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Core Strengthening and Balance in the Geriatric Population
Abstract
Aging usually reduces muscle capacity in the core muscles of the body causing a reduction in functional abilities and activities of daily living. In the present investigation, we evaluated the effect of an exercise regimen on strength training in the core muscles, balance, and reach. Thirteen subjects underwent 20 minutes of exercise per day, 3 days a week, for a period of 1 month using a 6 Second Abs machine (Savvier, LP, Carlsbad, CA), eliciting exercise on the rectus abdominis, transversus abdominis, and back extensor muscles. Balance and functional reach were assessed before and after the exercise program. Before exercise, the average maximum reach in the subjects was 15.4 ± 5.2, 16.9 ± 5.7, and 15.7 ± 4.8 cm for reach in the forward, right, and left directions, respectively. After training, reach increased to 22.4 ± 5.9, 20.6 ± 4.0, and 22.5 ± 5.3 cm in the respective directions. Associated with that movement, during maximum reach in the forward, right, and left directions, the reach angle of the body changed from 1.91° ± 2.76°, 2.31° ± 0.9°, and 0.9° ± 3.1° before training to 5.33° ± 1.83°, 4.72° ± 1.83°, and 2.42° ± 1.1° after the 1-month training program, showing a corresponding increase associated with the increased reach of these subjects. Not only were reach and the critical angle at which the subject exceeded his or her limit of stability increased, but tremor was reduced significantly for these subjects after training. The results show that even if older individuals are engaged in a basic fitness program, training is very beneficial to increasing their independence and functional activities of daily living.
... Regarding the positive effects of exercise training on balance, a great deal of research has focussed on balance improvement protocols using a myriad of training methods, including strength training, weight training, core stability, and neuromuscular training (Petrofsky et al. 2005;Carpes et al. 2008). Core stability training is a modality of training that focuses on trunk muscles. ...
... Enhancing trunk muscle forces provided stability in the core body, leading to postural performance improvements (Kibler et al. 2006;Borghuis et al. 2008;Larivi ere et al. 2015;Prieske et al. 2016). To date, studies have mostly explored and reported positive effects of core stability training on postural control and balance (Petrofsky et al. 2005;Carpes et al. 2008). For instance, 12 weeks of strength training for the core body using a Swiss ball increased dynamic balance in women (Sekendiz et al. 2010); however, the effects of core stability exercises on the balance of deaf children undergoing an 8-week training were not reported in the literature. ...
... The findings of the study indicated that PT and CST groups decreased the number of errors during BESS with open and closed eyes, leading to improvements in balance in deaf students. These findings are in line with previous studies (Lindsey and O'Neal 1976;Lewis et al. 1985;Petrofsky et al. 2005;Carpes et al. 2008;Sato and Mokha 2009;Hessari et al. 2011;Hyun et al. 2014;de Oliveira et al. 2015) which examined the effects of proprioception and core stability training on static balance and found significant effects. In open and closed eyes states, both experimental groups indicated similar significant training effects. ...
Purpose
Children with hearing impairment are unable to speak and may suffer from some physical problems such as weakness in postural performance ability and development. The aim of the current study was to explore the effects of proprioception versus core stability training for an 8-week period followed by a 6-month detraining protocol on the balance performance of deaf students.
Materials and methods
This is a randomized controlled trial design of three groups in blinded evaluators. The study was conducted at the school gym. A total of 30 participants, of male deaf students, were randomized into three groups: (1) one group receiving proprioception training (PT, n = 10), (2), one group receiving core stability training (CST, n = 10) for 8 weeks, and (3), and control group (CON, n = 10). The Balance Error Scoring System (BESS) test and Y-balance test assess static and dynamic balance at pre- and post-training following a 6-month detraining.
Results
Post 8 weeks of training intervention, PT and CST values showed significant improvements in both static (p = 0.001) and dynamic (p = 0.001) balance. Following the 6-month detraining, only the PT group maintained their improvements in both the static and dynamic balance tests (p = 0.348) and the CST group showed decreases in the balance tests (p = 0.034).
Conclusions
The results indicate that 8 weeks rehabilitation program (PT and CST) is an optimum training modality to enhance balance in deaf students and PT induces more training effects than CST for maintaining training benefits following the detraining
... The balance is of the most important indices of daily activities for elderly people [11]. Poor balance and physical readiness in the elderly is a multifactorial subject [12]. ...
... Poor balance and physical readiness in the elderly is a multifactorial subject [12]. Since irreversible consequences such as falling caused by reduced balance threat the lives of elderly people [11], prevention of falling is the best treatment. Different studies indicated that along with age increase, strength and endurance of the muscles also reduced, which in turn results in reduced balance, elevated body swing, and consequently, increased risk of falling [11]. ...
... Since irreversible consequences such as falling caused by reduced balance threat the lives of elderly people [11], prevention of falling is the best treatment. Different studies indicated that along with age increase, strength and endurance of the muscles also reduced, which in turn results in reduced balance, elevated body swing, and consequently, increased risk of falling [11]. The nature of hemodialysis and sedentary lifestyle expose the patients under hemodialysis to a large spectrum of physical and physiological complications [13]. ...
Purpose: The elderly patients undergoing hemodialysis who developed end-stage renal failure
are at higher risk for falling and its critical outcomes compared with their healthy counterparts due
to of poor balance, reduced muscle endurance, and sedentary lifestyle. The current study aimed at
evaluating the effect of selected core stability exercises on balance and muscle endurance in the
elderly patients undergoing hemodialysis.
Methods: In the current quasi-experimental study, a total of 30 patients undergoing hemodialysis
with the mean age of 62.24±6.51 years, the mean hemodialysis duration of 29.4±18.44 months,
and the history of falling at least once during the last year were selected using the purposive
convenience sampling method and then, the subjects were randomly allocated into 2 groups
of intervention (n=15) and control (n=15). To assess the static balance, dynamic balance, and
muscle endurance in the patients, the stork stand test, the timed Up and Go test (TUG), and the
sit-to-stand-to-sit test for 60 seconds (STS-60) were used, respectively. The selected core stability
exercises were performed for the intervention group in 6 weeks, three 45-minute sessions per
week. To analyze data, the repeated measures analysis of variance (RM ANOVA) with SPSS
version 22 was used; P<0.05 was considered the level of significance.
Results: Results of the current study indicated significant differences between the groups in
terms of static balance, dynamic balance, and muscle endurance (P<0.001). In other words, the
implemented exercises significantly affected the studied variables.
Conclusion: Based on the obtained results, the therapists can suggest the core stability exercises
as a safe and functional strategy to improve balance and muscle endurance in patients undergoing
hemodialysis, which may result in increased independence of action and reduced risk of falling
due to loss of balance.
... Two studies were based on convenient samples [28,29]. Four studies did not include a control group [30][31][32][33]. ...
... Intervention programs of studies that were eligible for review comprised CST on stable and unstable surfaces and PET. Adherence rates during training were inconsistently reported and ranged between 84-100 % for CST [21,24,30,31] and between 80-92 % for PET [25,26,32]. ...
... Interventions were conducted in a gym [24], in a senior center/residential house [26,30], in an outpatient medical center [21,31], in a private clinic [27], and at home [29,30,34]. CST was supervised by an expert on CST [21], by a physical therapist [31], or by trained instructors [24]. ...
Background:
The aging process results in a number of functional (e.g., deficits in balance and strength/power performance), neural (e.g., loss of sensory/motor neurons), muscular (e.g., atrophy of type-II muscle fibers in particular), and bone-related (e.g., osteoporosis) deteriorations. Traditionally, balance and/or lower extremity resistance training were used to mitigate these age-related deficits. However, the effects of resistance training are limited and poorly translate into improvements in balance, functional tasks, activities of daily living, and fall rates. Thus, it is necessary to develop and design new intervention programs that are specifically tailored to counteract age-related weaknesses. Recent studies indicate that measures of trunk muscle strength (TMS) are associated with variables of static/dynamic balance, functional performance, and falls (i.e., occurrence, fear, rate, and/or risk of falls). Further, there is preliminary evidence in the literature that core strength training (CST) and Pilates exercise training (PET) have a positive influence on measures of strength, balance, functional performance, and falls in older adults.
Objective:
The objectives of this systematic literature review are: (a) to report potential associations between TMS/trunk muscle composition and balance, functional performance, and falls in old adults, and (b) to describe and discuss the effects of CST/PET on measures of TMS, balance, functional performance, and falls in seniors.
Data sources:
A systematic approach was employed to capture all articles related to TMS/trunk muscle composition, balance, functional performance, and falls in seniors that were identified using the electronic databases PubMed and Web of Science (1972 to February 2013).
Study selection:
A systematic approach was used to evaluate the 582 articles identified for initial review. Cross-sectional (i.e., relationship) or longitudinal (i.e., intervention) studies were included if they investigated TMS and an outcome-related measure of balance, functional performance, and/or falls. In total, 20 studies met the inclusionary criteria for review.
Study appraisal and synthesis methods:
Longitudinal studies were evaluated using the Physiotherapy Evidence Database (PEDro) scale. Effect sizes (ES) were calculated whenever possible. For ease of discussion, the 20 articles were separated into three groups [i.e., cross-sectional (n = 6), CST (n = 9), PET (n = 5)].
Results:
The cross-sectional studies reported small-to-medium correlations between TMS/trunk muscle composition and balance, functional performance, and falls in older adults. Further, CST and/or PET proved to be feasible exercise programs for seniors with high-adherence rates. Age-related deficits in measures of TMS, balance, functional performance, and falls can be mitigated by CST (mean strength gain = 30 %, mean effect size = 0.99; mean balance/functional performance gain = 23 %, mean ES = 0.88) and by PET (mean strength gain = 12 %, mean ES = 0.52; mean balance/functional performance gain = 18 %, mean ES = 0.71).
Limitations:
Given that the mean PEDro quality score did not reach the predetermined cut-off of ≥6 for the intervention studies, there is a need for more high-quality studies to explicitly identify the relevance of CST and PET to the elderly population.
Conclusions:
Core strength training and/or PET can be used as an adjunct or even alternative to traditional balance and/or resistance training programs for old adults. Further, CST and PET are easy to administer in a group setting or in individual fall preventive or rehabilitative intervention programs because little equipment and space is needed to perform such exercises.
... The review study is tabulated in Table 1A. About author, title of the study and final conclusion of the study were described below in the Table 1; [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]. [9] Strength and Endurance Influence on the Trunk Muscle in the Functional Performance of Elderly Women. ...
... Jerrold s et al. Experimental study [24] Core strengthening and balance in geriatric population strengthening of core does aid in functional abilities ...
... [3] Muscle strength is lost in the axial muscles i.e. core muscles along with distal muscles which make it difficult to maintain balance. [4] Balance is the ability to maintain the body's center of gravity within the limits of stability as determined by the base of support. [5] The ability to maintain balance is an integrated task of neuromuscular, central nervous system and sensory system. ...
... Control group did not show any significant change in Berg Balance Scale, Y -balance Test (anterior,posteromedial, posterolateral) and Functional Reach Test. As Ageing is an on-going process, there are normal age associated changes taking place in the body which leads to impairments in balance [1] .Also, there is decline of physiological capacities and deterioration of ability to respond to stress in this period which increases vulnerability of the older adults to various impairments due to ageing process [4] . So there was no change seen in the control group. ...
Objective: Fall is defined as unintentional loss of balance that leads to failure of postural stability. Around 30% of older adults aged over 65 years have an episode of falls each year.. All postural control components undergo changes with ageing. Any impairment in neuromuscular, central nervous system and sensory system leads to fall. So the aim of present study was to determine the effects of Core stabilization exercises on balance performance in older adults. Methodology: Sixty participants both males and females aged between 65-75 years were divided into 2 groups, Experimental and Control group (n=30). Experimental group performed core stabilization exercises 5 times a week for 6 weeks, while control group carried on their routine daily activity for 6 weeks. Berg Balance Scale (BBS), Y-Balance Test, Functional Reach Test were assessed at the baseline and after 6 weeks of intervention. Results: Statistical analysis revealed that Experimental group showed significant improvement in BBS, Y-Balance Test and Functional Reach Test scores with (p ˂ 0.05) post 6 weeks of intervention. Control group showed no significant improvement in the scores. Conclusion: Core stabilization exercises had significant improvement on balance variables in experimental group when compared to control group.
... Ageing is an important part of all human being reflecting the biological changes that occur, but also reflecting cultural and societal conventions. Physiological changes occur with aging in all organ systems and are frequently seen due to decline in bone mass after certain age [1] . Aging is associated with a loss in muscle strength also usually reduces muscle capacity in the core muscles of the body causing a reduction in functional abilities [1] . ...
... Physiological changes occur with aging in all organ systems and are frequently seen due to decline in bone mass after certain age [1] . Aging is associated with a loss in muscle strength also usually reduces muscle capacity in the core muscles of the body causing a reduction in functional abilities [1] . Osteoarthritis (OA) is an age-related disorder and is often described as a chronic degenerative disease. ...
Background: Osteoarthritis (OA) is an age-related disorder and is often described as a chronic degenerative disease. Prevalence rates is estimated that 9.6% of men and 18% of women aged ≥ 60 years have symptomatic OA worldwide whereas in India it is 22% to 39%. Foot Posture Index (FPI) is a diagnostic clinical tool aimed at quantifying the degree to which a foot can be considered to be pronated, supinated or neutral position. Aim of the study: To determine correlation between Foot Posture Index and Knee Osteoarthritis in Elderly individuals. Methodology: Sampling method: Convenient sampling Study duration: 3 months Sample size: 100 participants Result: The Karl Pearson correlation co-efficient(r) for the above study is 0.43, R squared value is 0.18 and the two tailed p value is <0.0001 and thus the result shows extreme significance. Conclusion: The study concluded that, there is positive correlation between knee osteoarthritis (OA) and foot posture index. The abnormal foot posture was commonly seen in patients with OA Knee grade 3 and 4.
... [2] These disabilities, secondary to the normal aging process, can lead to loss of balance and poor gait in the older population [2] . Balance is the ability to maintain an upright posture during static and dynamic tasks which requires complex interactions between peripheral and central factors such as vision, somatosensation, vestibular sensation, motor output, and musculature [3] . Along with interaction of the nervous and musculoskeletal system, balance and postural control also requires interaction between vestibular system, visual system and somatosensory system. ...
... It is therefore hypothesized that addition of these exercises in balance training will prove as aid in elderly having balance impairment [4] . Falls and fall related injuries can cause limited mobility and functional decline leading to disability and may have a negative effect on the socioeconomic status and quality of life (QOL) in elderly individuals [3] . ADLs are frequently impaired due to weakness in core muscles such as the rectus abdominis, transversus abdominis, and the internal and external oblique muscles. ...
... These improvements in trunk muscle function are not surprising, given that Huber training required constant trunk muscle activation during isometric pushing/pulling efforts (50-75% of MVC) in various directions. Our results are in concordance to those reported by other authors that examined the effects of core strength or core stability training on trunk muscle function in older adults (Granacher et al., 2012;Cruz-Ferreira, Fernandes, Laranjo, Bernardo, & Silva, 2011;Petrofsky, Cuneo, Dial, Pawley, & Hill, 2005). Granacher et al. (2012) reported 21-53% increase in trunk muscle strength following 9-week core training under unstable conditions in older individuals. ...
... Granacher et al. (2012) reported 21-53% increase in trunk muscle strength following 9-week core training under unstable conditions in older individuals. Petrofsky et al. (2005) showed that 4-week core strength training program increased strength of trunk flexors and extensors of seniors by 33-36%. Kahle and Tevald (2014) recently reported 44% increase in abdominal muscle endurance following core strengthening program in healthy older men and women. ...
... Each person was evaluated 3 times with the first 2 evaluations (days 1 and 2) separated by 1-2 days, and the third 1 (day 3) after an interval of approximately 6 weeks. A 6-weeks interval is considered as the minimum duration of a therapeutic exercise intervention to demonstrate a clear improvement of strength (28,29). All muscle torque tests were performed by 3 experienced examiners (cS, MW, RH) and conducted at the same time of day to reduce effects of diurnal variation. ...
... Although the wide LoAs observed in our study probably induce high relative reliability values, the precision of the dAVId ® test devices is sensitive enough to detect changes that may be induced by a rigorous strengthening intervention programme of more than 4 weeks in elderly persons (28,29) and more than 9 weeks in young persons (16,40), where significant improvements in trunk muscle strength can be expected. the precision of the tests may, however, be insufficient to identify real improvements if healthy volunteers perform a short or less rigorous exercise programme or if healthy volunteers start a training programme with an initially high trunk strength performance baseline (43). ...
Objective:
To determine the short- and long-term test-retest reliability of maximum isometric trunk moment measurements in healthy volunteers over 50 years of age, to compare these results with those from volunteers younger than 50 years, and to test whether volunteers' anticipatory emotional state affects the precision of these measurements.
Methods:
Forty-two older persons (21 females; age range 50-90 years) and 44 younger persons (19 females; age range 18-49 years) performed maximum isometric trunk extensions, flexions, and rotations using dynamometers (DAVID, Fi, David Health Solutions Ltd, Helsinki, Finland). They repeated the tests after 1-2 days (short-term) and at 6 weeks (long-term). Retest-reliability was evaluated for age- and gender-specific subgroups, with assessment of intraclass correlation coefficient (ICC2,1) , standard error of measurement, smallest real difference, and smallest real difference, in percent.
Results:
For the elderly group, smallest real difference, in percent values varied up to 33% and were similar to those obtained from young volunteers. Precision of the trunk rotation tests was lower than that of trunk flexion or extension. Retest agreement exceeded 0.75 (ICC2,1) for all tests, with no relevant differences observed between gender- and age-specific subgroups. Neither participants' motivation nor their anticipatory emotions correlated with the individual coefficients of variation of the trunk muscle moment measurements.
Conclusion:
Isometric maximum trunk extension and flexion moment measurements taken from healthy persons > 50 years old are as reliable as those from persons < 50 years old, and can be expected to enable an acceptable level of detection of expected changes in muscle strength parameters as a result of planned exercise interventions.
... Strengthening these muscles not only has strong central effects in the body, such as cardiovascular training, but also causes an increase in stability of the trunk to extend during reach and functional activities. 19 These, in turn, reduce the risk of back injury. Lower and upper back injuries have always been a major problem in the United States and throughout the world. ...
... 17,18 But, abdominal crunches provide only low levels of muscle activity since the only resistance to core muscle activity is the body weight. 3,4,19 Therefore, large numbers of repetitions are needed to train. To increase muscle work, devices such as Swiss balls have been used as an adjunct to abdominal crunches. ...
Ten subjects were examined to deter- mine muscle use that occurred during core body exercise using a 7-inch diame- ter mini stability ball produced by Savvier LP (Santa Fe Springs, Ca) com- pared with abdominal crunches on the floor and on a Swiss ball. Muscle use was evaluated through the surface elec- tromyogram recorded above the abdom- inal and lower back muscles. Three levels of core exercise were tested with the mini stability ball. The results showed that crunches on the Swiss ball used approximately 50% more muscle work per second of exercise as did work
... 6 To study how to improve the comprehensive quality of students' Cardiopulmonary ability by using cardiopulmonary resistance training is the only way for the sustainable and innovative development of Wushu in the new era. 7 In order to improve the level of Wushu teaching and realize the benign reform of teaching, this paper takes the Wushu movement of a certain school as the main research object. In the research process, the field investigation method, literature collection method and experimental method are mainly used, and a series of teaching experiments are carried out in the practice of heart lung resistance training. ...
Introduction
Many studies have explored different training methods to improve cardiorespiratory capacity, ensuring better oxygen demand to help students develop better sports skills and teaching outcomes.
Objective
Explore the effects of applying resistance training on kung fu teaching.
Methods
40 kung fu athletes were selected as research volunteers. They were randomly divided into experimental and control groups; both were trained in a cardiopulmonary resistance protocol for 8 weeks, three times a week, using a breathing trainer. The control group trained at 20%, while the experimental group had their training at 50% of full capacity.
Results
The maximal inspiratory pressure, FEV1 / FVC, and mvv15 of the lung function indices increased significantly in the experimental group; the forced capacity and maximal ventilation of the oxygen uptake capacity indices also increased significantly. The blood oxygen saturation and the blood flow perfusion index of the oxygen utilization capacity indices had significant differences between the groups; the central balance and flexibility indices also showed significant differences.
Conclusion
After cardiopulmonary endurance training, the athletes’ capacity was significantly improved, inferring a benefit in the quality of kung fu teaching. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.
Cardiopulmonary Exercise Test; Physical Fitness; Kung Fu
... The results of our study have implications for balance training in older adults with osteoporosis, especially since current recommendations for falls prevention focus almost exclusively on lower extremity training [36]. Nine previous studies have found improvements in balance and functional measures after incorporating trunk muscle training into exercise programs [37][38][39][40][41][42][43][44][45]. However, only one of these was completed with people with osteoporosis [42]. ...
2021) The association between trunk muscle endurance, balance and falls self-efficacy in women with osteoporotic vertebral fractures: an exploratory analysis from a pilot randomized controlled trial, Disability and Rehabilitation, 43:16, 2268-2274, ABSTRACT Background: Trunk muscle endurance may be associated with balance and falls self-efficacy for people with osteoporosis. However, all previous studies have examined trunk muscle strength rather than endurance. Purpose: To explore the relationships between trunk muscle endurance and standing balance and falls self-efficacy for women with vertebral fractures. Materials and Methods: This is an exploratory, secondary analysis of baseline data of a pilot randomized controlled trial in Ontario, Canada. Thirty-one women with osteoporosis, aged 65 years or older, with at least one vertebral fracture were included. The associations between balance (Balance Outcome Measure for Elder Rehabilitation) and trunk muscle endurance (Timed Loaded Standing Test) and falls self-efficacy (Falls Efficacy Scale International) and trunk muscle endurance were tested via Spearman rank order correlation with Fisher's z transformations. Results: Trunk muscle endurance was correlated with better balance performance on the Balance Outcome Measure for Elder Rehabilitation [Spearman correlation coefficient, 0.71; 95% confidence interval: 0.47-0.85; p < 0.001], but not with falls self efficacy (Spearman correlation coefficient;-0.22; 95% confidence interval:-0.53 to 0.14; p ¼ 0.23). Conclusions: Trunk muscle endurance was moderately associated with better standing balance performance but not falls self-efficacy, highlighting the importance of trunk muscle endurance for standing balance for older adults with osteoporosis and vertebral fractures.
... 8,9 Hence, substantial repetitions of these exercises may be required to achieve optimum performance. 10 Alternatively, Trunk Stabilization Exercises (TSE) like side and back bridges are performed by adjusting the functional postures such as keeping the lumbar spine in a neutral position with little or no trunk movements. The chief goal of the TSE is to enhance and restore co-contraction and coordination of local and global muscles to improve the control of the pelvis and the lumbar spine. ...
Background: Trunk stability is key in controlling body balance and movements. Trunk Stabilization Exercises (TSE) and Conventional Trunk Exercises (CTE) are performed to improve dynamic balance. The authors have previously reported that dynamic balance was improved by a 12-week and 6-week TSE program. However, there is a dearth of research on its immediate effect on dynamic balance in trained soccer players.
Objective: To compare the immediate effeect of TSE with that of CTE on dynamic balance in trained soccer players.
Methods: Forty-eight male soccer players (24.60 ffi 1.38 years) participated in this crossover study, wherein each participant took part in three exercise sessions: TSE, CTE, and No Exercise control (NE), each consisting of three steps: pre-test, intervention and post-test, with an interval of one week between each exercise condition. To assess dynamic balance, the Y Balance Test-Lower Quarter (YBT-LQ) score in the anterior, posteromedial, and posterolateral directions was measured before and 5 minutes after each intervention.
Results: The YBT-LQ composite score was significantly improved after TSE (0.51) as compared to CTE (0.22) and NE (0.04) (p < 0.05). Furthermore, in TSE and CTE conditions, YBT-LQ scores of the posterolateral and posteromedial directions significantly improved at the post-test (p < 0.05).
Conclusions: Both TSE and CTE are effective in immediately improving dynamic balance; however, TSE showed greater improvement as compared to the latter. Immediate improvements in the posteromedial and posterolateral directions of the YBT-LQ were demonstrated after performing the TSE and CTE.
... Elderly age reduces core muscle strength, which in turn affects balance control. 16 Previous studies found that CSE improves both static and dynamic balance, and the quality of life in elderly women after 6-weeks of training. 17 There are some feedback devices; such as a pressure biofeedback or manual palpation, which allows the subject to recognize the correct exercise during CSE. ...
Objective: The elderly have a decrease in muscle power and cognitive functions, leading to a higher risk of falling. The core stabilization exercise is a standard exercise for the elderly, but is considered as non-interesting and has no immediate feedback. On the other hand, active video gaming is new technology, more interesting and provides immediate feedback. Thus, the objective was to compare the effectiveness of core stabilization exercise (CSE) and active video gaming (AVG) on dynamic balance, core and lower limb muscle strength and reaction time in elderly people.
Material and Methods: This study was a single-blind randomized controlled trial design; conducted from January to April, 2019. The participants were 34, healthy, elderly patients; who were randomly assigned to either the CSE group (n=17) or AVG group (n=17). All participants received a training program consisting of 60 minutes, 3 times a week, for 6 weeks. The CSE group received a core stabilization exercise program, while the AVG group received video gaming with balance control on a moveable platform (Sensamove® , the Netherlands). The participants were assessed for dynamic balance, core and lower limb muscle strength, and reaction time at pre-, two, forth, and sixth week.
Results: The AVG group showed superior and significant difference to the CSE group in dynamic balance after forth (p-value=0.004; 95% confidence interval (CI), -0.94 to -0.11) and sixth week (p-value=0.001; 95% CI, -1.22 to -0.25) of training, and reaction time after forth (p-value=0.028; 95% CI, -37.89 to –0.24) and sixth week of training (p-value= 0.026; 95% CI, -72.08 to -10.13). However, within group comparison, after sixth weeks of training, the CSE group had significantly increased in core (p-value=0.020; 95% CI, 1.01 to 21.55) and lower limb muscle strength (p-value=0.008; 95% CI, -2.68 to -0.39). In addition, the AVG group had significantly increased in dynamic balance (p-value=0.001; 95% CI, -2.18 to -0.66), lower limb muscle strength (p-value=0.001; 95% CI, -2.38 to -0.66), and reaction time (p-value= 0.007; 95% CI, -120.99 to -22.64).
Conclusion: Active video gaming showed better effectiveness than the core stabilization exercise in both dynamic balance and reaction time. Between before and after six weeks of training, the core stabilization exercise increased in core and lower limb muscle strength. In addition, active video gaming increased in dynamic balance, lower limb muscle strength and reaction time. So, active video gaming can be added in generic rehabilitation for improvement of muscle strength, reaction time and balance.
... For ACSM, these types of exercises should systematically be part of the training sessions of all healthy adults (ACSM, 2010;Scurati et al., 2016;Seo et al., 2012;Stephenson & Swank, 2004) to prevent any spinal and lower limbs injuries (Kliziene et al., 2015;Petersen & Nittinger, 2014;Hicks et al., 2005;Petrofsky et al., 2005;Hodges et al., 2005;Willson et al., 2005): ACSM's advices, in practice, support the effectiveness and systematic nature of this type of exercise in order to improve these functional relationships and to extend senior quality life; other Authors view Core stability exercises to prevent falls by increasing the static and dynamic balance ability (ACSM, 2010; Kahle & Tevald, 2014;Granacher et al., 2013;Kang, 2015). ...
... We would like to improve both the transverse abdominis and the diaphragm via active, functional, and resistive treatments including threshold systems, hypopressive exercise, and functional ventilation during movement [28][29][30]. In order to limit physiological impairment, some exercises including thoracic movement with the arms, chest, and spine mobility are introduced during global therapy in both directions: inhale and exhale [31,32]. In order to improve oxygenation and prevent congestion, ventilation should be harmonized throughout the lung territories, and mucociliary clearance should be promoted. ...
The COVID-19 infection has particularly affected older adults. Clinical observations in this population highlight major respiratory impairment associated with the development or aggravation of the patient’s frailty state. Mr. P is a 93-year-old frail patient, hospitalized after a COVID-19 infection. The assessment process of this patient has been supported by an innovative multi-systemic tool developed in view of the COVID-19 clinical consequences and a systemic evaluation of motor functions by the Frail’BESTest. This process allowed a mixed clinical picture associated with significant respiratory distress (linked with acute respiratory distress syndrome) and an evident motor frailty. The care plan was developed accordingly, and four assessments were done in the same manner until Mr. P returned home. This case report allows us to see a holistic COVID-19 clinical picture, showing the different axes of clinical reasoning to enhance the rehabilitation process. Furthermore, this case report illustrates the importance of rehabilitation in the COVID-19 context.
... The next paragraph will show the aims and exercises samples that have been proposed to Mr P.We would like to improve both transverse abdominis and diaphragm by active, functional and resistive treatment including threshold systems, hypopressive exercise and functional ventilation during efforts [28][29][30]. In order to limit physiological impairment, some exercises including thoracic movement with arms, chest and spine mobility are introduced during global therapy in both ways : inhale and exhale [31][32]. In order to improve oxygenation and prevent congestion, ventilation should be harmonized throughout the lung territories and mucociliary clearance should be promoted. ...
Introduction : Covid-19 infection has particularly affected older adults. Clinical observations in this population highlight major respiratory impairment associated with development or aggravation of frailty state.
Case Presentation : Mr P is a 93 years old frail patient, hospitalized after a COVID-19 infection. The assessment process of this patient has been supported by an innovative multi-systemic tool developed in view of the COVID-19 clinical consequences and a systemic evaluation of motor functions by the Frail BESTest. This process allowed presenting a mixed clinical picture associating an important respiratory distress (linked with the acute respiratory distress syndrome) and an evident motor frailty. The care plan was developed accordingly, and four assessment were done in the same manner until the return home of Mr P
Conclusion : This case report allows seeing holistically a COVID-19 clinical picture, showing the different axis of clinical reasoning to enhance the rehabilitation process. Furthermore, this case report illustrate the importance of rehabilitation in the Covid-19 context.
... Balance is the ability to maintain the center of gravity on the surface of the body with minimal change [4]. It is also one of the indicators of independence in daily activities [5]. Weakening of the balance due to increased age is the biggest reason for falling that is a common and serious problem in the elderly [6]. ...
Introduction. External focus instruction and self-controlled feedback have beneficial effects on motor learning. The purpose of the present study was to investigate the benefits of combined effects of external focus instruction and self-controlled feedback on balance performance in older adults.
Material and Methods. Forty older adults (mean age: 63.21 ± 3.6 years; all female) were selected and randomly divided into 4 groups: self-controlled feedback, external attention, external attention/self-controlled feedback and control group. The task of standing on the platform of the stabilometer device and trying to keep the platform horizontally as much as possible was performed in each 30-sec. trial. The participants of self-controlled group received feedback on the timing of balance after the trials. In the external focus of attention, participants noticed the signs that were located horizontally ahead of their feet. The test was conducted in two sessions. In the acquisition phase, 10 trials of 30 seconds were performed and the retention test was completed 24 hours later as 5 trials of 30 seconds.
Results. The results of mixed ANOVA on time data as an indicator of balance in the acquisition phase showed that the mixed group of external focus of attention and self-controlled feedback had better performance than the other groups (p = 0.004). In the retention test, the results of mixed ANOVA showed that the participants in the combined group of external focus and self-controlled feedback had better performance than the other groups (p = 0.006). The external focus of attention and self-controlled feedback performed similarly, and both were superior to the control group (p < 0.05).
Conclusions. The results of this study, supporting the OPTIMAL theory of motor learning in the elderly, showed that the combination of two factors of external focus and self-controlled feedback has a double advantage over the presence of each of the factors. Therefore, it is suggested that the combinations of external focus instructions and self-controlled feedback should be used to improve performance and motor learning in the classes of practical and clinical rehabilitation fields.
... In 9 studies participants were not receiving any training when in the comparison group and were expected to maintain regular levels of physical activity during the time of the trial (23,41,(44)(45)(46)(47)(48)(49)51). In 2 studies participants were hospitalized or living in a nursing home (42,43), one study was performed in a senior citizen center (28). One study described the intervention both in hospitalized patients and in outpatients (50). ...
Key points. Exercise-based core stability training interventions demonstrate considerable emphasis on traditional types of strength training components and only few exercise programs consider motor learning components to enhance function in older adults. It remains unclear whether additional motor learning components are more beneficial for effecting core stability training related outcomes in comparison to traditional exercise programming. Exercise practitioners and therapists should be aware that structured exercise programs for core stability training can be flexible in design, however, come with the probability of impacting differently on core stability training related outcomes in older adults. Background. To influence core stability related functioning in elderly, several types of resistance training interventions may be performed. Different types of core stability training will differently effect on training related outcomes. The objective of this systematic review is to investigate the effect of motor learning training strategies in comparison to traditional strength training for core stability. Methods. Selected articles were identified from MEDLINE, EMBASE, CINAHL, PsycINFO and Cochrane. Studies were included if published in English and aimed to train core stability. The studies should target subjects aged 60 years and older. Results. The search strategy yielded 13 studies that met the inclusion criteria; 11 describing traditional trunk strength exercising programmes and 2 using motor learning training strategies. The results do not allow favoring one training approach against the other due to insufficient studies comparing the two training approaches. Conclusion. Currently available literature does not present a wealth of information about the best strategy for core stability training in seniors. The limited availability of high-quality prospective studies that used a comparison between traditional and training approaches that use elements of motor learning warrants targeted future research investigating and comparing the effects of these approaches.
... 4 Keeping in view the efficacy of core stabilization exercise in sports, low back pain and improving trunk performance in the elderly population, various studies have been administered to find out the impact of core stabilization exercise with an aim to improve trunk stability, balance and mobility after the stroke. [20][21][22][23] In general, stabilization exercises along with muscle strengthening and endurance exercises are advised to improve trunk performance which have been reported to be effective in improving trunk function along with mobility and balance but whether these exercises are effective to improve trunk function in stroke is not well understood. 24 Muscles which inflict their action on the lumbar and sacral spine are categorized as "Local" muscles which work for the segmental stability of the lumbosacral spine and "Global" which the muscles are working in producing spinal movement. ...
Background: one of the most frequent determinants of long-term disability in the adults is Stroke which may affect the normal functioning of trunk and hence may disturb balance.
Objective: to assess the effects of “Abdominal Drawing-in Maneuver” and “Diaphragmatic Breathing Maneuver” in improving the stability of trunk in stroke patients.
Methods: A quasi-experimental study including 36 patients with confirmed diagnosis of the first incident of stroke was conducted. Patients were assigned randomly in two groups ADIM and DBM. Outcome measurements were evaluated using the “Trunk Impairment Scale”.
Results: after 4 weeks of training; “Trunk Impairment Scale” score improved significantly. Between groups comparison shows that trunk stability significantly improved in the group DBM as compared those in the group ADIM.
Conclusion: it may be concluded that Diaphragmatic Breathing Maneuver can be an effective technique in improving trunk stability in stroke patients.
... The results of our study have implications for balance training in older adults with osteoporosis, especially since current recommendations for falls prevention focus almost exclusively on lower extremity training [36]. Nine previous studies have found improvements in balance and functional measures after incorporating trunk muscle training into exercise programs [37][38][39][40][41][42][43][44][45]. However, only one of these was completed with people with osteoporosis [42]. ...
Background: Trunk muscle endurance may be associated with balance and falls self-efficacy for people with osteoporosis. However, all previous studies have examined trunk muscle strength rather than endurance.
Purpose: To explore the relationships between trunk muscle endurance and standing balance and falls self-efficacy for women with vertebral fractures.
Materials and Methods: This is an exploratory, secondary analysis of baseline data of a pilot randomized controlled trial in Ontario, Canada. Thirty-one women with osteoporosis, aged 65 years or older, with at least one vertebral fracture were included. The associations between balance (Balance Outcome Measure for Elder Rehabilitation) and trunk muscle endurance (Timed Loaded Standing Test) and falls self-efficacy (Falls Efficacy Scale International) and trunk muscle endurance were tested via Spearman rank order correlation with Fisher’s z transformations.
Results: Trunk muscle endurance was correlated with better balance performance on the Balance Outcome Measure for Elder Rehabilitation [Spearman correlation coefficient, 0.71; 95% confidence interval: 0.47–0.85; p < 0.001], but not with falls self efficacy (Spearman correlation coefficient; –0.22; 95% confidence interval: –0.53 to 0.14; p = 0.23).
Conclusions: Trunk muscle endurance was moderately associated with better standing balance performance but not falls self-efficacy, highlighting the importance of trunk muscle endurance for standing balance for older adults with osteoporosis and vertebral fractures.
• Implications for Rehabilitation
• Older adults with osteoporosis and vertebral fractures who have better trunk muscle endurance may also have better standing balance.
• There was no association between trunk muscle endurance and how confident a person is that they will not fall while completing various activities of daily living.
• Trunk muscle endurance training could be included as part of a standing balance rehabilitation program for this population.
... 9 The incidence of falling continues to rise after middle age 2 , due to a physiological deterioration associated with age, including: the impairment of cognitive, sensory systems, reduction in lower limb muscle strength, muscle capacity in the core muscles of the body, proprioception, joint range of motion, reaction time, and speed of movement. 7,10,11 These changes result in worse dynamic balance, which affects the activities of daily life along with increasing the risk of falling. 7,12,13 Therefore, effective exercise interventions for improving balance are important in order to prevent falling in middle-aged as well as older adults. ...
Objectives: The aim of this study to compare the effectiveness of the balance training program (BTP), and the core
stabilization program (CSP), on dynamic balance in healthy middle-aged individuals.
Material and Methods: This study was a single-blind randomized controlled trial design. Forty-two healthy middle-aged participants were randomly assigned to the BTP group (n=21), or the CSP group (n=21). Participants in both groups received an intervention program (balance training or core stabilization) 3 times a week, for 60 minutes, over 6 weeks. The primary outcome was the dynamic balance measured by the timed up and go test. The other outcomes were: core muscle endurance, muscle strength of the lower extremities, the flexibility of the lower back and hamstring muscles, and gait variables. The measurements included: the prone bridge endurance test, 5 times sit to stand test, sit and reach test and a wireless movement monitoring inertial sensor system, respectively. All outcomes were measured at baseline, and then after 6 weeks. The data were analyzed by the Independent Sample t-test between groups, and the paired t-test within either group.
Results: After 6 weeks, there was no statistically significant difference between the groups in either dynamic balance, or other variables, however, a statistically significant difference was found in core muscle endurance (p-value=0.003). In so saying, the BTP group, statistically significant improvements were found only in core muscle endurance, the flexibility of the lower back and hamstring muscles, and gait variables from pre- to post-test. Moreover, in the CSP group, there was a statistically significant difference from pre- to post-test in all measured outcomes.
Conclusion: The Core stabilization program is not superior to a balance training program, for the improvement of dynamic balance. Although, after 6 weeks of training, the study found that the Core stabilization program was effective for improving dynamic balance. This finding may point out that the Core stabilization program helps improve balance in a middle-aged person
... Values are presented as mean values (95% CIs). *Significant difference between groups at P ≤ 0.05, †significant difference from week 0 (baseline) at P ≤ 0.05, #significant difference from week 12 at P ≤ 0.05 and extension strength with the trunk strengthening exercise program are consistent with two previous studies 13,42 which showed that the use of an exercise program designed to specifically target the abdominal and lower back muscles potentially contributed to this large increase in trunk muscle strength. Changes in strength associated with the detraining phase were not significant or as apparent (−1.7% to −6.8%) as those observed in muscle size. ...
The aim of this study was to assess the effectiveness of a multimodal exercise program to increase trunk muscle morphology and strength in older individuals, and their associated changes in functional ability. Using a single-blinded parallel-group randomized controlled trial design, 64 older adults (≥60 years) were randomly allocated to a 12-week exercise program comprising walking and balance exercises with or without trunk strengthening/motor control exercises; followed by a 6-week walking-only program (detraining; 32 per group). Trunk muscle morphology (ultrasound imaging), strength (isokinetic dynamometer), and functional ability and balance (6-Minute Walk Test; 30 second Chair Stand Test; Sitting and Rising Test; Berg Balance Scale, Multi-Directional Reach Test; Timed Up and Go; Four Step Square Test) were the primary outcome measures. Sixty-four older adults (mean [SD]; age: 69.8 [7.5] years; 59.4% female) were randomized into two exercise groups. Trunk training relative to walking-balance training increased (mean difference [95% CI]) the size of the rectus abdominis (2.08 [1.29, 2.89] cm2 ), lumbar multifidus (L4/L5:0.39 [0.16, 0.61] cm; L5/S1:0.31 [0.07, 0.55] cm), and the lateral abdominal musculature (0.63 [0.40, 0.85] cm); and increased trunk flexion (29.8 [4.40, 55.31] N), extension (37.71 [15.17, 60.25] N), and lateral flexion (52.30 [36.57, 68.02] N) strength. Trunk training relative to walking-balance training improved 30-second Chair Stand Test (5.90 [3.39, 8.42] repetitions), Sitting and Rising Test (1.23 [0.24, 2.23] points), Forward Reach Test (4.20 [1.89, 6.51] cm), Backward Reach Test (2.42 [0.33, 4.52] cm), and Timed Up and Go Test (-0.76 [-1.40, -0.13] seconds). Detraining led to some declines but all outcomes remained significantly improved when compared to pre-training. These findings support the inclusion of trunk strengthening/motor control exercises as part of a multimodal exercise program for older adults.
... The purpose of this study was to evaluate the thickness and symmetry of TrA in regards to occurrence of low back pain (LBP) as well as to evaluate the efficacy of sonofeedback in learning and control of abdominal muscle activity. Taking into account the number of disorders that result in abnormal (delayed, asymmetric or decreased) activation of the TrA muscle, training of this muscle is considered to be an important component of the rehabilitation process for patients with LBP (39,8), scoliosis (40), incontinence (30), as well as in improving the autonomy and performance of daily activities in the elderly (41). According to this research, the LBP affects as many as 60% of students. ...
PURPOSE:
The purpose of the study was to evaluate thickness and symmetry of Transversus Abdominis muscle (TrA) during rest and activation with the use of Rehabilitative Ultrasound Imaging (RUSI) and the assessment of sonofeedback effectivness in learning and control of TrA activity.
MATERIAL AND METHODS:
The study was conducted on 28 healthy subjects (17 women and i 11 men) aged 19-22 years (mean 21±1,08 years). The subjects undergone RUSI assessment considering thickness of TrA in rest and during contraction. Basing on results the Activation Ration and Percent of Muscle Change were calculated.
RESULTS:
Mean thickness of TrA in rest was 3,19 mm among women and 4,37 mm among men. During controlled activity thickness of TrA increased by 69% on right side and by 64% on left side and respectively by 70% and 64% among men. The results showed a significant difference in TrA thickness between right and left side at rest and during contraction among men. During sonofeedback recorded thickness of TrA was significantly higher comparing to results without control of sonofeedback. TrA activity was lower in the group with low back pain and it was 64%, while in pain-free group the activity was 72%.
CONCLUSIONS:
1. RUSI is an effective method to evaluate the morphology and activity of the Transversus Abdominis muscle at rest and during controlled activation;
2. The decrease in thickness and activity impairment of TrA is related to the occurrence of low back pain;
3. The use of sonofeedback enables significant improvement in activation and equalization of TrA asymmetry.
... For sports and many other functional tasks, the core body is a key chain in the beginning-toend sequence in the transmission path from the ground to the upper limbs. Inefficiency in the central part of the body may affect individual performance and facilitate the occurrence of injuries (21). Both athletes and sedentary individuals are at the risk of hip joint damages. ...
... Ageing is the biological based universal changes process that occurs in all living organization from conception to death. [1] Ageing is associated with a decline in many body functions, an accompanying change in structure, loss of lean mass, age-related disuse, inactivity and degenerative diseases, and sensory functions [2,3] The World Health Organization also estimated that major Depression is the fourth most significant cause of disability worldwide for people aged 65 and older. [4] Depression is a major contributor to healthcare costs associated with older populations. ...
The objective of the study was to determine the relationship between balance and depression in the elderly. Methodology: 95 elderly subjects were taken from the Safdarjang Enclave, New Delhi and Gurgaon, Haryana, India in 2010-2011; Hindi mental status examination (HMSE) was administered to exclude the patients having cognitive problems with a score ≤ 19. Berg balance scale (BBS) and Geriatric Depression Scale (GDS) were then applied to assess the balance and depression. Results and Discussion: BBS has a significant negative linear correlation with GDS and age. Also, balance was also found to be predictive for depression. It was found that as the balance level decreases, the depression increases and the vice versa and with the age, balance problem also increases respectively. It was also found that males were more prone to balance problems as compare to females; and females were more prone to depression as compared to males. Conclusion: Balance had a significant negative linear correlation with depression and age.
Background and Aims Balance disorders and frequent falling are the important problems in the elderly, which is directly related to changes in their body structure and function. Many studies have been conducted to find new and safe ways to improve the balance of the elderly. This study aims to compare the effects of Pilates exercises on stable and unstable surfaces on the functional balance and core stability of older women. Methods In this quasi-experimental study, the study population includes all older women living in private nursing homes, in Rasht, Iran. Of these, 36 women aged 60-75 years were selected by a convenience sampling method and randomly assigned to three groups of control, Pilates on stable surface, and Pilates on unstable surface. The variables were assessed using the Fullerton advanced balance test, timed up & go test, and the McGill core endurance test. Experimental groups performed Pilates exercises for 8 weeks, while the control group performed their routine daily activities. Data were analyzed by one-way analysis of variance, t-test and Bonferroni’s post hoc test. The significance level was set at 0.05. Results There was a significant difference between the experimental and control groups; however, there was no significant difference between the experimental groups performed exercises on stable and unstable levels (P>0.05) Conclusion It is recommended to use Pilates exercises on stable or unstable surfaces for older women, especially residents of nursing homes with low mobility, to achieve their personal autonomy.
Background and Aims: This study aimed at the effects of 8 weeks TRX exercises and core stability exercises in the stable level on the landing pattern, the stability of the core area, and the balance of girls football players. Methods: Thirty athletes with trunk defects were screened by Tuck Jump test and selected as a statistical sample. Finally, assigned to two groups of 15 subjects at a stable level and varying level training. Both groups participated in pretest and post-test. Both groups training sessions for 8 weeks and three weeks each week on core stability training at both sustained (stable) and unstable (TRX). This study used the core stability practice protocol in the training section at a stable and unstable level. The static and dynamic balance were evaluated by BESS and Y tests, respectively. McGill’s endurance tests also evaluated the endurance of the core region. In addition, landing mechanics were assessed using the Landing Error Score System test. ANCOVA test was used to compare the differences between the research variables by two types of training. The stability of the core body was used in two groups of training (stable and TRX) and a t-test for correlating the changes within the group. Results: The results of the analysis of t-test showed that in the results of the stable training (P≤0.001) and TRX (P≤0.001) effect on score of the error of landing error, LESS, flexion 60 °, Sorensen, Right Plank, static balance and total dynamic balance score. In the post-test, there are significant differences between the two groups in the TRX and stable levels in LESS, Sorensen, static balance in the state stand on two legs on a soft surface and stand in the Tandem on a soft surface (P≤0.05). Conclusion: the results of this study showed that the use of core stability training at a stable and unstable level by helping to improve the landing jump activity, as well as improving muscular balance and endurance, can be eliminated by modifying some of the risk factors associated with an ACL injury to prevent Lower limb non-limiting injury in athletes with trunk defects.
2 ، زارﻋﻲ ﻣﻬﺪي 2 ﺧﻮﺷﺪل ﻣﻬﻴﺎر ، 3 1 اﺻﻼﺣﻲ ﺣﺮﻛﺎت و ﺷﻨﺎﺳﻲ آﺳﻴﺐ ارﺷﺪ ﻛﺎرﺷﻨﺎس ار داﻧﺸﮕﺎه ﺑﺪﻧﻲ، ﺗﺮﺑﻴﺖ ﮔﺮوه ، اﻳﺮان اراك، اك، 2 ﺳﺒﺰواري ﺣﻜﻴﻢ داﻧﺸﮕﺎه ورزﺷﻲ، ﻓﻴﺰﻳﻮﻟﻮژي دﻛﺘﺮي داﻧﺸﺠﻮي اﻳﺮان ﺳﺒﺰوار، ، 3 اﻳﺮان ﺷﺎﻫﺮود، ﺷﺎﻫﺮود، ﺻﻨﻌﺘﻲ داﻧﺸﮕﺎه ورزﺷﻲ، ﻣﺪﻳﺮﻳﺖ ارﺷﺪ ﻛﺎرﺷﻨﺎﺳﻲ داﻧﺸﺠﻮي ﻧﺸﺎﻧﻲ ﻧﻮ ﻳ ﺴﻨﺪه ﻣﺴ ﺆ ول : ﺳﺒﺰوار، ﺗﻮﺣﻴﺪﺷﻬﺮ، داﻧﺸﮕﺎه ﺳﺒﺰواري، ﺣﻜﻴﻢ داﻧﺸﻜﺪه ﺗﺮﺑﻴﺖ ﺑﺪﻧﻲ و ﻋﻠﻮم ورزﺷﻲ، اﻣ ﻓﺮزاﻧﻪ ﻴﻦ ﺣﺼﺎري وﺻﻮل : 17 / 7 / 91 اﺻﻼح ، : 25 / 10 / 91 ﭘﺬﻳﺮش ، : 15 / 12 / 91 ﭼﻜﻴﺪه ﻫﺪف و زﻣﻴﻨﻪ : ﻣﻄﺎﻟﻌﻪ اﻳﻦ ﺗﻌﺎدﻟ ﺗﻤﺮﻳﻨﺎت و ﻣﻴﺎﻧﻲ ﺳﺮﻳﻨﻲ ﻋﻀﻠﻪ ﺗﻘﻮﻳﺖ ﺗﻤﺮﻳﻨﻲ ﺑﺮﻧﺎﻣﻪ ﻧﻮع دو اﺛﺮ ﺳﺎﻟﻤﻨﺪ زﻧﺎن ﭘﺎﺳﭽﺮ ﻛﻨﺘﺮل ﺑﺮ ﻲ ﻣﻮرد را اﺳﺖ داده ﻗﺮار ارزﻳﺎﺑﻲ. و ﻣﻮاد روش ﻫﺎ : ﻧﻴﻤﻪ ﺗﺤﻘﻴﻖ ﻳﻚ ﻣﻄﺎﻟﻌﻪ اﻳﻦ ﭘﻴﺶ ﻃﺮح ﺑﺎ ﺗﺠﺮﺑﻲ آ زﻣﻮن-ﭘﺲ ﻣﺪاﺧﻠﻪ ﮔﺮوه دو ﺑﺎ و آزﻣﻮن ﻣﻲ ﻛﻨﺘﺮل ﮔﺮوه ﻳﻚ و ﺗﻤﺮﻳﻨﻲ ي-آن در ﻛﻪ ﺑﺎﺷﺪ، 45 ﺳﻨﻲ داﻣﻨﻪ ﺑﺎ ﺳﺎﻟﻤﻨﺪ زن 65-55 ﺳﺎل و دردﺳﺘﺮس روش ﺑﻪ د ورود ﻣﻼﻛﻬﺎي اﺷﺘﻦ ﺑ ﻪ ﺻﻮرت ﺗﺼﺎدﻓﻲ ﺗﻤﺮﻳﻦ ﮔﺮوه ﺳﻪ ﺑﻪ ﺷﺪﻧﺪ ﺗﻘﺴﻴﻢ ﻛﻨﺘﺮل و ﺗﻌﺎدﻟﻲ ﺗﻤﺮﻳﻦ ﻣﻴﺎﻧﻲ، ﺳﺮﻳﻨﻲ ﺗﻘﻮﻳﺖ. ﺗﻌﺎدﻟﻲ ﺗﻤﺮﻳﻨﺎت و ﻣﻴﺎﻧﻲ ﺳﺮﻳﻨﻲ ﺗﻤﺮﻳﻦ ﮔﺮوه دو ﻣﺪت ﺑﻪ را ﻣﺮﺑﻮﻃﻪ ﺗﻤﺮﻳﻨﻲ ﭘﺮوﺗﻜﻞ 6 ﻫﻔﺘﻪ ، 3 ﻫﻔﺘﻪ در ﺑﺎر ﺑ ﻪ ﻣﻴﺎن در روز ﻳﻚ ﺻﻮرت دادﻧﺪ اﻧﺠﺎم. ﺗ دوره از ﺑﻌﺪ و ﻗﺒﻞ ﻛﻨﻨﺪﮔﺎن، ﺷﺮﻛﺖ ﭘﺎﺳﭽﺮ ﻛﻨﺘﺮل در ﺗﻐﻴﻴﺮ ﺑﻪ ﻤﺮﻳﻦ، آزﻣﻮن وﺳﻴﻠﻪ ﺑﺮگ) Berg Test (اﻧﺪازه ﺷﺪ ﮔﻴﺮي. از اﺳﺘﻔﺎده ﺑﺎ آﻣﺎري ﺗﺤﻠﻴﻞ و ﺗﺠﺰﻳﻪ آﻣﺎري آزﻣﻮن t وارﻳﺎﻧﺲ ﺗﺤﻠﻴﻞ و ﻫﻤﺒﺴﺘﻪ) ANOVA (اﻧﺠﺎم ﺷﺪ. ﻳﺎﻓﺘﻪ ﻫﺎ : ﻳﺎﻓﺘﻪ ﺗﺤﻘﻴﻖ ﻫﺎي ﻧﺸﺎن داد ﻛﻪ ﺑﺮﻧﺎﻣﻪ اﻋﻤﺎل ﻣﻲ ﺗﻌﺎدﻟﻲ و ﻣﻴﺎﻧﻲ ﺳﺮﻳﻨﻲ ﺗﻘﻮﻳﺘﻲ ﺗﻤﺮﻳﻦ ي ﭘ ﻛﻨﺘﺮل ﺑﻬﺒﻮد ﺑﺎﻋﺚ ﺗﻮاﻧﺪ ﺎﺳﭽﺮ) 003 / 0 p= (و) 012 / 0 p= (ﺷﻮد ﺳﺎﻟﻤﻨﺪ زﻧﺎن در. ﻣﻌﻨﻲ ﺗﻔﺎوت ﻫﻤﭽﻨﻴﻦ داده ﺑﻴﻦ داري ﭘﺲ ﻫﺎي ﺗﻘﻮﻳﺘﻲ ﺗﻤﺮﻳﻦ ﮔﺮوه آزﻣﻮن ﮔﺮوه ﺑﺎ ﺗﻌﺎدﻟﻲ ﺗﻤﺮﻳﻦ و ﻣﻴﺎﻧﻲ ﺳﺮﻳﻨﻲ ﺷﺪ دﻳﺪه ﺗﻌﺎدل آزﻣﻮن در ﻛﻨﺘﺮل) 005 / 0 p= (و) 001 / 0 p= .(ﻣﻌﻨ ﺗﻔﺎوت ﻫﻤﭽﻨﻴﻦ ﺎ ﺗﻤ و ﻣﻴﺎﻧﻲ ﺳﺮﻳﻨﻲ ﺗﻘﻮﻳﺘﻲ ﮔﺮوه دو ﺑﻴﻦ داري ﺗﻌﺎدﻟﻲ ﺮﻳﻦ) 6 / 0 p= (ﻧﺸﺪ دﻳﺪه. ﻧﺘﻴﺠﻪ ﮔﻴﺮي : از ﻳﺎﻓﺘﻪ ﻫﺎي ﻣﻲ ﺗﺤﻘﻴﻖ ﻣﻴﺎﻧﻲ ﺳﺮﻳﻨﻲ ﻋﻀﻠﻪ ﺗﻘﻮﻳﺖ ﻛﻪ ﮔﺮﻓﺖ ﻧﺘﻴﺠﻪ ﺗﻮان ﺑﻬﺒﻮد ﺑﺎﻋﺚ در ﭘﺎﺳﭽﺮ ﻛﻨﺘﺮل ﻣﻲ ﺳﺎﻟﻤﻨﺪ زﻧﺎن ﺷﻮد. ﻛﻠﻴﺪي ﻫﺎي واژه : ﺳﺎﻟﻤﻨﺪ، ﭘﺎﺳﭽﺮ، ﻛﻨﺘﺮل ﺗﻘﻮﻳﺘﻲ ﺗﻤﺮﻳﻦ ﻣﻴﺎﻧﻲ، ﺳﺮﻳﻨﻲ ﺗﻌﺎدﻟﻲ ﺗﻤﺮﻳﻦ ﻣﻘﺪﻣﻪ ﻣﺴﻦ اﻓﺮاد ﺟﻤﻌﻴﺖ اﺳﺖ اﻓﺰاﻳﺶ ﺑﻪ رو ﺟﻬﺎن در ، ﺑﻪ ﻃﻮري ﭘﻴﺶ ﻛﻪ ﻣﻲ ﺑﻴﻨﻲ ﺳﺎل در رﻗﻢ اﻳﻦ ﺷﻮد 2030 ﺑﻪ 25 ﻳﺎﺑﺪ اﻓﺰاﻳﺶ درﺻﺪ) 1 .(ﻫﻢ ﺳﺎﻟﻤﻨﺪان، ﺟﺎﻣﻌﻪ رﺷﺪ ﺑﺎ راﺳﺘﺎ ﭘﻴﺸﮕﻴﺮي و ﺗﺸﺨﻴﺺ اﻫﻤﻴﺖ آن ﻣﺸﻜﻼت ﺑﻬﺒﻮد ﺑﺮاي ﻫﺎ زﻧﺪﮔﻲ ﻛﻴﻔﻴﺖ ، اﺳﺖ ﺑﺮﺧﻮردار زﻳﺎدي اﻫﻤﻴﺖ از. ﻛﻨﺎر در ﭘﮋوﻫﺸﻲ ﻣﻘﺎﻟﻪ
Objective: Since direct foot kick is one of the most important strikes in Jeet Kune Do, its effectiveness depends on both the force of the hit and balance control during and after the hit execution, this study undertaken to examine the effect and persistence of eight-week of core stability training on balance and force of a direct foot kick of elite young male Jeet Kune Do (Wushu) athletes. Methods: 24 elite young Jeet Kune Do athletes were randomly assigned to an experimental and a control groups. The experimental group performed the core stability training program for eight consecutive weeks. Static (stork test), dynamic test (tandem test) and force of a direct foot kick of the athletes in both groups were measured in three stages including before, after (eight weeks of core stability training) and a 4-week follow-up detraining period. Results: The results showed that core stability training had a significant and persistent effect on static and dynamic balance. However, the training program had no significant effect on the force production of a direct foot kick after a 4-week of detraining period. Conclusion: It seems that the core stability training program improves the neuromuscular system function by strengthening the muscles of the core area. This in turn prevents the dislocation of the center of gravity outside the base of support and decreases its oscillation (displacement), therefore, as a result of persistence effect of the program, balance ability and direct kicking power improves.
[Purpose] To investigate the effect of a postoperative program with added trunk muscle training for proximal femoral fractures. [Participants and Methods] Postoperatively, patients admitted to a convalescent rehabilitation ward were categorized into a control group (normal physiotherapy; 9 patients) and an intervention group (added trunk muscle training; 9 patients). Before and after the 4-week intervention, patients' trunk function, walking ability, balance function, lower limb muscle strength, pain, and fall self-efficacy scale were measured, and changes between the two groups were compared. [Results] In the intervention group, trunk function (thickness of the abdominal rectus, thoracic erector spinae and external abdominal oblique muscles, and endurance of the abdominal muscle), walking ability (timed up-and-go test), and balance function (Berg Balance scale) significantly improved compared to the control group. [Conclusion] These findings suggest that trunk muscle training may promote the recovery of walking ability and balance function in postoperative patients.
کنترل عصبی- عضلانی مطلوب مجموعۀ کمری لگنی هنگام حرکت انسان نقشی حیاتی در حفظ پاسچر تنه و افزایش کارایی حرکت دارد. اختلال طیف اوتیسم از جمله معلولیتهای رشدی-عصبی است. این کودکان بهدلیل نقص رشدی در سیستم عصبی و نیز کمتحرکی، دچار ضعف تعادل، ثبات و کنترل تنه هستند. هدف پژوهش حاضر بررسی اثر 8 هفته تمرین ثبات مرکزی بر عملکرد مجموعۀ کمری لگنی کودکان اوتیسم است. نمونۀ آماری شامل 32 پسر دارای اختلال طیف اوتیسم با دامنۀ سنی10-6 سال بود که بر حسب شاخص تشخیصی گیلیام گارز همگن شده و بهطور تصادفی در دو گروه 16 نفرۀ کنترل و آزمایشی تقسیم شدند. تمرینات ثبات مرکزی براساس پروتکل جفری به مدت 8 هفته، 3 جلسه در هفته بهصورت انفرادی در گروه تجربی اجرا شد. عملکرد مجموعۀ کمری لگنی از طریق آزمون استپ داون سنجیده شد. پس از بررسی نرمال بودن دادهها با آزمون کولموگروف اسمیرنوف، از آزمون تی وابسته و مستقل استفاده شد. یافتهها نشان داد تمرینات ثبات مرکزی در بهبود عملکرد کمری لگنی سمت برتر و غیربرتر کودکان اوتیسم در گروه تجربی مؤثر بوده است (05/0(P≤ درصورتیکه در گروه کنترل تغییر معناداری مشاهده نشد. ازاینرو میتوان این تمرینات را بهعنوان برنامهای مؤثر در کارایی عملکردی تنه و ثبات ناحیۀ مرکزی بدن در برنامههای توانبخشی کودکان اوتیسم توصیه کرد.
کلیدواژهها
استپ داون ثبات مرکزی طیف اوتیسم عملکرد کمری لگنی کودکان
كنترل عصبي- عضلاني مطلوب مجموعة كمري لگني هنگام حركت انسان نقشي حياتي در حفظ پاسچر تنـه و افـزايش
كارايي حركت دارد. اختلال طيف اوتيسم از جمله معلوليتهاي رشدي-عصبي است. اين كودكان به دليـل نقـص رشـدي
در سيستم عصبي و نيز كم تحركي، دچار ضعف تعادل، ثبات و كنترل تنه هستند. هـدف پـژوهش حاضـر بررسـي اثـر 8
هفته تمرين ثبات مركزي بر عملكرد مجموعة كمري لگني كودكان اوتيسم اسـت. نمونـة آمـاري شـامل 32 پسـر داراي
اختلال طيف اوتيسم با دامنة سني10-6 سال بود كه بر حسب شاخص تشخيصي گيليـام گـارز همگـن شـده و بـهطـور
تصادفي در دو گروه 16 نفرة كنترل و آزمايشي تقسيم شدند. تمرينات ثبات مركزي براساس پروتكل جفري بـه مـدت 8
هفته، 3 جلسه در هفته بهصورت انفرادي در گروه تجربي اجرا شد. عملكرد مجموعة كمري لگني از طريق آزمون اسـتپ
داون سنجيده شد. پس از بررسي نرمال بودن دادهها با آزمون كولموگروف اسـميرنوف، از آزمـون تـي وابسـته و مسـتقل
استفاده شد. يافته ها نشان داد تمرينات ثبات مركزي در بهبود عملكرد كمري لگني سمت برتر و غيربرتر كودكان اوتيسم
در گروه تجربی مؤثر بوده است صورتيكه در گروه كنترل تغيير معناداري مشاهده نشد. ازاينرو مـيتـوان
اين تمرينات را به عنوان برنامه هاي مؤثر در كارايي عملكردي تنه و ثبات ناحيـة مركـزي بـدن در برنامـه هـاي توانبخشـي
كودكان اوتيسم توصيه كرد.
واژه هاي كليدي
استپ داون، ثبات مركزي، طيف اوتيسم، عملكرد كمري لگني، كودكان.
Background and Aim: The core stabilizer muscle weakness can have a negative effect on the balance. On the other hand, the stability of the core area as a connection with the effective transfer of force produced in the lower extremity to the upper limb through the trunk leads to better exercise. Purpose: The present study was carried out to compare the effects of core stability trainings on stable and unstable levels on the female athletes' balance. Materials and Methods: The statistical society of the current study consisted of 30 female athletes from Guilan province who were intentionally selected to take part in the study. They were divided into two groups of 15: stable training and unstable levels of training for 6 weeks, 3 sessions per week. Static balance dynamic balance were evaluated using BESS and Y balance tests, respectively. To analyze the difference in balance between the athletes in the two groups, statistical analysis of covariance and t-correlation analysis were used. Results: The results of the study showed a significant effect of both training protocols on static and dynamic balance (P = 0.001). Also, the results of covariance analysis indicated that training on unstable level had higher efficiency on static and dynamic balance (P <0.05). Conclusion: The results of the present research suggest that, given the difference between the two types of training in affecting the balance component, in addition to the fact that both types of body stabilization trainings can be useful to improve the balance by strengthening the muscles that are Spinal and pelvic controls, coaches and athletes should use unstable levels of core stability training to improve balance.
Aims: Individuals with lower extremity amputation have more difficulties than healthy people in static and dynamic balance. The significant effect of core stability training in different subjects has proven in previous studies. Therefore, the aim of this study was to investigate the effect of core stability training on static and dynamic balance and strength on disabled veterans with unilateral below knee amputation.
Materials & Methods: This semi-experimental study with pretest-posttest design and control group was carried out on 36 disabled veterans with unilateral below knee amputation in Mashhad city in 2018. The subjects were selected by the purposive sampling method and the subjects were randomly divided into two experimental and control groups (N=18). After measuring the static and dynamic balance and strength variables, core stability training was performed for the subjects of the experimental group for 8 weeks and 3 sessions per week under the supervision of the researcher. Then, the research variables were again evaluated in two groups. Data were analyzed through SPSS 19 software using independent and paired sample t-tests.
Findings: There was a significant difference between the mean scores of post-test and pre-test in the experimental group (p0.05). Also, there was a significant difference between the experimental and control groups in the post-test step (p
Background: Patients with chronic renal failure suffer physical and physiological constraints as a result of the hemodialysis process and lack of mobility. The aim of this study was to investigate the effects of selected core stability exercises on the pain, fatigue and physical performance in elderly hemodialysis patients. Methods: In this quasi-experimental study, 30 hemodialysis man patients with a mean age (62.246.51 years), history of dialysis (29.418.44 months) and dialysis three times a week were selected by available manner and randomly were divided into exercise (n=15) and control group (n=15). Pain, fatigue and physical performance of the patients was measured before and after the training program with VAS questionnaire, FSS questionnaire and two minute walk tests. Patient in the experimental group were done modified core stabilization exercises for 6 weeks, 45-minute three sessions in week. To analyze the data, variance analysis was used to measure the repeated values at the significance level (p0.05). Results: The results indicated that the changes and interactions of the two variables of pain (F=24.61, P=0.001), Fatigue (F=41.03, P=0.001) and the physical function (F=83.07, P=0.001) were significant in the experimental group after exercise. Also in the experimental group, showed significant improvement in the pain, fatigue and physical performance (p<0/05), compared to the control group. Conclusion: According to mobility constraints and aggravation of patients' problems in sport strategies based on lower extremity, the selected core stability exercises were an effective and suitable option for elderly hemodialysis in reducing the pain, fatigue and improving physical function, this type of exercise can be used as a non-pharmaceutical strategy by therapists and care staff.
Background & Aims: Mental retardation appears to be is one of the most common mental disabilities and causing disturbance of balance in these people. The purpose of this study was to compare the effect of Core Stability Training program and Closed Kinetic Chain Training program on the dynamic balance of mentally retarded students.
Materials & Methods: forty five male student with mentally retarded were randomly divided in three groups: Control, Core Stability and closed kinetic chain (15 subjects in each group). Participants in both core stability and closed kinetic chain groups were trained 8 weeks (3 session per week). Get Up and Go test was used at baseline and end of 8 weeks to measure dynamic balance of all groups. Data was analyzed by using ANOVA to measure differences between groups (p≤0.05).
Result: dynamic balance results demonstrated a significant differences between core Stability and control groups (P=0.000), closed kinetic chain and control groups (P=0.006) and Core Stability and closed kinetic chain groups (P=0.002).
Conclusion: Core stabilization training program and closed kinetic chain training program improved the static and dynamic balance of mentally retarded students, which it is suggested that dynamic balance can be beneficial in rehabilitation program to mentally retarded students.
The purpose of this research was to examine the permanency and effect of core stability short term training on static and dynamic balance in children with development of balance. To conduct this study, 30 male students with mean age 8.5 year from the first grade of primary school were selected among 162 students through Bruininks- Oseretsky motor skill test (BOT-2) and then they were random assignment into two groups (experimental and control groups, each group (15 subjects). The control group has traditional sport training class. Before performing the core stability training, the static and dynamic balances of participants were measured by "Romberg" and Y- Balance. The experimental group performed the core stability training for eight weeks, and then they stopped training for four weeks, after that study variable were measured again. The findings were analyzed by one- way analysis of Covariance method. Findings indicated a significant effect of core stability training on balance in experimental group. Respect to the results of this research, it can be concluded that the core stability training programs has a short time and longtime effect on the children's motor performance. One of the suggestions of this research is that core stability training be used to enhance motor capability of children, specially balancing.
Keywords: Core Stability Training, Static Balance, Dynamic Balance, Children
Twenty subjects were evaluated to test the effectiveness of a portable abdominal device (6 second Abs Machine (Savvier, LP, Carlsbad,CA). The relationship between work and peak surface EMG (sEMG) of a traditional crunch was compared to six different exercises using the 6 Second Abs Machine (SAM). sEMG was used to evaluate the bilateral rectus and oblique muscles. The work accomplished (EMG amplitude x time of contraction) in a crunch was 9 times greater using the SAM device for the Rectus and 11 times greater for the Oblique muscles (p<0.02). The sitting reverse exercise was 40 times greater at the oblique muscle and 23 times greater for the rectus musculature (p<0.02). Average peak sEMG of a SAM crunch compared to a traditional crunch was 39% greater at the Rectus and 37% at the Oblique (p<0.02). The sitting reverse crunches increased to 78% at the Rectus and 113% at the Oblique (p<0.001) on the SAM compared to the traditional crunch. The SAM provided much greater exercise for the rectus and oblique muscles when performed in a seated and supine position than traditional crunches.
Background & Aims: Stroke is a sudden and local neurologic defect from ischemic damages into the brain changing the function of a part of the body and physical sensation of the body condition. The purpose of this study was to survey the effect of core stabilization trainings on the static and dynamic balance of stroke patients.
Materials & Methods: In a case-control study, 26 male Stroke patients divided in two groups (CTL, 13 Stroke patients with a mean age of 57.3± 4.22 years, height 168.26±2.12 cm, weight 74.68±6.24 kg) and (TRN, 13 Stroke patients with a mean age 55.30±5.04 years, height 171.53±3.41 cm, weight 76.56±7.51 kg), TRN group was performed a core stabilization program for 8 weeks and three times per week. The pre-test and post-test of Sharpened Romberg test was done for measure static balance and Get Up and Go test was done for measure dynamic balance of two groups. Independent T-test was used to analyze the data (p≤0.05).
Result: Results showed significant differences in mean of static balance (open eye (p 011) and closed eye (p=0.003)) and for dynamic balance (P=0.001) in both groups.
Conclusion: Core stabilization training program improve the static and dynamic balance of Stroke patients and can be used for the improve balance in rehabilitation of Stroke patients.
Abstract
Background & Aims: Multiple sclerosis or MS is a disease of the central nervous system the main network of nerves that carry electrical impulses throughout the body. The purpose of this study was to survey the effect of core stabilization training program on the dynamic balance of MS patients.
Materials & Methods: In a case-control study, 20 male MS patients in two groups (CTL, 10 MS patients with a mean age of 44.3± 3.22 years, height 178.36±2.12 cm, weight 73.68±6.74 kg) and (TRN, 10 MS patients with a mean age 42.35±6.04 years, height 174.53±3.41 cm, weight 74.56±7.51 kg), TRN group performed a core stabilization program for 8 weeks and three times per week was studied. The pre-test and post-test of Get Up and Go test was done for measure dynamic balance of two groups. Independent T-test was used to analyze the data (p≤0.05).
Result: Results showed significant differences in mean TRN and CTL groups in dynamic balance test (P=0.000).
Conclusion: Core stabilization training program improve the dynamic balance of MS patients and can be used for the improve balance of patients with Multiple sclerosis.
Keywords: Multiple Sclerosis, Core Stability, Dynamic balance
Background & Aims: Mental retardation is one of the most common mental disabilities that are allocated about 3% of the world's population. The purpose of this study was to survey the effect of core stabilization training program on the static and dynamic balance of mentally retarded students.
Materials & Methods: In a case-control study, 30 male mentally retarded students divided into two groups (CTL, 15 mentally retarded with a mean age of 11.23± 3.11 years, height 148 ± 7.51cm, weight 35.26 ±5.13kg) and (TRN, 15 mentally retarded with a mean age 11.53 ±2.25 years, height 150±7.02 cm, weight 42.12±7.08 kg), TRN group was performed a core stabilization program for 8 weeks and three times per week. The pre-test and post-test of Sharpened Romberg test was done to measure static balance, while 'Get Up' and 'Go test' was done to measure dynamic balance of two groups. Independent T-test was used to analyze the data (p≤0.05).
Result: Results showed significant differences in the mean of static balance (open eye (p
0.000), closed eye (p≤0.000)), and for dynamic balance (P≤0.000) in both groups.
Conclusion: Core stabilization training program improve the static and dynamic balance of mentally retarded students, and it can be used with other training programs for improving the balance of mentally retarded students.
Participation in exercise programs is heartily recommended for older adults since the level of physical fitness directly influences functional independence. The aim of this present study was to investigate the effects of supervised Pilates exercise training on the physical function, hypothesizing that a period of Pilates exercise training (PET) can increase overall muscle strength, body composition, and balance, during single and dual-task conditions, in a group of post-menopausal women. Twenty-five subjects, aged 59 to 66 years old, were recruited. Eligible participants were assessed prior and after 3 months of PET performed twice per week. Muscular strength was evaluated with handgrip strength (HGS) test, 30-s chair sit-to-stand test (30CST), and abdominal strength (AST) test. Postural control and dual-task performance were measured through a stabilometric platform while dynamic balance with 8 ft up and go test. Finally, body composition was assessed by means of dual-energy X-ray absorptiometry. Statistically significant improvements were detected on HGS (+8.22 %), 30CST (+23.41 %), 8 ft up and go test (-5.95 %), AST (+30.81 %), medio-lateral oscillations in open eyes and dual-task condition (-22.03 % and -10.37 %). Pilates was effective in increasing upper body, lower body, and abdominal muscle strength. No changes on body composition were detected. Results on this investigation indicated also that 12-week of mat Pilates is not sufficient to determine a clinical meaningful improvement on static balance in single and dual-task conditions.
هدف: هدف اين پژوهش بررسي 6 هفته برنامه تمريني ثبات مركزي بر ميزان زمين خوردن سالمندان است.
66 سال، وزن : /20±5/ روش بررسي : در اين كارآزمايي باليني، 40 نفر از زنان سالمند (ميانگين سن : 98
159 سانتيمتر)، بطور داوطلبانه در تحقيق شركت كردند . آزمودني ها يك هفته /94±7/ 62/60±5/78 كيلوگرم، قد : 8
« با خطر زمين خوردن كم » قبل از شروع تمرينات ثبات مركزي، بر اساس نمرات آزمون تعادلي برگ به دو گروه
گروه 2) تقسيم شدند . سپس به صورت تصادفي به دو گ روه تجربي و ) « با خطر زمين خوردن زياد » (گروه 1) و
كنترل تقسيم شدند . گروه هاي تجربي، تمرينات ثبات مركزي (شامل سه سطح) را انجام دادند. مدت تمرين در هر
جلسه تمرين، حدود 30 دقيقه و طول دوره تمريني 6 هفته (به صورت يك روز در ميان ) بود . پس از اتمام
تمرينات، پس آزمون تعادل برگ در همان محيط از گروه هاي كنترل و تجربي به عمل آمد. به منظور تحليل داده ها
0 استفاده شد. / وابسته در سطح معنيداري 05 t مستقل و t از آزمونهاي آماري
يافته ها: نتايج نشان داد كه بين گروه تجربي و كنترل در گروه هاي با خطر زمين خوردن كم و زياد (گروه هاي
اما در پ سآزمون، گروه هاي تجربي (p=0/ و 193 p=0/ 1و 2) در پيش آزمون اختلاف معني داري وجود نداشت ( 486
ميزان پيشرفت در گروه تجربي با خطر .(p=0/ و 001 p=0/ عملكرد بهتري نسبت به گروه هاي كنترل داشتند ( 007
3% بود. / 0% و 7 / 15 % و براي گروه هاي كنترل به ترتيب 95 / 3% و 06 / زمين خوردن كم و زياد به ترتيب برابر 38
نتيجه گيري: يافته هاي تحقيق نشان دادند كه تمرينات ثبات مركزي مي تواند كنترل پاسچر و در نتيجه ميزان زمين
خوردن را در سالمندان بهبود بخشد.
كليدواژه ها: مركز بدن، تمرين درماني، تعادل پاسچر، زمين خوردن، سالمندان.
Background
Aging is associated with increased prevalence of
multiple diseases, with decline of the functional reserve of
many organs and systems and a progressive restriction in
personal and social resources. Therefore this designed to
clarify the effect of exercise on recovery.
Methods and design
A prospective cohort of 174 consecutive patients
recruited from General surgery department of El-Mataria
Teaching Hospital, Cairo, Egypt, with 68.2±5.3 years (60 to
75 years), underwent open abdominal surgery, they were
randomly divided into; Mobilizing Group (MG= 80); Nonmobilized
group (NMG=75). After surgery MG participated
in mobility program; range of motion exercise, sitting out of
bed, trunk flexibility exercises, upper limb elevation exercise
using bottles and walking exercise. Non-mobilized group
(NMG=75) instructed to keep their activity level without
changes. The primary assessment includes; Time Up and
Go Test (TUGT), Functional reach test (FRT) and hand grip
strength. There were no significant difference in TUGT, FRT,
and grip strength between MG and NMG group
preoperatively and at 1 and 3 weeks, postoperatively with
significant decline in functional recovery.
Results and conclusion
There were significant differences at 6 weeks, 3 and 6
months postoperatively with greater improvement in
functional recovery to preoperative level for mobilizing
group. Surgical treatment can be offered to elderly patients
60 years old but with predictable decline in functional
independence. Collaboration between surgeon and
physiotherapist for establishing an effective rehabilitation
program may be helpful for restoring their function
independence.
As hygienic principles are increasingly considered, longevity and elderly population augments in consequence. Sixty females recruited from a total of 200 and aged more than 60 years (70.6 ± 6.0 yrs, 55.8 ± 5.8 kg of weight and 157.8 ± 7.8 cm of height) were classified as low falling risk and high falling risk. Then, these subjects were randomly divided into two experimental and control groups. A week prior to starting the training program, their balance status were measured with the Berg balance test (BBT) and compared with independent and dependent t-tests. The experimental group followed a core stabilization program of three days per week, for eight weeks. At the end of this period, they performed better (p<0.05) than the controls. The training program had also better effects on the high risk group. Significant differences were observed for balance following the training program, in both the anteroposterior and mediolateral planes (p<0.05). In conclusion, significant differences were shown in improving balance and postural control after a related training program in elderly women.
As hygienic principles are increasingly considered, longevity and elderly population augments in consequence. Sixty females recruited from a total of 200 and aged more than 60 years (70.6 ± 6.0 yrs, 55.8 ± 5.8 kg of weight and 157.8 ± 7.8 cm of height) were classified as low falling risk and high falling risk. Then, these subjects were randomly divided into two experimental and control groups. A week prior to starting the training program, their balance status were measured with the Berg balance test (BBT) and compared with independent and dependent t-tests. The experimental group followed a core stabilization program of three days per week, for eight weeks. At the end of this period, they performed better (p<0.05) than the controls. The training program had also better effects on the high risk group. Significant differences were observed for balance following the training program, in both the anteroposterior and mediolateral planes (p<0.05). In conclusion, significant differences were shown in improving balance and postural control after a related training program in elderly women.
Background:
Age-related postural misalignment, balance deficits and strength/power losses are associated with impaired functional mobility and an increased risk of falling in seniors. Core instability strength training (CIT) involves exercises that are challenging for both trunk muscles and postural control and may thus have the potential to induce benefits in trunk muscle strength, spinal mobility and balance performance.
Objective:
The objective was to investigate the effects of CIT on measures of trunk muscle strength, spinal mobility, dynamic balance and functional mobility in seniors.
Methods:
Thirty-two older adults were randomly assigned to an intervention group (INT; n = 16, aged 70.8 ± 4.1 years) that conducted a 9-week progressive CIT or to a control group (n = 16, aged 70.2 ± 4.5 years). Maximal isometric strength of the trunk flexors/extensors/lateral flexors (right, left)/rotators (right, left) as well as of spinal mobility in the sagittal and the coronal plane was measured before and after the intervention program. Dynamic balance (i.e. walking 10 m on an optoelectric walkway, the Functional Reach test) and functional mobility (Timed Up and Go test) were additionally tested.
Results:
Program compliance was excellent with participants of the INT group completing 92% of the training sessions. Significant group × test interactions were found for the maximal isometric strength of the trunk flexors (34%, p < 0.001), extensors (21%, p < 0.001), lateral flexors (right: 48%, p < 0.001; left: 53%, p < 0.001) and left rotators (42%, p < 0.001) in favor of the INT group. Further, training-related improvements were found for spinal mobility in the sagittal (11%, p < 0.001) and coronal plane (11%, p = 0.06) directions, for stride velocity (9%, p < 0.05), the coefficient of variation in stride velocity (31%, p < 0.05), the Functional Reach test (20%, p < 0.05) and the Timed Up and Go test (4%, p < 0.05) in favor of the INT group.
Conclusion:
CIT proved to be a feasible exercise program for seniors with a high adherence rate. Age-related deficits in measures of trunk muscle strength, spinal mobility, dynamic balance and functional mobility can be mitigated by CIT. This training regimen could be used as an adjunct or even alternative to traditional balance and/or resistance training.
To compare sitting stability between patients with high and low thoracic spinal cord injury (SCI), to determine the factors that can predict sitting stability, and to examine the relationship between sitting stability and functional performance.
Cross-sectional assessment was performed on subjects with paraplegia.
Rehabilitation hospital affiliated with a medical university.
Convenience sample of 30 adults with complete chronic thoracic SCI.
Not applicable. Main Outcome Measures: (1) Postural sway during quiet sitting over 30 seconds was recorded as static sitting stability, and composite maximal weight-shift during leaning tasks over 30 seconds was measured as dynamic sitting stability; (2) age, body weight, trunk length, trunk strength, postonset duration, injury level, and presence of spasticity were examined as predictive variables for sitting stability; and (3) the time for completion of upper- and lower-body dressing and undressing and transfer was measured as functional performance.
A significant difference in composite maximal weight-shift was found between high and low thoracic SCI subjects (t=2.90, P<.01). Injury level and trunk length were 2 important predictive factors for dynamic sitting stability, and they explained 43.5% of the variance. Only the completion time of upper-body dressing and undressing correlated significantly with static (r=.465, P=.01) and dynamic (r=-.377, P<.05) sitting stability.
The subjects with low thoracic SCI showed better dynamic sitting stability than those with high thoracic SCI. Injury level and trunk length, not trunk flexion or extension strength, predicted the outcome of dynamic sitting stability. Measures were not precise enough to predict functional performance from the viewpoint of injury level and sitting stability. The underlying premise that a reduction or increase in trunk strength is indicative of poorer or better sitting stability in SCI individuals is questioned, and implications for problem identification and treatment planning are discussed.
An economic evaluation was conducted alongside a randomized controlled trial.
Little is known about the effectiveness of cognitive-behavioral treatment options for patients following lumbar disc surgery. If the knowledge available was supported by an economic evaluation, the information could then be used to make recommendations for the implementation of cognitive-behavioral treatment in the routine of rehabilitation following lumbar disc surgery.
To examine the cost-effectiveness of a behavioral-graded activity program, which is an operant treatment, compared to usual care as delivered by a physical therapist for patients following first-time lumbar disc surgery.
For the economic evaluation, a societal viewpoint was applied. The primary outcome measures (measured at the 12-month follow-up) were global perceived effect and functional status. To evaluate the economic consequences of the treatments, direct health care and non-health care costs were considered, as well as indirect costs.
The clinical outcomes showed no relevant differences between behavioral-graded activity (n = 52) and UC (n = 53). Treatment costs were almost identical in the two intervention groups. The difference in direct health care costs was, although not statistically significant, 264 EURO [95% CI: -3-525] higher in behavioral-graded activity than in usual care per patient-year. It was mainly the excess cost of visiting the physiotherapist in the behavioral-graded activity group that accounted for this difference. The difference in direct non-health care costs, although not statistically significant, was 388 EURO [95% CI: -217; 992] lower in the usual care group due to unpaid help by friends or family. Consequently, although again not statistically significant, the total direct costs in behavioral-graded activity are 639 EURO [95% CI: -91; 1368] higher than in usual care. For the indirect costs, there was a statistically significant difference, behavioral-graded activity being more expensive. The sensitivity analysis showed that these results are fairly robust.
This study concludes that there are no differences between the two treatment conditions on any of the clinical outcome measures but that behavioral-graded activity is associated with higher costs. Consequently, there is no reason for the implementation of behavioral-graded activity as the standard treatment for patients following lumbar disc surgery.
Six control subjects and eight subjects with type 1 and type 2 diabetes were studied to understand the relationship between skin temperature, central body temperature, and sweat rate. The results of the experiments show that for all diabetic subjects (both type 1 and type 2) heat tolerance was poor. In fact, with a 30 minute exposure to an environmental temperature of 42°C, even though subjects were at rest, central body temperature increased 1°C more than that of controls. Further, skin temperature also increased. The reason for the increase in skin temperature and central body temperature appeared to be a failure of sweating. Sweating was lower at any skin temperature or at any skin location in diabetic compared with control subjects. Thus both Type 1 and Type 2 diabetic subjects were more susceptible to heat stress. This could have significant implications for heat disorders such as heat stroke for individuals with diabetes.
Four male and 4 female subjects participated in a series of experiments to determine the aerobic capacity of the abdominal muscles and to see if a portable abdominal machine called the 6 Second Abs machine could increase the aerobic endurance and strength of the abdominal muscles. Subjects were trained for 20 minutes per day 3 times per week for 3 weeks. Each training session involved accomplishing 6 second supine abdominal crunches with feet on a wall at a load adjusted to fatigue the subject in 20 minutes or less. When 20 minutes could be accomplished, the load on the abdominal exerciser was increased for the next training day. After 3 weeks of training, there was a 35.8% increase in abdominal strength and an increase in VO2 max of 93%. Over the same period, the work accomplished during a 20-minute session increased by 66.9%. Thus by using a progressive resistance exerciser for abdominal training, a large increase in training of strength and endurance could be accomplished in a short time.
Seven male and 4 female subjects were examined to assess muscle use, while performing standard abdominal crunches lying in the supine position versus abdominal crunches performed in the seated and supine positions using an exercise device called the 6 Second Abs. The results of the experiments showed that much of the work in a supine sit up was due to work against gravity. The addition of resistive bands, when exercising in the supine position, caused an increase in work accomplished during abdominal exercise by at least 15-fold. Further, significant exercise was accomplished when using the machine in the seated position facing forward. More significantly, by rotating the trunk to the seated position, muscle use can be switched from the rectus abdominus, facing forward to the obliques when the trunk is rotated to the side, thereby increasing oblique work 15-fold over standard crunches. In addition to advantages of abdominal exercise in the normal population, this type of exercise is important for people with disabilities, since work may not be possible in a supine position. Abdominal exercise in the seated position with the 6 Second Abs machine appears to control timing better and is more muscle specific than exercise in the supine position.
Respiratory complications, such as pneumonia and atelectasis, are major causes of mortality and inhibit rehabilitation programs in spinal cord injury. Tetraplegic patients cannot cough enough to clear their sputum because of expiratory muscle weakness, mainly of the abdominal muscles. However, tetraplegics are still able to activate some muscles during coughing. Some tetraplegics, even though they cannot contract the abdominal muscles, can cough effectively. It was supposed that some accessory expiratory muscles were activated during coughing in tetraplegics. We, therefore, studied the peak expiratory flow rate, expiratory muscle strength, and the activities of the pectoralis major and latissimus dorsi muscles in 11 complete tetraplegics. Peak expiratory flow rate was measured by spirometry. Expiratory muscles strength was assessed by maximal expiratory mouth pressure; muscle activity was assessed by means of the root mean square voltage obtained by surface electromyography. The results showed that peak expiratory flow rate, maximal expiratory mouth pressure, and root mean square of these two muscles were correlated with neurological level. Peak expiratory flow rate was correlated with peak expiratory flow rate. Peak expiratory flow rate was correlated with the root mean square voltage of the pectoralis major and latissimus dorsi muscles. It was supposed that these two muscles were activated as accessory expiratory muscles and play an important role in expiratory function in tetraplegic patients.
Previous studies on the relationship of age to isometric muscular strength are few, on isometric endurance rare, and on the physiological responses to static effort nonexistent. This investigation assessed the maximal handgrip strength, the duration of a fatiguing handgrip contraction at a tension of 40% of maximal strength and the heart rate and blood pressure during that contraction of 100 men aged from 22 to 62 yr. The subjects of this study were all men employed in a machine shop for a large aircraft corporation. The homogeneity of their occupations may well explain why, unlike previous reports, we found no change in muscular strength or muscular endurance with age. However, although heart rate increased during the contraction in all subjects, the increase in heart rate was greater in younger men. In contrast, while both systolic and diastolic blood pressures increased during the contraction in all subjects, the largest increase in systolic blood pressure was attained by the men in the older decades; there was no difference due to age in the diastolic blood pressures. The implications of these findings are discussed.
Cellular energetics can be studied non-invasively using 31P nuclear magnetic resonance (NMR). Besides the concentration of the major phosphorus-containing metabolites, enzyme-catalysed fluxes and intracellular pH can be obtained from the NMR measurement. Metabolic acidosis in the ischaemic myocardium has been studied in the perfused rat heart. Comparison of the pH, measured from the position of the inorganic phosphate (Pi) resonance, with the pH obtained from the resonance of 2-deoxyglucose 6-phosphate (accumulated after perfusion with 2-deoxyglucose) demonstrates that cytoplasmic pH values are being obtained. The pH changes during ischaemia are quantitatively related to the glycogen leads to lactate conversion. Preperfusion with insulin enhanced the lactate production but resulted in the maintenance of ATP for a longer period during ischaemia, even though acidosis was enhanced. In acute renal acidosis, the decrease in intracellular pH is smaller than might have been expected, as demonstrated in the perfused rat kidney. The importance of acidosis in relation to renal preservation was examined in human kidneys prior to transplantation. 31P NMR studies on human forearm muscle have been done. The pH changes measured during aerobic and anaerobic exercise demonstrate the importance of glycogenolysis in providing energy for ATP production. In a patient with suspected McArdle's syndrome, 31P NMR was used to detect the lack of glycogenolysis since during both aerobic and anaerobic exercise a pH rise was observed together with the rapid breakdown of phosphocreatine.
The purpose of this study was to investigate the relationships between blood lactic acid (LA) accumulation, maximum anaerobic power, glycolytic enzyme activity, and skeletal muscle fibre composition in endurance trained runners. Venous LA was measured in 15 male middle distance (MD) and long distance (LD) runners before and after a 30 second all out ergometer ride. Muscle biopsies of the lateral gastrocnemius muscle were obtained prior to exercise for determination of lactate dehydrogenase (LDH), and phosphofructokinase (PFK) enzyme activities and histochemical classification of fast twitch (FT) and slow twitch (ST) muscle fibres. Significant differences were observed in %FT fibre composition (47.8(MD) and 34.6 (LD), and mean VO2 max values were significantly higher in the LD runners (62.8 (MD) and 68.7 (LD) ml.kg.-1 min.-1). Blood lactate values following maximal treadmill running were significantly higher in the MD group (15.0 mM) when compared with LD runners (11.9 mM). Total anaerobic power output was calculated according to the "Wingate Anaerobic Test" at 51 (MD) and 49 (LD) kpm. kg.-1 min.-1 and mean post-exercise LA values were 8.6 mM (MD) and 8.0 mM (LD). Similar non-significant differences were observed when muscular power was determined via the "Margaria Test" (109.6 (LD) kgm.sec-1). Correlations were determined and the best relationship was between PFK and %FT (R = 0.84). The data suggest that the ergometer test was of insufficient duration, and thus did not result in maximal accumulation of LA and/or metabolically produced LA is removed rapidly in endurance trained muscle. Endurance training in middle and long distance runners fails to produce high value for anaerobic power tests.
Anaerobic threshold (AT) and maximum oxygen uptake (max VO2) were determined in 15 young female cross-country skiers, aged 15--20 years, during incremental bycycle ergometer exercise. Succinate dehydrogenase (SDH), malate dehydrogenase (MDH), citrate synthase (CS) and lactate dehydrogenase (LDH) were analyzed biochemically and percentage of slow twitch fibres (%ST fibres, myosin adenosine triphosphatase staining) histochemically in muscle samples obtained from m. vastus lateralis. Max VO2 correlated significantly with anaerobic threshold in ml x kg-1 x min-1 (mlAT) but when AT was expressed in percent of max VO2 (%AT) the correlation was insignificant. Significant correlations were found between %AT and SDH (r = 0.63) and between mlAT and CS (r = 0.58). Max VO2 showed no significant correlations with the enzymes studied or %ST fibres. The results of the study seem to support the hypothesis that anaerobic threshold is related to oxidative capacity of muscle.
Respiratory complications, such as pneumonia and atelectasis, are major causes of mortality and inhibit rehabilitation programs in spinal cord injury. Tetraplegic patients cannot cough enough to clear their sputum because of expiratory muscle weakness, mainly of the abdominal muscles. However, tetraplegics are still able to activate some muscles during coughing. Some tetraplegics, even though they cannot contract the abdominal muscles, can cough effectively. It was supposed that some accessory expiratory muscles were activated during coughing in tetraplegics. We, therefore, studied the peak expiratory flow rate, expiratory muscle strength, and the activities of the pectoralis major and latissimus dorsi muscles in 11 complete tetraplegics. Peak expiratory flow rate was measured by spirometry. Expiratory muscles strength was assessed by maximal expiratory mouth pressure; muscle activity was assessed by means of the root mean square voltage obtained by surface electromyography. The results showed that peak expiratory flow rate, maximal expiratory mouth pressure, and root mean square of these two muscles were correlated with neurological level. Peak expiratory flow rate was correlated with peak expiratory flow rate. Peak expiratory flow rate was correlated with the root mean square voltage of the pectoralis major and latissimus dorsi muscles. It was supposed that these two muscles were activated as accessory expiratory muscles and play an important role in expiratory function in tetraplegic patients.
Groups of 50 healthy male controls and 50 subjects suffering from paraplegia (aged 20-65 years) were examined as to the inter-relationships between age, paraplegia and the strength, endurance, blood pressure and heart rate responses to fatiguing isometric exercise. Contractions were maintained in both groups under voluntary effort and through a contraction induced by electrical stimulation in the paraplegic group. All contractions were maintained to fatigue at a tension of 40% of the maximal muscle strength in either the handgrip or quadriceps muscles. Muscle strength of the handgrip was higher in the paraplegic subjects than in the controls, averaging 589 N and 463 N, respectively for the two groups. In contrast, quadriceps leg extension strength averaged 696 N in the controls and 190 N in the paraplegic groups; for both groups, ageing was associated with a reduction in muscle strength. While leg endurance was less in the paraplegic group than the control group, handgrip endurance was similar in the two groups, endurance increasing with ageing in both the controls and paraplegics. Both systolic and diastolic blood pressures increased at rest in paraplegic and control subjects with age. The magnitude of the pressor response to exercise also increased with age. This was true during both voluntary exercise and exercise induced through electrical stimulation in the paraplegic groups. The heart rate response (change in heart rate during exercise) to a fatiguing isometric handgrip contraction decreased by about 50% between the ages of 20 and 60 years in both the controls and paraplegics for isometric handgrip exercise. In contrast, heart rate changed little with age during contractions of the quadriceps muscle in paraplegics which were induced by electrical stimulation.
Impaired mobility is one of the strongest predictors for falls in older people. We hypothesized that exercise as part of a fall prevention program would have positive effects, both short- and long-term, on gait, balance and strength in older people at high risk of falling and with varying levels of cognition, residing in residential care facilities. A secondary hypothesis was that these effects would be associated with a reduced risk of falling.
187 out of all residents living in 9 facilities, > or =65 years of age were at high risk of falling. The facilities were cluster-randomized to fall intervention or usual care. The intervention program comprised: education, environment, individually designed exercise, drug review, post-fall assessments, aids, and hip protectors. Data were adjusted for baseline performance and clustering.
At 11 weeks, positive intervention effects were found on independent ambulation (FAC, p=0.026), maximum gait speed (p=0.002), and step height (> or =10 cm, p<0.001), but not significantly on the Berg Balance Scale. At 9 months (long-term outcome), 3 intervention and 15 control residents had lost the ability to walk (p=0.001). Independent ambulation and maximum gait speed were maintained in the intervention group but deteriorated in the control group (p=0.001). Residents with both higher and lower cognition benefited in most outcome measures. No association was found between improved mobility and reduced risk of falling.
Exercise, as part of a fall prevention program, appears to preserve the ability to walk, maintain gait speed, ambulate independently, and improve step height. Benefits were found in residents with both lower and higher cognitive impairment, but were not found to be associated with a reduced risk of falling.
The effects of 5 weeks of unilateral lower limb suspension (ULLS) and flywheel resistance exercise (RE) on skeletal muscle protein composition were examined in thirty-one subjects (40 +/- 8y), divided into three groups: ULLS, ULLS+RE, and RE. Pre and post biopsy samples were examined for protein concentration, myosin heavy chain (MHC) and actin concentration. VL protein concentration of the three groups did not change. Soleus protein concentration following ULLS decreased (p<0.05). MHC and actin content of the VL and soleus were unaltered. Muscle mass changed from pre to post: ULLS -11% (VL), -11% (soleus), both p<0.05; ULLS+RE +9%, p<0.05; RE +6%, P<0.05. Therefore, the increase or decrease in VL muscle mass over 5 weeks occurred while maintaining protein, MHC and actin. However, soleus muscle atrophy occurred at the expense of other muscle proteins, since MHC and actin were maintained and protein concentrations decreased.