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Carpenter DJ, Peluso C, Hilton C, Velasquez F, Annichine A, Matsko K, Rosenberg J, Diaz AK, Hyde P, Beriwal S, Champ CE. EXERT-BC: A pilot study of an exercise regimen designed to improve functional mobility, body composition, and strength after the treatment for breast cancer. Cancer Med 2024; 13:e7001. [PMID: 38491821 PMCID: PMC10943368 DOI: 10.1002/cam4.7001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 01/18/2024] [Accepted: 01/31/2024] [Indexed: 03/18/2024] Open
Abstract
PURPOSE Resistance training may offer several unique advantages within breast cancer (BC) survivorship care; however, safety concerns have limited the application of high-intensity compound movements necessary to elicit optimal changes in body composition, strength, and quality of life in this population. The EXERT-BC trial assesses the safety and feasibility of an evidence-based, dose-escalated resistance training regimen among BC survivors, with the goal of improving physical and metabolic function, mobility, muscle mass, and body composition. METHODS Participants included women with breast cancer underwent a 3-month thrice weekly exercise regimen involving dose escalation of high-intensity compound exercises. Coprimary outcomes included safety and adherence. Pre- and post-regimen assessment included body composition testing, functional mobility and balance, total load (weight × repetitions × sets) across compound exercises, and patient reported quality of life. Pairwise comparison was performed via the paired t test. RESULTS Fourty participants completed a 3-month exercise regimen, with a median age of 57 years (range, 27-74 years) and 73% having stage 0-2 BC. BC therapies concurrent with exercise included anti-estrogen therapy (80%), radiotherapy (30%), and non-hormonal systemic therapy (15%). No adverse events were observed aside from a single case of self-limited knee pain. Session attendance exceeded a prespecified threshold of 75%, and 98% patients reported ongoing compliance to an exercise regimen following regimen completion. Significant reductions in percent body fat (p < 0.001) and increases in percent muscle mass (p = 0.011) were observed. Significant increases in resting metabolic rate (p = 0.023), bilateral grip strength (p < 0.001), functional movement screen (p < 0.001), bilateral Y-Balance testing (p < 0.001), and Godin questionnaire scores (p < 0.001) were observed. CONCLUSION A 3-month dose-escalated resistance training regimen comprising high-intensity compound movements appears safe with a high degree of adherence among breast cancer survivors, resulting in demonstrable improvements in body composition, metabolic parameters, strength increases, and patient-reported quality of life.
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Affiliation(s)
- David J. Carpenter
- Department of Radiation OncologyWellstar Paulding Medical CenterHiramGeorgiaUSA
- Department of Radiation OncologyDuke University Medical CenterDurhamNorth CarolinaUSA
- Exercise Oncology ConsortiumPittsburghPennsylvaniaUSA
| | - Chris Peluso
- Exercise Oncology ConsortiumPittsburghPennsylvaniaUSA
- Allegheny Health Network Cancer Institute Exercise Oncology and Resiliency CenterPittsburghPennsylvaniaUSA
| | - Christie Hilton
- Department of Medical OncologyAllegheny Health NetworkPittsburghPennsylvaniaUSA
| | - Frank Velasquez
- Allegheny Health Network Sports Performance CenterPittsburghPennsylvaniaUSA
| | - Adam Annichine
- Department of Radiation OncologyWellstar Paulding Medical CenterHiramGeorgiaUSA
- Allegheny Health Network Sports Performance CenterPittsburghPennsylvaniaUSA
| | - Krista Matsko
- Allegheny Health Network Sports Performance CenterPittsburghPennsylvaniaUSA
| | - Jared Rosenberg
- Department of Exercise ScienceSyracuse UniversitySyracuseNew YorkUSA
| | - Alexander K. Diaz
- Department of Radiation OncologyMurray‐Calloway County HospitalMurrayKentuckyUSA
| | - Parker Hyde
- Department of KinesiologyNorthern Georgia UniversityDahlonegaGeorgiaUSA
| | - Sushil Beriwal
- Department of Radiation OncologyAllegheny Health NetworkPittsburghPennsylvaniaUSA
| | - Colin E. Champ
- Exercise Oncology ConsortiumPittsburghPennsylvaniaUSA
- Allegheny Health Network Cancer Institute Exercise Oncology and Resiliency CenterPittsburghPennsylvaniaUSA
- Department of Radiation OncologyAllegheny Health NetworkPittsburghPennsylvaniaUSA
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Brandt T, Schwandner CTL, Schmidt A. Resistance exercise snacks improve muscle mass in female university employees: a prospective, controlled, intervention pilot-study. Front Public Health 2024; 12:1347825. [PMID: 38379679 PMCID: PMC10877054 DOI: 10.3389/fpubh.2024.1347825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 01/23/2024] [Indexed: 02/22/2024] Open
Abstract
Background Although resistance training (RT) is essential to preserve musculoskeletal fitness and maintain a healthy, independent life into old age, few women perform RT. We investigated whether resistance exercise snacking (RES) could be an efficient training approach for the workplace health promotion (WHP) to minimize barriers for participation and facilitate RT in women in order to improve musculoskeletal fitness. Methods This pilot-study followed a prospective, controlled intervention design. Female employees with sedentary occupations doing RT on less than 2 days/week before study participation were included. Participants self-selected for either intervention (IG) or control group (CG). While the IG [N = 15, mean age 42.1 (SD = 11.1) years] did 10 min of RES on working days for 12 weeks, the CG [N = 15, mean age 49.9 (SD = 9.7) years] was instructed to maintain their habitual physical activity. Primary endpoint was change in muscle mass. Secondary endpoint was change in maximum isometric strength. Balance, cardiovascular fitness, perceived health, and general life satisfaction was assessed for exploratory purpose. Measurements were taken before and after the intervention. Results 12 participants of IG and 14 of CG completed the study. Muscle mass improved significantly more in the IG [+0.42 (SD = 0.54) kg] compared to the CG [-0.16 (SD = 0.51) kg] (p = 0.01, ƞ2p = 0.24). Strength did not change significantly between groups. Nevertheless, there was a trend for greater improvements in the IG compared to the CG for trunk extension, trunk flexion, and upper body push but not upper body pull. Regarding exploratory endpoints, no significant between-group changes were found. Despite their poor fitness, both groups perceived their health as good and had high life satisfaction before and after the intervention. Conclusion RES could be an effective approach for the WHP to promote RT in inactive women with sedentary occupations and improve their muscle mass.
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Canli T, Canli U, Taskin C, Aldhahi MI. Motor Coordination in Primary School Students: The Role of Age, Sex, and Physical Activity Participation in Turkey. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1524. [PMID: 37761485 PMCID: PMC10528536 DOI: 10.3390/children10091524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/04/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023]
Abstract
Motor coordination (MC) is an essential skill underpinning precise and controlled movements, contributing significantly to daily functioning and overall performance. The developmental trajectory of MC in children is intricately shaped by a spectrum of factors encompassing age, gender, and physical activity engagement. Delving into the complex interrelation of these variables holds the potential to unravel nuanced developmental trends and offer targeted avenues for interventions aimed at augmenting motor proficiency in the pediatric population. This study aimed to assess the differences in MC of primary school students based on sex, age, and physical activity participation (PAP). A total of 848 students from public primary schools, aged between 6-9 years, including 412 boys and 436 girls. The MC was measured using Körperkoordinationstest für Kinder (KTK3+) test battery, which included Jumping sideways (JS), Balancing backward (BB), Moving sideways (MS), and Eye-Hand Coordination (EHC). One-way multivariate analysis of variance (MANOVA) was used to determine the binary and triple interactions of sex, age, and PAP variables on the MC parameters of the participants. The study revealed that boys aged 6-9 had higher scores than girls on eye-hand coordination (EHC) (p < 0.02). No significant gender-related differences in balancing backward (BB), jumping sideways (JS), and moving sideways (MS) were found. When the subtests of KTK3+ were compared by age, a significant difference was observed between the groups in all subtests (p < 0.05). With respect to PAP, students with PAP had a significant advantage in all subtests of the KTK3+ (p < 0.05). The double co-effects or triple co-effects of age, sex, and PAP parameters do not influence the KTK parameters. This study presents evidence supporting sex differences in the motor skills of children within this age range and highlights the potential impact of age and physical activity on motor development.
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Affiliation(s)
- Tulay Canli
- Institute of Health Sciences, Tekirdag Namık Kemal University, Tekirdag 59010, Turkey;
| | - Umut Canli
- Sports Science Faculty, Tekirdag Namik Kemal University, Tekirdag 59010, Turkey
| | - Cuneyt Taskin
- Kirkpinar Faculty of Sport Sciences, Trakya University, Edirne 22000, Turkey;
| | - Monira I. Aldhahi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia;
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Segal AD, Vargas BL, Richards FG, Shelley CJ, Silverman AK. Healthy aging reduces dynamic balance control as measured by the simplified Star Excursion Balance Test. Gait Posture 2023; 103:190-195. [PMID: 37244214 DOI: 10.1016/j.gaitpost.2023.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 05/11/2023] [Accepted: 05/18/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND Detecting and classifying factors that contribute to age-related balance decline are essential for targeted interventions. Dynamic postural tests that challenge neuromuscular balance control are important to detect subtle deficits that affect functional balance in healthy aging. RESEARCH QUESTION How does healthy aging affect specific components of dynamic postural control as measured by the simplified Star Excursion Balance Test (SEBT)? METHODS Twenty healthy younger (18-39 years) and twenty healthy older (58-74 years) adults performed the standardized simplified SEBT, which involved standing on one leg and reaching the contralateral leg as far as possible in the anterior, posteromedial, and posterolateral directions. Optical motion capture was used to quantify the maximum reach distance normalized by body height (%H) for three repeated trials in each direction per leg. Linear mixed effects models and pairwise comparisons of estimated marginal means were used to assess differences (p < 0.05) in normalized maximum reach distance by age group, reach direction, and leg dominance. Intersubject and intrasubject variability were also assessed by age group using coefficients of variation (CV). RESULTS Healthy older adults had less dynamic postural control compared to younger adults, with shorter reach distances in the anterior (7.9 %), posteromedial (15.8 %), and posterolateral (30.0 %) directions (p < 0.05). Leg dominance and sex did not significantly affect SEBT score for either age group (p > 0.05). Low intrasubject variability (CV<0.25 %) was found for repeated trials in both the older and younger participants. Therefore, the comparatively higher intersubject variability (Range CV=8-25 %) was mostly attributed to differences in SEBT performance across participants. SIGNIFICANCE Quantifying dynamic postural control in healthy older adults in a clinical setting is important for early detection of balance decline and guiding targeted and effective treatment. These results support that the simplified SEBT is more challenging for healthy older adults, who may benefit from dynamic postural training to mitigate age-related decline.
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Affiliation(s)
- Ava D Segal
- Department of Mechanical Engineering, Colorado School of Mines, Golden, CO, USA.
| | - Brooklyn L Vargas
- Department of Mechanical Engineering, Colorado School of Mines, Golden, CO, USA
| | - Fiona G Richards
- Department of Mechanical Engineering, Colorado School of Mines, Golden, CO, USA
| | - Cameron J Shelley
- Department of Mechanical Engineering, Colorado School of Mines, Golden, CO, USA
| | - Anne K Silverman
- Department of Mechanical Engineering, Colorado School of Mines, Golden, CO, USA; Quantitative Biosciences and Engineering, Colorado School of Mines, Golden, CO, USA
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Forelli F, Le Coroller N, Gaspar M, Memain G, Kakavas G, Miraglia N, Marine P, Maille P, Hewett TE, Rambaud AJ. Ecological and Specific Evidence-Based Safe Return To Play After Anterior Cruciate Ligament Reconstruction In Soccer Players: A New International Paradigm. Int J Sports Phys Ther 2023; 18:526-540. [PMID: 37020454 PMCID: PMC10069338 DOI: 10.26603/001c.73031] [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: 10/10/2022] [Accepted: 01/15/2023] [Indexed: 04/04/2023] Open
Abstract
Existing return to play (RTP) assessments have not demonstrated the ability to decrease risk of subsequent anterior cruciate ligament (ACL) injury after reconstruction (ACLR). RTP criteria are standardized and do not simulate the physical and cognitive activity required by the practice of sport. Most RTP criteria do not include an ecological approach. There are scientific algorithms as the "5 factor maximum model" that can identify risk profiles and help reduce the risk of a second anterior cruciate ligament injury. Nevertheless, these algorithms remain too standardized and do not include the situations experienced in games by soccer players. This is why it is important to integrate ecological situations specific to the environment of soccer players in order to evaluate players under conditions closest to their sporting activity, especially with high cognitive load. One should identify high risk players under two conditions: Clinical analyses commonly include assessments such as isokinetic testing, functional tests (hop tests, vertical force-velocity, profile), running, clinical assessments (range of motion and graft laxity), proprioception and balance (Star Excursion Balance Test modified, Y-Balance, stabilometry) and psychological parameters (kinesophobia, quality of life and fear of re-injury). Field testing usually includes game simulation, evaluation under dual-task conditions, fatigue and workload analysis, deceleration, timed-agility-test and horizontal force-velocity profiles. Although it seems important to evaluate strength, psychological variables and aerobic and anaerobic capacities, evaluation of neuromotor control in standard and ecological situations may be helpful for reducing the risk of injury after ACLR. This proposal for RTP testing after ACLR is supported by the scientific literature and attempts to approximate the physical and cognitive loads during a soccer match. Future scientific investigation will be required to demonstrate the validity of this approach. Level of Evidence 5.
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Kim JG, Lee DW, Bae KC, Choi BC, Yang SJ, Cho SI, Kim DH. Correlation of Y Balance with Clinical Scores and Functional Tests after Anterior Cruciate Ligament Reconstruction in Young and Middle-Aged Patients. Clin Orthop Surg 2023; 15:50-58. [PMID: 36778986 PMCID: PMC9880508 DOI: 10.4055/cios21131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 10/31/2021] [Accepted: 11/22/2021] [Indexed: 11/06/2022] Open
Abstract
Background Criteria for return to sports (RTS) following anterior cruciate ligament (ACL) reconstruction have been extensively studied. But there is no consensus among investigators regarding which factors are most important in determining a safe RTS. Methods Sixty-one patients who underwent ACL reconstruction were included. Subjective knee scoring systems (International Knee Documentation Committee [IKDC] score and Lysholm score), functional performance tests (carioca test and single-leg hop for distance [SLHD] test), and isokinetic knee strength test were used for assessment and analyzed for association with the limb symmetry index (LSI) of the Y-balance test for lower quarter (YBT-LQ). Results The LSI of the YBT-LQ was significantly correlated with Lysholm score, IKDC score, Carioca, LSI for the SLHD, and extensor strength deficit at 6 months after ACL reconstruction. At 12 months, Lysholm score, IKDC score, LSI for the SLHD, and extensor strength deficit were significantly correlated with the LSI of the YBT-LQ. Conclusions The YBT-LQ test could be used conveniently as an additional tool to assess the patient's functional performance results after ACL reconstruction in outpatient clinics.
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Affiliation(s)
- Jin-Goo Kim
- Department of Orthopedic Surgery and Sports Center, Myungji Hospital, Hanyang University, Seoul, Korea
| | - Dhong-Won Lee
- Department of Orthopaedic Surgery, KonKuk University Medical Center, Seoul, Korea
| | - Ki-Cheor Bae
- Department of Orthopedic Surgery, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea
| | - Byung-Chan Choi
- Department of Orthopedic Surgery, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea
| | - Sang-Jin Yang
- Department of Health and Exercise, Tongwon University, Gwangju, Korea
| | - Seung-Ik Cho
- Sports Medical Center, KonKuk University Medical Center, Seoul, Korea
| | - Du-Han Kim
- Department of Orthopedic Surgery, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea
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Kim MS, Heo MY, Joo HJ, Shim GY, Chon J, Chung SJ, Soh Y, Yoo MC. Neutrophil-to-Lymphocyte Ratio as a Predictor of Short-Term Functional Outcomes in Acute Ischemic Stroke Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:898. [PMID: 36673655 PMCID: PMC9859224 DOI: 10.3390/ijerph20020898] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/02/2023] [Accepted: 01/03/2023] [Indexed: 06/17/2023]
Abstract
Background: Neutrophil-to-lymphocyte ratio (NLR), a systemic inflammatory biomarker, has been associated with poorer outcomes in acute ischemic stroke patients. The present study was designed to expand these findings by investigating the association between NLR and short-term functional outcomes in acute ischemic stroke patients. Methods: This retrospective study evaluated patients within 7 days after the onset of acute ischemic stroke. Stroke severity on admission was measured using the National Institutes of Health Stroke Scale (NIHSS). The functional outcomes were assessed using the Berg Balance Scale (BBS), Manual Function Test (MFT), the Korean version of the modified Barthel Index (K-MBI), and the Korean Mini-Mental State Examination (K-MMSE) within 2 weeks of stroke onset. The modified Rankin Scale (mRS) was evaluated at discharge. Results: This study included 201 patients, who were grouped into three NLR tertiles (<1.84, 1.84−2.71, and >2.71) on admission. A multivariate analysis showed that the top tertile group (NLR > 2.71) had significantly higher risks of unfavorable outcomes on the K-MBI (p = 0.010) and K-MMSE (p = 0.029) than the bottom tertile group (NLR < 1.84). Based on the optimal cut-off values from a receiver operating characteristic curve analysis, a higher NLR was significantly associated with higher NIHSS scores (p = 0.011) and unfavorable outcomes on the K-MBI (p = 0.002) and K-MMSE (p = 0.001). Conclusions: A higher NLR is associated with poorer short-term functional outcomes in acute ischemic stroke patients.
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Affiliation(s)
| | | | | | | | | | | | - Yunsoo Soh
- Correspondence: (Y.S.); (M.C.Y.); Tel.: +82-2-958-8980 (M.C.Y.); Fax: +82-2-958-8470 (M.C.Y.)
| | - Myung Chul Yoo
- Correspondence: (Y.S.); (M.C.Y.); Tel.: +82-2-958-8980 (M.C.Y.); Fax: +82-2-958-8470 (M.C.Y.)
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Chaudhary P, Kathuria D, Suri S, Bahndral A, Kanthi Naveen A. Probiotics- its functions and influence on the ageing process: A comprehensive review. FOOD BIOSCI 2023. [DOI: 10.1016/j.fbio.2023.102389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Relationship Among 3 Different Core Stability Tests in Healthy Young Adults: Validity and Gender Differences. J Sport Rehabil 2022; 31:385-390. [PMID: 34969011 DOI: 10.1123/jsr.2021-0014] [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: 01/10/2021] [Revised: 10/23/2021] [Accepted: 10/25/2021] [Indexed: 11/18/2022]
Abstract
CONTEXT Core stability is important for preventing injury and improving performance. Although various tests for evaluating core stability have been reported to date, information on their relationship and the effect of gender differences is limited. This study aimed to (1) identify correlations among the 3 core stability tests and to examine the validity of each test and (2) identify gender differences in the test relationship and determine whether gender influenced test selection. DESIGN Cross-sectional study. METHODS Fifty-one healthy volunteers (27 men and 24 women) participated in the study. The participants underwent the following 3 tests: Sahrmann Core Stability Test (SCST), the lumbar spine motor control tests battery (MCBT), and Y Balance Test (YBT). Each parameter was analyzed according to all parameters and gender using the Spearman rank correlation coefficient. RESULTS Overall, there was a strong positive correlation between SCST and MCBT and moderate positive correlations between SCST and YBT and between MCBT and YBT. Conversely, gender-specific analyses revealed no significant correlations between YBT and SCST and between YBT and MCBT in women, although significantly strong correlations were found among all tests in men. CONCLUSION Although these 3 tests evaluated interrelated functions and may be valid as core stability tests, the results should be carefully interpreted when performing YBT in women.
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Strength and Balance in Recreational Golfers and Non-Golfers Aged 65-79 Years in Community Settings. J Aging Phys Act 2022; 31:257-264. [PMID: 36084931 DOI: 10.1123/japa.2021-0498] [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: 12/20/2021] [Revised: 07/04/2022] [Accepted: 07/16/2022] [Indexed: 11/18/2022]
Abstract
Inactive older adults tend to have decreased strength and balance compared with their more active peers. Playing golf has the potential to improve strength and balance in older adults. The aim of the study was to compare the strength and balance of recreational golfers with non-golfers, aged 65-79 years. Grip strength, single leg balance, and Y Balance Test (YBT) were assessed. Golfers (n = 57) had significantly (right, p = .042; left, p = .047) higher maximal grip strength, than non-golfers (n = 17). Single leg stance times were significantly longer in golfers (right, p = .021; left, p = .001). Normalized YBT reach distances were significantly greater for golfers than non-golfers for composite, posteromedial, and posterolateral directions on both right and left legs. Playing golf appears to be associated with better grip and both static and dynamic balance in 65-79 year olds, indicating that a study of the effects of playing golf is warranted through a larger, fully powered, longitudinal study.
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Lanza MB, Arbuco B, Ryan AS, Shipper AG, Gray VL, Addison O. Systematic Review of the Importance of Hip Muscle Strength, Activation, and Structure in Balance and Mobility Tasks. Arch Phys Med Rehabil 2022; 103:1651-1662. [PMID: 34998714 PMCID: PMC10089299 DOI: 10.1016/j.apmr.2021.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 11/02/2022]
Abstract
OBJECTIVE The aim of this systematic review was to identify the associations of the hip abductor muscle strength, structure, and neuromuscular activation on balance and mobility in younger, middle-aged, and older adults. DATA SOURCES We followed PRISMA guidelines and performed searches in PubMed, Embase, CINAHL, and Physiotherapy Evidence Database. STUDY SELECTION Study selection included: (1) studies with patients aged 18 years or older and (2) studies that measured hip abduction torque, surface electromyography, and/or muscle structure and compared these measures with balance or mobility outcomes. DATA EXTRACTION The extracted data included the study population, setting, sample size, sex, and measurement evaluated. DATA SYNTHESIS The present systematic review is composed of 59 research articles including a total of 2144 young, middle-aged, and older adults (1337 women). We found that hip abductor strength is critical for balance and mobility function, independent of age. Hip abductor neuromuscular activation is also important for balance and mobility, although it may differ across ages depending on the task. Finally, the amount of fat inside the muscle appears to be one of the important factors of muscle structure influencing balance. CONCLUSIONS In conclusion, a change in all investigated variables (hip abduction torque, neuromuscular activation, and intramuscular fat) appears to have an effect during balance or mobility tasks across age ranges and may elicit better performance. Future studies are necessary to confirm the effect of these variables across age ranges and the effects of interventions.
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Affiliation(s)
- Marcel B Lanza
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD.
| | - Breanna Arbuco
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD
| | - Alice S Ryan
- Department of Medicine, Division of Gerontology and Palliative Medicine, University of Maryland School of Medicine, Baltimore, MD; Baltimore Geriatric Research, Education, and Clinical Center, VAHMC, Baltimore, MD
| | - Andrea G Shipper
- Health Sciences and Human Services Library, University of Maryland, Baltimore, MD
| | - Vicki L Gray
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD
| | - Odessa Addison
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD; Baltimore Geriatric Research, Education, and Clinical Center, VAHMC, Baltimore, MD
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Goliwas M, Małecka J, Lewandowski J, Kamińska E, Adamczewska K, Kocur P. Analysis of dependencies between Fugl-Meyer Assessment Scale test and Berg Balance Scale test as an assessment of the increased muscle tone in chronic-phase patients after a ischemic stroke. REHABILITACJA MEDYCZNA 2022. [DOI: 10.5604/01.3001.0015.8241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: The basic functional assessment, on the basis of which rehabilitation programming is carried out in a patient after a stroke, consists in examining the efficiency of the upper and lower limbs, balance and i.a. muscle tension. Therefore, it is important to identify and understand the relationships between these basic data in order to make conclusions easier and to set good goals in rehabilitation.
Objective: The aim of the study was to investigate the relation between the assessment of the motor efficiency of the lower limb, measured Fugl-Meyer Assessment Scale (FMA) and the balance, measured Berg Balance Scale (BBS) and between the FMA and the assessment of muscle tone, measured modified Ashworth scale in chronic-phase patients after an ischemic stroke before and after a 6-week rehabilitation process.
Material and methods: The study group consisted of 37 patients after stroke (post-stroke duration > 1 year). All patients were subjected to a double functional assessment. Main measures: motor function in the lower limb, balance and spasticity in the lower limb. Spearman correlation coefficients was used to identify and analyze the relationship between the FMA and BBS as an assessment of the increased muscle tone.
Results: There was a highly significant p <0.0001 positive correlation between the FMA and BBS tests: first period r = 0.6120, second period r = 0.6604. There was a highly significant (p <0.0001) negative correlation between the assessment of FMA test and the muscle tone: first period r = -0.6814, second period r = -0.6532.
Conclusions: People in chronic phase after an ischemic stroke have a high positive correlation between the motor efficiency of the lower limb and balance. This study shows also a high, negative correlation between the motor efficiency of the lower limb, and the muscle tone of this limb. Both before and after rehabilitation process.
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Affiliation(s)
- Magdalena Goliwas
- Department of Clinical Physiotherapy, University School of Physical Education in Poznan, Poland
| | - Joanna Małecka
- Department of Clinical Physiotherapy, University School of Physical Education in Poznan, Poland
| | - Jacek Lewandowski
- Department of Clinical Physiotherapy, University School of Physical Education in Poznan, Poland
| | - Ewa Kamińska
- Department of Clinical Physiotherapy, University School of Physical Education in Poznan, Poland
| | - Katarzyna Adamczewska
- Department of Clinical Physiotherapy, University School of Physical Education in Poznan, Poland
| | - Piotr Kocur
- Department of Clinical Physiotherapy, University School of Physical Education in Poznan, Poland
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Nicol JL, Woodrow C, Cunningham BJ, Mollee P, Weber N, Smith MD, Nicol AJ, Gordon LG, Hill MM, Skinner TL. An Individualized Exercise Intervention for People with Multiple Myeloma—Study Protocol of a Randomized Waitlist-Controlled Trial. Curr Oncol 2022; 29:901-923. [PMID: 35200576 PMCID: PMC8870457 DOI: 10.3390/curroncol29020077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/28/2022] [Accepted: 01/31/2022] [Indexed: 11/16/2022] Open
Abstract
People with multiple myeloma (MM) are second only to people with lung cancer for the poorest reported health-related quality of life (HRQoL) of all cancer types. Whether exercise can improve HRQoL in MM, where bone pain and lesions are common, requires investigation. This trial aims to evaluate the efficacy of an exercise intervention compared with control on HRQoL in people with MM. Following baseline testing, people with MM (n = 60) will be randomized to an exercise (EX) or waitlist control (WT) group. EX will complete 12-weeks of supervised (24 sessions) and unsupervised (12 sessions) individualized, modular multimodal exercise training. From weeks 12–52, EX continue unsupervised training thrice weekly, with one optional supervised group-based session weekly from weeks 12–24. The WT will be asked to maintain their current activity levels for the first 12-weeks, before completing the same protocol as EX for the following 52 weeks. Primary (patient-reported HRQoL) and secondary (bone health and pain, fatigue, cardiorespiratory fitness, muscle strength, body composition, disease response, and blood biomarkers) outcomes will be assessed at baseline, 12-, 24- and 52-weeks. Adverse events, attendance, and adherence will be recorded and cost-effectiveness analysis performed. The findings will inform whether exercise should be included as part of standard myeloma care to improve the health of this unique population.
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Affiliation(s)
- Jennifer L. Nicol
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane 4072, Australia; (B.J.C.); (A.J.N.); (T.L.S.)
- QIMR Berghofer Medical Research Institute, Brisbane 4006, Australia; (L.G.G.); (M.M.H.)
- Correspondence:
| | - Carmel Woodrow
- Haematology, Division of Cancer, Princess Alexandra Hospital, Brisbane 4102, Australia; (C.W.); (P.M.)
| | - Brent J. Cunningham
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane 4072, Australia; (B.J.C.); (A.J.N.); (T.L.S.)
| | - Peter Mollee
- Haematology, Division of Cancer, Princess Alexandra Hospital, Brisbane 4102, Australia; (C.W.); (P.M.)
- Faculty of Medicine, The University of Queensland, Brisbane 4006, Australia
| | - Nicholas Weber
- Haematology, Cancer Care Services, Royal Brisbane and Women’s Hospital, Brisbane 4006, Australia;
| | - Michelle D. Smith
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane 4072, Australia;
| | - Andrew J. Nicol
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane 4072, Australia; (B.J.C.); (A.J.N.); (T.L.S.)
- Brisbane Clinic for Lymphoma, Myeloma and Leukaemia, Greenslopes Private Hospital, Brisbane 4120, Australia
| | - Louisa G. Gordon
- QIMR Berghofer Medical Research Institute, Brisbane 4006, Australia; (L.G.G.); (M.M.H.)
- Faculty of Medicine, The University of Queensland, Brisbane 4006, Australia
- Palliative Care Outcomes Centre, School of Nursing and Cancer, Queensland University of Technology, Brisbane 4059, Australia
| | - Michelle M. Hill
- QIMR Berghofer Medical Research Institute, Brisbane 4006, Australia; (L.G.G.); (M.M.H.)
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane 4006, Australia
| | - Tina L. Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane 4072, Australia; (B.J.C.); (A.J.N.); (T.L.S.)
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Balcancı O, Melikoglu MA. The relationship between serum hydroxyvitamin D levels and fall risks in young adults. J Bone Miner Metab 2021; 39:1076-1081. [PMID: 34324081 DOI: 10.1007/s00774-021-01252-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 07/13/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Serum hydroxyvitamin D [25(OH)D] has a role in several aspects of physical performance. Our aim was to determine the possible association between serum 25(OH)D deficiency on the fall risk in young adults by using an objective computerized technique. MATERIALS AND METHODS This cross-sectional study included 80 adults aged 18-40 years with 25(OH)D deficiency and 40 age-matched controls. The participants were devided into three groups according to serum 25(OH)D levels: Group 1; deficient, Group 2; insufficient and Group 3; sufficient (serum 25(OH)D level < 20, 20 to < 30 and 30-100 ng/mL, respectively). The age, gender, height and weight were recorded. To evaluate the fall risk, the Berg Balance test as a clinical assessment and a computerised posturography devise as an objective technique were used. Serum 25(OH)D levels were analyzed by ELISA. Pearson Chi-square, the Kruskal Wallis and Spearman correlation tests were used for statistical analysis. RESULTS 42 male and 78 female participants were evaluated. In posturographic evaluation, although fall risk score was the highest in group 1 and the lowest in group 3, these differences could not reach statistical significance. However, statistically significant higher fall risk was found in participants with 25(OH)D deficiency (25(OH)D< 30) than in controls (25(OH)D> 30) (p = 0.036). Also a statistically significant correlation was determined between serum 25(OH)D levels and the posturography fall risk scores (p = 0.016, r = - 0, 219). CONCLUSION By using an objective computerized technique, fall risk was found to be higher in young adults with 25(OH)D deficiency than in the controls. Vitamin D deficiency, even when clinically occult, seems to affect balance negatively.
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Affiliation(s)
- Okan Balcancı
- Department of Physical Medicine and Rehabilitation, Hopa State Hospital, Artvin, Turkey
| | - Meltem Alkan Melikoglu
- Department of Phycical Medicine and Rehabilitation, Rheumatolgy Division, Ataturk University School of Medicine, Erzurum, Turkey.
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Flickinger J, Fan J, Wellik A, Ganetzky R, Goldstein A, Muraresku CC, Glanzman AM, Ballance E, Leonhardt K, McCormick EM, Soreth B, Nguyen S, Gornish J, George-Sankoh I, Peterson J, MacMullen LE, Vishnubhatt S, McBride M, Haas R, Falk MJ, Xiao R, Zolkipli-Cunningham Z. Development of a Mitochondrial Myopathy-Composite Assessment Tool. JCSM CLINICAL REPORTS 2021; 6:109-127. [PMID: 35071983 PMCID: PMC8782422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND 'Mitochondrial Myopathy' (MM) refers to genetically-confirmed Primary Mitochondrial Disease (PMD) that predominantly impairs skeletal muscle function. Validated outcome measures encompassing core MM domains of muscle weakness, muscle fatigue, imbalance, impaired dexterity, and exercise intolerance do not exist. The goal of this study was to validate clinically-meaningful, quantitative outcome measures specific to MM. METHODS This was a single centre study. Objective measures evaluated included hand-held dynamometry, balance assessments, Nine Hole Peg Test (9HPT), Functional Dexterity Test (FDT), 30 second Sit to Stand (30s STS), and 6-minute walk test (6MWT). Results were assessed as z-scores, with < -2 standard deviations considered abnormal. Performance relative to the North Star Ambulatory Assessment (NSAA) of functional mobility was assessed by Pearson's correlation. RESULTS In genetically-confirmed MM participants [n = 59, mean age 21.6 ± 13.9 (range 7 - 64.6 years), 44.1% male], with nuclear gene aetiologies, n = 18/59, or mitochondrial (mtDNA) aetiologies, n = 41/59, dynamometry measurements demonstrated both proximal [dominant elbow flexion (-2.6 ± 2.1, mean z-score ± standard deviation, SD), hip flexion (-2.5 ± 2.3), and knee flexion (-2.8 ± 1.3)] and distal muscle weakness [wrist extension (-3.4 ± 1.7), palmar pinch (-2.5 ± 2.8), and ankle dorsiflexion (-2.4 ± 2.5)]. Balance [Tandem Stance (TS) Eyes Open (-3.2 ± 8.8, n = 53) and TS Eyes Closed (-2.6 ± 2.7, n = 52)] and dexterity [FDT (-5.9 ± 6.0, n = 44) and 9HPT (-8.3 ± 11.2, n = 53)] assessments also revealed impairment. Exercise intolerance was confirmed by strength-based 30s STS test (-2.0 ± 0.8, n = 38) and mobility-based 6MWT mean z-score (-2.9 ± 1.3, n = 46) with significant decline in minute distances (slope -0.9, p = 0.03, n = 46). Muscle fatigue was quantified by dynamometry repetitions with strength decrement noted between first and sixth repetitions at dominant elbow flexors (-14.7 ± 2.2%, mean ± standard error, SEM, n = 21). All assessments were incorporated in the MM-Composite Assessment Tool (MM-COAST). MM-COAST composite score for MM participants was 1.3± 0.1(n = 53) with a higher score indicating greater MM disease severity, and correlated to NSAA (r = 0.64, p < 0.0001, n = 52) to indicate clinical meaning. Test-retest reliability of MM-COAST assessments in an MM subset (n = 14) revealed an intraclass correlation coefficient (ICC) of 0.81 (95% confidence interval: 0.59-0.92) indicating good reliability. CONCLUSIONS We have developed and successfully validated a MM-specific Composite Assessment Tool to quantify the key domains of MM, shown to be abnormal in a Definite MM cohort. MM-COAST may hold particular utility as a meaningful outcome measure in future MM intervention trials.
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Affiliation(s)
- Jean Flickinger
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Physical Therapy, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jiaxin Fan
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Amanda Wellik
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Rebecca Ganetzky
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Amy Goldstein
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Colleen C. Muraresku
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Allan M. Glanzman
- Department of Physical Therapy, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Elizabeth Ballance
- Department of Physical Therapy, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Kristin Leonhardt
- Department of Physical Therapy, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Elizabeth M. McCormick
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Brianna Soreth
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Sara Nguyen
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Jennifer Gornish
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Ibrahim George-Sankoh
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - James Peterson
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Laura E. MacMullen
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Shailee Vishnubhatt
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Michael McBride
- Cardiovascular Exercise Physiology Laboratory, Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Richard Haas
- Metabolic and Mitochondrial Disease Center, La Jolla, CA, USA
- Department of Neurosciences, University of California San Diego School of Medicine, La Jolla, CA, USA
| | - Marni J. Falk
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Rui Xiao
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Zarazuela Zolkipli-Cunningham
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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16
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Flickinger J, Fan J, Wellik A, Ganetzky R, Goldstein A, Muraresku CC, Glanzman AM, Ballance E, Leonhardt K, McCormick EM, Soreth B, Nguyen S, Gornish J, George‐Sankoh I, Peterson J, MacMullen LE, Vishnubhatt S, McBride M, Haas R, Falk MJ, Xiao R, Zolkipli‐Cunningham Z. Development of a Mitochondrial Myopathy‐Composite Assessment Tool. JCSM CLINICAL REPORTS 2021. [DOI: 10.1002/crt2.41] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Affiliation(s)
- Jean Flickinger
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics Children's Hospital of Philadelphia Philadelphia PA 19104 USA
- Department of Physical Therapy Children's Hospital of Philadelphia Philadelphia PA USA
| | - Jiaxin Fan
- Department of Biostatistics, Epidemiology and Informatics University of Pennsylvania Perelman School of Medicine Philadelphia PA USA
| | - Amanda Wellik
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics Children's Hospital of Philadelphia Philadelphia PA 19104 USA
| | - Rebecca Ganetzky
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics Children's Hospital of Philadelphia Philadelphia PA 19104 USA
- Department of Pediatrics University of Pennsylvania Perelman School of Medicine Philadelphia PA USA
| | - Amy Goldstein
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics Children's Hospital of Philadelphia Philadelphia PA 19104 USA
- Department of Pediatrics University of Pennsylvania Perelman School of Medicine Philadelphia PA USA
| | - Colleen C. Muraresku
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics Children's Hospital of Philadelphia Philadelphia PA 19104 USA
| | - Allan M. Glanzman
- Department of Physical Therapy Children's Hospital of Philadelphia Philadelphia PA USA
| | - Elizabeth Ballance
- Department of Physical Therapy Children's Hospital of Philadelphia Philadelphia PA USA
| | - Kristin Leonhardt
- Department of Physical Therapy Children's Hospital of Philadelphia Philadelphia PA USA
| | - Elizabeth M. McCormick
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics Children's Hospital of Philadelphia Philadelphia PA 19104 USA
| | - Brianna Soreth
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics Children's Hospital of Philadelphia Philadelphia PA 19104 USA
| | - Sara Nguyen
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics Children's Hospital of Philadelphia Philadelphia PA 19104 USA
| | - Jennifer Gornish
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics Children's Hospital of Philadelphia Philadelphia PA 19104 USA
| | - Ibrahim George‐Sankoh
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics Children's Hospital of Philadelphia Philadelphia PA 19104 USA
| | - James Peterson
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics Children's Hospital of Philadelphia Philadelphia PA 19104 USA
| | - Laura E. MacMullen
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics Children's Hospital of Philadelphia Philadelphia PA 19104 USA
| | - Shailee Vishnubhatt
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics Children's Hospital of Philadelphia Philadelphia PA 19104 USA
| | - Michael McBride
- Cardiovascular Exercise Physiology Laboratory, Division of Cardiology Children's Hospital of Philadelphia Philadelphia PA USA
| | - Richard Haas
- Metabolic and Mitochondrial Disease Center La Jolla CA USA
- Department of Neurosciences University of California San Diego School of Medicine La Jolla CA USA
| | - Marni J. Falk
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics Children's Hospital of Philadelphia Philadelphia PA 19104 USA
- Department of Pediatrics University of Pennsylvania Perelman School of Medicine Philadelphia PA USA
| | - Rui Xiao
- Department of Biostatistics, Epidemiology and Informatics University of Pennsylvania Perelman School of Medicine Philadelphia PA USA
- Department of Pediatrics University of Pennsylvania Perelman School of Medicine Philadelphia PA USA
| | - Zarazuela Zolkipli‐Cunningham
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics Children's Hospital of Philadelphia Philadelphia PA 19104 USA
- Department of Pediatrics University of Pennsylvania Perelman School of Medicine Philadelphia PA USA
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Ha SY, Sung YH. The effect of scapular strengthening exercise using elastic band on balance and quality of life in the old people. J Exerc Rehabil 2021; 17:214-219. [PMID: 34285900 PMCID: PMC8257434 DOI: 10.12965/jer.2142222.111] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 04/10/2021] [Indexed: 12/04/2022] Open
Abstract
The old people are weakened and misaligned due to aging, and their balance and quality of life are reduced. We investigated that the effect of scapular strengthening exercise on balance and quality of life in the old people. A scapular strengthening exercise was applied to the experimental group, and the general conditioning exercise was applied to the control group for 40 min per session, 5 times a week, for a total of 4 weeks. As a result, the static balance and Y-balance test performance improved in the experimental group (P<0.05). The physical function and mental health, and general health of 36-item Short Form health survey improved in the experimental group (P<0.05). Therefore, the scapular strengthening exercise could be suggested as an intervention method that could improve the balance and quality of life of the old people.
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Affiliation(s)
- Sun-Young Ha
- Department of Physical Therapy, Graduate School, Kyungnam University, Changwon, Korea
| | - Yun-Hee Sung
- Department of Physical Therapy, Graduate School, Kyungnam University, Changwon, Korea.,Department of Physical Therapy, College of Health Sciences, Kyungnam University, Changwon, Korea
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Queen RM, Schmitt D. Sex-Specific Difference in Dynamic Balance Following Total Hip Replacement. Innov Aging 2021; 5:igab019. [PMID: 34316518 PMCID: PMC8304153 DOI: 10.1093/geroni/igab019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Indexed: 11/14/2022] Open
Abstract
Background and Objectives Total hip arthroplasty (THA) is a common surgical procedure in older adults (65 years or older). THA has high patient satisfaction, but little is known about balance and mobility limitations after surgery and if outcomes are sex-specific. This study was aimed to evaluate post-THA asymmetry during unilateral standing and a dynamic balance and reach test and test the hypotheses that balance performance would be decreased on the surgical limb and that balance deficits would be greater in women than in men. Research Design and Methods Primary, unilateral THA (70 male, 57 female) patients completed a bilateral 10-s single-leg stance test. Sixty male but only 34 female participants could maintain unilateral balance for 10 s or greater. The cohort who successfully completed the 10-s single-limb stance test then completed a Lower Quarter Y-Balance Test in which the maximum anterior (ANT), posteromedial (PM), and posterolateral reach distances were obtained bilaterally and used to calculate the asymmetry score. All variables were compared using a mixed-model repeated-measures analysis of variance (sex by limb), while independent samples t tests were used to assess sex-specific asymmetry. Results Women failed single-leg stance at a higher rate than men (85.7% vs 59.6%; p = .001). Reach distance was different between limbs for all reach directions (p < .004) with greater reach distance on the nonoperative limb for all patients. Men had a greater reach distance in the ANT (p = .004) and PM (p = .006) directions. Discussion and Implications These results indicate that post-THA, the operative limb and female patients have greater balance limitations. These results are novel and reveal sex-specific patterns that emphasize the need for sex-specific postoperative rehabilitation programs to improve long-term outcomes, especially in older adults with muscle weakness and balance deficits.
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Affiliation(s)
- Robin M Queen
- Kevin P. Granata Biomechanics Lab, Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, USA.,Department of Orthopaedic Surgery, Virginia Tech Carilion School of Medicine, Roanoke, USA
| | - Daniel Schmitt
- Department of Evolutionary Anthropology, Duke University, Durham, North Carolina, USA
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Nelson S, Wilson CS, Becker J. Kinematic and Kinetic Predictors of Y-Balance Test Performance. Int J Sports Phys Ther 2021; 16:371-380. [PMID: 33842033 PMCID: PMC8016412 DOI: 10.26603/001c.21492] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 11/09/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The Y-Balance Test (YBT) assesses dynamic stability and neuromuscular control of the lower extremity. Several authors have analyzed kinematic predictors of YBT performance with conflicting results, but the influence of kinetic factors is not well understood. PURPOSE To examine kinematic predictors of YBT performance and determine the joint kinetics which predict YBT performance. STUDY DESIGN Cross-sectional study. METHODS Thirty-one physically active individuals performed YBT trials on a force plate while whole body kinematics were recorded using a motion capture system. Sagittal, frontal, and transverse plane joint kinematics and joint moments were calculated at maximum reach in each YBT reach direction. Variables correlated with reach distances at the p < 0.2 level were entered into a stepwise linear regression. RESULTS In the anterior direction, knee flexion and torso rotation (R2 =0.458, p<0.001) and knee extensor and hip abductor moments (R2 =0.461, p<0.001) were the best kinematic and kinetic predictors of reach distance. In the posterior medial direction, hip flexion, ankle dorsiflexion, and ankle rotation accounted for 45.8% of the variance in reach direction (p<0.001) while hip and knee extensor, and hip abductor moments explained 72.6% of the variance in reach distance (p<0.001). In the posterior lateral direction, hip flexion and pelvic rotation (R2 =0.696, p<.001) and hip extensor moments (R2 =0.433, p=0.001) were the best kinematic and kinetic predictors of reach distance. CONCLUSION The ability to generate large hip and knee joint moments in the sagittal and frontal plane are critical for YBT performance. LEVEL OF EVIDENCE 3.
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20
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Bulow A, Bellemare A, Anderson JE, Leiter JRS, MacDonald PB, Peeler JD. Lower Extremity Kinematics of the Y-Balance Test in Healthy and ACL Injured Adolescent Females. Int J Sports Phys Ther 2021; 16:381-392. [PMID: 33842034 PMCID: PMC8016411 DOI: 10.26603/001c.21529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 11/08/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Adolescent females are at significant risk for sustaining an ACL injury. The Y-Balance Test (YBT) is frequently used to evaluate neuromuscular control and lower extremity function. However, few studies have quantified 2D lower extremity kinematics during performance of the YBT, and there is an absence of kinematic data specific to at-risk adolescent females. PURPOSE To examine lower extremity joint kinematics during execution of the YBT by healthy and ACL-injured adolescent females. STUDY DESIGN Prospective cohort. METHODS Twenty-five healthy and ten ACL-injured (mean time from injury 143 days) adolescent females were assessed using the YBT. Sagittal and frontal plane knee and ankle motion was video recorded during execution of the YBT anterior reach movement. Ankle dorsi-flexion, knee flexion, and knee valgus angles were quantified via kinematic analysis. ANOVAs with a post hoc Bonferroni correction were used to compare YBT scoring (%LL) and kinematic data between groups. Pearson product-moment correlations determined the relationship between kinematic data and YBT scoring. RESULTS Healthy and ACL-injured subjects demonstrated similar YBT scores and lower extremity kinematic data. Healthy subjects demonstrated a weak positive correlation between ankle dorsiflexion and YBT scoring, and a weak negative correlation between knee valgus and YBT scoring. These relationships did not exist for ACL-injured subjects. Kinematic data for both groups also demonstrated a large degree of variability, regardless of YBT score. CONCLUSIONS Adolescent females frequently utilize a variety of lower extremity movement strategies when performing a functional movement task, and scoring on the YBT offers limited insight regarding lower extremity joint kinematics and ACL-injury risk in a physically active adolescent female population. LEVEL OF EVIDENCE Level 3.
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21
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Lee C, Fleming N, Donne B. Comparison of Balance Variables Across Active and Retired Athletes and Age Matched Controls. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2021; 14:76-92. [PMID: 34055155 PMCID: PMC8136550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Postural control is a major falls risk factor, therefore identifying protective mechanisms is essential. Physical activity enhances postural stability but effect duration has been minimally researched. The current study investigated if prolonged early life training exposure protected neuromuscular balance processes later in life. Static and dynamic balance variables were assessed in 77 healthy adults. Two age ranges (18 - 35yr, young; > 50yr, retired) were divided into weight bearing athlete and control groups; young athlete (YA), young control (YC), retired athlete (RA) and retired control (RC). Static balance was quantified using force platform derived sway velocity (mm.s-1) and C90area (mm2) data (stable and unstable surfaces, eyes open and closed) Dynamic balance was assessed using the Y balance test (YBT). Results demonstrated significant age effect across groups. However, an athletic effect was evident only assessing dynamic balance and static time to error variables. Mean time to error data (YA, 27.8 ± 5.8; YC, 20.5 ± 11.1; RA, 9.4 ± 8.5; RC, 8.6 ± 9.1 s) recorded significant age and athletic effects for the most challenging condition completed (single leg stance, eyes closed, stable surface). Mean maximum YBT composite score (YA, 90.0 ± 5.4%; YC, 83.6 ± 6.5%; RA, 80.8 ± 10.7%; RC, 72.4 ± 15.5%) demonstrated an age effect, and also identified a group effect in the retired cohorts. The current study supports research highlighting declined balance with ageing. Overall, former athleticism did not significantly enhance static balance in later life. Dynamic balance incorporates muscle strength possibly inferring a protective role in former athletes.
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Affiliation(s)
- Caitriona Lee
- Department of Anatomy and Physiology, School of Medicine, Trinity College Dublin, IRELAND
| | - Neil Fleming
- Department of Anatomy and Physiology, School of Medicine, Trinity College Dublin, IRELAND
| | - Bernard Donne
- Department of Anatomy and Physiology, School of Medicine, Trinity College Dublin, IRELAND
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22
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Wang H, Yu H, Kim YH, Kan W. Comparison of the Effect of Resistance and Balance Training on Isokinetic Eversion Strength, Dynamic Balance, Hop Test, and Ankle Score in Ankle Sprain. Life (Basel) 2021; 11:life11040307. [PMID: 33916136 PMCID: PMC8065734 DOI: 10.3390/life11040307] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/27/2021] [Accepted: 03/31/2021] [Indexed: 12/26/2022] Open
Abstract
Ankle sprain is a commonly recurring sports injury. This study aimed to compare the rehabilitation effects of resistance and balance training programs in patients with recurrent ankle sprain. Patients with recurrent lateral ankle sprain completed a home-based rehabilitation program comprising resistance training (RT; n = 27) or balance training (BT; n = 27). RT consisted of exercises using elastic tube bands, and BT consisted mainly of exercises performed using a variety of balance tools. Exercises were performed for 6 weeks, twice a day for 20 min, 5 days per week. Isokinetic eversion strength, Y-Balance test and hop tests, and foot and ankle outcome score (FAOS) were evaluated. Both RT and BT significantly improved strength and dynamic balance (p < 0.05). Compared to RT, BT also significantly improved the outcome of the crossover hop test (p = 0.008). The changes reflected group and time in pain (p = 0.022), sports (p = 0.027), and quality of life (p = 0.033) of FAOS were significantly greater in BT than RT.
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Affiliation(s)
- Haifang Wang
- School of Physical Education, Luoyang Normal College, Yibin District, Luoyang City 471934, China;
| | - Hailong Yu
- Department of Athletic Sports, Beijing Sport University, Beijing 100084, China;
| | - Yong Hwan Kim
- Department of Physical Education, Gangneung–Wonju National University, Gangwon 25457, Korea
- Correspondence: (Y.H.K.); (W.K.); Tel.: +82-33-640-2557 (Y.H.K.); +86-13-9301-00387 (W.K.); Fax: +82-33-641-3659 (Y.H.K.); +86-931-891-2129 (W.K.)
| | - Wencong Kan
- Sports Teaching and Research Department, Lanzhou University, Lanzhou 730000, China
- Correspondence: (Y.H.K.); (W.K.); Tel.: +82-33-640-2557 (Y.H.K.); +86-13-9301-00387 (W.K.); Fax: +82-33-641-3659 (Y.H.K.); +86-931-891-2129 (W.K.)
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Jang EM, Park SH. Effects of Neuromuscular Electrical Stimulation Combined with Exercises versus an Exercise Program on the Physical Characteristics and Functions of the Elderly: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052463. [PMID: 33802260 PMCID: PMC7967594 DOI: 10.3390/ijerph18052463] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/24/2021] [Accepted: 02/25/2021] [Indexed: 11/16/2022]
Abstract
(1) Background-The application of neuromuscular electrical stimulation (NMES) combined with low-intensity exercise to the elderly can be more efficient than low-intensity exercise only in terms of delaying the loss of muscle mass. We aimed to assess the adjunct of NMES to low-intensity lower limb strengthening exercise to prevent falls in frail elderly for a relatively short period of 4 weeks. (2) Methods-Thirty elderly women aged 65 or above were randomly categorized into three groups: control group (CON, n = 8), exercise group (EX, n = 10), and NMES with exercise group (EX + NMES, n = 9). The exercise group took part in a lower limb strengthening exercise program for one hour three times a week for four weeks. Furthermore, the NMES with exercise group had added NMES stimulation when exercising. The limbs' muscle mass, body fat mass, calf circumference, grip force, five times sit-to-stand test, timed up-and-go test (TUG), one-leg stand test, and Y-balance test (YBT) were evaluated at baseline and 4 weeks after. (3) Results-Comparisons between the three groups showed that the TUG was significantly decreased and the YB was significantly increased in NMES with exercise group (p < 0.05). (4) Conclusions-These results suggested that a combination of NMES stimulation and exercises was more helpful in strengthening balance than exercises alone in the short term.
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Affiliation(s)
| | - So Hyun Park
- Correspondence: ; Tel.: +82-055-380-9465; Fax: +82-55-380-9305
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Tanwar T, Veqar Z, Ghrouz AK, Spence DW, Pandi-Perumal SR. Is poor sleep quality associated with a deterioration in postural control? Sleep Sci 2021; 14:207-213. [PMID: 35186198 PMCID: PMC8848529 DOI: 10.5935/1984-0063.20200061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 09/25/2020] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The primary aim was to investigate whether any association exists between poor sleep quality and deterioration in postural control among university student population. MATERIALS AND METHODS A case-control study was conducted in which sleep quality of 119 university students from different departments of Jamia Millia Islamia University, New Delhi, India was assessed using Pittsburgh sleep quality index (PSQI) following which the participants postural control, or dynamic balance was measured using the Y balance test (YBT). The participants were divided into two groups (A and B) based on their PSQI cut off scores. The YBT data was then evaluated for the dynamic balance assessment of the participants. RESULTS The mean age of the participants was 22.23±2.29 out of which 86 were female and 33 were male. The mean BMI of the participants was 21.58±3.66. Group A included 63 participants who had "good" sleep quality (global PSQI score < 5) whereas group B included 56 participants who had "poor" sleep quality (global PSQI score ≥ 5). Group comparisons based on t-test revealed a significant difference (p<0.05) between means of the two groups, with the mean balance of group A being greater than that of group B. Also, chi-square testing showed no significant association between the BMI and dynamic balance scores for the participants (p<0.10). CONCLUSION The findings of the study conclude that poor sleep quality is associated with a deterioration of postural control in university students. The study also revealed that there was no association between BMI and dynamic balance in this population.
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Affiliation(s)
- Tarushi Tanwar
- Jamia Millia Islamia, Centre for Physiotherapy and Rehabilitation Sciences - New Delhi - Delhi - India
| | - Zubia Veqar
- Jamia Millia Islamia, Centre for Physiotherapy and Rehabilitation Sciences - New Delhi - Delhi - India. ,Corresponding author: Zubia Veqar. E-mail:
| | - Amer K. Ghrouz
- An-Najah National University, Department of Applied Medical Sciences - Nablus - West Bank - Palestinian Territories
| | - David Warren Spence
- Independent Research Consultant, Independent Research Consultant - Toronto - Ontario - Canada
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Almarzouki R, Bains G, Lohman E, Bradley B, Nelson T, Alqabbani S, Alonazi A, Daher N. Improved balance in middle-aged adults after 8 weeks of a modified version of Otago Exercise Program: A randomized controlled trial. PLoS One 2020; 15:e0235734. [PMID: 32667956 PMCID: PMC7363097 DOI: 10.1371/journal.pone.0235734] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 06/18/2020] [Indexed: 11/28/2022] Open
Abstract
Objective The objective of this randomized controlled trial was to examine dynamic balance changes (reach distance) in middle-aged adults using the Y Balance Test (YBT) following 8 weeks of home-based exercise program adapted from the Otago Exercise Program (OEP). Methods Fifty-two healthy middle-aged adults with mean age of 54.4±5.4 years and body mass index of 27.7±5.7 kg/m2 were randomly assigned into either the exercise group (a modification of the Otago Exercise Program, that consisted of home-based balance and strength exercises) or the non-exercise group (continuation of usual lifestyle) by having the participants select a paper from a sealed envelope. The YBT was used to measure participants’ dynamic balance in the right and left anterior (RA, LA), posteromedial (RPM, LPM), and posterolateral (RPL, LPL) directions. Results The outcome in this trial was reach distance (cm). There was a significant group by time interaction in terms of reach distance for all directions (p<0.05, η2 ranged from 0.06 to 0.20). In the exercise group, results of the repeated measures analysis of variance (ANOVA) showed significant improvements in the reach distance in all the directions (p<0.001). In contrast, the non-exercise group had significant difference only in the left posterolateral direction (p = 0.009). Participants in the exercise group achieved significantly greater reach distance (cm) (95% confidence interval (CI)) for RA[(2.8, 0.4 to 5.2), p = 0.023]; LA[(3.2, 0.9 to 5.6), p = 0.008]; RPM[(4.0, 1.0 to 7.9), p = 0.046]; LPM[(5.8,1.3 to 10.3), p = 0.013]; RPL[(7.6, 2.6 to 12.6), p = 0.003]; and LPL[(4.2, 0.3 to 8.2), p = 0.035]. Conclusion The modified version of OEP appears to be effective in improving parameters of dynamic balance in the middle-aged adult population. The improvements in YBT reach distance in the exercise group are indicative of the significance of performing balance and strength exercises regularly for this population.
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Affiliation(s)
- Rana Almarzouki
- Department of Physical Therapy, School of Allied Health Professions, Loma Linda University, Loma Linda, California, United States of America
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
- * E-mail:
| | - Gurinder Bains
- Department of Allied Health Studies, School of Allied Health Professions, Loma Linda University, Loma Linda, California, United States of America
| | - Everett Lohman
- Department of Physical Therapy, School of Allied Health Professions, Loma Linda University, Loma Linda, California, United States of America
| | - Bruce Bradley
- Department of Physical Therapy, School of Allied Health Professions, Loma Linda University, Loma Linda, California, United States of America
| | - Todd Nelson
- Department of Physical Therapy, School of Allied Health Professions, Loma Linda University, Loma Linda, California, United States of America
| | - Samiah Alqabbani
- Department of Rehabilitation Sciences, School of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia
| | - Asma Alonazi
- Department of Physical Therapy, School of Applied Medical Sciences, Majmaah University, Riyadh, Kingdom of Saudi Arabia
| | - Noha Daher
- Department of Allied Health Studies, School of Allied Health Professions, Loma Linda University, Loma Linda, California, United States of America
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Otsuka R, Oyanagi K, Hokari M, Shinoda T, Harada J, Shimogai T, Takahashi Y, Kitai T, Iwata K, Tsubaki A. Preoperative physical performance-related postoperative delirium in patients after cardiovascular surgery. Arch Gerontol Geriatr 2020; 91:104172. [PMID: 32707522 DOI: 10.1016/j.archger.2020.104172] [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: 01/13/2020] [Revised: 06/15/2020] [Accepted: 06/29/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES This investigation clarified the relationship between a short physical performance battery (SPPB) that can comprehensively and safely evaluate balance function, walking ability, lower limb muscle strength, and postoperative delirium. METHODS This was a retrospective observational study performed at Kobe City Medical Center General Hospital. Patients who underwent surgery at the Kobe City Medical Center General Hospital Cardiovascular Surgery from August 1, 2016 to July 31, 2017 were included. Preoperative physical functions were obtained. Those showing positive results using the confusion assessment method for intensive care unit (ICU) during the ICU stay were considered as the delirium group, and the postoperative and non-postoperative delirium groups were compared. A multiple logistic regression analysis was performed with the presence or absence of onset of delirium as the dependent variable and the SPPB total score and age as dependent variables. RESULTS There were 193 subjects in this study (120 males and 73 females). Sixteen patients (8.4 %) had postoperative delirium. The age in the postoperative delirium group was significantly higher than in the postoperative delirium group (77.8 (7.0) years vs. 70.0 (11.1) years). BMI and SPPB total score were significantly lower in the postoperative delirium group. From the multiple logistic regression, the SPPB total score (OR: 0.754, 95 % CI: 0.643-0.883, p < 0.001) was extracted as a factor related to postoperative delirium onset. CONCLUSION It was illuminated that in patients with cardiovascular surgery, preoperative low physical function was not affected by age and became a risk factor of postoperative delirium onset.
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Affiliation(s)
- Ryohei Otsuka
- Department of Rehabilitation, Kobe City Medical Center General Hospital, 2-1-1 Minatojima Minamimachi, Chuo-ku, Kobe City, Hyogo Prefecture, Japan; Graduate School of Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata City, Niigata Prefecture, Japan.
| | - Keiichi Oyanagi
- Department of Rehabilitation, Kobe City Medical Center General Hospital, 2-1-1 Minatojima Minamimachi, Chuo-ku, Kobe City, Hyogo Prefecture, Japan
| | - Misaki Hokari
- Department of Rehabilitation, Kobe City Medical Center General Hospital, 2-1-1 Minatojima Minamimachi, Chuo-ku, Kobe City, Hyogo Prefecture, Japan; Graduate School of Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata City, Niigata Prefecture, Japan
| | - Taku Shinoda
- Department of Rehabilitation, Kobe City Medical Center General Hospital, 2-1-1 Minatojima Minamimachi, Chuo-ku, Kobe City, Hyogo Prefecture, Japan
| | - Jumpei Harada
- Department of Rehabilitation, Kobe City Medical Center General Hospital, 2-1-1 Minatojima Minamimachi, Chuo-ku, Kobe City, Hyogo Prefecture, Japan
| | - Takayuki Shimogai
- Department of Rehabilitation, Kobe City Medical Center General Hospital, 2-1-1 Minatojima Minamimachi, Chuo-ku, Kobe City, Hyogo Prefecture, Japan
| | - Yusuke Takahashi
- Department of Rehabilitation, Kaetsu Hospital, 1459-1 Higashi Kanazawa, Akiha-ku, Niigata City, Niigata Prefecture, Japan
| | - Takeshi Kitai
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, 2-1-1 Minatojima Minamimachi, Chuo-ku, Kobe City, Hyogo Prefecture, Japan
| | - Kentaro Iwata
- Department of Rehabilitation, Kobe City Medical Center General Hospital, 2-1-1 Minatojima Minamimachi, Chuo-ku, Kobe City, Hyogo Prefecture, Japan
| | - Atsuhiro Tsubaki
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata City, Niigata Prefecture, Japan
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Palmer TB, Farrow AC, Palmer BM. Relationships between hamstring morphological characteristics and postural balance in elderly men. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2020; 20:88-93. [PMID: 32131372 PMCID: PMC7104577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The link between hamstring morphology and postural balance performance in older adults is not well understood. This study aimed to examine the relationships between hamstring morphological characteristics of muscle size (cross-sectional area [CSA]) and quality (echo intensity [EI]) and postural balance with the eyes open and closed in elderly men. METHODS Nineteen healthy elderly men (age= 73±4 years) participated in this study. Muscle CSA and EI were determined from ultrasound scans of the hamstrings. Postural balance was assessed with the eyes open and closed using a commercially designed balance testing device, which provides a measurement of static stability based on the sway index. RESULTS The sway index with eyes closed was significantly related to muscle EI (r=0.474; P=0.040) but not CSA (r=0.021; P=0.932). The sway index with eyes open was not related to muscle CSA (r= -0.036; P=0.883) or EI (r=-0.079; P=0.747). CONCLUSIONS The significant relationship observed between the sway index with eyes closed and muscle EI suggests that hamstring muscle quality may be a characteristic relevant to postural balance in the absence of visual feedback. These findings may provide important insight regarding the morphological mechanisms involved in maintaining balance and in the development of proper training programs aimed at improving postural stability in older individuals.
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Affiliation(s)
- Ty B. Palmer
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX,Corresponding author: Ty B. Palmer, PhD, Assistant Professor, Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX 79409 E-mail:
| | - Ahalee C. Farrow
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX
| | - Bailey M. Palmer
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX
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Effect of Textured and Prefabricated Insole Use With Medical or Sports Shoes on Dynamic Postural Control in Elderly People. TOPICS IN GERIATRIC REHABILITATION 2020. [DOI: 10.1097/tgr.0000000000000255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Adcock M, Thalmann M, Schättin A, Gennaro F, de Bruin ED. A Pilot Study of an In-Home Multicomponent Exergame Training for Older Adults: Feasibility, Usability and Pre-Post Evaluation. Front Aging Neurosci 2019; 11:304. [PMID: 31824295 PMCID: PMC6882741 DOI: 10.3389/fnagi.2019.00304] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 10/24/2019] [Indexed: 11/13/2022] Open
Abstract
Aging is associated with sensory, motor and cognitive impairments that may lead to reduced daily life functioning including gait disturbances, falls, injuries and mobility restrictions. A strong need exists for implementing effective evidence-based interventions for healthy aging. Therefore, the aim of this study was to (i) evaluate the feasibility and usability of an in-home multicomponent exergame training and (ii) explore its effects on physical functions, cognition and cortical activity. Twenty-one healthy and independently living older adults were included (11 female, 74.4 ± 7.0 years, range: 65-92 years) and performed 24 trainings sessions (each 40 min) over eight weeks. The first part was conducted in a living lab (home-like laboratory environment), the second part at participants' home. The multicomponent exergame included Tai Chi-inspired exercises, dance movements and step-based cognitive games to train strength, balance and cognition. Attendance and attrition rates were calculated and safety during training was evaluated to determine feasibility. Participants rated the usability of the exergame (System Usability Scale) and reported on their game experience (Game Experience Questionnaire). Physical and cognitive functions and cortical activity (resting state electroencephalopathy) were assessed pre and post intervention. Results showed a high training attendance rate for the living lab and the home-based setting (91.7 and 91.0%, respectively) with a rather high attrition rate (28.6%, six drop-outs). Half of the drop-out reasons were related to personal or health issues. System usability was rated acceptable with a mean score of 70.6/100. Affective game experience was rated favorable. Significant improvements were found for minimal toe clearance, short-term attentional span, and information processing speed (p < 0.05). No significant pre-post differences were found for cortical activity. To summarize, the exergame is generally feasible and usable for healthy older adults applied in an in-home setting and provides an overall positive emotional game experience. Nevertheless, flawless technical functionality should be a mandatory consideration. Additionally, the training might have potential positive influence on specific functions in older adults. However, the efficacy has to be evaluated in a future randomized controlled trial assessing the behavioral and neuroplastic changes in a larger population after a longer training period.
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Affiliation(s)
- Manuela Adcock
- Institute of Human Movement Science and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Melanie Thalmann
- Institute of Human Movement Science and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Alexandra Schättin
- Institute of Human Movement Science and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Federico Gennaro
- Institute of Human Movement Science and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Eling D. de Bruin
- Institute of Human Movement Science and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
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Abstract
Testing balance and fall risk with older adults of varying abilities is of increasing importance. The primary aim of this study was to evaluate the validity of the lower quarter Y-balance test (YBT-LQ) in older adults. A secondary aim was to provide estimates of reliability with this population. A total of 30 male (n = 15) and female (n = 15) subjects (66.8 ± 6.5 years) performed the YBT-LQ, 30-s chair stand test, 8-foot up and go test, timed up and go test, single-leg stance, and Activities-Specific Balance Confidence Scale questionnaire. The YBT-LQ was performed on two separate occasions by two investigators in random order. YBT-LQ was significantly correlated with age (p < .01), timed up and go test (p = .003), 8-foot up and go test (p < .001), 30-s chair stand test (p < .001), Activities-Specific Balance Confidence Scale (p = .002), and single-leg stance (p = .005) performance. The intraclass correlation coefficient(3,1) score for the reliability of the YBT-LQ was .95 (95% confidence interval [.89, .97]). The YBT-LQ appears to be a valid and reliable assessment to use with older adults.
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Hirunyaphinun B, Taweetanalarp S, Tantisuwat A. Relationships between lower extremity strength and the multi-directional reach test in children aged 7 to 12 years. Hong Kong Physiother J 2019; 39:143-150. [PMID: 31889765 PMCID: PMC6900330 DOI: 10.1142/s1013702519500136] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 08/12/2019] [Indexed: 11/18/2022] Open
Abstract
Objective This study investigates the relationships between the Multi-Directional Reach Test (MDRT) and lower extremity strength in typical children. Methods The MDRT including forward, backward, leftward, and rightward directions was measured in 60 children aged between 7 and 12 years old with typical development. The lower extremity muscle groups were measured using a hand-held dynamometer. Results The reaching score in each direction had positive relationships with the strengths of several lower extremity muscle groups ( r = 0 . 26 to 0 . 52 , p < 0 . 05 ) . Only the strengths of the hip flexor and knee flexor muscles significantly correlated with the MDRT scores in all directions ( r = 0 . 26 to 0 . 50 , p < 0 . 05 ) . Conclusion This study highlights the strength of the hip and knee flexor muscle groups as being important domain to control balance in all directions. These findings may be used for therapists in planning a balance program to improve the limits of stability.
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Affiliation(s)
- Benjaporn Hirunyaphinun
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, 154 Rama 1 Rd., Pathumwan, Bangkok 10330, Thailand
| | - Soontharee Taweetanalarp
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, 154 Rama 1 Rd., Pathumwan, Bangkok 10330, Thailand
| | - Anong Tantisuwat
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, 154 Rama 1 Rd., Pathumwan, Bangkok 10330, Thailand
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van Aswegen H, Roos R, McCree M, Quinn S, Mer M. Investigation of physical and functional impairments experienced by people with active tuberculosis infection: A feasibility pilot study. Afr J Disabil 2019; 8:515. [PMID: 31534920 PMCID: PMC6739538 DOI: 10.4102/ajod.v8i0.515] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 04/03/2019] [Indexed: 01/09/2023] Open
Abstract
Background Tuberculosis (TB) remains a significant healthcare problem. Understanding physical and functional impairments that patients with active TB present with at the time of diagnosis and how these impairments change over time while they receive anti-TB therapy is important in developing appropriate rehabilitation programmes to optimise patients’ recovery. Objectives The aim of this study was to assess the acceptability, implementation and practicality of conducting a prospective, observational and longitudinal trial to describe physical and functional impairments of patients with active TB. Method A feasibility pilot study was performed. Patients with acute pulmonary TB admitted to an urban quaternary-level hospital were recruited. Physical (muscle architecture, mass and power, balance, and breathlessness) and functional (exercise capacity) outcomes were assessed in hospital, and at 6 weeks and 6 months post-discharge. Descriptive statistics were used to analyse the data. Results High dropout (n = 5; 41.7%) and mortality (n = 4; 33.3%) rates were observed. Limitations identified regarding study feasibility included participant recruitment rate, equipment availability and suitability of outcome measures. Participants’ mean age was 31.5 (9.1) years and the majority were human immunodeficiency virus (HIV) positive (n = 9; 75%). Non-significant changes in muscle architecture and power were observed over 6 months. Balance impairment was highlighted when vision was removed during testing. Some improvements in 6-minute walk test distance were observed between hospitalisation and 6 months. Conclusion Success of a longitudinal observational trial is dependent on securing adequate funding to address limitations observed related to equipment availability, staffing levels, participant recruitment from additional study sites and participant follow-up at community level. Participants’ physical and functional recovery during anti-TB therapy seems to be limited by neuromusculoskeletal factors.
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Affiliation(s)
- Heleen van Aswegen
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Wits-University of Queensland Critical Care Infection Collaboration Group, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ronel Roos
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Wits-University of Queensland Critical Care Infection Collaboration Group, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Melanie McCree
- Wits-University of Queensland Critical Care Infection Collaboration Group, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Samantha Quinn
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Mervyn Mer
- Wits-University of Queensland Critical Care Infection Collaboration Group, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Department of Medicine, Divisions of Critical Care and Pulmonology, Charlotte Maxeke Johannesburg Academic Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Abstract
BACKGROUND Vestibular, neurological and musculoskeletal functions are affected in patients with renal failure. These problems can in turn affect the balance system in peritoneal dialysis (PD) patients. Previously, postural balance changes were shown in hemodialysis patients. This is the first study that evaluates whether there are similar changes in patients with PD. OBJECTIVE This study aimed to compare balance and fall risk between patients undergoing PD treatment and healthy subjects, and aimed to determine the correlation between biochemical parameters and fall risk and balance assessments in PD patients. METHODS This controlled study included 58 patients receiving PD treatment (PD Group) and 75 healthy subjects (Control Group). The Berg Balance Scale (BBS) and Tetrax® Interactive Balance System were used for the comparison of balance between groups. For patients in the PD Group, duration of PD, blood pressure, Kt/Vurea (actual mass of urea removed via peritoneal dialysis), and serum biochemical parameters were recorded and correlation analysis was performed between these parameters and balance measurements. RESULTS There were no statistically significant differences between groups in terms of demographics or BBS scores (p> 0.05). The fall risk of patients in the PD Group was significantly higher than those in the Control Group (p< 0.0001) according to Tetrax measurements. Female gender, older age, higher BMI, and higher blood glucose levels were negatively correlated with balance parameters of PD patients (r> 0.3). There was no statistically significant correlation between duration of PD, blood pressure, and Kt/Vurea with balance parameters or fall risk. CONCLUSIONS Balance was impaired in patients undergoing PD in comparison to healthy subjects. Fall risk may be evaluated using the Tetrax® instead of BBS for this population. Serum glucose level, BMI and age appear to affect balance and fall risk. Therefore, optimization of body weight and normalization of serum glucose levels are important factors for improving balance. The duration of PD, blood pressure, and Kt/Vurea do not affect balance system.
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Affiliation(s)
- Pınar Doruk Analan
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Rüya Özelsancak
- Department of Nephrology, Faculty of Medicine, Baskent University, Ankara, Turkey
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Freund JE, Stetts DM, Oostindie A, Shepherd J, Vallabhajosula S. Lower Quarter Y-Balance Test in healthy women 50-79 years old. J Women Aging 2018; 31:475-491. [PMID: 30153091 DOI: 10.1080/08952841.2018.1510248] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The Lower Quarter Y-Balance Test (LQ-YBT), a measure of dynamic balance used in young adults, has not been adequately studied in older women. We determined the reliability, normative values, and relationships to other balance measures for LQ-YBT in women aged 50-79 years. Interrater reliability was strong, and test-retest reliability was moderate to strong. Results by decade showed women 50-59 years had significantly better scores than both older groups. There were moderate positive correlations between single leg stance, gait speed, and LQ-YBT composite score. LQ-YBT may be used as a dynamic balance assessment in healthy older women.
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Affiliation(s)
- Jane E Freund
- Department of Physical Therapy Education, Elon University, Elon, North Carolina, USA
| | - Deborah M Stetts
- Department of Physical Therapy Education, Elon University, Elon, North Carolina, USA
| | - Autumn Oostindie
- Department of Physical Therapy Education, Elon University, Elon, North Carolina, USA
| | - Jacob Shepherd
- Department of Physical Therapy Education, Elon University, Elon, North Carolina, USA
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Åkesson N, Leffler AS, Rydwik E. Evaluation of Feasibility of a Balance and Strength Training Program for New Users of a Wheeled Walker in an Outpatient Rehabilitation Clinic. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2018. [DOI: 10.1080/02703181.2017.1380113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- N. Åkesson
- Rehab Nordväst, Stockholm County Council, Stockholm, Sweden
- Academic Primary Care Centre (Cefam), Stockholm County Council, Stockholm, Sweden
| | - A.-S. Leffler
- Dept of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - E. Rydwik
- FOU nu, Research and Development Unit for the Elderly, Stockholm County Council, Stockholm, Sweden
- Dept of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
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Hébert-Losier K. Clinical Implications of Hand Position and Lower Limb Length Measurement Method on Y-Balance Test Scores and Interpretations. J Athl Train 2017; 52:910-917. [PMID: 28937801 PMCID: PMC5687235 DOI: 10.4085/1062-6050-52.8.02] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
CONTEXT The Lower Quarter Y-Balance Test (LQ-YBT) was developed to provide an effective and efficient screen for injury risk in sports. Earlier protocol recommendations for the LQ-YBT involved the athlete placing the hands on the hips and the clinician normalizing scores to lower limb length measured from the anterior-superior iliac spine to the lateral malleolus. The updated LQ-YBT protocol recommends the athlete's hands be free moving and the clinician measure lower limb length to the medial malleolus. OBJECTIVE To investigate the effect of hand position and lower limb length measurement method on LQ-YBT scores and their interpretation. DESIGN Cross-sectional study. SETTING National Sports Institute of Malaysia. PATIENTS OR OTHER PARTICIPANTS A total of 46 volunteers, consisting of 23 men (age = 25.7 ± 4.6 years, height = 1.70 ± 0.05 m, mass = 69.3 ± 9.2 kg) and 23 women (age = 23.5 ± 2.5 years, height = 1.59 ± 0.07 m, mass = 55.7 ± 10.6 kg). INTERVENTION(S) Participants performed the LQ-YBT with hands on hips and hands free to move on both lower limbs. MAIN OUTCOME MEASURE(S) In a single-legged stance, participants reached with the contralateral limb in each of the anterior, posteromedial, and posterolateral directions 3 times. Maximal reach distances in each direction were normalized to lower limb length measured from the anterior-superior iliac spine to the lateral and medial malleoli. Composite scores (average of the 3 normalized reach distances) and anterior-reach differences (in raw units) were extracted and used to identify participants at risk for injury (ie, anterior-reach difference ≥4 cm or composite score ≤94%). Data were analyzed using paired t tests, Fisher exact tests, and magnitude-based inferences (effect size [ES], ±90% confidence limits [CLs]). RESULTS Differences between hand positions in normalized anterior-reach distances were trivial (t91 = -2.075, P = .041; ES = 0.12, 90% CL = ±0.10). In contrast, reach distances were greater when the hands moved freely for the normalized posteromedial (t91 = -6.404, P < .001; ES = 0.42, 90% CL = ±0.11), posterolateral (t91 = -6.052, P < .001; ES = 0.58, 90% CL = ±0.16), and composite (t91 = -7.296, P < .001; ES = 0.47, 90% CL = ±0.11) scores. A similar proportion of the cohort was classified as at risk with the hands on the hips (35% [n = 16]) and the hands free to move (43% [n = 20]; P = .52). However, the participants classified as at risk with the hands on the hips were not all categorized as at risk with the hands free to move and vice versa. The lower limb length measurement method exerted trivial effects on LQ-YBT outcomes. CONCLUSIONS Hand position exerted nontrivial effects on LQ-YBT outcomes and interpretation, whereas the lower limb length measurement method had trivial effects.
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Affiliation(s)
- Kim Hébert-Losier
- Faculty of Health, Sport and Human Performance, Adams Centre for High Performance, University of Waikato, Mount Maunganui, Tauranga, New Zealand
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Otero M, Esain I, González-Suarez ÁM, Gil SM. The effectiveness of a basic exercise intervention to improve strength and balance in women with osteoporosis. Clin Interv Aging 2017; 12:505-513. [PMID: 28352163 PMCID: PMC5358963 DOI: 10.2147/cia.s127233] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Objective To determine the effects of a simple exercise program on the balance and strength of postmenopausal women with osteoporosis. Methods This program was based on low intensity strength and balance exercises, and was carried out with simple, readily available equipment. Sixty five women were randomly assigned to either the experimental group (EG; n=33, age: 57.4±4.8 years) or the control group (CG; n=32, age: 58.8±4.5 years). Participants in the EG underwent balance and strength training for 60 min, three times/week for 6 months. Each session consisted of warm-up exercises (10 min), balance training (20 min), strength training (20 min), and cooldown (10 min). Participants from the CG were asked not to modify their usual habits during the course of the study. Static balance was evaluated using the blind monopodal stance static balance test. In contrast, dynamic balance was assessed using the “8-foot up and go” test, whereas the strength of the upper and lower limbs was measured using the “arm curl” and “30 s chair stand” tests, respectively. All these variables were assessed at baseline and upon program completion. Results The EG showed significant improvements (P<0.001) in static balance (21%), dynamic balance (36%), and in the strength of the upper (80%) and lower (47%) limbs in comparison to the CG after the sixth month. Participants in the CG showed significantly lower values (P<0.001) in the four tests. In addition, a significant inverse relationship between static balance and the strength of the upper (r=−0.390; P=0.001) and lower (r=−0.317; P=0.01) limbs was found. Conclusion The present study demonstrates that a physical exercise program based on balance and strength exercises, carried out with simple and readily available equipment, is capable of significantly improving the strength and balance of women with osteoporosis.
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Affiliation(s)
- Montserrat Otero
- Department of Physical Education and Sport, Faculty of Education and Sport Sciences, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz
| | - Izaro Esain
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
| | - Ángel M González-Suarez
- Department of Physical Education and Sport, Faculty of Education and Sport Sciences, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz
| | - Susana M Gil
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
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