Declines in motor transfer following upper extremity task-specific training in older adults

BACKGROUND

Age-related declines in function can limit older adults' independence with activities of daily living (ADLs). While task-specific training maybe a viable approach to improve function, limited clinical resources prevent extensive training on wide ranges of skills and contexts. Thus, training on one task for the benefit of another (i.e., transfer) is important in geriatric physical rehabilitation. The purpose of this study was to test whether motor transfer would occur between two functionally different upper extremity tasks that simulate ADLs in a sample of older adults following task-specific training.

METHODS

Ninety community dwelling adults ages 43 to 94 years old performed two trials of a functional dexterity and functional reaching task at baseline, and were then assigned to one of two groups. The training group completed 3 days of task-specific training (150 trials) on the functional reaching task, whereas the no-training group received no training on either task. Both groups were re-tested on both tasks at the end of Day 3.

RESULTS

No significant interactions were observed between group (training vs. no-training) and time (baseline vs. re-test) on the functional dexterity task (i.e. transfer task), indicating no difference in the average amount of change from baseline to re-test between the groups. However, post hoc bivariate linear regression revealed an effect of age on motor transfer within the training group. For those who trained on the functional reaching task, the amount of transfer to the dexterity task was inversely related to age. There was no significant relationship between age and motor transfer for the no-training group.

DISCUSSION AND CONCLUSIONS

Results of our a priori group analysis suggest that functional reaching training did not, on average, transfer to the dexterity task. However, post hoc regression analysis showed that motor transfer was both experience- and age-dependent, such that motor transfer may decline with advanced age. Future research will consider how functional and cognitive aging influences transfer of motor skills across different activities of daily living.

The effectiveness of functional task exercise and physical therapy as prevention of functional decline in community dwelling older people with complex health problems

Background

A physically active lifestyle in older people contributes to the preservation of good health. We assessed the influence of physiotherapy on daily functioning among community dwelling older people (75+) with complex health problems identified with screening, versus usual care. We also compared functional task exercise (FTE), with problems prioritized by older people, trained in the home environment, versus usual preventive physical therapy (PPT).

Methods

Design: FTE and PPT were compared in a randomized controlled trial (RCT). Both interventions were compared with daily functioning in an observational study: control group.

Setting/Participants: Community-dwelling persons aged ≥75 years with daily activity limitations enlisted in 83 general practices (n = 155).

Interventions: Both intervention groups (FTE, n = 76 and PPT, n = 79) received individual, 30 min treatments. The control group (n = 228) did not get any experimental intervention offered.

Measurements: Groningen Activities of Daily Living Restriction Scale (GARS).

Statistical analyses: Linear Mixed Model analysis, correcting for age, sex, baseline scores and clustering by physiotherapist were used to compare the different groups.

Results

At baseline, 74% percent of the intervention trial group was female vs 79% in the control group. Median ages were 83.9 and 84.7 respectively.

The median baseline GARS-score for the control group was 41.0 (25 and 75 percentile): 35.0; 48.0) and 40.0 (25 and 75 percentile: 32.3; 46.0) for the intervention group (FTE + PPT). The mean change over time was 3.3 (2.5; 4.1) for the control group. Mean difference in change over time between the intervention (FTE + PPT) and the control group was − 2.5 (− 4.3; − 0.6) (p = .009).

Between FTE and PPT the difference in change was − 0.4 (95% CI: -2.3; 3.0, p = 0.795).

Conclusion

An exercise intervention led by physiotherapists may slow down decline in self-reported daily functioning in older persons with daily activity limitations, identified by pro-active case finding.

Trial registration

Netherlands trial register (NTR2407). Registered 6th of July 2010.

Electronic supplementary material

The online version of this article (10.1186/s12877-018-0859-3) contains supplementary material, which is available to authorized users.

Bench stepping with incremental heights improves muscle volume, strength and functional performance in older women

AIM

Task-specific exercises such as bench stepping can improve functional ability and reduce falling incidents in older adults. However, such exercises are often not optimized to improve muscle volume and force-velocity characteristics. This study determined the effects of a 12-week stepping program using incremental step heights (STEEP), on muscle volume, strength, power, functional ability and balance performance in older women.

METHODS

Forty-five community-dwelling women (69y ± 4) were randomly assigned to the STEEP group or a non-training CONTROL group. Training intensity was primarily determined by step height, while training volume remained equal. Thigh muscle volume (CT-scan), force-velocity characteristics of the knee extensors (Biodex dynamometer) and functional ability (Short Physical Performance Battery, timed stair ascent, 10-m walk test and countermovement jump height) were determined pre- and post-intervention. In addition, 3D trunk accelerations were recorded at the lower back to assess balance during the Short Physical Performance Battery balance tests.

RESULTS

Two-way ANOVA showed that the STEEP program increased thigh muscle volume, knee extensor isometric peak torque, dynamic peak power, unloaded rate of velocity development and improved performance on all functional tests to a greater extent than CONTROL (p < .05), except the countermovement jump. No improvements were found for peak velocity and balance performance (p > .05).

CONCLUSION

Our results indicate that bench step training with incremental step heights simultaneously improves functional ability, thigh muscle volume and force-velocity characteristics of the knee extensors in older women.

Weight bearing exercise can elicit similar peak muscle activation as medium-high intensity resistance exercise in elderly women

PURPOSE

To assess whether stepping-based weight bearing exercise (WBE) can elicit peak activation of upper leg muscles similar to resistance exercise (RE) at an intensity required to induce strength gains in elderly women.

METHODS

Muscular activation of several upper leg muscles was measured during RE and WBE in a cohort of 19 healthy elderly women (69.3 ± 3.4 years). WBE consisted of forward and lateral stepping with step heights of 10, 20 and 30 cm. Muscular activation was compared to 60% of one-repetition maximum (1-RM) of congruent RE.

RESULTS

Peak activation during WBE was higher than RE at 60% 1-RM during forward and lateral stepping in vastus lateralis starting at 20 cm (p = 0.049 and p = 0.001), and biceps femoris at 30 cm step height (p = 0.024 and p = 0.030). Gluteus maximus peak activation matched RE at 60% 1-RM at 20 and 30 cm step height regardless of step direction (p ≥ 0.077). Peak activation of the rectus femoris and gluteus medius matched RE activation at 60% 1-RM during lateral stepping at 30 cm (p = 0.355 and p = 0.243, respectively) but not during forward stepping. WBE did not induce similar activation as RE in the semitendinosus.

CONCLUSION

In WBE, most upper leg muscles were recruited at an equal or higher intensity than in RE at 60% 1-RM. Lateral stepping at 30 cm step height showed the highest training potential of all WBE's applied.

Effects of comprehensive rehabilitation training in combination with multi-mode analgesia on body function recovery after tumor-type knee replacement

Objective:

To discuss the significance of comprehensive rehabilitation training combined with multimodal analgesia (MMA) for the early knee function recovery of patients with knee bone tumor who underwent prosthesis replacement operation.

Methods:

Sixty patients with knee bone tumor who underwent prosthesis replacement operation were selected and randomly divided into two groups according to rehabilitation training and postoperative analgesic methods, namely, observation group and control group, 30 cases in each group. The control group was treated with symptomatic treatment (drugs were given based on pain before and after surgery) and continuous passive motion (CPM) functional training, while the observation group was treated with comprehensive rehabilitation training combined with MMA. The compliance of patients in the two groups was compared and the first-time off-bed activity time was recorded. Recovery conditions of wounds were observed, and recovery conditions of limb functions after operations were evaluated.

Results:

The compliance of patients in the observation group was significantly higher than that in the control group, and the difference was statistically significant (P<0.05). The first-time off-bed activity time of patients of the observation group was earlier than that of the control group. The wound recovery condition of the observation group 7 days after operation was better compared to that of the control group, and the difference between two groups two weeks after operation was not statistically significant. The Hospital for special surgery knee (HSS) score and evaluation result of range of motion (ROM) of knees of the observation group were both better than those of the control group in different periods after operation, and the differences were statistically significant (P<0.05).

Conclusion:

Comprehensive rehabilitation training combined with MMA can improve the compliance of patients and help patients off bed earlier, and remarkably promote the early recovery of knee functions; hence it deserves to be promoted clinically.

Cardiopulmonary exercise capacity and quality of life of patients with heart failure undergoing a functional training program: study protocol for a randomized clinical trial

BACKGROUND

Exercise intolerance is a common finding in heart failure that generates a vicious cycle in which the individual starts to limit his activities even more due to progressive fatigue. Regular physical exercise can increase the cardiopulmonary exercise capacity of these individuals. A new approach to physical exercise, known as functional training, could improve the oxygen consumption and quality of life of patients with heart failure; however, there is no information about the effect of this modality of exercise in this patient population. This randomized trial will compare the effects of 36 sessions of functional training versus strength training in heart failure patients.

METHODS

This randomized parallel-design examiner-blinded clinical trial includes individuals of both sexes aged ≥40 years receiving regular follow-up at a single academic hospital. Subjects will be randomly allocated to an intervention group (for 12-week functional training) or an active comparator group (for 12-week strength training). The primary outcomes will be the difference from baseline to the 3-month time point in peak oxygen consumption on cardiopulmonary exercise testing and quality of life assessed by the Minnesota Living with Heart Failure Questionnaire. Secondary outcome measures will include functionality assessed by the Duke Activity Status Index and gait speed test; peripheral and inspiratory muscular strength, assessed by hand grip and manovacuometry testing, respectively; endothelial function by brachial artery flow-mediated dilation; lean body mass by arm muscle circumference; and participant adherence to the exercise programs classified as a percentage of the prescribed exercise dose.

DISCUSSION

The functional training program aims to improve the functional capacity of the individual using exercises that relate to his specific physical activity transferring gains effectively to one's daily life. In this context, we believe that that functional training can increase the cardiopulmonary exercise capacity and quality of life of patients with heart failure. The trial has been recruiting patients since October 2017.

TRIAL REGISTRATION

NCT03321682. Registered on October 26, 2017.

The effectiveness of functional training on impulsiveness of females with intellectual disability

The aim of this study was to determine the effectiveness of Functional Training (FT) on impulsiveness of female students with Intellectual Disability (ID). The research method was pretestposttest- with a control group. The statistical population consisted of all female students with ID in elementary school of Shiraz studying under the auspices of the Special Education Organization in 2018-2019. The participants included 30 female students with ID selected through convenience sampling and randomly assigned to the experimental (n=14) and control (n=14) groups. The experimental group received the functional training for 15 sessions, while the control group did not receive any intervention. The Barratt Impulsiveness Scale Version 11 (BIS-11) was used for measuring the impulsiveness. The Impulsiveness pre-test was performed for both experimental and control groups. The experimental group received the FT for 15 sessions, while the control group did not receive any intervention. At the end of the intervention, post-test was performed for both groups. Mann-Whitney U test was used to analyze the data. The results showed that the mean scores of impulsivities and its subscales (motor impulsiveness, attentional impulsiveness and nonplanning impulsiveness) in the experimental group were significantly reduced. The results showed that FT had a significant effect on impulsiveness of female students with ID (p<0.001). Therefore, it is recommended to design and implement a FT program to improve impulsiveness in people with ID.

Effect of six-week traditional resistance and functional training on functional performance in female netball players

Background

Improving the quality of functional movements in athletes generally requires additional training targeting specific functional deficiencies. However, well-rounded, traditional strength and conditioning program should also improve player’s movement quality. Therefore, the primary aim of this study was to compare the effect of two different six-week interventions on the functional score of female netball players.

Methods

In a randomized controlled study, players were divided into control and intervention group. Both groups completed identical six-week strength and conditioning program, with the intervention group also completing additional corrective exercises three sessions per week during the same period.

Results

The FMS® score was significantly higher in the intervention group after 6-week program (f = 9.85, p = 0.004). However, the differences in total score may be attributed mainly to differences between groups in active straight leg raise (p = 0.004) and trunk stability push-up test (p = 0.02), as other individual tests demonstrated similar time and group effect.

Conclusion

These results indicate that although FMS® based intervention may improve overall functional movement score, the athletes in both groups have demonstrated similar improvements in most of the individual tests. Hence, a well-rounded strength and conditioning program incorporating athlete-specific exercises based on limitations identified in the functional movement screen, may result in a balanced training strategy and reduce the need for supplementary functional training sessions.

Muscular HSP70 content is higher in elderly compared to young, but is normalized after 12 weeks of strength training

Purpose

Aging is associated with increased myocellular stress and loss of muscle mass and function. Heat shock proteins (HSPs) are upregulated during periods of stress as part of the cells protective system. Exercise can affect both acute HSP regulation and when repeated regularly counteract unhealthy age-related changes in the muscle. Few studies have investigated effects of exercise on HSP content in elderly. The aim of the study was to compare muscular HSP levels in young and elderly and to investigate how training affects HSP content in muscles from aged males and females.

Methods

Thirty-eight elderly were randomized to 12 weeks of strength training (STG), functional strength training (FTG) or a control group (C). To compare elderly to young, 13 untrained young performed 11 weeks of strength training (Y). Muscle biopsies were collected before and after the intervention and analyzed for HSP27, αB-crystallin and HSP70.

Results

Baseline HSP70 were 35% higher in elderly than in young, whereas there were no differences between young and elderly in HSP27 or αB-crystallin. After the training intervention, HSP70 were reduced in STG (− 33 ± 32%; P = 0.001) and FTG (− 28 ± 30%; P = 0.012). The decrease in HSP70 was more pronounced in the oldest. In contrast, Y increased HSP27 (134 ± 1%; P < 0.001) and αB-crystallin (84 ± 94%; P = 0.008).

Conclusion

Twelve weeks of STG or FTG decreased the initial high levels of HSP70 in aged muscles. Thus, regular strength training can normalize some of the increases in cellular stress associated with normal aging, and lead to a healthier cellular environment in aged muscle cells.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00421-021-04633-4.

A comparison of abductor hallucis muscle activation and medial longitudinal arch angle during nine different foot exercises

BACKGROUND

Intrinsic foot muscles are known to support the medial longitudinal arch (MLA) and stabilize the foot, and they are activated with weight bearing and increased postural demand. Various types of intrinsic foot muscle training have been reported, but one of the most useful of these, the short foot exercise, is challenging to perform effectively and requires practice, making it difficult to implement in ordinary clinical settings.

RESEARCH QUESTION

What are the differences in abductor hallucis longus (ABH) muscle activity and MLA angle during intrinsic foot muscle exercises that employ weight bearing and balancing conditions when they are performed with minimal practice?

METHODS

Sixteen healthy volunteers performed nine different intrinsic foot muscle exercises, practiced once or twice. The exercises consisted of toe curl, short foot without pushing, short foot with pushing and toe spread exercises in sitting and standing positions, and single leg swing in a standing position. Each exercise was performed three times for five seconds. The activities of the ABH muscles were measured using surface electromyographic (EMG) sensors and the MLA angles during the exercises were captured using an optical motion tracking system. The integrals of the ABH EMG signals were calculated.

RESULTS

Differences in the integral and maximum of the ABH EMG signal were found between the exercises (p < 0.001). Post-hoc pair-wise analysis revealed that the EMG activity was larger during the swing exercise than in exercises other than toe spread, both in sitting and standing positions, and short foot exercise with pushing while standing. The minimum MLA angle during each exercise was smaller for the toe spread exercise in a sitting position than other exercises (p < 0.023).

SIGNIFICANCE

A single leg swing exercise may be effective for self-exercise of intrinsic foot muscles, particularly when intensive supervised physiotherapy is not possible.

Progressive functional training in patients who underwent jaw defect reconstruction using vascularized iliac flaps: A randomized controlled trial

OBJECTIVE

This trial was aimed at investigating the effects of progressive functional training on hip mobility, lower-limb stability, quality of life, and hip complications in patients who have undergone jaw defect reconstruction using vascularized iliac flaps.

METHODS

Patients who underwent reconstruction surgery with vascularized iliac flaps were randomly divided into control and training groups. The control group, according to routine nursing practice, only received activity and safety guidance after the operation. The training group received progressive functional training for functional exercise. The primary outcomes were donor area function-Harris hip score and the timed "Up and Go" test. Secondary outcomes were patients' quality of life, the hip visual analog scale, and other complications. Observations and evaluations were performed before the surgery and on postoperative day 7 and at months 1, 3, 6, and 12.

RESULTS

The donor area function and quality of life of the patients in the training group were significantly improved at 1, 3, 6, and 12 months after surgery, and the differences were statistically significant. The load-dependent pain in the training group was significantly reduced compared with that in the control group. The incidence rates of gait disturbance at postoperative months 3, and 6 in the training group were significantly lower than the corresponding rates in the control group (P < 0.05).

CONCLUSION

Progressive functional training can accelerate the restoration of hip function and stability of lower-limb movement, alleviate gait disorders, relieve pain, and improve patients' quality of life.

Early functional training is not superior to routine rehabilitation in improving walking distance and multifidus atrophy after lumbar fusion: a randomized controlled trial with 6-month follow-up

PURPOSE

To investigate the effects of early functional training within a 12-week rehabilitation program on walking distance and lumbar multifidus atrophy following lumbar fusion surgery.

METHODS

A total of 52 patients who underwent lumbar fusion surgery were randomly assigned to either the early functional training group (n = 26) or the routine rehabilitation group (n = 26). The early functional training group (FT group) began a progressive functional training program within the first 12 weeks post-surgery, while the routine rehabilitation group (RH group) started the same training program 12 weeks after surgery. The primary outcome was the walking distance, measured as the 6-minute walk distance (6MWD) at the 3-month, and 6-month follow-up. Secondary outcomes included the cross-sectional area (CSA) of the multifidus muscles, the Visual Analogue Scale (VAS) score, the Oswestry Disability Index (ODI) score, the Short Form 36 Health Survey (SF-36) subscales, including the Physical Component Summary (PCS) and Mental Component Summary (MCS), and the incidence of adverse events. The primary aim was evaluated using a 2-way mixed-model analysis of covariance (ANCOVA), with treatment group as the between-subjects factor and time as the within-subjects factor, after adjusting for baseline measures.

RESULTS

Among the total patients, 38 (73.1%) left with at least one follow-up result, and 29 (55.8%) completed all treatment sessions and obtained an MRI assessment. The mixed-model ANCOVA revealed a significant group-by-time interaction for the 6MWD (F = 6.214, p = 0.003). Patients in the FT group demonstrated superior 6MWD compared to the GH group at 3 months (95% CI: 32.51 to 101.88, p < 0.001). No significant differences were found between the two groups at the 6-month follow-up (95% CI: -15.34 to 54.03, p = 0.271). Regarding secondary outcomes, no significant group-by-time effects were found for ODI (F = 1.221, p = 0.299), PCS (F = 0.166, p = 0.847), or MCS (F = 0.282, p = 0.755). No significant differences were found in the CSA of multifidus muscles between the groups. Nine patients (17.3%) experienced adverse events.

CONCLUSION

Early functional training after lumbar fusion was not superior to routine rehabilitation in improving walking distance, multifidus atrophy, pain, physical function, and quality of life during the 6-month follow-up. Trial registration number (TRN): ChiCTR2300068296.

Effect of task-based bilateral arm training on upper limb recovery after stroke: A systematic review and meta-analysis

OBJECTIVE

Upper limb recovery is a crucial component of stroke rehabilitation aimed to maximize functional activities and reduce disability. Using both arms post stroke is essential to carry out many functional activities but the evidence on bilateral arm training (BAT) is understudied. To investigate the evidence for efficacy of task-based BAT on upper limb recovery, function, and participation post stroke.

METHODS

We included 13 randomized controlled trials, and methodological quality was assessed using Cochrane risk of bias tool and the PEDro scale. The outcome measures such as Fugl-Meyer Assessment-Upper Extremity (FMA-UE), Action Research Arm Test (ARAT), Wolf Motor Function Test (WMFT), Motor Activity Log (MAL), Box and Block Test (BBT), Modified Barthel Index (MBI), Functional Independence Measure (FIM), and Stroke Impact Scale (SIS) were synthesized and analysed based on ICF.

RESULTS

When comparing BAT with control group, BAT showed improvement in the pooled standard mean difference (SMD) of FMA-UE (SMD= 0.62, 95% confidence interval (CI), 0.12 to 1.12, p = 0.01; I²=83%). The control group showed significant improvement in MAL-QOM (SMD= -0.10, 95%CI, -0.77 to 0.58, p = 0.78; I²=89%). Compared to conventional group, BAT showed a significant improvement in BBT (SMD= 0.52, 95%CI, 0.04 to 1.00, p = 0.03; I²=0%). When compared with BAT, unimanual training yielded a significant improvement (SMD= -0.60, 95%CI, -0.98 to -0.22, p = 0.002; I²=0%) in MAL-QOM. In real-life participation, the control group showed improvement in SIS (SMD= -0.17, 95% (CI), -0.70 to 0.37, p = 0.54; I²=48%) over BAT.

CONCLUSIONS

Task-based BAT appears to improve upper limb motor function post stroke. The benefits of task-based BAT on activity performance and participation in real life are not statistically significant.

Effect of functional training on fundamental motor skills among children: A systematic review

Objectives

Fundamental motor skills (FMS) are the foundation of children's movement, requiring tailored training and guidance for development. As an emerging training method, functional training is optimistic in promoting the development of children's fundamental motor skills. However, current studies have not assessed the effect of functional training on fundamental motor skills. This review aims to address this gap by evaluating the effects of functional training on fundamental motor skills.

Design

A search was conducted in five databases: PubMed, Scopus, ProQuest, Web of Science, and SPORT Discus, from January 2000 to June 2023.

Method

This search followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Results

The results of the search identified a total of twenty-six articles. Improvements were primarily demonstrated in the three main areas of fundamental motor skills: locomotor skills (n = 17), balance skills (n = 10), and object control skills (n = 2).

Conclusions

The results suggest that functional training programs can improve children's fundamental motor skills. Existing evidence also concludes that functional training significantly impacts locomotor and balance skills, whereas further research is required to confirm its positive effects on object control skills.

The effect of functional training on level of brain-derived neurotrophic factor and functional performance in women with obesity

Obesity is the underlying cause of various health conditions such as hypertension, diabetes, and respiratory diseases. It is associated with low self-confidence, emotional disorder, anxiety, depression, social isolation, and suicide. In the present study, we investigated the effect of functional training on obese women's brain-derived neurotrophic factor (BDNF) and executive functioning. To this end, 25 obese women were randomly assigned to 3 different groups labelled as active obese women-functional training, inactive obese women-functional training, and control group. The subjects performed 24 one-hour-long sessions of functional training three times a week. The intensity of activity for the research groups was moderate, which was equivalent to a level of 6-7 on the Borg scale. The analysis of intragroup results indicated that functional training increased serum BDNF significantly in both active and inactive obese women. It was also observed to improve executive functioning in both groups of the obese women via decreasing the number of errors, increasing the number of true responses, and reducing reaction time. The analysis of intergroup results, on the other hand, revealed that there were no significant differences between active and inactive obese women in terms of serum BDNF and executive functioning after functional training. Training promotes cognitive health, and this study adds that functional training may be important for improvement and maintenance of brain health and functional performance. Therefore, by increasing BDNF level through functional exercises, it is possible to help improve the cognitive functions of obese women.

The effect of functional exercise program on physical functioning in older adults aged 60 years or more: A systematic review and meta-analysis of randomized controlled trials

OBJECTIVE

In this systematic review and meta-analysis, we assessed the impact of functional exercise training on physical functioning parameters in older adults 60 years and older.

METHOD

Databases including PubMed, MEDLINE, CINAHL, SPORTDiscus, and Cochrane Library were systematically searched.

RESULTS

Sixteen articles were included. Meta-analysis demonstrated that functional training significantly improved Barthel index (p = 0.01), gait speed (p = 0.002), gait cadence (p = 0.0002), Berg Balance Scale (p = 0.0003), Timed Up and Go test (TUG; p = 0.02), step length (p < 0.0001), Five Chair Stand (p < 0.0001) and physical activity questionnaire for the older adults score (p < 0.00001). However, hand grip strength remained unchanged.

DISCUSSION

These findings underscore the significance of incorporating functional exercises in interventions for healthy aging and maintaining independence among older individuals. Further investigation is needed to explore long-term effects and optimal implementation strategies for functional exercise regimens in this populations.

[Effects of functional training combined with self-made hand flexing training band in treatment of scar contracture after burn injury of dorsal hand]

Objective: To observe the effects of functional training combined with self-made hand flexing training band in treatment of scar contracture after burn injury of dorsal hand. Methods: Forty-six patients with scar contracture after deep partial-thickness or full-thickness burn injury of dorsal hand hospitalized in our department from March 2013 to February 2015 were divided into routine training group (RT, n=18) and comprehensive training group (CT, n=28) according to their willingness. Two weeks after the wounds were healed, patients in group RT were treated with functional training of hands and self-made pressure gloves, while patients in group CT were treated with self-made hand flexing training band (consisting of nylon strap, flexing band, and velcro) on the basis of those in group RT. All patients were treated for 3 months. Before and after treatment, scar condition of affected hands was assessed with Vancouver Scar Scale (VSS). The range of motion of joints of affected hands was measured by Total Active Movement (TAM) Scale. The function of affected hands was evaluated by Carroll Upper Extremity Function Test. Data were processed with t test, chi-square test, and Mann-Whitney U test. Results: (1) The score of VSS in patients of group RT was (10.0±1.9) points before treatment and (4.4±1.4) points after treatment, with the improved score of (5.6±1.0) points. The score of VSS in patients of group CT was (10.5±1.8) points before treatment and (4.6±1.4) points after treatment, with the improved score of (5.9±1.2) points. There was no statistically significant difference in the improved score of patients between the two groups (t=0.834, P>0.05). The score of VSS in patients of groups RT and CT after treatment was significantly lower than that before treatment (with t values respectively 14.014 and 10.003, P values below 0.01). (2) Before treatment, the ratios of excellent and good results according to TAM were 2/9 in patients of group RT and 3/14 in group CT, with no statistical differences between them (χ(2)=2.140, P>0.05). After treatment, the ratio of excellent and good results according to TAM in patients of group CT (6/7) was higher than that in group RT (5/9, χ(2)=0.023, P=0.038). The ratios of excellent and good results according to TAM in patients of groups RT and CT after treatment were significantly higher than those before treatment (with Z values respectively -2.023 and -4.780, P values below 0.05). (3) The improved score of hand function in patients of group CT was (26±12) points, which was higher than (15±7) points in group RT (t=3.278, P=0.002). The score of hand function in patients of groups RT and CT after treatment was significantly higher than that before treatment (with t values respectively 2.628 and 6.125, P values below 0.05). There were no significant differences in grades of hand function of patients between the two groups before treatment (Z=-0.286, P>0.05). After treatment, the grade of hand function in patients of group CT was higher than that in group RT(Z=-1.993, P=0.046). The grades of hand function in patients of groups RT and CT after treatment were significantly higher than those before treatment (with Z values respectively -2.717 and -4.998, P values below 0.01). Conclusions: For patients with scar contracture after burn injury of dorsal hand, early functional training combined with hand flexing training band can improve the range of motion of hand joints and functional recovery of hand, and the result was better than functional training alone.

A functional exercise program improves pain and health related quality of life in patients with fibromyalgia: a randomized controlled trial

BACKGROUND/OBJECTIVE

Fibromyalgia is a non-inflammatory syndrome characterized by generalized muscle pain, with other symptoms. Numerous forms of physical training for this population have been studied through high-quality randomized clinical trials involving strength, flexibility, aerobic conditioning and multicomponent exercise interventions. This research evaluated the effectiveness of a functional exercise program at reducing pain, improving functional capacity, increasing muscle strength as well as improving flexibility, balance and quality of life in individuals with fibromyalgia.

METHODS

Eighty-two women with fibromyalgia were randomized into two groups. The functional exercise group performed functional exercises in 45-minute sessions twice per week for 14 weeks. The stretching exercise group performed flexibility exercises with the same duration and frequency. Outcome measures were: visual analog scale for widespread pain; Fibromyalgia Impact Questionnaire for health-related quality of life; Timed Up and Go test for functional performance; one-repetition maximum for muscle strength, Sit and Reach test on Wells bench for flexibility; Berg Balance Scale for balance; SF-36 for general quality of life.

RESULTS

After the intervention, the functional exercise group had a statistically significant reduction in pain (interaction p = 0.002), and improvement in health-related quality of life measured by the Fibromyalgia Impact Questionnaire (interaction p < 0.001) and in general health state domain of SF-36 (interaction p = 0.043) compared to the stretching exercise group. No significant differences between groups were found regarding improvements in functional capacity, muscle strength, flexibility or balance.

CONCLUSION

Functional exercise training was effective at reducing pain and improving quality of life in patients with fibromyalgia compared to stretching exercises.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT03682588 First prospectively registered in March 2018.

Somatotype and bioelectrical impedance vector analysis of Italian CrossFit® practitioners

Objectives

CrossFit® is a high-intensity sport characterized by various workouts that require strength, speed, endurance, or agility, impacting participants' body composition. This observational study aimed to determine the morphological (anthropometrical and bioelectrical) profile of CrossFit® athletes and to compare them with other athletic populations.

Methods

Anthropometrical measurements and bioelectrical vector analysis (classic and specific approaches) were performed on 145 CrossFit® practitioners (107 men aged 30.7 ± 8.4 years and 38 women aged 28.1 ± 6.7 years). Each participant's relative somatotype was calculated and compared between sexes and with a Spanish CrossFit® athletes' group. Resistance-reactance graphs and Hotelling's T2 test were applied to characterize the sample, compare them with an athletes' reference population, and identify differences between somatotype groups.

Results

The most represented somatotype in both groups was the balanced mesomorph (male 3.5-5.2 - 1.7 and female 4.4-4.5 - 1.8). Compared with Spanish CrossFit® athletes, significant differences were denoted for men but not women (SAD = 2.3). The bioelectrical graphs indicated that the distribution of CrossFit® athletes is quite heterogeneous and within average values for the athlete's reference. The mesomorphic and endomorphic components were associated with a higher phase angle.

Conclusions

CrossFit® practitioners predominantly present a mesomorphic component and show a body type like other power athletes, although with less pronounced characteristics. The somatotype may influence the vector's position in the RXc graphs. This study provided the bioelectrical tolerance ellipses for CrossFit® practitioners in classic and specific approaches for the first time.

Is functional training functional? a systematic review of its effects in community-dwelling older adults

BACKGROUND

Age-related decline in physical and cognitive capacity increases older adults' risk of disability, long-term care placement, and mortality rate. Functional training, which uses activities of daily living or simulated movements to complete activities as the intervention medium, could be more effective than rote exercise, which uses repetitive movements without added purpose, in preventing late-life disability in older people. With a growing number of studies in this area, systematically studying the effect of functional training is needed. The purpose of this systematic review was to examine the effects of functional training on the outcomes of activities of daily living, physical functioning, and cognitive function in community-dwelling older adults.

METHODS

Literature published between January 2010 and April 2024 in 10 electronic databases were searched and screened. This timeframe was established to include studies published within the last 15 years. Each identified article was screened and reviewed by two authors independently. The methodological quality of the included studies was evaluated using the PEDro Scale. Key findings were synthesized according to participants' characteristics and intervention types.

RESULTS

The review included 32 studies. In the general community-dwelling older adult population (20 studies), studies that applied functional training as a single-component approach showed a positive effect on activities of daily living. However, the training effect on balance and mobility was not superior to that of other exercise programs. Moreover, the effect was mixed when functional training was combined with other intervention components. In older adults with mild cognitive impairment (5 studies), Simulated Functional Tasks Exercise, a single-component training, consistently demonstrated positive effects on the activities of daily living and cognitive functions. In older adults with dementia (4 studies) or frailty (3 studies), the effect was mixed across the single- and multi-component approaches.

CONCLUSION

Functional training alone is effective in preventing late-life disability in general community-dwelling older adults. When training activities challenge both motor and cognitive abilities, the effect seems to improve the performance of activities of daily living and cognitive functions in older adults with mild cognitive impairment. Additional studies of functional training in older adults with cognitive impairment or frailty are recommended.

High-intensity functional training modulates oxidative stress and improves physical performance in adolescent male soccer players: a randomized controlled trial

While regular exercise training is known to decrease oxidative stress (OS) and enhance antioxidant functions in adults, limited data exist on OS responses in the pediatric population. This study aimed to investigate the effects of high-intensity functional training (HIFT) on oxidative stress and physical performance in adolescent soccer players. In this randomized controlled trial, 20 well-trained adolescent soccer players were divided into HIFT (n = 10) and moderate-intensity soccer technical training (MITT, n = 10) groups. Both groups trained for 8 weeks (3 days/week). Oxidative stress biomarkers (MDA, 8-OHDG, H2O2, GPx, CAT) and physical performance (VO2peak, vertical jump height [VJH], maximal explosive power [MEP]) were assessed pre- and post-intervention. Repeated measure mixed ANOVA (2 × 2) with a significance level of P < 0.05 was used to determine differences between and within subjects. The main effect of interaction was significant for VO2peak, VJH and MEP (P < 0.05). The main effect of interaction was not significant for CAT, 8-OHDG, GPx, H2O2 and MDA (P > 0.05). Following intervention, VO2peak and VJH performance in the HIFT were significantly higher than MITT (P < 0.05). MDA and H2O2 in the HIFT decreased significantly (P < 0.05), but no significant changes were observed in the MITT (P > 0.05). CAT activity decreased significantly (P < 0.05), while GPx activity increased significantly (P < 0.05) in both groups. 8-OHDG did not show significant changes in both groups (P > 0.05). Eight weeks of HIFT did not cause greater OS compared to MITT, while could improve physical performance parameters. These findings suggest that HIFT is a viable and time-efficient training strategy for enhancing athletic performance in youth sports. Trial registration: The present study was a randomized controlled trial (registration number: IRCT20190530043762N1, 25/09/2019, Iran).

Feasibility and preliminary efficacy of different intensities of functional training in elderly type 2 diabetes patients with cognitive impairment: a pilot randomised controlled trial

BACKGROUND

Aging and type-2 diabetes (T2D) are the most important risk factors for cognitive impairment and Alzheimer's disease. Exercise training is an effective, safe, and practical intervention in improving glucose metabolism, physical function, and cognitive disorders. This pilot study investigated the feasibility and preliminary efficacy of high-intensity low-volume (HIFT) vs. low-intensity high-volume (LIFT) functional training in elderly T2D patients with cognitive impairment.

METHODS

Forty-eight elderly T2D patients (31 female, 17 male, age 67.5 ± 5.8 years, MMSE score 18.8 ± 2.6, FBG 209.5 ± 37.9) were randomly assigned to HIFT, LIFT and control groups. Cognitive impairment was diagnosed with MMSE ≤ 23 based Iranian society. The SDMT, CVLT-II, BVMT-R, and Stroop tests were used to evaluated processing speed, learning, memory and attention respectively. Physical fitness tests include: tandem stance and walk test; TUG; 6MWT, 10MWT; SSST; 5TSTS; and hand grip was used to evaluated static and dynamic balance, agility, walking endurance, gait speed, lower limb function and lower and upper body strength respectively. As well as, Biochemical (FBG, insulin, HOMA-IR, HbA1c) and physiological outcomes (SBP, and DBP) were assessed. The HIFT group performed six weeks of functional training (three sessions per week) with 120-125% of the lactate threshold. The LIFT group performed six weeks of functional training (five sessions per week) with a 70-75% lactate threshold. Feasibility, safety, and acceptability of exercise programs were assessed at the end of the study.

RESULT

HIFT showed a higher adherence rate (91% vs. 87.5%), safety, and acceptability compared to LIFT. MMSE and Stroop scores, 6MWT, FBG, insulin, HOMA-IR, HbA1c, SBP, and DBP significantly improved in HIFT (all, P ≤ 0.004) and LIFT (all, P ≤ 0.023). Changes in 6MWT, FBG, insulin, HOMA-IR, and HbA1c in HIFT (all, P ≤ 0.001) and LIFT (all, P ≤ 0.008) were significant compared to the control group. Changes in Stroop scores were significant only in the HIFT group compared to the control group (P = 0.013). SDMT, CVLT-II, BVMT-R, balance test, 10MWT, SSST, TUG and hang grip significantly improved only in HIFT (all, P ≤ 0.038).

CONCLUSION

HIFT vs. LIFT is a safe, feasible, and effective approach for improving some aspects of physical, biochemical, and cognitive function in elderly T2D patients with cognitive impairment. This pilot study provides initial proof-of-concept data for the design and implementation of an appropriately powered randomised controlled trial (RCT) of HIFT vs. LIFT in a larger sample of elderly T2D patients with cognitive impairment.

TRIAL REGISTRATION

Randomized controlled trial (RCT) (Iranian Registry of Clinical Trials, trial registration number: IRCT20230502058055N1. Date of registration: 11/06/2023.

Effects of functional training on muscle strength, jumping, and functional movement screen in wushu athletes: A systematic review

This study aims to analyse the effects of functional training on muscle strength, jumping, and functional movement screen in wushu athletes.

METHODS

This study followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A systematic search of electronic databases was also conducted, including EBSCOhost, Scopus, PubMed, Web of Science, CNKI, Google Scholar, and Wanfang. The Physiotherapy Evidence Database (PEDro) scale was an effective indicator to evaluate the quality of studies included in the systematic review.

RESULTS

This systematic review included 474 participants aged 8-24 years old. The intervention period for most studies was 12 weeks. Among the included studies, 6 focused on muscle strength, 4 on jumping performance, and 11 on functional movement screen.

CONCLUSION

These articles have been analysed, and the positive impact of functional training interventions on muscle strength, jumping, and functional movement screen of wushu athletes has been verified.

Enhancing Physical Fitness in Elite Field Hockey Players with A Twelve-Week Functional Training Program: A Cluster Randomized Control Trial

This study aimed to explore the impact of functional training on the physical fitness of young elite field hockey players. The study comprised 40 young elite male field hockey players with the following characteristics (mean ± SD age: 21.5 ± 0.8 years; height: 176.9 ± 2.6 cm; weight: 68.4 ± 5.1 kg; BMI: 21.8 ± 1.3; training experience: 51.2 ± 5.4 months). Twenty participants were allocated to two groups: the functional training group (FTG) and the control training group (CG). Each group received 60-minute training sessions three times per week for 12 weeks. Generalized estimating equation analysis and a Bonferroni test for pairwise comparisons were used to assess the intervention's efficacy. Before the start of the exercise program, no statistically significant differences were observed in physical fitness measures between the FTG and CG (p > 0.05). However, by the sixth week, a significant difference appeared in both the T-Agility test (p < 0.001) and endurance (p = 0.024) between the two groups, while no notable distinctions were detected in other fitness parameters (p > 0.05). After a 12-week training program, the FTG demonstrated improvements in all physical fitness measures [flexibility (p < 0.001); Illinois agility test (p < 0.001); T-agility test (p = 0.020); endurance (p < 0.001)] except speed, which exhibited no significant impact (p = 0.175). Notable enhancements in T-agility and endurance were evident after just six weeks of functional training, and a 12-week functional training regimen showed superiority over standard training approaches in young elite male field hockey players. These findings encourage the efficacy of functional training exercises over traditional methods in enhancing athletes' fitness parameters.

The experience of chronic protracted mandibular dislocation treatment: manual vs. surgical reduction

Temporomandibular joint dislocation is a common challenge in dental care, but it can be promptly addressed through manual realignment, making it standard procedure in the realm of oral health. Nonetheless, effectively preventing and treating chronic protracted mandibular dislocation (CPMD), characterized by prolonged dislocation, remains a significant challenge. Hence, a retrospective analysis was conducted on the clinical data of 10 patients diagnosed with chronic protracted mandibular dislocation (CPMD), encompassing diagnosis, treatment, and prognosis details. CPMD tends to be more prevalent among the elderly population, with an average age of 67.2±11.9 years and a male-to-female ratio of 1:9. All diagnosed patients presented with bilateral anterior dislocation, each requiring diverse pre-treatment approaches. The most significant risk factor contributing to CPMD was unconsciousness resulting from nervous system injury, which delayed the perception of symptoms associated with temporomandibular joint dislocation. 90% of CPMD patients experienced successful treatment through manual reduction, while a refractory CPMD cohort, resistant to manual reduction, necessitated surgical intervention for resolution. All patients underwent treatment involving elastic intermaxillary traction, which served as the primary means of achieving reduction. Subsequent analysis of CT data revealed that condylar displacement beyond the zygomatic arch served as an indication for surgical reduction. Consequently, manual reduction under general anesthesia combined with elastic intermaxillary traction proved effective for managing CPMD cases. However, cases displaying excessive vertical displacement beyond the zygomatic arch should be considered for surgical intervention based on CT findings.