Tae Kwon Do: an effective exercise for improving balance and walking ability in older adults

Using Martial Arts Training as Exercise Therapy Can Benefit All Ages

Martial arts training focuses on whole-body movement patterning, philosophy, interpersonal interactions, and functional self-defense. Such training has positive impacts on physical, psychological, and cognitive well-being in older adults and children with and without clinical conditions. We hypothesize that martial arts training can be delivered as a form of exercise therapy for people at all ages to enhance overall health.

Taekwondo Poomsae practise in slow motion and the balance of healthy older adults: A Pre-Experimental Study

BACKGROUND AND PURPOSE

Poor balance confidence and functional balance can lead to falls in community-dwelling older adults. Exercises utilising slow movements have been shown to improve balance in this population. It is hypothesised that by superimposing the use of slow movements onto Taekwondo Poomsae, there could be similar benefits in improving balance confidence and functional balance in older adults.

METHODS

This was a pre - experimental study. Fifteen community-dwelling older adults received 11 weeks of Slow Poomsae (SP) training using a proposed 50-min protocol. Pre- and post-intervention scores of the Activities-Specific Balance Confidence Simplified Scale (ABC-S), Berg Balance Scale (BBS), Dynamic Gait Index (DGI), and 'Timed Up and Go' test (TUG) assessments were recorded and compared.

RESULTS

Fifteen eligible participants with mean and standard deviation (SD) of age 73.8 (6.05) years completed the study. Significant improvements (p < 0.05) were seen in the pre-post differences between ABC-S, BBS, DGI, and TUG, with median score changes of 15 points (Z = -3.408), 3 points (Z = -3.306), 3 points (Z = -2.852), and 3.5 s (Z = -3.296) respectively.

CONCLUSION

The preliminary findings support the efficacy of SP as a potential balance training programme that is safe for healthy older adults to improve their balance confidence and functional balance. More research is required on this topic that leans towards a large population blinded randomised controlled trial with a longer intervention period and inclusion of a follow-up to further elucidate the effects of long-term practice and novelty of SP.

A qualitative investigation of health benefits through a modified Taekwondo activity among nursing home residents

BACKGROUND

A few studies suggest that Taekwondo is an effective intervention in increasing physical functions among older adults. This study is intended to focus on a multitude of health benefits of participation in a modified Taekwondo activity for nursing home residents in the U.S.

METHODS

This qualitative study used semi-structured, in-depth interviews with seven participants consisting of 2 males and 5 females older adults from a community nursing home. The interview protocol included content mapping and content mining interview questions. The study followed the five steps of constant comparative analysis.

RESULTS

Four main themes were identified as health benefits resulting from a modified Taekwondo participation: (a) promoting mental health, (b) increasing physical functions, (c) stimulating cognitive abilities, and (d) facilitating positive social interaction.

DISCUSSION

This study indicates modified Taekwondo can be instrumental in promoting their physical functioning, cognitive functioning, social interactions, and mental health. Practical implications and further discussion are addressed in this paper.

Effectiveness of Adapted Taekwondo, Multi-Component Training and Walking Exercise on Health Status in Independent Older Women: Study Protocol for a Randomized Controlled Trial (TKD & Aging Project)

This study protocol aims to analyze and compare the effects of an adapted taekwondo program with respect to multi-component training and walking exercise on health status in independent older women. Secondarily, we analyze the variability of the inter-individual response and compare it according to the designated training system. The sample will consist of 64 women between 60 and 65 years, randomly assigned to experimental group 1 (n = 16; adapted taekwondo), experimental group 2 (n = 16; multi-component training), experimental group 3 (n = 16, walking exercise) or control group (n = 16; no intervention). The experimental groups will perform the designated training for three sessions (60 min per session) per week over 16-weeks, while the control group will not receive any treatment. The main outcome will provide information about (i) blood pressure, (ii) lipid profile, (iii) frequency of food consumption, (iv) body composition, (v) cognitive status, (vi) brain activity, (vii) health-related quality of life (HRQoL) and (viii) physical-functional fitness. Our hypothesis indicates that adapted taekwondo produces more significant effects and greater inter-individual responses in cognitive status, brain activity, HRQoL, and postural balance than the others training methods. If this intervention proves effective, it could be an alternative for older women.

Five weeks of Yuishinkai karate training improves balance and neuromuscular function in older adults: a preliminary study

Background

Martial arts training has shown positive impacts on balance and physiological measurements. Further investigation of the contents and feasibility of an effective therapeutic assessment of martial arts is needed in older adults, mainly for future applications and real-world implementation.

Methods

Sixteen older adults (8 male, 8 female, age 59–90 years), with or without chronic conditions, participated in a preliminary study using 5-weeks of karate training and a triple baseline control procedure. Group and single subject data analyses were conducted for dynamic balance, Timed Up and Go (TUG), hand grip, ankle plantarflexion force, and spinal cord excitability (via the soleus H-reflex) pre- and post-training.

Results

On average, participants completed a total of 2437 steps, 1762 turns, 3585 stance changes, 2047 punches, 2757 blocks, and 1253 strikes. Karate training improved dynamic balance performance such that the group average time was reduced (time to target (−13.6%, p = 0.020) and time to center (−8.3%, p = 0.010)). TUG was unchanged when considering the entire group (p = 0.779), but six participants displayed significant changes. Left handgrip (7.9%, p = 0.037), and plantarflexion force in the right (28.8%, p = 0.045) and left leg (13.3%, p = 0.024) increased for the group. Spinal cord excitability remained unchanged in group data analysis but 5 individuals had modulated H_max/M_max ratios.

Conclusion

5-weeks of karate training delivered in a fashion to mimic generally accessible community-level programs improved balance and strength in older adults. Whole-body movement embodied in karate training enhanced neuromuscular function and postural control. We met the overriding goal of this preliminary study to emphasize and assess feasibility and safety for the generalizability of martial arts interventions to real-world communities to impact health outcomes. Further quantitative work should explore threshold dose and development of martial arts training interventions as potential “exercise is medicine” functional fitness for older adults.

Effectiveness of Olympic Combat Sports on Balance, Fall Risk or Falls in Older Adults: A Systematic Review

Simple Summary

The regular practice of physical activity has achieved greater diffusion in recent years as a strategy for fall prevention and improving or maintaining the general health status of older adults, which contributes to an active and healthy lifestyle. The strategies to promote active and healthy aging need to be reassessed due to the COVID-19 pandemic to promote the safe practice of physical activity among older adults, considering, among other measures, practicing social distancing or training at home. Such a scenario could provide the opportunity to promote physical activity that requires a limited number of participants in reduced spaces for its practice, such as Olympic combat sports. In this review, an overview of the effects of Olympic combat sports on balance, fall risk, or falls in older adults is presented. From 1496 records, eight studies were included, involving 322 older adults (64% female; mean age = 71.1 years). The available evidence does not allow a definitive recommendation for or against Olympic combat sports interventions as an effective strategy to improve balance and reduce the fall risk or falls in older adults. Therefore, more high-quality studies are required to draw definitive conclusions.

Abstract

This systematic review and meta-analysis aimed to assess the available body of published peer-reviewed articles related to the effects of Olympic combat sports (OCS), compared with active/passive controls, on balance, fall risk, or falls in older adults. The TESTEX and GRADE scales assessed the methodological quality and certainty of the evidence. The protocol was registered in PROSPERO (code: CRD42020204034). From 1496 records, eight studies were included, involving 322 older adults (64% female; mean age = 71.1 years). The TESTEX scale revealed all studies with a score ≥ 60% (moderate-high quality). The GRADE scale indicated all studies with at least some concerns, up to a high risk of bias (i.e., was rated very low). Meta-analyses were planned, although the reduced number of studies precluded its incorporation in the final manuscript. Only two from six studies that assessed balance found improvements after OCS compared to controls. No differences were found between OCS vs. control groups for fall risk or falls. The available evidence does not allow a definitive recommendation for or against OCS interventions as an effective strategy to improve balance and reduce the fall risk or falls in older adults. Therefore, more high-quality studies are required to draw definitive conclusions.

Effects of a 4-month judo program on gait performance in older adults

BACKGROUND

Falls prevention is a critical goal of training program for older individuals. This study explored the effects of a judo program on gait performance in older adults.

METHODS

Pre- and post-intervention (15 weeks, 1-hr session, twice a week) step length (cm), gait cycle time (s), speed (m·s-1) and cadence (step·min-1) mean values (AVG) and coefficients of variation (CV) were assessed in a judo (JG: N.=16 novice judoka; age=69.3±3.9 years) and a control (CG: N.=14 healthy older adults; age=70.1±4.5 years) group. Two 3 (motor complexity: flat, corridor, hurdling) ×2 (group: JG, CG) ×2 (time: pre, post) MANOVAs with repeated measures were applied to ascertain differences in gait parameters.

RESULTS

A significant Time×Motor Complexity×Group interaction was found for AVG and CV. For AVG, JG showed improvements for flat and hurdling conditions in step length (flat: ∆=+2.6%, d=0.4; hurdling: ∆=+3.2%, d=0.4), gait cycle (flat: ∆=-4.3%, d=0.4; hurdling: ∆=-4.0%, d=0.5), speed (flat: ∆=+6.6%, d=0.7; hurdling: ∆=+6.7%, d=0.6) and cadence (flat: ∆=4.3%, d=0.4; hurdling: ∆=3.9%, d=0.5). For CV, JG improved step length for flat (∆=-20.9%, d=0.6) and hurdling (∆=-16.3%, d=0.8) conditions, whereas CG showed a deterioration in the step length for the corridor condition (∆=+22.3%, d=0.7).

CONCLUSIONS

The findings demonstrated the effectiveness of an adapted judo program for improving gait performance in older individuals, suggesting a potential protective effect for fall risk.

Taekwondo Enhances Cognitive Function as a Result of Increased Neurotrophic Growth Factors in Elderly Women

The purpose of this study was to investigate the effects of regular taekwondo (TKD) training on physical fitness, neurotrophic growth factors, cerebral blood flow (CBF) velocity, and cognitive function in elderly women. Thirty-seven women aged 65 or older were randomly assigned to either TKD (n = 19) or control (n = 18) group. TKD training was performed at 50⁻80% maximum heart rate (HRmax) for 60 min, five times per week for 16 weeks. All participants underwent the following examinations before and after the intervention: Senior Fitness Test; serum levels of neurotrophic growth factors, including brain-derived neurotrophic factor (BDNF), vascular endothelial growth factor (VEGF), and insulin-like growth factor-1 (IGF-1); systolic, diastolic, and mean blood flow velocity and pulsatility index of the middle cerebral artery using Doppler ultrasonography; Mini-Mental State Examination for dementia screening (MMSE-DS); and Stroop Color and Word Test (word, color, and color-word). In the TKD group, lower body strength and flexibility, aerobic endurance levels, BDNF, VEGF, and IGF-1 serum levels as well as the color-word test scores were significantly increased after as compared to before the intervention (p < 0.05). No statistically significant differences were found in cerebral blood flow velocities and the MMSE-DS score (p > 0.05). These findings suggest that regular TKD training may be effective in improving not only fitness but also cognitive function in elderly women. The latter effect may be due to increased neurotrophic growth factor levels.

Health benefits of hard martial arts in adults: a systematic review

Participation in organized sports is promoted as a means of increasing physical activity levels and reducing chronic disease risk in adults. Hard martial arts practice (i.e. using body contact techniques), has gained in popularity over time. This review explores the evidence for health benefits of "hard" martial arts practice within the adult population. A systematic electronic database search was conducted, and quality assessments applied the Effective Public Health Practice Project tool. Twenty-eight studies met the inclusion criteria, examining balance, cognitive function, muscular skeletal status, psychological, cardiovascular fitness, and metabolic effects. The majority of studies reported positive effects resulting from hard martial arts practice, showing some improvement and maintenance of balance, cognitive function and psychological health. Benefits may be obtained regardless of the age of practice commencement. However, quality of the evidence is affected by methodological weaknesses across the studies. "Hard" martial arts seem to have potential to improve balance and cognitive functions that decline with age, which can lead to poorer health outcomes among the elderly (e.g. cognitive decline, falls and fractures). Benefits should be further investigated with improved intervention studies, representative samples and longer follow-up periods in order to establish associations with morbidity and mortality in the long term.

Changes in dual-task performance after 5 months of karate and fitness training for older adults to enhance fall prevention

BACKGROUND

Demographic changes resulting in an aging population are major factors for an increase of fall-related injuries. Especially in situations where dual tasks such as walking whilst talking have to be performed simultaneously the risk of a fall-related injury increases. It is well known that some types of martial art (e.g. Tai Chi) can reduce the risk of a fall. It is unknown if the same is true for karate.

AIM AND METHODS

In this randomized, controlled study 68 people with a mean age of 69 years underwent 5-month karate training, 5-month fitness training or were part of a control group. Before and after the time of intervention a gait analysis with normal walk, a cognitive dual task and a motor dual task were performed. The gait parameter step frequency, walking speed, single-step time and single-step length were investigated.

RESULTS

It could be seen that all groups improved their gait parameters after a 5-month period, even the control group. A sporty intervention seems to affect mainly the temporal gait parameters positively. This effect was especially demonstrated for normal walk and cognitive dual task.

CONCLUSIONS

An improvement of the human walk seems to be possible through karate and fitness training, even under dual-task conditions. A prolonged intervention time with multiple repetitions of gait analysis could give better evidence if karate is a useful tool to increase fall prevention.

Effects of Taekwondo intervention on balance in children with autism spectrum disorder

The purpose of this study was to investigate the effects of an 8-week Taekwondo (TKD) intervention on balance in children with autism spec-trum disorder (ASD). A total of 14 children with ASD participated in this study. Eight children (eight males; mean age, 10.25±2.38 yr) completed TKD intervention (50 min/2 times/8 week), and six children received no intervention serving as controls (five males, one female; mean age, 10.00±2.83 yr). A computed posturography system with a long forceplate (NeuroCom Balance Master) was used to evaluate static (double and single leg stance with various test conditions) and functional balance (step-quick-turn). Balance was measured before and after the intervention. A mixed-model analysis of variance showed a significant group by time interaction in single leg stance balance. After the intervention, the TKD group displayed a greater improvement in single leg stance balance with eyes closed condition than the control group (P=0.046). Within-group analysis showed that the TKD group significantly improved single leg stance balance with eyes open condition (P=0.014). In addition, TKD group displayed trends of improvements in double leg stance balance with unstable surface under eyes closed condition (ES=0.83) and step-quick-turn (Cohen d [ES]=0.70). The control group did not show any significant changes in balance outcomes. In conclusion, TKD training can help children with ASD improve their balance. Children with ASD also showed a high rate of adherence (92%) to the TKD training. Our findings suggest that TKD can be a fun, feasible, and effective therapeutic option for balance improvement of children with ASD.

Pre-pubertal males practising Taekwondo exhibit favourable postural and neuromuscular performance

Background

The postural and neuromuscular performances in healthy children taekwondo (TKD) practitioners in comparison with control children were examined.

Methods

Seventeen healthy pre-pubertal males undertaking only physical education at school (age: 11.88 ± 0.33 years) and 12 pre-pubertal male TKD practitioners (>3 years, 4 sessions a week) (age 11.66 ± 0.49 years) were recruited. Performances in the dynamic postural control (Star Excursion Balance Test -SEBT), vertical jump [squat jump (SJ) and countermovement jump (CMJ)] and sprint running (distances: 5, 10, 20 and 30 m) tests were compared between the two groups.

Results

The performances of the TKD practitioners were better than those of the non-TKD active for the SEBT (for 14 of 16 conditions, p < 0.05), SJ (p < 0.01), CMJ (p < 0.03) sprint running (5 m, p < 0.01; 10 m, p < 0.04; the performances for the 20 and 30 m sprints were not significant, p > 0.05).

Conclusions

TKD practice would stimulate sensory input and motor output of the postural system that would enhance its efficiency. In addition, the dynamic nature of TKD would develop the muscle power of the lower limbs. In our sample of healthy pre-pubertal males, TKD appears to improve postural and neuromuscular functions, but further research is required.

Electronic supplementary material

The online version of this article (doi:10.1186/s13102-016-0040-2) contains supplementary material, which is available to authorized users.

The effect of 12-week Pilates exercises on wellness in the elderly

The purpose of this study is to examine the efficiency of 12-week Pilates exercises on wellness in the elderly. Before Pilates exercises training, the 88 elderly (63 females, 25 males) were given and completed a Wellness Scale. Then, the elderly participated in Pilates exercises and completed the same scale afterwards. Results of paired t-test showed that participants in 12-week Pilates exercises experienced significant improvement in physical (t=2.762, P<0.01), social (t=3.362, P<0.001), spiritual (t=2.307, P<0.05), and emotional wellness (t=2.489, P<0.05). Consequently, Pilates exercises helped improve wellness of the elderly.

The Effects of Taekwondo Training on Brain Connectivity and Body Intelligence

OBJECTIVE

Many studies have reported that Taekwondo training could improve body perception, control and brain activity, as assessed with an electroencephalogram. This study aimed to assess body intelligence and brain connectivity in children with Taekwondo training as compared to children without Taekwondo training.

METHODS

Fifteen children with Taekwondo training (TKD) and 13 age- and sex-matched children who had no previous experience of Taekwondo training (controls) were recruited. Body intelligence, clinical characteristics and brain connectivity in all children were assessed with the Body Intelligence Scale (BIS), self-report, and resting state functional magnetic resonance imaging.

RESULTS

The mean BIS score in the TKD group was higher than that in the control group. The TKD group showed increased low-frequency fluctuations in the right frontal precentral gyrus and the right parietal precuneus, compared to the control group. The TKD group showed positive cerebellum vermis (lobe VII) seed to the right frontal, left frontal, and left parietal lobe. The control group showed positive cerebellum seed to the left frontal, parietal, and occipital cortex. Relative to the control group, the TKD group showed increased functional connectivity from cerebellum seed to the right inferior frontal gyrus.

CONCLUSION

To the best of our knowledge, this is the first study to assess the effect of Taekwondo training on brain connectivity in children. Taekwondo training improved body intelligence and brain connectivity from the cerebellum to the parietal and frontal cortex.

RAD. Comparison of postural balance between professional tae kwon do athletes and young adults

This study aimed to compare the postural balance of professional tae kwon do athletes with a non-tae kwon do adult group. Nineteen participants (nine tae kwon do practitioners and ten non-tae kwon do practitioners) were tested. To measure the postural sway, a force platform was used and the equipment recorded the main parameters: area of center of pressure; mean frequency, and velocity of center of pressure for both anteroposterior and mediolateral directions were measured for all participants. Before starting the assessment, the subjects received instructions and performed familiarization with the equipment and protocol. Participants were instructed to carry out three balance tests on a single-leg stance position with eyes opened. Values obtained in the postural assessment of professional athletes with the force platform were lower for all parameters compared to non-practitioners, except the frequency of center of pressure in the mediolateral direction. However, a significant difference (p=0.021) between the groups was found only in the center of pressure velocity parameter in the anteroposterior direction. These results have any implications on sport rehabilitation programs for balance assessments in athletes.

Taekwondo training improves balance in volunteers over 40

Balance deteriorates with age, and may eventually lead to falling accidents which may threaten independent living. As Taekwondo contains various highly dynamic movement patterns, Taekwondo practice may sustain or improve balance. Therefore, in 24 middle-aged healthy volunteers (40–71 year) we investigated effects of age-adapted Taekwondo training of 1 h a week during 1 year on various balance parameters, such as: motor orientation ability (primary outcome measure), postural and static balance test, single leg stance, one leg hop test, and a questionnaire. Motor orientation ability significantly increased in favor of the antero-posterior direction with a difference of 0.62° toward anterior compared to pre-training measurement, when participants corrected the tilted platform rather toward the posterior direction; female gender being an independent outcome predictor. On postural balance measurements sway path improved in all 19 participants, with a median of 9.3 mm/s (range 0.71–45.86), and sway area in 15 participants with 4.2 mm²/s (range 17.39–1.22). Static balance improved with an average of 5.34 s for the right leg, and with almost 4 s for the left. Median single leg stance duration increased in 17 participants with 5 s (range 1–16), and in 13 participants with 8 s (range 1–18). The average one leg hop test distance increased (not statistically significant) with 9.5 cm. The questionnaire reported a better “ability to maintain balance” in 16. In conclusion, our data suggest that age-adapted Taekwondo training improves various aspects of balance control in healthy people over the age of 40.

The dose-response relationship of balance training in physically active older adults

A 6-wk group balance-training program was conducted with physically active older adults (based on American College of Sports Medicine requirements) to investigate the effect of dose-related static and dynamic balance-specific training. All participants, age 60-87 yr, continued their regular exercise program while adding balance training in 1 of 3 doses: three 20-min sessions/wk (n = 20), one 20-min session/wk (n = 21), or no balance training (n = 19). Static balance (single-leg-stance, tandem), dynamic balance (alternate stepping, limits of stability), and balance confidence (ABC) were assessed pre- and posttraining. Significant interactions were observed for time in single-leg stance, excursion in limits of stability, and balance confidence, with the greatest increase observed in the group that completed 3 training sessions/wk. The results demonstrate a dose-response relationship indicating that those who are already physically active can improve balance performance with the addition of balance-specific training.

Backward walking training improves balance in school-aged boys

Background

Falls remain a major cause of childhood morbidity and mortality. It is suggested that backward walking (BW) may offer some benefits especially in balance and motor control ability beyond those experienced through forward walking (FW), and may be a potential intervention for prevention of falls. The objective of this study was to investigate the effects of BW on balance in boys.

Methods

Sixteen healthy boys (age: 7.19 ± 0.40 y) were randomly assigned to either an experimental or a control group. The experimental group participated in a BW training program (12-week, 2 times weekly, and 25-min each time) but not the control group. Both groups had five dynamic balance assessments with a Biodex Stability System (anterior/posterior, medial/lateral, and overall balance index) before, during and after the training (week- 0, 4, 8, 12, 24). Six control and six experimental boys participated in a study comparing kinematics of lower limbs between FW and BW after the training (week-12).

Results

The balance of experimental group was better than that of control group after 8 weeks of training (P < 0.01), and was still better than that of control group (P < 0.05), when the BW training program had finished for 12 weeks. The kinematic analysis indicated that there was no difference between control and experimental groups in the kinematics of both FW and BW gaits after the BW training (P > 0.05). Compared to FW, the duration of stance phase of BW tended to be longer, while the swing phase, stride length, walking speed, and moving ranges of the thigh, calf and foot of BW decreased (P < 0.01).

Conclusion

Backward walking training in school-aged boys can improve balance.

Taekwondo training speeds up the development of balance and sensory functions in young adolescents

OBJECTIVES

This study aimed (1) to identify the developmental status of balance and sensory functions in young adolescents as compared to adults and, (2) to explore the effect of Taekwondo (TKD) training on the development of balance and sensory systems in young adolescents.

DESIGN

Cross-sectional controlled trial.

METHODS

Sixty-six participants including 42 adolescents (21 TKD practitioners, 21 non-TKD practitioners) and 24 adults were tested. The sway velocity of centre of gravity was recorded during standing on the non-dominant leg on a Smart Equitest ® system. The somatosensory, vestibular and visual ratios were also measured with the machine.

RESULTS

Adult participants swayed slower than both TKD and non-TKD adolescent groups during single leg stance with eyes open (p=0.007 and p<0.001, respectively). The TKD adolescent group, in turn, swayed slower than the non-TKD adolescent group (p<0.001). Adult participants had better visual ratio than both TKD and non-TKD adolescents (p=0.001 and p<0.001, respectively) while there was no difference between the TKD and non-TKD adolescents (p=0.164). For the vestibular ratio, there was no significant difference between adult participants and TKD adolescents (p=0.432). Adolescents who did not practice TKD showed significantly lower vestibular ratio than TKD adolescents and adults (p=0.003 and p<0.001, respectively). In addition, there was no significant difference in the somatosensory ratio among the 3 participant groups (p=0.711).

CONCLUSIONS

Participation in TKD appears to speed up the development of postural control and vestibular function in adolescents. Clinicians might advocate TKD exercise as a therapeutic intervention for young people with balance or vestibular dysfunctions.

Low-level Taekwondo practitioners have better somatosensory organisation in standing balance than sedentary people

Sports training, especially for those requiring fast and skilled movements have been reported to improve one's postural control, but the underlying sensory integration mechanism is unknown. The purpose is to explore the sensory organisation strategies for maintaining standing balance in Taekwondo practitioners, and to examine the quasi-static and dynamic balance performance in subjects with and without TKD training. Case-control study was used as a study design. Eleven subjects with low level of Taekwondo training for 1-3 years, and eleven sedentary healthy subjects were assessed with the sensory organisation tests (SOT) under six visual and somatosensory input conditions and their balance upon landing from self- or operator-triggered drop test with the eyes closed condition. The SOT measured the equilibrium scores, whereas the drop test assessed the time to stabilisation (TTS), normalised peak force and distance of antero-posterior and medial-lateral centre of pressure on landing. Results for the SOT test revealed that Taekwondo subjects performed better during stance with eyes closed on a fixed support than the untrained group (p = 0.011). For the drop tests, the untrained group was slower in postural correction as revealed by the longer TTS than the Taekwondo group after the operator-triggered drops (p = 0.018). All subjects had a larger normalised peak force in operator-triggered than self-triggered drops. In conclusion, we observed that people with low-level Taekwondo training have better balance performance than untrained subjects as shown in the SOT results and shorter TTS with the drop test. They may rely more on the somatosensory and vestibular inputs for maintaining balance. People with balance problems may benefit from Taekwondo training.

Threshold Berg balance scale scores for gait-aid use in elderly subjects: a secondary analysis

PURPOSE

To determine the threshold Berg Balance Scale (BBS) scores that discriminate among levels of gait-aid use in elderly subjects.

METHODS

A secondary analysis of data combined from two projects was performed. Both projects determined BBS performance, self-selected gait speed, and gait-aid use in samples of community-dwelling, independently ambulant individuals older than 65 years of age. Receiver operating characteristic curves were used to identify BBS scores that optimized identification of individuals with different levels of ambulation.

RESULTS

Previously determined associations between BBS score and various indicators of ambulatory ability were reproduced with the combined data set. Threshold BBS scores were identified for ability to walk without an aid (≥49/56) and ability to walk without a four-wheeled walker (≥43/56). The percent agreement values for the identified threshold scores ranged from 51% to 87%.

CONCLUSIONS

Although some threshold BBS scores could be determined, the accuracies of the scores render them of limited use for guiding gait-aid prescription in individual clients.

Physical Benefits of Dancing for Healthy Older Adults: A Review

Dancing is a mode of physical activity that may allow older adults to improve their physical function, health, and well-being. However, no reviews on the physical benefits of dancing for healthy older adults have been published in the scientific literature. Using relevant databases and keywords, 15 training and 3 cross-sectional studies that met the inclusion criteria were reviewed. Grade B–level evidence indicated that older adults can significantly improve their aerobic power, lower body muscle endurance, strength and flexibility, balance, agility, and gait through dancing. Grade C evidence suggested that dancing might improve older adults’ lower body bone-mineral content and muscle power, as well as reduce the prevalence of falls and cardiovascular health risks. Further research is, however, needed to determine the efficacy of different forms of dance, the relative effectiveness of these forms of dance compared with other exercise modes, and how best to engage older adults in dance participation.

Use of the Short Physical Performance Battery Score to predict loss of ability to walk 400 meters: analysis from the InCHIANTI study

BACKGROUND

Early detection of mobility limitations remains an important goal for preventing mobility disability. The purpose of this study was to examine the association between the Short Physical Performance Battery (SPPB) and the loss of ability to walk 400 m, an objectively assessed mobility outcome increasingly used in clinical trials.

METHODS

The study sample consisted of 542 adults from the InCHIANTI study aged 65 and older, who completed the 400 m walk at baseline and had evaluations on the SPPB and 400 m walk at baseline and 3-year follow-up. Multiple logistic regression models were used to determine whether SPPB scores predict the loss of ability to walk 400 m at follow-up among persons able to walk 400 m at baseline.

RESULTS

The 3-year incidence of failing the 400 m walk was 15.5%. After adjusting for age, sex, education, body mass index, Mini-Mental State Examination, number of medical conditions, and 400 m walk gait speed at baseline, SPPB score was significantly associated with loss of ability to walk 400 m after 3 years. Participants with SPPB scores of 10 or lower at baseline had significantly higher odds of mobility disability at follow-up (odds ratio [OR] = 3.38, 95% confidence interval [CI]: 1.32-8.65) compared with those who scored 12, with a graded response across the range of SPPB scores (OR = 26.93, 95% CI: 7.51-96.50; OR = 7.67, 95% CI: 2.26-26.04; OR = 8.28, 95% CI: 3.32-20.67 for SPPB < or = 7, SPPB 8, and SPPB 9, respectively).

CONCLUSIONS

The SPPB strongly predicts loss of ability to walk 400 m. Thus, using the SPPB to identify older persons at high risk of lower body functional limitations seems a valid means of recognizing individuals who would benefit most from preventive interventions.