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Maccarone MC, Avenia M, Masiero S. Postural-motor development, spinal range of movement and caregiver burden in Prader-Willi syndrome-associated scoliosis: an observational study. Eur J Transl Myol 2024. [PMID: 38651535 DOI: 10.4081/ejtm.2024.12533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 04/03/2024] [Indexed: 04/25/2024] Open
Abstract
Prader-Willi syndrome (PWS) is a rare genetic disorder characterized by hypothalamic dysfunction, hypotonia, cognitive deficits, and hyperphagia, primarily resulting from genetic abnormalities on chromosome 15. Among its varied manifestations, musculoskeletal issues, notably scoliosis, pose important challenges in management. This study aims to investigate differences in postural-motor development and spinal range of movement between preadolescents and adolescents with PWS, with and without scoliosis, while also exploring the potential impact of scoliosis on caregiving burden, an aspect yet to be thoroughly explored in existing literature. This observational study evaluated 13 individuals diagnosed with PWS, including 5 with scoliosis (PWS-Sc) and 7 without (PWS-NSc). Inclusion criteria comprised ages 8 to 18 years, confirmed PWS diagnosis through genetic testing, and scoliosis diagnosis. Anamnestic data, physical examinations, and surface measurements were collected, along with parental burden assessments using the Zarit Burden Interview (ZBI). Both groups displayed delays in achieving postural-motor milestones, with the PWS-Sc group exhibiting a more pronounced delay, although statistical significance was not achieved. The main curve magnitude in the PWS-Sc group averaged 31.5° Cobb, with 60% of cases presenting an S-shaped curve. Surface measurements of physiological curves did not differ significantly between groups, but the scoliosis-affected group exhibited lower lumbar extension values (p=0.04). The overall ZBI revealed higher scores in the PWS-Sc group, although statistical significance was not reached. However, significant differences were observed in single questions score evaluating aspects such as social life and caregiver uncertainty (p=0.04 and p=0.03, respectively). Despite the small sample size, delays in achieving postural-motor milestones, particularly in individuals with scoliosis, were observed. The differences recorded in lumbo-pelvic movement suggest that tailored interventions may be beneficial. The heightened caregiving burden in the scoliosis group underscores the need for targeted support. Early intervention and ongoing monitoring should be important for accurate diagnosis and appropriate care, potentially with psychological support for caregivers.
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Affiliation(s)
| | - Mariarosa Avenia
- Physical medicine and rehabilitation School, Department of Neuroscience, University of Padua.
| | - Stefano Masiero
- Rehabilitation Unit and Physical medicine and rehabilitation School, Department of Neuroscience, University of Padua.
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Juan-Recio C, Prat-Luri A, Barbado D, Vera-Garcia FJ, Moreno-Pérez V. Reliability of a Trunk Flexion and Extensor Muscle Strength Test with Hand-Held and Isokinetic Dynamometers in Female Athletes. J Hum Kinet 2024; 92:43-52. [PMID: 38736593 PMCID: PMC11079922 DOI: 10.5114/jhk/172640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 09/20/2023] [Indexed: 05/14/2024] Open
Abstract
An accurate trunk muscle strength assessment seems very important to design and individualize training and rehabilitation programs in clinical and sport settings. Hand-held dynamometers (HHDs) are interesting alternatives to isokinetic dynamometers for assessing trunk isometric muscle strength because they are inexpensive instruments and easy to use. This cross-sectional observational study aimed to examine the reliability of two novel sitting tests for assessing trunk flexion and extension isometric strength using an HHD and their relationship with two other novel isometric tests that use an isokinetic dynamometer. Twenty-four female amateur athletes (age: 24.5 ± 2.64 years; body height: 164.45 ± 6.33 cm; body mass: 63.17 ± 10.35 kg) participated in this study. A test-retest design was carried out one-week apart to examine the reliability. The relationship and the degree of agreement between the HHD and the isokinetic dynamometer measurements were analysed using Pearson correlation and Bland-Altman analysis, respectively. In general, the reliability of all isometric strength tests was good, with ICCs ranging from 0.65 to 0.87 and typical error < 15%. Pearson correlations were moderate, with values of r = 0.47 (R2 = 0.22) and r = 0.42 (R2 = 0.18) for flexion and extension strength, respectively. Bland-Altman plots showed no agreement between HHDs and isokinetic measurements. All trunk isometric tests using both, an isokinetic dynamometer and HHDs, provide reliable measurements for assessing trunk flexion and extension strength. According to the comparative analysis, both measurement types are different and cannot be used interchangeably. Health and sport professionals should choose the test that best suits the biomechanical characteristics required for functional goals or success in a given sport.
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Affiliation(s)
- Casto Juan-Recio
- Sports Research Centre, Department of Sports Sciences, Miguel Hernández University of Elche, Alicante, Spain
| | - Amaya Prat-Luri
- Sports Research Centre, Department of Sports Sciences, Miguel Hernández University of Elche, Alicante, Spain
| | - David Barbado
- Sports Research Centre, Department of Sports Sciences, Miguel Hernández University of Elche, Alicante, Spain
| | - Francisco J. Vera-Garcia
- Sports Research Centre, Department of Sports Sciences, Miguel Hernández University of Elche, Alicante, Spain
| | - Víctor Moreno-Pérez
- Sports Research Centre, Department of Sports Sciences, Miguel Hernández University of Elche, Alicante, Spain
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Vlazna D, Krkoska P, Sladeckova M, Parmova O, Barusova T, Hrabcova K, Vohanka S, Matulova K, Adamova B. Trunk muscle dysfunction in patients with myotonic dystrophy type 2 and its contribution to chronic low back pain. Front Neurol 2023; 14:1258342. [PMID: 37954643 PMCID: PMC10637363 DOI: 10.3389/fneur.2023.1258342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 10/11/2023] [Indexed: 11/14/2023] Open
Abstract
Introduction Myotonic dystrophy type 2 (MD2) presents with a varied manifestation. Even though the myopathy in these patients is more widespread, axial musculature involvement is one of the most prominent conditions. MD2 patients also often report chronic low back pain (CLBP). The purpose of this study was to evaluate trunk muscle function, including respiratory muscles, in patients with MD2 and to compare it with healthy controls, to determine the occurrence of CLBP in patients with MD2, and to assess whether trunk muscle dysfunction increases the risk of CLBP in these patients. Methods We enrolled 40 MD2 patients (age range 23 to 76 years, 26 women). A comprehensive battery of tests was used to evaluate trunk muscle function. The tests consisted of quantitative muscle strength testing of low back extensor muscles and respiratory muscles and the assessment of trunk muscle endurance. A neurological evaluation contained procedures assessing the distribution of muscle weakness, myotonia, and pain, and used questionnaires focused on these items and on disability, depression, and physical activity. Results The results of this study suggest that patients with MD2 show significant dysfunction of the trunk muscles, including the respiratory muscles, expressed by decreased muscle strength and endurance. The prevalence of CLBP in patients with MD2 was 52.5%. Based on our analysis, the only independent significant risk factor for CLBP in these patients was maximal isometric lower back extensor strength in a prone position ≤ 15.8 kg (OR = 37.3). Other possible risk factors were severity of myotonia and reduced physical activity. Conclusion Outcomes of this study highlighted the presence of axial muscle dysfunction, respiratory muscle weakness, and frequent occurrence of CLBP together with its risk factors in patients with MD2. We believe that the findings of this study may help in management and prevention programs for patients with MD2.
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Affiliation(s)
- Daniela Vlazna
- Department of Neurology, Center for Neuromuscular Diseases (Associated National Center in the European Reference Network ERN EURO-NMD), University Hospital Brno, Brno, Czechia
- Faculty of Medicine, Masaryk University, Brno, Czechia
- Department of Rehabilitation, University Hospital Brno, Brno, Czechia
| | - Peter Krkoska
- Department of Neurology, Center for Neuromuscular Diseases (Associated National Center in the European Reference Network ERN EURO-NMD), University Hospital Brno, Brno, Czechia
- Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Michaela Sladeckova
- Department of Neurology, Center for Neuromuscular Diseases (Associated National Center in the European Reference Network ERN EURO-NMD), University Hospital Brno, Brno, Czechia
- Faculty of Medicine, Masaryk University, Brno, Czechia
- Department of Rehabilitation, University Hospital Brno, Brno, Czechia
- Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Olesja Parmova
- Department of Neurology, Center for Neuromuscular Diseases (Associated National Center in the European Reference Network ERN EURO-NMD), University Hospital Brno, Brno, Czechia
| | | | | | - Stanislav Vohanka
- Department of Neurology, Center for Neuromuscular Diseases (Associated National Center in the European Reference Network ERN EURO-NMD), University Hospital Brno, Brno, Czechia
- Faculty of Medicine, Masaryk University, Brno, Czechia
| | | | - Blanka Adamova
- Department of Neurology, Center for Neuromuscular Diseases (Associated National Center in the European Reference Network ERN EURO-NMD), University Hospital Brno, Brno, Czechia
- Faculty of Medicine, Masaryk University, Brno, Czechia
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Alfaya FF, Reddy RS, Alshahrani MS, Gautam AP, Mukherjee D, Al Salim ZA, Alqhtani RS, Ghulam HSH, Alyami AM, Al Adal S, Jabour AA. Exploring the Interplay of Muscular Endurance, Functional Balance, and Limits of Stability: A Comparative Study in Individuals with Lumbar Spondylosis Using a Computerized Stabilometric Force Platform. Life (Basel) 2023; 13:2104. [PMID: 37895485 PMCID: PMC10608059 DOI: 10.3390/life13102104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/17/2023] [Accepted: 10/22/2023] [Indexed: 10/29/2023] Open
Abstract
Lumbar spondylosis, characterized by degenerative changes in the lumbar spine, often leads to pain, reduced spinal stability, and musculoskeletal dysfunction. Understanding the impact of lumbar spondylosis on musculoskeletal function, particularly lumbar extensor endurance, functional balance, and limits of stability, is crucial for improving the management and well-being of affected individuals. This study aimed to assess lumbar extensor endurance, functional balance, and limits of stability in individuals with lumbar spondylosis compared to age-matched healthy individuals and explore the correlations among these parameters within the lumbar spondylosis group. The lumbar spondylosis group consisted of 60 individuals initially screened by an orthopedician and referred to physical therapy. Age-matched healthy controls (n = 60) were recruited. Inclusion criteria encompassed adults aged 45-70 years for both groups. Lumbar extensor endurance was assessed using the Sorensen test, functional balance with the Berg Balance Scale, and limits of stability using a computerized stabilometric force platform. Lumbar extensor endurance was significantly lower in individuals with lumbar spondylosis compared to healthy controls (23.06 s vs. 52.45 s, p < 0.001). Functional balance, as assessed by the Berg Balance Scale, demonstrated a significant decrement in the lumbar spondylosis group (48.36 vs. 53.34, p < 0.001). Additionally, limits of stability variables, under both eyes-open and eyes-closed conditions, exhibited marked impairments in the lumbar spondylosis group (p < 0.001 for all variables). Within the lumbar spondylosis group, lumbar extensor endurance exhibited significant positive correlations with functional balance (0.46, p < 0.001) and negative correlations with limits of stability variables (r ranging from -0.38 to -0.49, p < 0.01 for all variables). This study underscores the significance of addressing lumbar extensor endurance, functional balance, and stability impairments in the comprehensive management of lumbar spondylosis.
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Affiliation(s)
- Fareed F Alfaya
- Department of Orthopedic Surgery, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
| | - Ravi Shankar Reddy
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Mastour Saeed Alshahrani
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Ajay Prashad Gautam
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Debjani Mukherjee
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Zuhair A Al Salim
- Department of Sport Science and Physical Activity, College of Science, University of Hafr Al Batin, Hafr Al Batin 39524, Saudi Arabia
| | - Raee S Alqhtani
- Physical Therapy Department, Medical Applied Sciences College, Najran University, Najran 66462, Saudi Arabia
| | - Hussain Saleh H Ghulam
- Physical Therapy Department, Medical Applied Sciences College, Najran University, Najran 66462, Saudi Arabia
| | - Abdullah Mohammed Alyami
- Physical Therapy Department, Medical Applied Sciences College, Najran University, Najran 66462, Saudi Arabia
| | - Saeed Al Adal
- Physical Therapy Department, Medical Applied Sciences College, Najran University, Najran 66462, Saudi Arabia
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Triantafyllou A, Papagiannis G, Stasi S, Gkrilias P, Kyriakidou M, Kampouroglou E, Skouras AZ, Tsolakis C, Georgoudis G, Savvidou O, Papagelopoulos P, Koulouvaris P. Lumbar Kinematics Assessment of Patients with Chronic Low Back Pain in Three Bridge Tests Using Miniaturized Sensors. Bioengineering (Basel) 2023; 10:bioengineering10030339. [PMID: 36978730 PMCID: PMC10044747 DOI: 10.3390/bioengineering10030339] [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: 01/29/2023] [Revised: 02/24/2023] [Accepted: 03/03/2023] [Indexed: 03/30/2023] Open
Abstract
Lumbar muscle atrophy, diminished strength, stamina, and increased fatigability have been associated with chronic nonspecific low back pain (LBP). When evaluating patients with LBP, trunk or core stability, provided by the performance and coordination of trunk muscles, appears to be essential. Several clinical tests have been developed to identify deficiencies in trunk performance, demonstrating high levels of validity and reproducibility. The most frequently prescribed tests for assessing the core body muscles are the prone plank bridge test (PBT), the side bridge test (SBT), and the supine bridge test (SUBT). However, quantitative assessments of the kinematics of the lumbar spine during their execution have not yet been conducted. The purpose of our study was to provide objective biomechanical data for the assessment of LBP patients. The lumbar spine ranges of motion of 22 healthy subjects (Group A) and 25 patients diagnosed with chronic LBP (Group B) were measured using two inertial measurement units during the execution of the PBT, SUBT, and SBT. Statistically significant differences between the two groups were found in all three tests' kinematic patterns. This quantitative assessment of lumbar spine motion transforms the three bridge tests into an objective biomechanical diagnostic tool for LPBs that may be used to assess the efficacy of applied rehabilitation programs.
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Affiliation(s)
- Athanasios Triantafyllou
- Biomechanics Laboratory, Department of Physiotherapy, University of the Peloponnese, 23100 Sparta, Greece
- Sports Excellence, 1st Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Georgios Papagiannis
- Biomechanics Laboratory, Department of Physiotherapy, University of the Peloponnese, 23100 Sparta, Greece
- Sports Excellence, 1st Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Sophia Stasi
- Laboratory of Neuromuscular and Cardiovascular Study of Motion, Physiotherapy Department, Faculty of Health and Care Science, University of West Attica, 12243 Egaleo, Greece
| | - Panagiotis Gkrilias
- Biomechanics Laboratory, Department of Physiotherapy, University of the Peloponnese, 23100 Sparta, Greece
| | - Maria Kyriakidou
- Biomechanics Laboratory, Department of Physiotherapy, University of the Peloponnese, 23100 Sparta, Greece
| | - Effrosyni Kampouroglou
- 2nd Department of Surgery, Aretaieio Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Apostolos-Zacharias Skouras
- Sports Excellence, 1st Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Charilaos Tsolakis
- Sports Excellence, 1st Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, 12462 Athens, Greece
- Sports Performance Laboratory, School of Physical Education & Sports Science, National and Kapodistrian University of Athens, 17237 Athens, Greece
| | - George Georgoudis
- Department of Physiotherapy, University of West Attica, 12243 Athens, Greece
| | - Olga Savvidou
- Sports Excellence, 1st Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Panayiotis Papagelopoulos
- Sports Excellence, 1st Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Panagiotis Koulouvaris
- Sports Excellence, 1st Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, 12462 Athens, Greece
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Krkoska P, Vlazna D, Sladeckova M, Minarikova J, Barusova T, Batalik L, Dosbaba F, Vohanka S, Adamova B. Adherence and Effect of Home-Based Rehabilitation with Telemonitoring Support in Patients with Chronic Non-Specific Low Back Pain: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1504. [PMID: 36674258 PMCID: PMC9860722 DOI: 10.3390/ijerph20021504] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
Home-based exercises have been on the rise recently. This pilot study aimed to assess the adherence and effect of a home-based rehabilitation programme using telemonitoring in patients with chronic non-specific low back pain (CNLBP). Twenty-seven patients with CNLBP were enrolled in the study, each of whom underwent a neurological assessment, including patient-oriented measures and a functional assessment-a battery of tests that comprehensively evaluated trunk muscle function. The rehabilitation programme lasted 18 weeks and included daily home-based exercises. A mobile application or an exercise diary was used to monitor compliance. Adherence to the programme was excellent for both the diary and mobile application groups, with 82.3% in the diary group exercising at least once a day and 72.9% twice a day, and 94.8% in the mobile application group exercising at least once a day and 86.6% twice a day. Both patient-oriented and functional outcomes improved significantly; however, the relative changes of the parameters in these two groups did not correlate, which supports the idea that trunk muscle function does not directly relate to patient complaints and that CNLBP is a multifactorial issue. This model of rehabilitation programme should be used in clinical practice, as its adherence and effectiveness seem noticeable.
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Affiliation(s)
- Peter Krkoska
- Department of Neurology, Center for Neuromuscular Diseases (Associated National Center in the European Reference Network ERN EURO-NMD), University Hospital Brno, 625 00 Brno, Czech Republic
- Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Daniela Vlazna
- Department of Neurology, Center for Neuromuscular Diseases (Associated National Center in the European Reference Network ERN EURO-NMD), University Hospital Brno, 625 00 Brno, Czech Republic
- Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
- Department of Rehabilitation, University Hospital Brno, 625 00 Brno, Czech Republic
| | - Michaela Sladeckova
- Department of Neurology, Center for Neuromuscular Diseases (Associated National Center in the European Reference Network ERN EURO-NMD), University Hospital Brno, 625 00 Brno, Czech Republic
- Department of Rehabilitation, University Hospital Brno, 625 00 Brno, Czech Republic
- Department of Public Health, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Jitka Minarikova
- Department of Rehabilitation, University Hospital Brno, 625 00 Brno, Czech Republic
- Department of Rehabilitation and Sports Medicine, Second Medical Faculty, Charles University and University Hospital Motol, 150 06 Prague, Czech Republic
| | - Tamara Barusova
- Institute of Biostatistics and Analysis Ltd., 602 00 Brno, Czech Republic
| | - Ladislav Batalik
- Department of Rehabilitation, University Hospital Brno, 625 00 Brno, Czech Republic
- Department of Public Health, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Filip Dosbaba
- Department of Rehabilitation, University Hospital Brno, 625 00 Brno, Czech Republic
| | - Stanislav Vohanka
- Department of Neurology, Center for Neuromuscular Diseases (Associated National Center in the European Reference Network ERN EURO-NMD), University Hospital Brno, 625 00 Brno, Czech Republic
- Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Blanka Adamova
- Department of Neurology, Center for Neuromuscular Diseases (Associated National Center in the European Reference Network ERN EURO-NMD), University Hospital Brno, 625 00 Brno, Czech Republic
- Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
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Randomized Controlled Trial of Group Exercise Intervention for Fall Risk Factors Reduction in Nursing Home Residents. Can J Aging 2022; 42:328-336. [PMID: 35950596 DOI: 10.1017/s0714980822000265] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE The aim of this study was to assess the effectiveness of a multidimensional exercise intervention on improving fall risk deterrent factors, such as overall strength and flexibility in nursing home residents. METHODS A multi-centre, randomized controlled trial was finally utilized in 40 older adults (>65 years) who were randomly allocated to the intervention or the control group (20 subjects in each). The intervention group attended an exercise program twice a week for eight weeks, to improve functional mobility. The control group did not receive any intervention. Measurements before and after intervention included the Hand Grip Strength (HGS) testing, the Sit-to-Stand test (SST), the Back Scratch Test (BST), and the Sit-and-Reach test (SRT). RESULTS MANOVA revealed significant time effects, V = 0.336, F(6, 33) = 2.78, p = 0.027, partial η2 = 0.336; group effects, V = 0.599, F(6, 33) = 8.22, p < 0.001, partial η2 = 0.599; and group*time interaction, V = 0.908, F(6, 33) = 54.52, p < 0.001, partial η2 = 0.908. A subsequent univariate analysis did not reveal a significant time effect for any variable (p > 0.05). Significant group effects were observed only for SRT (p < 0.05). Significant group*time interactions were observed for all the examined variables (p < 0.05). Dependent t-tests showed that the older adults in the exercise group were significantly improved in all the examined parameters (p < 0.05). Except for SRT (p > 0.05), all the other parameters significantly deteriorated in the control group (p < 0.05). CONCLUSIONS Significant improvements were demonstrated in strength and flexibility among nursing home residents following an eight-week group exercise training program.
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