelve consecutive weeks. All children were assessed at baseline and after 36-session. Original Research Article Emara; BJMMR, 10(2): 1-10, 2015; Article no.BJMMR.19132 2 Assessment included peak torque of quadriceps and hamstring muscles using Biodex Isokinetic Dynamometer and functional balance using Pediatric Berg balance scale (PBBS). Results: Significant differences were observed in both groups when comparing their pre and post treatment mean values of all measuring variables (p<0.05). Peak torque of the quadriceps changed from (32.60±1.183, 32.933±1.533) to (38.40±1.681, 40.466±1.060) and peak torque of the hamstring changed from (25.00±1.81265, 25.933±2.0517) to (32.533±2.474, 35.933±2.631) for the control and study group respectively, indicating more improvement in favor of the study group. Both groups demonstrated a significant increase in functional balance, with more improvement in favor of group B. Conclusion: It can be concluded that gait training using AGT may be used as a therapeutic intervention for improving muscle performance and functional balance in children with hemophilic knee arthritis. Although our sample was not large, the effect size was moderate to large (0.85 and 0.83) for the knee extensors and flexors respectively and 0.553 for PBBS.

Comparative Effects of Horse Exercise versus Traditional Exercise Programs on Gait, Muscle Strength, and Body Balance in Healthy Older Adults

This study evaluates the separate effect and retention of 12-week traditional (TE) and horse (HE) exercise programs on physical function in healthy older participants (61 to 87 years old). Thirty-eight participants were randomly assigned to three groups: TE (n = 17), HE (n = 10), and control group (n = 11). TE and HE underwent a supervised exercise program (3 day/week). Maximal gait speed, muscle strength, and body balance were assessed at weeks 0, 12, and 16. Only TE and HE displayed significant improvements (P < .05) in knee extensor strength, and only HE had faster gait speed. Marginal balance improvements were found only in HE in the medial-lateral direction. However, TE showed larger improvements in handgrip than HE. The largest retention was in knee extensor strength but most of the exercise effects were lost in the follow-up. Besides TE, exercise with a horse may be an alternative option to older adults, provided that they want to interact with the animal.

Aerobic exercise training in modulation of aerobic physical fitness and balance of burned patients.

[Purpose] This study aimed to determine the impact of aerobic exercise on aerobic capacity, balance, and treadmill time in patients with thermal burn injury. [Subjects and Methods] Burned adult patients, aged 20–40 years (n=30), from both sexes, with second degree thermal burn injuries covering 20–40% of the total body surface area (TBSA), were enrolled in this trial for 3 months. Patients were randomly divided into; group A (n=15), which performed an aerobic exercise program 3 days/week for 60 min and participated in a traditional physical therapy program, and group B (n=15), which only participated in a traditional exercise program 3 days/week. Maximal aerobic capacity, treadmill time, and Berg balance scale were measured before and after the study. [Results] In both groups, the results revealed significant improvements after treatment in all measurements; however, the improvement in group A was superior to that in group B. [Conclusion] The results provide evidence that aerobic exercises for adults with healed burn injuries improve aerobic physical fitness and balance.

Efficacy of Stomatognathic Alignment Exercise Program on Mouth Opening Limitation Improvement in Spastic Myogenic Temporomandibular Disorder of Hemiparetic Cerebral Palsy Children

Objectives: The aim of this work was to show the efficacy of stomatognathic alignment exercise program on mouth opening limitation improvement in spastic myogenic temporomandibular disorder of hemiparetic cerebral palsy children. Method: Thirty children were enrolled in this study and randomly assigned into two groups; group A (traditional physiotherapy program plus stomatognathic alignment exercise program), and group B (traditional physiotherapy program only). I used the standard ruler for detecting and follow up mouth opening limitation depends on the ratio between maximum comfortable mouth opening and maximum assisted mouth opening. This measurement was taken before initial treatment and after 12 weeks of treatment. The children parents in both groups A and B were instructed to complete 1 hour of home routine program. Results: Data analysis was available on the 30 hemiplegic cerebral palsy children participated in the study. The mean value of mouth opening in both groups (assessed by C.M) at baseline measurement (pre-treatment) and (post-treatment) was insignificant (p>0.05). Both groups had a significant improvement in mouth opening posttreatment. The average improvement of mouth opening tended to being highly significant in the study group than in the control group. The percentage of improvement of mouth opening were (16%) in the study group compared to the control group (4%). Conclusion: According the results of this study it can be concluded that the combined effect of physiotherapy training program in addition to stomatognathic alignment exercise program can be recommended in improvement mouth opening ratio in hemiplegic cerebral palsy children.

Kinesio Taping versus sensorymotor training for patients with knee osteoarthritis

Background: Osteoarthritis is a chronic disabling disease that generates many impairments of functional health status. The purpose of this study was to compare between Kinesio taping and sensorymotor training for treating patients with knee osteoarthritis. Methods: Sixty patients with knee osteoarthritis aged from 30-50 years were assigned into three equal groups. Group (I) received traditional exercise program, group (II) received the same program in addition to kinesio taping for knee joint, group (III) received the same program plus sensorymotor training for eight weeks. blind assessment was conducted at the beginning of the study and after 8 weeks of the treatment to measure pain intensity, proprioceptive acuity and functional disability. Results: The results revealed that there was a significant improvement in proprioception acuity and functional activities in sensorymotor training group while pain level is significantly better improved in kinesio taping group (p

Effect of Whole-Body Vibration on Muscle Strength and Balance in Diplegic Cerebral Palsy

The purpose of this study was to investigate the effects of whole-body vibration training on muscle strength and balance in children with diplegic cerebral palsy. Fifteen children were assigned to the experimental group, which received whole-body vibration training (9 mins per day, 5 days per week). Another 15 were assigned to the control group, which participated in a traditional physical therapy exercise program for 3 successive months. Baseline and posttreatment assessments were performed using the Biodex isokinetic dynamometer to evaluate the knee extensors peak torque at 60 degrees per second and 90 degrees per second and using the Biodex balance system to evaluate stability index. The children in the experimental group showed a significant improvement when compared with those in the control group (P < 0.001). The peak torque at 60 degrees per second and 90 degrees per second after treatment was 28.8 ± 0.45 and 47.5 ± 0.7 N · m and 30.9 ± 0.68 and 54.2 ± 1.7 N · m for the control and the experimental group, respectively. The overall stability index after treatment was 2.75 and 2.2 for the control group and the experimental group, respectively. Whole-body vibration training may be a useful tool for improving muscle strength and balance in children with diplegic cerebral palsy.

Comparative Effects of Horse Exercise Versus Traditional Exercise Programs on Gait, Muscle Strength, and Body Balance in Healthy Older Adults

This study evaluates the separate effect and retention of 12-week traditional (TE) and horse (HE) exercise programs on physical function in healthy older participants (61 to 87 years old). Thirty-eight participants were randomly assigned to three groups: TE (n = 17), HE (n = 10), and control group (n = 11). TE and HE underwent a supervised exercise program (3 day/week). Maximal gait speed, muscle strength, and body balance were assessed at weeks 0, 12, and 16. Only TE and HE displayed significant improvements (P < .05) in knee extensor strength, and only HE had faster gait speed. Marginal balance improvements were found only in HE in the medial-lateral direction. However, TE showed larger improvements in handgrip than HE. The largest retention was in knee extensor strength but most of the exercise effects were lost in the follow-up. Besides TE, exercise with a horse may be an alternative option to older adults, provided that they want to interact with the animal.

Exercise and perceived quality of life during survivorship: a pilot study comparing traditional and non-traditional cancer recovery programs

PURPOSE: To determine if cancer survivors could increase their perceived QOL using a non-traditional exercise and cancer recovery program consisting of resistance tubing, balance balls, and hand-weights. A second purpose was to compare perceived QOL ratings between survivors using a traditional versus non-traditional exercise program. METHODS: Sixty cancer survivors were assigned into two weight training groups (traditional and non-traditional). Participants were given a pre and post-test assessment using the FACT-G scale, designed to measure QOL ratings in a cancer population. Participants worked out for 12 weeks, two times per week for 30 to 60 minutes using individually prescribed exercise programs. The traditional group used various machines, while the non-traditional group used resistance tubing, stability balls, etc. RESULTS: Cancer survivors using the non-traditional training program significantly increased their perceived QOL, F(1, 58), = 5.61, p = .021. Overall, survivors under both conditions significantly increased their perceived QOL, F(1, 118) = 7.71, p = .006. CONCLUSIONS: Inexpensive non-traditional equipment can

The Effectiveness of Physical Therapist–Administered Group-Based Exercise on Fall Prevention

Falls are a verified cause of morbidity and mortality in adults older than 65 years. Exercise under the direction of a physical therapist has been shown to reduce the risk of falls in older adults; however, it is not clear whether physical therapist-directed group-based exercise could produce similar results. The purpose of this systematic review was to summarize the evidence on the effectiveness of physical therapist-administered group-based exercise when compared with various controls for falls prevention and improvement of quality of life. A computerized search of PubMed and CINAHL was performed. An exhaustive hand search was also performed of the references of all full-text articles. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed for this review. Studies were included if they met the following criteria: (1) comparison of group-based exercise led by a physical therapist to a control group; (2) ambulatory elderly men or women, aged 65 years or older; (3) subjects in the community or institutional setting; (4) the use of 1 or more outcome measures related to functional balance and/or quality of life; (5) randomized controlled or clinical trials; and (6) published in English, between December 1, 2001, and June 7, 2012. The PEDro scale was used to assess the quality of each study included in this review. The computerized search strategy and hand search revealed 213 potential articles, 10 of which met the inclusion criteria. After assessment with the PEDro scale, 8 of these were considered high-quality studies (score > 6/10). Seven studies compared group-based exercise to a nonexercise control group, while 3 studies compared group-based exercise with a physical therapist-prescribed home exercise program. Outcomes measured include fall rate, balance, physical performance, health-related quality of life, and fear of falling. When group-based exercise was compared with no intervention, group-based exercise was found to be more effective in decreasing fall frequency, increase balance, and improve quality of life. When compared with a physical therapist-prescribed home exercise program, the group-based exercise results were not statistically different but showed improvements in some quality of life and physical functioning measures. There is also some evidence to suggest that group-based exercise promotes greater patient satisfaction and exercise adherence. There is preliminary evidence to suggest that the group-based exercise is effective for falls prevention, quality-of-life enhancement, and balance improvements in the older adults comparable with traditional home exercise programs.