Effect of stationary cycle exercise on gait and balance of elderly women

Professionals' Perspectives of Smart Stationary Bikes in Rehabilitation: Qualitative Study

Background

Stationary bikes are used in numerous rehabilitation settings, with most offering limited functionalities and types of training. Smart technologies, such as artificial intelligence and robotics, bring new possibilities to achieve rehabilitation goals. However, it is important that these technologies meet the needs of users in order to improve their adoption in current practice.

Objective

This study aimed to collect professionals' perspectives on the use of smart stationary bikes in rehabilitation.

Methods

Twelve health professionals (age: mean 43.4, SD 10.1 years) completed an online questionnaire and participated in a semistructured interview regarding their needs and expectations before and after a 30-minute session with a smart bike prototype.

Results

A content analysis was performed with inductive coding. Seven main themes emerged: (1) bike functionalities (cycling assistance, asymmetric resistance, and forward and backward cycling), (2) interface between bike and users (simple, user-friendly, personalized, with written reminders during training), (3) feedback to users (user and performance data), (4) training programs (preprogrammed and personalized, and algorithmic programs), (5) user engagement (telerehabilitation, group sessions, music, and automatic suggestion of training), (6) the bike as a physical device (dimensions, comfort, setup, screen, etc), and (7) business model (various pricing strategies, training for professionals, and after-sales service).

Conclusions

This study provides an interpretive understanding of professionals' perspectives regarding smart stationary bikes and is the first to identify the expectations of health professionals regarding the development of future bikes in rehabilitation.

Scientometric Research and Critical Analysis of Gait and Balance in Older Adults

Gait and balance have emerged as a critical area of research in health technology. Gait and balance studies have been affected by the researchers' slow follow-up of research advances due to the absence of visual inspection of the study literature across decades. This study uses advanced search methods to analyse the literature on gait and balance in older adults from 1993 to 2022 in the Web of Science (WoS) database to gain a better understanding of the current status and trends in the field for the first time. The study analysed 4484 academic publications including journal articles and conference proceedings on gait and balance in older adults. Bibliometric analysis methods were applied to examine the publication year, number of publications, discipline distribution, journal distribution, research institutions, application fields, test methods, analysis theories, and influencing factors in the field of gait and balance. The results indicate that the publication of relevant research documents has been steadily increasing from 1993 to 2022. The United States (US) exhibits the highest number of publications with 1742 articles. The keyword "elderly person" exhibits a strong citation burst strength of 18.04, indicating a significant focus on research related to the health of older adults. With a burst factor of 20.46, Harvard University has made impressive strides in the subject. The University of Pittsburgh displayed high research skills in the area of gait and balance with a burst factor of 7.7 and a publication count of 103. The research on gait and balance mainly focuses on physical performance evaluation approaches, and the primary study methods include experimental investigations, computational modelling, and observational studies. The field of gait and balance research is increasingly intertwined with computer science and artificial intelligence (AI), paving the way for intelligent monitoring of gait and balance in the elderly. Moving forward, the future of gait and balance research is anticipated to highlight the importance of multidisciplinary collaboration, intelligence-driven approaches, and advanced visualization techniques.

Interactive boxing-cycling on frailty and activity limitations in frail and prefrail older adults: A randomized controlled trial

BACKGROUND

Frailty is common among older adults, often associated with activity limitations during physical and walking tasks. The interactive boxing-cycling combination has the potential to be an innovative and efficient training method, and our hypothesis was that interactive boxing-cycling would be superior to stationary cycling in improving frailty and activity limitations in frail and prefrail older adults.

OBJECTIVE

To examine the impact of interactive boxing-cycling on frailty and activity limitations in frail and prefrail older adults compared to stationary cycling.

MATERIALS AND METHODS

A single-blinded randomized controlled trial. Forty-five participants who met at least one frailty phenotype criteria were randomly assigned to receive either interactive boxing-cycling (n = 23) or stationary-cycling (n = 22) for 36 sessions over 12 weeks. The interactive boxing-cycling was performed on a cycle boxer bike with an interactive boxing panel fixed in front of the bike. The primary outcomes were frailty status, including score and phenotypes. Secondary outcomes included activity limitations during physical and walking tasks. The pre- and post-intervention data of both groups were analyzed using a repeated measures two-way ANOVA.

RESULTS

Both types of cycling significantly improved frailty scores (p<0.001). Interactive boxing-cycling was more effective than stationary cycling in reversing the frailty phenotype of muscle weakness (p = 0.03, odds ratio 9.19) and demonstrated greater improvements than stationary cycling in arm curl (p = 0.002, η2=0.20), functional reach (p = 0.001, η2=0.22), and grip strength (p = 0.02, η2=0.12) tests. Additionally, interactive boxing-cycling exhibited a greater effect on gait speed (p = 0.02, η2=0.13) and gait variability (p = 0.01, η2=0.14) during dual-task walking.

CONCLUSION

In frail and prefrail older adults, interactive boxing-cycling effectively improves frailty but is not superior to stationary cycling. However, it is more effective at improving certain activity limitations.

REGISTRATION NUMBER

TCTR20220328001.

Effects of a high-DHA multi-nutrient supplement and exercise on mobility and cognition in older women (MOBILE): a randomised semi-blinded placebo-controlled study

There is a complex interplay between mobility and cognition in older adults. We have previously shown that a high-DHA multi-nutrient supplement improves habitual walking speed, verbal memory and psychomotor response latency in older women. Exercise also improves mobility and cognition in older adults, and n-3 fatty acids and exercise share a range of overlapping biological effects. This study examined for the first time the effects of the high-DHA multi-nutrient supplement and aerobic exercise on mobility and cognition in older women. Women (mean age 67 (sd 8) years) were assigned to the following groups: multi-nutrient (1 g DHA, 160 mg EPA, 240 mg Ginkgo biloba, 60 mg phosphatidylserine, 20 mg d-α tocopherol, 1 mg folic acid and 20 µg vitamin B12 per d, n 13), multi-nutrient and exercise (spin class twice per week, n 14), exercise and placebo (n 12) or placebo (n 12). The multi-nutrient was given for 24 weeks and exercise for 12 weeks. No treatment effects were observed for the primary outcome, habitual walking speed. Improvements in verbal memory and executive function were seen for all treatments groups v. placebo (all, P < 0·05). Significant improvements in self-reported emotional well-being were seen with multi-nutrient and exercise groups v. placebo (P = 0·03). The results suggest that the high-DHA multi-nutrient supplement produces similar improvements in cognitive function to aerobic exercise, offering the intriguing prospect that supplementation may be able to mitigate some of the effects of low physical activity on cognitive function in the elderly.

An Immersive Motor Protocol for Frailty Rehabilitation

Frailty is a pre-clinical condition that worsens physical health and quality of life. One of the most frequent symptoms of frailty is an increased risk of falling. In order to reduce this risk, we propose an innovative virtual reality motor rehabilitation program based on an immersive tool. All exercises will take place in the CAVE, a four-screen room with a stationary bike. The protocol will include two types of exercises for the improvement of balance: "Positive Bike" and "Avoid the Rocks." We will choose evaluation scales related to the functional aspects and subjective perception of balance. Our aim is to prove that our innovative motor rehabilitation protocol is as effective as or more effective than classical rehabilitation.

A Randomized Controlled Trial Investigating the Feasibility and Adherence to an Aerobic Training Program in Healthy Individuals

CONTEXT

Concussion management is moving from passive rest strategies to active interventions, including aerobic exercise therapy. Little information is available regarding the feasibility and adherence of these programs.

OBJECTIVES

To determine whether an aerobic exercise training program intended for rehabilitation in people with concussion is feasible. Healthy, nonconcussed subjects were studied in this phase 1 trial.

DESIGN

Phase 1 parallel-group, randomized controlled trial in a sample of healthy (nonconcussed), recreationally active university students.

SETTING

Laboratory.

PATIENTS

40 healthy university students.

METHODS

Participants were equally randomized to acute concussion therapy intervention (ACTIVE) training or nontraining groups. All participants completed maximal cardiopulmonary exercise tests on a stationary cycle ergometer at 2 test sessions approximately 14 days apart. During this 2-week study period, ACTIVE training participants completed six 30-minute cycling sessions, progressing from 60% to 80% of the participant's individualized maximal oxygen consumption. A subset of participants (NACTIVE = 12, Nnontraining = 11) wore physical activity monitors throughout the 2-week study period.

MAIN OUTCOMES MEASURES

Study protocol and randomization effectiveness, exercise safety and adherence, and progressive intensity of the ACTIVE training procedures.

RESULTS

No adverse events occurred during any exercise sessions. Twelve ACTIVE training participants (60%) completed all training sessions, and every participant completed at least 4 sessions. Heart rate increased throughout the training period (P < .001), but symptom changes and training adherence remained stable despite the progressively increasing workload. ACTIVE training participants completed approximately 30 additional minutes of physical activity on training sessions days, although that was not statistically significant (P = .20).

CONCLUSIONS

University-aged students were adherent to the ACTIVE training protocol. Future research should investigate the safety and feasibility of aerobic training programs in acutely concussed individuals to determine their appropriateness as a clinical rehabilitation strategy.

Characteristics, Usability, and Users Experience of a System Combining Cognitive and Physical Therapy in a Virtual Environment: Positive Bike

We present the architecture and usability evaluation of virtual reality system-"Positive Bike"-designed for improving cognitive and motor conditions in frail elderly patients. The system consists of a cycle-ergometer integrated in an immersive virtual reality system (CAVE) which allows combining motor and cognitive exercises according to a "dual-task" paradigm. We tested the usability and user's experience of the prototype in a pilot evaluation study that involved five elderly patients. The prototype was tested in one-session training to understand the limitations and areas for improvement of our system. The evaluation consisted in (i) usability assessment using the system usability scale; (ii) evaluation of user's engagement using the flow state scale; and (iii) expert evaluation involving interviews with domain experts. Results showed a good usability, both for system usability scale and the semi-structured interview. The level of flow (i.e., enjoyment with the task at hand) measured using the short flow state scale, was also high. Analysis of semi-structured interview carried out with domain experts provided further indications to improve the system. Overall, these findings show that, despite some limitations, the system is usable and provides an enjoyable user's experience.

Geriatric Cyclists: Assessing Risks, Safety, and Benefits

Nearly 1 in every 3 Americans ride bicycles each year, but only 20% of the reported 100 million cyclists ride on a weekly basis. Bicycling is a common form of transportation and recreation and has gained popularity among the elderly patients. In recent years, the number of elderly cyclists has increased steadily and studies have cited ease of use, need for exercise, and enjoyment as important contributing factors. The benefits of physical activity on health is well-documented, and elderly individuals are encouraged to remain active to reduce the progression of age-related weakness and loss of muscle mass. Safety concerns, however, have been a prevalent public health issue. According to the Center for Disease Control and Prevention, elderly and teenage cyclists account for the highest number of head injuries and fatalities among all cyclists. Safety measures that include wearing protective gear such as helmets and choosing the appropriate bicycle have been recommended to minimize the risk of sustaining injuries while riding. Despite these concerns, bicycling has remained a popular and exciting activity for the elderly patients.

Intervention for the maintenance and improvement of physical function and quality of life among elderly disaster victims of the Great East Japan Earthquake and Tsunami

PURPOSE

The purpose of this study was to examine the effectiveness of an exercise class implemented in an area affected by the Great East Japan Earthquake and Tsunami for maintaining and improving physical function and quality of life (QOL) among elderly victims.

METHODS

Participants were 45 elderly disaster victims. To measure the effectiveness of the exercise classes, results on the Functional Reach Test (FRT), Timed Up and Go Test (TUG), One-leg Standing Balance (OSB), and Chair Stand Test (CST) were measured at the beginning of the exercise classes, and after 3 and 6months. In order to assess health-related QOL, the 8-item Short-Form Health Survey (SF-8) was carried out at the beginning of the exercise classes, and after 1, 3, and 6months.

RESULTS

Of the 45 people who consented to participate, 27 continued the program for 6months and were used for analysis. Analysis of the results for FRT, OSB, and CST showed significant improvements (respectively, p=.000, .007, and .000). SF-8 showed significant increases for the subscales of bodily pain (p=.004), general health perception (p=.001), and mental health (p=.035).

CONCLUSIONS

By continuing an exercise program for 6months, improvements were seen in lower limb muscle strength and balance functions. Effectiveness for HRQOL was also observed.

Assessment of physical health status and quality of life among Saudi older adults

[Purpose] This study investigated physical health status and quality of life among older Saudi adults. [Subjects and Methods] Participants included older adults (N = 55) aged 60-90 years (mean = 67.9± 7.71) from a major hospital in Jeddah. Subjects completed surveys and evaluations including assessments of personal and socio-demographic characteristics, caregiver presence, personal habits, perceived health, primary physical and psychological complaints, physician-diagnosed chronic diseases, and functional capacity (i.e., activities of daily living). [Results] Results showed a significant positive correlation between age and ADL; age and memory problems, anxiety, and loneliness; and sleep disturbance and falls. Main factors contributing to quality of life decline were chronic disease, falls, sedentary lifestyle, sleep disturbances, and financial concerns. Participants with diabetes mellitus (58.18%) and hypertension (29.0%) had a very high fall rate. Participants engaged in minimal physical activity (63%), often due to bone and joint pain (90.0%), and led sedentary lives (69%). Single sensory impairments were significantly and independently linked to high depression risk and decreased self-sufficiency. [Conclusion] Healthy lifestyle and behavioral changes should be promoted through community-based health education programs for older Saudi adults. Chronic disease screening programs for the elderly population (especially diabetes and hypertension) are recommended.

The effects of isometric trunk exercises and dynamic trunk exercises on gait in elderly people

The purpose of this study was to compare the effects of dynamic trunk exercises and isometric trunk exercises on gait in elderly people. [Subjects] This study randomly allocated 20 elderly people to an isometric trunk exercise group (n=10) and a dynamic trunk exercise group (n=10). The exercises were performed for 30 minutes three times a week for 12 weeks. Gait speed, stride length, cadence, and step width were measured at a normal pace using GAITRite. All groups were evaluated before and after 12 weeks. [Results] The isometric exercise group showed a significant change in gait velocity, cadence, and left and right step lengths. The dynamic trunk exercise group showed a significant change in gait velocity, cadence, left and right step lengths, left and right step times, and left and right stride lengths. Moreover, a comparison of the exercise effect between the two groups showed a significant difference in gait velocity. [Conclusion] The results of this study suggest that isometric trunk exercises and dynamic trunk exercises have a positive effect on gait function in elderly people. In particular, isometric trunk exercises are recommended to promote gait velocity.

Leg muscle activation and distance setting of the leg cycle ergometer for use by the elderly

[Purpose] This study verified the leg muscle activities of elderly subjects performing leg cycle ergometer exercise. [Subjects] Forty-one elderly persons were the subjects of this study. [Methods] For the three distances corresponding to knee flexion angles of 15, 45, and 70, the muscle activities of the rectus femoris, biceps femoris, tibialis anterior and lateral gastrocnemius were measured while the subjects exercised on a cycle ergometer. [Results] The rectus femoris and biceps femoris showed statistically significant increases as the distance between the cycle ergometer and the body increased, and the lateral gastrocnemius muscle activation showed a statistically significant increase as the distance from the body to the cycle ergometer decreased. [Conclusion] When the elderly have limb muscle weakness, leg cycle ergometer distances should be adjusted.