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Oberholster CK, Taylor CJ, Huynh M, Gordon BA. The immediate and lasting balance outcomes of clinical falls-prevention programs: A non-randomised study. PLoS One 2024; 19:e0299146. [PMID: 38483927 PMCID: PMC10939286 DOI: 10.1371/journal.pone.0299146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 02/05/2024] [Indexed: 03/17/2024] Open
Abstract
PURPOSE Exercise-based falls-prevention programs are cost-effective population-based approaches to reduce the risk of falling for older adults. The aim was to evaluate the short-term and long-term efficacy of three existing falls-prevention programs. METHODS A non-randomized study design was used to compare the immediate-post and long-term physical outcome measures for three falls prevention programs; one high-level land-based program, one low-level land-based program and a water-based Ai Chi program. Timed-up-and-go (TUG), five-times sit-to-stand (5xSTS), six-minute walk test (6MWT) and six-meter walk test were assessed at baseline, post-program, and at six-months follow-up. Linear mixed models were used to analyze between- and within- group differences, with the high-level land-based program used as the comparator. RESULTS Thirty-two participants completed post-program assessment and 26 returned for follow-up. There was a difference in the age (years) of participants between programs (p = 0.049). The intercept for TUG and six-meter walk test time was 47.70% (23.37, 76.83) and 32.31s (10.52, 58.41), slower for the low-level group and 40.49% (17.35, 69.89) and 36.34s (12.75, 64.87), slower for the Ai Chi group (p < 0.01), compared with the high-level group. Mean time taken to complete the TUG was less both immediately post-program and at 6-month follow-up (p = 0.05). Walking speed for the six-meter walk test was only faster at six-months (p < 0.05). The 5xSTS duration was significantly reduced only at post-intervention (p < 0.05). CONCLUSION These results indicate land-based and water-based falls-prevention programs improve physical outcome measures associated with falls-risk and many improvements are maintained for six months after the completion of the program. (Retrospective trial registration: ACTRN1262300119069).
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Affiliation(s)
- Candice K. Oberholster
- Holsworth Research Initiative, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
- The Royal Melbourne Hospital, Allied Health (Physiotherapy and Exercise Physiology), Melbourne, Victoria, Australia
| | - Carolyn J. Taylor
- La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Minh Huynh
- La Trobe School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Brett A. Gordon
- Holsworth Research Initiative, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
- La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
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Li Y, Liu M, Zhou K, Dong G, Manor B, Bao D, Zhou J. The comparison between effects of Taichi and conventional exercise on functional mobility and balance in healthy older adults: a systematic literature review and meta-analysis. Front Public Health 2023; 11:1281144. [PMID: 38164444 PMCID: PMC10757983 DOI: 10.3389/fpubh.2023.1281144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 12/05/2023] [Indexed: 01/03/2024] Open
Abstract
Background Taichi is beneficial for functional mobility and balance in older adults. However, such benefits of Taichi when comparing to conventional exercise (CE) are not well understood due to large variance in study protocols and observations. Methods We reviewed publications in five databases. Eligible studies that examined the effects of Taichi on the outcomes of functional mobility and balance in healthy older adults as compared to CE were included. Subgroup analyses compared the effects of different types of CE (e.g., single and multiple-type exercise) and different intervention designs (e.g., Taichi types) on those outcomes (Registration number: CRD42022331956). Results Twelve studies consisting of 2,901 participants were included. Generally, compared to CE, Taichi induced greater improvements in the performance of Timed-Up-and-Go (SMD = -0.18, [-0.33 to -0.03], p = 0.040, I2 = 59.57%), 50-foot walking (MD = -1.84 s, [-2.62 to -1.07], p < 0.001, I2 = 0%), one-leg stance with eyes open (MD = 6.00s, [2.97 to 9.02], p < 0.001, I2 = 83.19%), one-leg stance with eyes closed (MD = 1.65 s, [1.35 to 1.96], p < 0.001, I2 = 36.2%), and functional reach (SMD = 0.7, [0.32 to 1.08], p < 0.001, I2 = 86.79%) tests. Subgroup analyses revealed that Taichi with relatively short duration (<20 weeks), low total time (≤24 h), and/or using Yang-style, can induce significantly greater benefits for functional mobility and balance as compared to CE. Uniquely, Taichi only induced significantly greater improvements in Timed-Up-and-Go compared to single- (SMD = -0.40, [-0.55 to -0.24], p < 0.001, I2 = 6.14%), but not multiple-type exercise. A significant difference between the effects of Taichi was observed on the performance of one-leg stance with eyes open when compared to CE without balance (MD = 3.63 s, [1.02 to 6.24], p = 0.006, I2 = 74.93%) and CE with balance (MD = 13.90s, [10.32 to 17.48], p < 0.001, I2 = 6.1%). No other significant difference was shown between the influences of different CE types on the observations. Conclusion Taichi can induce greater improvement in functional mobility and balance in older adults compared to CE in a more efficient fashion, especially compared to single-type CE. Future studies with more rigorous design are needed to confirm the observations here.
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Affiliation(s)
- Yiting Li
- School of Sport Medicine and Physical Therapy, Beijing Sport University, Beijing, China
| | - Meng Liu
- Sports Coaching College, Beijing Sport University, Beijing, China
| | - Kaixiang Zhou
- College of Physical Education and Health Science, Chongqing Normal University, Chongqing, China
| | - Gengxin Dong
- School of Sport Medicine and Physical Therapy, Beijing Sport University, Beijing, China
| | - Brad Manor
- Hebrew Senior Life Hinda and Arthur Marcus Institute for Aging Research, Harvard Medical School, Boston, MA, United States
| | - Dapeng Bao
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China
| | - Junhong Zhou
- Hebrew Senior Life Hinda and Arthur Marcus Institute for Aging Research, Harvard Medical School, Boston, MA, United States
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Liu Y, Song Q, Zhou Z, Chen Y, Wang J, Tian X, Sun W. Effects of fatigue on balance and ankle proprioception during drop landing among individuals with and without chronic ankle instability. J Biomech 2023; 146:111431. [PMID: 36603367 DOI: 10.1016/j.jbiomech.2022.111431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 12/17/2022] [Accepted: 12/29/2022] [Indexed: 01/01/2023]
Abstract
This study aimed to explore the effects of fatigue on the balance and ankle proprioception during drop landing of individuals with chronic ankle instability (CAI). A total of 35 participants with unilateral CAI and 35 healthy participants participated in this study. A static balance test, dynamic balance test, and ankle proprioception test were conducted before and after fatigue. Fatigue was induced with turn back runs and vertical jumps protocol. Sway distance of the center of pressure (COP), root mean square of the COP (RMS), total excursions (TOTEX), mean velocity (MVELO), 95% confidence ellipse area of the COP movements (95% AREA), Normalise Reach Distance in the anterior (ANT), posteromedial (PM), and posterolateral (PL) directions, and the area under the curve (AUC) were calculated and analyzed. There were significant group by fatigue interactions for static balance variables, normalise reach distance in the PM and PL directions, and AUC. Fatigue reduced balance and ankle proprioception in individuals with CAI. After fatigue, static and dynamic balance and ankle proprioception during drop landing were significantly worse in the CAI group than in the control group. Fatigue had a significant negative effect on balance and ankle proprioception in CAI patients. Therefore, fatigue may be an important factor causing repeated ankle sprain in CAI patients.
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Affiliation(s)
- Yanan Liu
- Shandong Sport University, Jinan, China
| | | | | | - Yan Chen
- Shandong Sport University, Jinan, China
| | | | | | - Wei Sun
- Shandong Sport University, Jinan, China.
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Chen Y, Wan A, Mao M, Sun W, Song Q, Mao D. Tai Chi practice enables prefrontal cortex bilateral activation and gait performance prioritization during dual-task negotiating obstacle in older adults. Front Aging Neurosci 2022; 14:1000427. [PMID: 36466597 PMCID: PMC9716214 DOI: 10.3389/fnagi.2022.1000427] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 10/31/2022] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND With aging, the cognitive function of the prefrontal cortex (PFC) declined, postural control weakened, and fall risk increased. As a mind-body exercise, regular Tai Chi practice could improve postural control and effectively prevent falls; however, underlying brain mechanisms remained unclear, which were shed light on by analyzing the effect of Tai Chi on the PFC in older adults by means of functional near-infrared spectroscopy (fNIRS). METHODS 36 healthy older adults without Tai Chi experience were divided randomly into Tai Chi group and Control group. The experiment was conducted four times per week for 16 weeks; 27 participants remained and completed the experiment. Negotiating obstacle task (NOT) and negotiating obstacle with cognitive task (NOCT) were performed pre- and post-intervention, and Brodmann area 10 (BA10) was detected using fNIRS for hemodynamic response. A three-dimensional motion capture system measured walking speed. RESULTS After intervention in the Tai Chi group under NOCT, the HbO2 concentration change value (ΔHbO2) in BA10 was significantly greater (right BA10: p = 0.002, left BA10: p = 0.001), walking speed was significantly faster (p = 0.040), and dual-task cost was significantly lower than pre-intervention (p = 0.047). ΔHbO2 in BA10 under NOCT was negatively correlated with dual-task cost (right BA10: r = -0.443, p = 0.021, left BA10: r = -0.448, p = 0.019). There were strong negative correlations between ΔHbO2 and ΔHbR under NOCT either pre-intervention (left PFC r = -0.841, p < 0.001; right PFC r = -0.795, p < 0.001) or post-intervention (left PFC r = -0.842, p < 0.001; right PFC r = -0.744, p < 0.001). CONCLUSION Tai Chi practice might increase the cognitive resources in older adults through the PFC bilateral activation to prioritize gait performance during negotiating obstacles under a dual-task condition.
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Affiliation(s)
- Yan Chen
- College of Sport and Health, Shandong Sport University, Jinan, Shandong, China
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Aiying Wan
- College of Sport and Health, Shandong Sport University, Jinan, Shandong, China
| | - Min Mao
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Wei Sun
- College of Sport and Health, Shandong Sport University, Jinan, Shandong, China
| | - Qipeng Song
- College of Sport and Health, Shandong Sport University, Jinan, Shandong, China
| | - Dewei Mao
- College of Sport and Health, Shandong Sport University, Jinan, Shandong, China
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
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Chen J, Xue X, Xu J, Zeng J, Xu F. Emerging Trends and Hotspots in Tai Chi Fall Prevention: Analysis and Visualization. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148326. [PMID: 35886172 PMCID: PMC9320470 DOI: 10.3390/ijerph19148326] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/29/2022] [Accepted: 07/05/2022] [Indexed: 02/04/2023]
Abstract
Recently, substantial studies have increased around the topic of the tai chi fall-prevention field. Few studies, however, have revealed the current progress and hotspots under a bibliometric analysis. Therefore, the present study aimed to conduct Citespace, a significant application for bibliometric analysis, to carry out the situation and trend in this field. This study has identified the core countries are the United States, China, Australia, and England, which are also the origins of the core institutions. Besides this, we also have found two large research groups led by Li and Sherrington. Moreover, the result has revealed that J Aging Phys Act and J Am Geriatr Soc are the primary journals. Geriatrics and gerontology, sport sciences, rehabilitation, and gerontology are the leading categories. Furthermore, one of the more important findings to come out in this study are that “elderly”, “Parkinson’s disease”, “vestibular rehabilitation”, “frail patient”, and “community fall prevention” are the research hotspots. “Women”, “proprioception”, “cognitive impairment”, “dementia”, “osteoarthritis”, and “stroke” are the potential research trend in the future. These findings suggest that the tai chi fall-prevention field has a broad research prospect. Although several questions remain uncertain currently, it is worthy for scholars to do further study.
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Affiliation(s)
- Jiesi Chen
- School of Physical Education, Hangzhou Normal University, Hangzhou 311121, China; (J.C.); (X.X.); (J.Z.)
| | - Xin Xue
- School of Physical Education, Hangzhou Normal University, Hangzhou 311121, China; (J.C.); (X.X.); (J.Z.)
| | - Jing Xu
- School of Physical Education, Nanjing Xiaozhuang University, Nanjing 211171, China;
| | - Jinshu Zeng
- School of Physical Education, Hangzhou Normal University, Hangzhou 311121, China; (J.C.); (X.X.); (J.Z.)
| | - Fei Xu
- School of Physical Education, Hangzhou Normal University, Hangzhou 311121, China; (J.C.); (X.X.); (J.Z.)
- Correspondence:
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Rentz C, Far MS, Boltes M, Schnitzler A, Amunts K, Dukart J, Minnerop M. System Comparison for Gait and Balance Monitoring Used for the Evaluation of a Home-Based Training. SENSORS (BASEL, SWITZERLAND) 2022; 22:4975. [PMID: 35808470 PMCID: PMC9269735 DOI: 10.3390/s22134975] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 06/24/2022] [Accepted: 06/28/2022] [Indexed: 06/15/2023]
Abstract
There are currently no standard methods for evaluating gait and balance performance at home. Smartphones include acceleration sensors and may represent a promising and easily accessible tool for this purpose. We performed an interventional feasibility study and compared a smartphone-based approach with two standard gait analysis systems (force plate and motion capturing systems). Healthy adults (n = 25, 44.1 ± 18.4 years) completed two laboratory evaluations before and after a three-week gait and balance training at home. There was an excellent agreement between all systems for stride time and cadence during normal, tandem and backward gait, whereas correlations for gait velocity were lower. Balance variables of both standard systems were moderately intercorrelated across all stance tasks, but only few correlated with the corresponding smartphone measures. Significant differences over time were found for several force plate and mocap system-obtained gait variables of normal, backward and tandem gait. Changes in balance variables over time were more heterogeneous and not significant for any system. The smartphone seems to be a suitable method to measure cadence and stride time of different gait, but not balance, tasks in healthy adults. Additional optimizations in data evaluation and processing may further improve the agreement between the analysis systems.
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Affiliation(s)
- Clara Rentz
- Institute of Neuroscience and Medicine (INM-1), Research Centre Juelich, 52428 Juelich, Germany; (K.A.); (M.M.)
| | - Mehran Sahandi Far
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Juelich, 52428 Juelich, Germany; (M.S.F.); (J.D.)
- Institute of Systems Neuroscience, Medical Faculty, Heinrich-Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - Maik Boltes
- Institute for Advanced Simulation (IAS-7), Research Centre Juelich, 52428 Juelich, Germany;
| | - Alfons Schnitzler
- Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty, Heinrich-Heine University Duesseldorf, 40225 Duesseldorf, Germany;
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - Katrin Amunts
- Institute of Neuroscience and Medicine (INM-1), Research Centre Juelich, 52428 Juelich, Germany; (K.A.); (M.M.)
- C. and O. Vogt Institute for Brain Research, Medical Faculty, University Hospital Duesseldorf, Heinrich-Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - Juergen Dukart
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Juelich, 52428 Juelich, Germany; (M.S.F.); (J.D.)
- Institute of Systems Neuroscience, Medical Faculty, Heinrich-Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - Martina Minnerop
- Institute of Neuroscience and Medicine (INM-1), Research Centre Juelich, 52428 Juelich, Germany; (K.A.); (M.M.)
- Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty, Heinrich-Heine University Duesseldorf, 40225 Duesseldorf, Germany;
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University Duesseldorf, 40225 Duesseldorf, Germany
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A Systematic Review on Detraining Effects after Balance and Fall Prevention Interventions. J Clin Med 2021; 10:jcm10204656. [PMID: 34682776 PMCID: PMC8539369 DOI: 10.3390/jcm10204656] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 10/05/2021] [Accepted: 10/05/2021] [Indexed: 11/17/2022] Open
Abstract
Since the COVID-19 pandemic hit, lockdowns have been implemented to fight off infections in countries around the world. Whilst this measure is without a doubt effective against spreading infection, it might also decrease participation in exercise. For older adults, exercise is particularly important in the prevention of falls, and sudden detraining because of a lockdown or due to other causes might have detrimental consequences. This systematic review study aims to assess what is currently known on detraining effects for balance outcomes. Nine studies were included within this review. Results suggest that detraining effects could already be significant as early as 4 weeks after stopping the intervention. Programs that specifically focus on improving balance were more robust against detraining, with most positive effects still being present after 8 weeks. However, even with a specific focus on balance, studies started to show some signs of detraining. The current study is limited by the low number of included studies in the review, indicating a need to further confirm these results.
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Wehner C, Blank C, Arvandi M, Wehner C, Schobersberger W. Effect of Tai Chi on muscle strength, physical endurance, postural balance and flexibility: a systematic review and meta-analysis. BMJ Open Sport Exerc Med 2021; 7:e000817. [PMID: 33614126 PMCID: PMC7871341 DOI: 10.1136/bmjsem-2020-000817] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2021] [Indexed: 12/16/2022] Open
Abstract
Objective To investigate the impact of Tai Chi training on muscle strength, physical endurance, postural balance and flexibility, as measured by tests commonly used in health-related fitness or competitive sports contexts. Design Systematic review and meta-analysis. Data sources The following databases were searched up to 31 July 2020: CINAHL, Cochrane Library, MEDLINE via PubMed and SPORTDiscus. Eligibility criteria for studies Inclusion: (1) Randomised controlled trials published in German or English; (2) Tai Chi used as an intervention to improve physical performance; (3) Test methods commonly used in health-related fitness or competitive sports and (4) Participants aged ≥16 years (irrespective of health status). Exclusion: (1) Studies not focusing on Tai Chi or including Tai Chi mixed with other interventions and (2) Modified or less than eight Tai Chi movements. Results Out of 3817 records, 31 studies were included in the review, 21 of them in the meta-analysis. Significant improvements in handgrip strength (2.34 kg, 95% CI 1.53 to 3.14), walking distance during 6 min (43.37 m, 95% CI 29.12 to 57.63), standing time in single-leg-stance with open eyes (6.41 s, 95% CI 4.58 to 8.24) and thoracolumbar spine flexibility (2.33 cm, 95% CI 0.11 to 4.55) were observed. Conclusion Tai Chi training seems to moderately improve physical fitness when evaluated by tests used in health-related fitness or competitive sports. Moreover, thoracolumbar spine flexibility seems to be a factor in the improvement of postural balance. Further research is needed, including younger healthy participants performing a widely used, standardised form (eg, Peking-style routine) with high-intensity movements (eg, use of lower stances).
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Affiliation(s)
- Christian Wehner
- Institute for Sports Medicine, Alpine Medicine and Health Tourism, Private University for Health Sciences Medical Informatics and Technology, Hall, Austria
| | - Cornelia Blank
- Institute for Sports Medicine, Alpine Medicine and Health Tourism, Private University for Health Sciences Medical Informatics and Technology, Hall, Austria
| | - Marjan Arvandi
- Institute of Public Health, Medical Decision Making and HTA, Private University for Health Sciences Medical Informatics and Technology, Hall, Austria
| | - Carina Wehner
- WuYuan - School of Chinese Martial Arts, Kungfu, Taijiquan and Qigong, Munich, Germany
| | - Wolfgang Schobersberger
- Institute for Sports Medicine, Alpine Medicine and Health Tourism, Private University for Health Sciences Medical Informatics and Technology, Hall, Austria
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