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Im DJ, Ku J, Kim YJ, Cho S, Cho YK, Lim T, Lee HS, Kim HJ, Kang YJ. Utility of a Three-Dimensional Interactive Augmented Reality Program for Balance and Mobility Rehabilitation in the Elderly: A Feasibility Study. Ann Rehabil Med 2015; 39:462-72. [PMID: 26161353 PMCID: PMC4496518 DOI: 10.5535/arm.2015.39.3.462] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 10/16/2014] [Indexed: 11/16/2022] Open
Abstract
Objective To improve lower extremity function and balance in elderly persons, we developed a novel, three-dimensional interactive augmented reality system (3D ARS). In this feasibility study, we assessed clinical and kinematic improvements, user participation, and the side effects of our system. Methods Eighteen participants (age, 56-76 years) capable of walking independently and standing on one leg were recruited. The participants received 3D ARS training during 10 sessions (30-minute duration each) for 4 weeks. Berg Balance Scale (BBS) and the Timed Up and Go (TUG) scores were obtained before and after the exercises. Outcome performance variables, including response time and success rate, and kinematic variables, such as hip and knee joint angle, were evaluated after each session. Results Participants exhibited significant clinical improvements in lower extremity balance and mobility following the intervention, as shown by improved BBS and TUG scores (p<0.001). Consistent kinematic improvements in the maximum joint angles of the hip and knee were observed across sessions. Outcome performance variables, such as success rate and response time, improved gradually across sessions, for each exercise. The level of participant interest also increased across sessions (p<0.001). All participants completed the program without experiencing any adverse effects. Conclusion Substantial clinical and kinematic improvements were observed after applying a novel 3D ARS training program, suggesting that this system can enhance lower extremity function and facilitate assessments of lower extremity kinematic capacity.
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Affiliation(s)
- Dal Jae Im
- Department of Rehabilitation, Eulji Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Jeunghun Ku
- Department of Biomedical Engineering, Keimyung University, Daegu, Korea
| | - Yeun Joon Kim
- Department of Rehabilitation, Daehan Hospital, Seoul, Korea
| | - Sangwoo Cho
- Graduate School of Technology and Innovation Management, Hanyang University, Seoul, Korea
| | - Yun Kyung Cho
- Department of Occupational Therapy, Eulji Hospital, Seoul, Korea
| | - Teo Lim
- Department of Physical therapy, Eulji Hospital, Seoul, Korea
| | - Hye Sun Lee
- Department of Biostatistics, Yonsei University of College of Medicine, Seoul, Korea
| | - Hyun Jung Kim
- Department of Rehabilitation, Eulji Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Youn Joo Kang
- Department of Rehabilitation, Eulji Hospital, Eulji University School of Medicine, Seoul, Korea
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102
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Loh DA, Hairi NN, Choo WY, Mohd Hairi F, Peramalah D, Kandiben S, Lee PL, Gani N, Madzlan MF, Abd Hamid MAI, Akram Z, Chu AS, Bulgiba A, Cumming RG. MultiComponent Exercise and theRApeutic lifeStyle (CERgAS) intervention to improve physical performance and maintain independent living among urban poor older people--a cluster randomised controlled trial. BMC Geriatr 2015; 15:8. [PMID: 25887235 PMCID: PMC4334409 DOI: 10.1186/s12877-015-0002-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 01/20/2015] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The ability of older people to function independently is crucial as physical disability and functional limitation have profound impacts on health. Interventions that either delay the onset of frailty or attenuate its severity potentially have cascading benefits for older people, their families and society. This study aims to develop and evaluate the effectiveness of a multiComponent Exercise and theRApeutic lifeStyle (CERgAS) intervention program targeted at improving physical performance and maintaining independent living as compared to general health education among older people in an urban poor setting in Malaysia. METHODS This cluster randomised controlled trial will be a 6-week community-based intervention programme for older people aged 60 years and above from urban poor settings. A minimum of 164 eligible participants will be recruited from 8 clusters (low-cost public subsidised flats) and randomised to the intervention and control arm. This study will be underpinned by the Health Belief Model with an emphasis towards self-efficacy. The intervention will comprise multicomponent group exercise sessions, nutrition education, oral care education and on-going support and counselling. These will be complemented with a kit containing practical tips on exercise, nutrition and oral care after each session. Data will be collected over four time points; at baseline, immediately post-intervention, 3-months and 6-months follow-up. DISCUSSION Findings from this trial will potentially provide valuable evidence to improve physical function and maintain independence among older people from low-resource settings. This will inform health policies and identify locally acceptable strategies to promote healthy aging, prevent and delay functional decline among older Malaysian adults. TRIAL REGISTRATION ISRCTN22749696.
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Affiliation(s)
- Debbie Ann Loh
- Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Noran Naqiah Hairi
- Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Wan Yuen Choo
- Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Farizah Mohd Hairi
- Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Devi Peramalah
- Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Shathanapriya Kandiben
- Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Pek Ling Lee
- Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Norlissa Gani
- Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Mohamed Faris Madzlan
- Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Mohd Alif Idham Abd Hamid
- Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Zohaib Akram
- Department of Oral Pathology, Oral Medicine and Periodontology, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.
| | - Ai Sean Chu
- Fitness First Malaysia, Menara MBF, Jalan Sultan Ismail, Kuala Lumpur, Malaysia.
| | - Awang Bulgiba
- Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Robert G Cumming
- Centre for Education and Research on Ageing, Concord Hospital, Concord, NSW, Australia. .,Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia.
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103
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Jeon MY, Jeong H, Petrofsky J, Lee H, Yim J. Effects of a randomized controlled recurrent fall prevention program on risk factors for falls in frail elderly living at home in rural communities. Med Sci Monit 2014; 20:2283-91. [PMID: 25394805 PMCID: PMC4243515 DOI: 10.12659/msm.890611] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background Falling can lead to severe health issues in the elderly and importantly contributes to morbidity, death, immobility, hospitalization, and early entry to long-term care facilities. The aim of this study was to devise a recurrent fall prevention program for elderly women in rural areas. Material/Methods This study adopted an assessor-blinded, randomized, controlled trial methodology. Subjects were enrolled in a 12-week recurrent fall prevention program, which comprised strength training, balance training, and patient education. Muscle strength and endurance of the ankles and the lower extremities, static balance, dynamic balance, depression, compliance with preventive behavior related to falls, fear of falling, and fall self-efficacy at baseline and immediately after the program were assessed. Sixty-two subjects (mean age 69.2±4.3 years old) completed the program – 31 subjects in the experimental group and 31 subjects in the control group. Results When the results of the program in the 2 groups were compared, significant differences were found in ankle heel rise test, lower extremity heel rise test, dynamic balance, depression, compliance with fall preventative behavior, fear of falling, and fall self-efficacy (p<0.05), but no significant difference was found in static balance. Conclusions This study shows that the fall prevention program described effectively improves muscle strength and endurance, balance, and psychological aspects in elderly women with a fall history.
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Affiliation(s)
- Mi Yang Jeon
- Department of Nursing, Gyeongsang National University, Jinju, Korea
| | | | - Jerrold Petrofsky
- Department of Physical Therapy, Loma Linda University, Loma Linda, USA
| | | | - JongEun Yim
- Department of Physical Therapy, Sahmyook University, Seoul, Korea
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Wang DC, Chen TJ, Lin ML, Jhong YC, Chen SC. Exercise prevents the increased anxiety-like behavior in lactational di-(2-ethylhexyl) phthalate-exposed female rats in late adolescence by improving the regulation of hypothalamus-pituitary-adrenal axis. Horm Behav 2014; 66:674-84. [PMID: 25251977 DOI: 10.1016/j.yhbeh.2014.09.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 09/13/2014] [Accepted: 09/15/2014] [Indexed: 11/25/2022]
Abstract
Both the detrimental effects of early life adversity and the beneficial effects of exercise on the hypothalamic-pituitary-adrenal (HPA) axis have been reported. Early life exposure to di-(2-ethylhexyl)-phthalate (DEHP) may impair the development of endocrine system. In this study, we investigated the effects of lactational DEHP exposure on stress responses in late adolescent female rats and examined the protective role of treadmill running. Sprague-Dawley dams were fed with DEHP (10mg/kg per day) or vehicle during lactation. After weaning, the female offspring rats were trained to exercise on a treadmill for 5 weeks and then stressed by exploring on an elevated plus maze. The activities of HPA axis were evaluated by measuring the plasma levels of ACTH and corticosterone, the expressions of adrenal enzymes cholesterol side-chain cleavage enzyme (CYP11A1) and cytochrome P-450 11β-hydroxylase (CYP11B1), and the expression of hypothalamic glucocorticoid receptors (GR). The results demonstrate that DEHP-exposed rats exhibited enhanced anxiety-like behaviors. Increased hypothalamic GR and plasma ACTH levels, but decreased adrenal CYP11A1 and corticosterone levels, were observed in DEHP-exposed animals under stressed condition. Importantly, in DEHP-exposed animals, exercise during childhood-adolescence reduced anxiety-like behaviors by normalizing stress-induced alterations in ACTH level and adrenal CYP11A1 expression. The findings of this study suggest that treadmill running may provide beneficial effects on ameliorating the dysregulation of HPA axis in lactational DEHP-exposed adolescent female rats.
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Affiliation(s)
- Dean-Chuan Wang
- Department of Sports Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.
| | - Tsan-Ju Chen
- Department of Physiology, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Ming-Lu Lin
- Department of Sports Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Yue-Cih Jhong
- Department of Sports Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Shih-Chieh Chen
- Department of Anatomy, Kaohsiung Medical University, Kaohsiung City, Taiwan
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105
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Mura G, Sancassiani F, Migliaccio GM, Collu G, Carta MG. The association between different kinds of exercise and quality of life in the long term. Results of a randomized controlled trial on the elderly. Clin Pract Epidemiol Ment Health 2014; 10:36-41. [PMID: 24707314 PMCID: PMC3975633 DOI: 10.2174/1745017901410010036] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 02/06/2014] [Accepted: 02/10/2014] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Quality of Life (QoL) tends to decrease with age. Exercise has been shown to be effective in improving some psychosocial features related to QoL. We carried out a randomized controlled trial to verify the long-term efficacy of an intensive fitness program versus a lighter program on the QoL of an elderly sample, compared to QoL of a large normative sample. METHODS Participants aged ≥65 years were randomly assigned in a 1:1 fashion either to a vigorous physical activity program group (VAG) or to a postural gymnastic group (PGG). Depressive symptoms were screened by PHQ-9. QoL assessment was done by SF-12. Multivariate analysis of variance (MANOVA) was conducted to test differences between the two groups over time. Comparison with the normative sample was carried out by means of ANOVA 1-way. RESULTS Both VAG and PGG showed low PHQ9 scores at the beginning and at the end of the trial, indicating the absence of depressive symptoms. At the end of the study, both groups had a higher level of QoL, measured by means of SF-12, than the normative standardized sample. While SF-12 scores for both groups decreased slightly 12 weeks after the end of the trial, only the VAG group maintained significantly-higher scores than those of the normative sample. CONCLUSIONS A vigorous physical activity program group might be associated with better maintenance of results over time as compared to a postural gymnastic program. These results require future confirmation by further studies on large samples.
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Affiliation(s)
- Gioia Mura
- Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Italy
| | - Federica Sancassiani
- Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Italy
| | | | | | - Mauro Giovanni Carta
- Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Italy
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