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Effectiveness of resistance exercise using elastic bands on flexibility and balance among the elderly people living in the community: A systematic review and meta-analysis

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Young Ran Yeun
Young Ran Yeun
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[Purpose] The purpose of this study was to determine the effects of resistance exercise using elastic bands on flexibility and balance among the elderly people living in the community. [Subjects and Methods] Database search was conducted by using PubMed, CINAHL, Embase, RISS, NDSL, NANET, DBpia, and KoreaMed. The meta-analysis, which was based on 19 studies, covered a total of 649 participants and used either the fixed effects or random effects model. [Results] The effect size estimates showed that resistance exercise using elastic bands have significantly increased the functional reach test score (Standard Mean Difference: 1.18, 95% CI 0.48 to 1.89) and timed up and go test score (Mean Difference: 2.89, 95% CI 2.55 to 3.22). [Conclusion] The review findings suggest that resistance exercise using elastic bands is effective for improving the flexibility and balance of the elderly people living in the community. However, further research is deemed necessary by using a large sample size or follow-up measure in order to provide evidence-based recommendations.
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1695
Review Article
Eectiveness of resistance exercise using elastic
bands on exibility and balance among
the elderly people living in the community:
a systematic review and meta-analysis
Young Ran Yeun
1)
1) Department of Nursing, Kangwon National University: 346 Hwangjogil, Dogyeeup, Samcheok,
Gangwondo 245-710, Republic of Korea
Abstract. [Pur pose] The purpose of this study was to deter mine the effects of resistance exercise using elastic
bands on exibility and balance among the elderly people living in the community. [Subjects and Methods] Data-
base search was conducted by using PubMed, CINAHL, Embase, RISS, NDSL, NANET, DBpia, and KoreaMed.
The meta-analysis, which was based on 19 studies, covered a total of 649 participants and used either the xed
effects or random effects model. [Results] The effect size estimates showed that resistance exercise using elastic
bands have signicantly increased the functional reach test score (Standard Mean Difference: 1.18, 95% CI 0.48 to
1.89) and timed up and go test score (Mean Difference: 2.89, 95% CI 2.55 to 3.22). [Conclusion] The review nd-
ings suggest that resistance exercise using elastic bands is effective for improving the exibility and balance of the
elderly people living in the community. However, further research is deemed necessary by using a large sample size
or follow-up measure in order to provide evidence-based recommendations.
Key words: Elastic band, Flexibility, Balance
(This article was submitted May 12, 2017, and was accepted Jun. 15, 2017)
INTRODUCTION
Fall-related injuries are important health concerns worldwide in the elderly people living in the community. According
to a previous study, 32% of the elderly aged 65 to 74 years old and 51% of the elderly aged 85 years or older experienced a
fall at least once a year1). Approximately 20% to 30% of the elderly with a fall incident also sustained hip fractures and head
injuries. These reduced their mobility and independence, thereby resulting in a decreased quality of life and an increased risk
of death due to the secondary complications2). For this reason, it is important to develop and implement interventions in order
to prevent fall incidents in the elderly people living in the community.
A recent study showed that risk factors for fall incidents can be reduced via exercise intervention3). In particular, elastic
bands for resistance exercise are easy to use, convenient to carry, economical, and safe. The elderly people living in the com-
munity can easily do this resistance exercise at the comfort of their homes without the assistance of an expert4). In addition,
it is suitable for the muscle strengthening of the elderly people, since it is possible to load in all directions, and the intensity
of the load can be naturally controlled unlike the exercise device, wherein the load is articially controlled5).
Based on the systematic review and meta-analysis on the physical function of the elderly people living in the community
to date, there is a study that evaluated the effect of home-based resistance training on their strength and functional ability6),
and a study that evalauted the effect of physical activity intervention on their physical function7). However, there have been
no studies on the effect of resistance exercise using elastic bands on the exibility and balance of the elderly. Therefore, this
J. Phys. Ther. Sci. 2 9: 1695–169 9, 2017
Corresponding author. Young Ran Yeun (E-mail: yeunyr@kangwon.ac.k r)
©2017 The Societ y of Physical Therapy Science. Published by IPEC Inc.
This is an open-access art icle distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives
(by-nc-nd) License. (CC-BY-NC-ND 4.0: https://creativecommons.org/licenses/by-nc-nd /4.0/)
The Journal of Physical Therapy Science The Journal of Physical Therapy Science
J. Phys. Ther. Sci. Vol. 29, No. 9, 2017 1696
study aimed to provide the guideline and direction for interventions that will help prevent fall incidents in the elderly people
by verifying the effect of resistance exercise using elastic bands on the exibility and balance of the elderly people living in
the community.
SUBJECTS AND METHODS
This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses
(PRISMA), which is a research guideline for systematic review and meta-analysis. The data selection criteria based on the
description form of the systematic literature review, including the Participants, Interventions, Comparisons, Outcomes, and
Study design (PICOS), are as follows. Participants (P) refer to the elderly people aged 65 years or older who are living in the
community. Intervention (I) refers to the resistance exercise using elastic bands that is given alone or in combination with
another intervention. Comparisons (C) refer to the group without an intervention and the group with the aforementioned
intervention. Outcomes (O) refer to the studies that measured exibility or balance in the elderly people by using the Func-
tional Reach Test (FRT), Timed Up and Go (TUG) test, and One Leg Standing Test (OLST). Study design (S) refers to the
randomized controlled and non-randomized controlled trials.
The data search was carried out without a limitation in a year and targeted the articles that were published until March
2017. The search databases used were PubMed, CINAHL, Embase, RISS, NDSL, NANET, DBpia, and KoreaMed. The
search keywords used were elder, elderly, older, aged, senior, geriatric, resistance, elastic, rubber, thera, latex, band, program,
training, test, functional reach, timed up and go, one leg standing, clinical, randomized, controlled trial, random, placebo, etc.
The selected articles were analyzed by using the RevMan 5.3 program of Cochrane Library. The effect size was estimated
with the xed effects model or random effects model, and the mean difference (MD) or standardized mean difference (SMD)
was presented. The homogeneity of the studies was tested via I2 of Higgins.
RESU LT S
Database searches identied 1,162 studies. Abstracts of 587 studies suggested that 106 articles were potentially eligible
for inclusion; however, only 19 studies met the inclusion criteria (Fig. 1). The total number of study participants was 649
persons (experiment group, 344 persons; control group, 305 persons). The risk-of-bias scores ranged from 8 to 11 out of 12
points (M ± SD, 9.74 ± 1.05) (Table 1). The effect size on FRT was 1.18 (95% CI 0.48 to 1.89), and I2, which represented
heterogeneity, was 83% (Fig. 2). The effect size on TUG was −0.36 (95% CI −0.88 to 0.16), and I2, which represented hetero-
geneity, was 85% (Fig. 3). The effect size on OLST was 2.89 (95% CI 2.55 to 3.22), and I2, which represented heterogeneity,
was 64% (Fig. 4).
DISCUSSION
Resistance exercise using elastic bands has been used as an important intervention for the prevention of fall incidents
by increasing the equilibrium and balance of the elderly; however, a comprehensive analysis for resistance exercise using
elastic bands has rarely been performed. In this study, a
systematic review and a meta-analysis were conducted on
19 studies, including a total of 649 participants, in order
to determine the effectiveness of resistance exercise using
elastic bands on the exibility and balance of the elderly
people living in the community.
The study result showed that resistance exercise using
elastic bands was remarkably effective in improving the
FRT score (EF=1.18) and OLST score (EF=2.89) of the
elderly people living in the community. However, it did
not have a statistically signicant effect in improving the
TUG score. These results were similar to that of the previ-
ous study that conducted a meta-analysis on 15 studies
and reported that exercise was effective in enhancing the
Berg Balance Scale (BBS) score of frail older adults, but
it was not effective in improving the TUG performance8).
De Vries NM et al.9) reported that physical exercise
therapy had a positive effect on the mobility and physical
functioning of the elderly people living in the community.
Howe TE et al.10) showed that exercise was effective in
improving the TUG (4 studies) and OLST (3 studies) of
the elderly people based on the meta-analysis result of Fig. 1. Flow diagram of the study selection process
169 7
Tab le 1. Characteristics of included studies
First author and
year
Study
design
Participants Interventions
Comparisons Scale Total risk-
of-bias score
Total N
(eN/cN) Mean age % of females Ty p e Dur. week Freq./
week N. of Ses. Min Repeated
time RPE
Cyarto 2008a RCT 86 (38,48) 79.0 82.6 RE 20 240 60 30 NR Wal ki ng TUG, OLST 11
Cyarto 2008b RCT 129 (81,48) 78.0 78.3 RE 20 240 60 30 NR Walk ing TUG, OLST 11
Han 2008 RCT 24 (12,12) 74.9 10 0 RE 8 3 24 60 20–30 12–14 Usual care TUG, OLST 10
Haseqawa 2014 NRCT 52 (32, 20) 72.3 59.6 RE 9327 90 12 13– 17 SE TUG 10
Hwang 2013 NRCT 22 (11,11) 78.8 NR RE 12 336 60 8–36 11–16 Usual care FRT, OLST 8
Kang 2011 NRCT 20 (10,10) 77. 6 100 PN F+RE 6318 30 15 NR PNF FRT, TUG 9
Kim 2008 RCT 30 (15,15) 75.6 NR RE 9327 50 36 NR Usual care FRT, TUG, OLST 11
Kim 2012 RCT 16 (8,8) 72.6 62.5 RE 9327 40 30 13-14 Usual care FRT, TUG 10
Kim 2013 NRCT 22 (11,11) 70.4 100 RE+SE 12 336 50 30 NR SE TUG, OLST 9
Kim 2014 NRCT 28 (14,14) 75.8 74.1 RE 8 2 16 50 30 NR Fall education FRT, TUG, OLST 10
Kyung 2014 NRCT 24 (12,12) 65.1 100 RE 8 3 18 60 45 12–14 Usual care OLST 8
Lee 2009 NRCT 24 (12,12) 70.5 100 RE 8 3 24 50 20–30 1 2–14 Usual care FRT, TUG, OLST 11
Lee 2014 RCT 20 (10,10) 6 9.0 NR RE 8 2 16 30 20 NR Usual care FRT 10
Lee 2015 RCT 20 (10,10) 73.5 100 RE 8 4 24 40 15 11-13 Usual care OLST 9
No 2013 NRCT 16 (8,8) 67.1 10 0 RE 12 336 50 NR NR Usual care FRT 9
Park 2009 N RCT 2 2 (11 ,11) 73.3 100 RE 8 3 24 50 45 NR Usual care OLST 10
Skeleton 1995 RCT 40 (20,20) 79.5 100 RE 12 112 60 8NR Usual care F RT 11
Yoo 2014 NRCT 30 (15,15 ) ≥80 NR RE 12 224 60 24– 48 NR Usual care FRT, TUG 8
Yu 2013 RCT 24 (12,12) 65.3 41.6 RE+SE 5315 NR 6NR SE TUG 10
RCT: randomiz ed controlled trials; NRCT: non-randomized controlled t rials; NR: not reported; RE: resista nce exercise; SE: stretch exercise; PNF: proprioceptive neuromuscu lar fa cilitation; RPE:
rate of perceived exertion; FRT: Functional reach test; TUG: Timed up & go test; OLST: One leg standing test
J. Phys. Ther. Sci. Vol. 29, No. 9, 2017 1698
the previous articles. Oh et al. reported that the muscle strength of the elderly improved by 9.8% to 23.5% after 18 weeks
of elastic band resistance training11). Another study showed that the elastic band resistance exercise increased the muscle
strength of the inactive, yet healthy, elderly people and frail elderly people by 3–17% and 6–18%, respectively12). Therefore,
it is believed that the improved muscle strength due to the resistance exercise using elastic bands might have directly or
indirectly inuenced the improvement of the balance and exibility of the elderly people. A systematic review for the effect
of resistance exercise using elastic bands on the muscle strength of the elderly is also necessary.
Fig. 3. Forest plot of TUG
Fig. 4. Forest plot of OLST
Fig. 2. Forest plot of FRT
169 9
According to the previous studies, the risk of a fall incident is higher in the group with less than 25.4 cm FRT, as compared
to the group with greater than 25.4 cm13), and OLST is a signicant and easy-to-administer predictor of injurious falls14).
Based on the results of this study, the resistance exercise using elastic bands need to be actively utilized in order to improve
the FRT and OLST of the elderly people living in the community.
This is the rst meta-analysis study to comprehensively determine the effect of resistance exercise using elastic bands
in order to improve the balance and exibility of the elderly people living in the community. Nevertheless, there are some
limitations. First, long-term effect was not analyzed, since the sample size was small and the follow-up measure was not
performed. After further studies are conducted in the future, it is deemed necessary to perform another systematic review.
Second, fail safe numbers (FSN) that examines how many unpublished studies would have been needed to jeopardize the
results was not calculated. Future research can utilize FSN or different statistical methods to consider publication bias.
ACKNOWLEDGEMENT
This study was supported by 2016 Research Grant from Kangwon National University (No. 620160144).
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... I 2 = 97%; p < 0.0001). Similarly, interventions using elastic bands in older people have shown statistically significant improvements (p < 0.01) in TUG compared to active/inactive control groups in previous meta-analyses performed (50,51). In the same way, Labata-Lezaun et al. (7), in a meta-analysis of older people, showed statistically significant improvements in TUG (p = 0.0001) in favor of multicomponent training interventions regarding active/inactive control groups. ...
... In the same way, Labata-Lezaun et al. (7), in a meta-analysis of older people, showed statistically significant improvements in TUG (p = 0.0001) in favor of multicomponent training interventions regarding active/inactive control groups. However, interventions using active exergames in a shorter period range from 3 to 20 weeks with 2-3 sessions per week for 30-60 min, compared to interventions using elastic bands, which range from 8 to 28 weeks with 1-3 sessions per week for 30-90 min (51), and multicomponent training, which range from 9 to 48 weeks with 2-5 sessions for 30-90 min (7); this can lead to an increase in lower limb muscle strength along with balance related to improvements in BBS and TUG; these adaptations can reduce the risk of fear and falls in older people (22). Limitations in lower limb mobility, such as alterations in dynamic balance, actions such as walking, getting up from a chair, or both, are indicators of impaired functional independence (22). ...
... Regarding the dose used by the interventions with active exergames that report results for the BBS, TUG, and 30-s chair stand tests, a duration between 3 and 20 weeks was reported with 2-3 weekly sessions for 30-60 min, with moderate-to-vigorous intensities ranging from 3 to 6 in the 10-point RPE (78). Another type of training with elastic bands has shown statistically significant improvements on these variables with interventions ranging from 8 to 28 weeks with 1-3 sessions per week for 30-90 min with intensities of 25-80% of the one-repetition maximum (1RM) from 1 to 2 sets per session of 5-20 repetitions per set in upper and lower limbs exercises as reported in various meta-analyses in older people (50,51,61,69). As the multicomponent training has shown statistically significant improvements in these previously mentioned variables (BBS and TUG), the following is a good example with interventions ranging from 9 to 48 weeks with 2 to 5 sessions per week for 30-90 min with upper and lower limbs exercises, as reported in different meta-analyses (7,46). ...
Effects of active exergames on physical performance in older people: an overview of systematic reviews and meta-analysis
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This overview assessed the available body of published peer-reviewed systematic reviews and meta-analyses related to the effects of active exergames compared with active/passive control on physical performance outcomes in older people. The methodological quality and certainty of evidence were assessed using PRISMA, AMSTAR 2, and GRADE. The protocol was registered in PROSPERO (code: CRD42023391694). The main outcomes indicate that 4,477 records, five systematic reviews, and 10 meta-analyses were included. The AMSTAR-2 reported six meta-analyses with high methodological quality, four moderate quality, two systematic reviews with low quality, and three very-low quality. Meta-analysis was performed on balance using the Berg Balance Scale (BBS) and Timed Up-and-Go (TUG) tests, on cardiorespiratory fitness using the 6-min walk test, and on upper and lower limbs muscle strength using the handgrip strength, knee extension, and 30-s chair stand tests. Significant differences in favor of the active exergames groups concerning active/passive groups were reported in BBS (SMD = 0.85; 95% CI = 0.12–1.58; I² = 96%; p = 0.02), TUG (SMD = 1.44; 95% CI = 0.71–2.16; I² = 97%; p < 0.0001), and 30-s chair stand test (SMD = 0.79; 95% CI = 0.33–1.25; I² = 88%; p = 0.0008). However, no significant differences were reported in favor of the active exergames groups in 6-min walk (SMD = 0.93; 95% CI = −0.64 to 2.50; I² = 95%; p = 0.24), handgrip strength (SMD = 0.67; 95% CI = −0.04 to 1.38; I² = 84%; p = 0.06), and knee extension tests (SMD = 0.20; 95% CI = −0.05 to 0.44; I² = 95%; p = 0.12) compared to active/passive control. However, it was impossible to perform a meta-analysis for the variables of walking speed as a fall risk due to the diversity of instruments and the small number of systematic reviews with meta-analysis. In conclusion, interventions utilizing active exergames have shown significant improvements in the static and dynamic balance and lower limb muscle strength of apparently healthy older people, compared to control groups of active/inactive participants, as measured by BBS, TUG, and 30-s chair stand tests. However, no significant differences were found in the 6-min walk, HGS, and knee extension tests. Systematic review registration PROSPERO, CRD42023391694.
View
... Similarly in a systematic review with meta-analysis on different modalities of resistance training in older people with sarcopenia on physical performance, a low certainty of evidence was presented (Lu et al., 2021). Some systematic reviews of EBT on flexibility, balance, and fragility (Daryanti Saragih et al., 2022;Yeun, 2017) in older people have been published; however, they have not included certainty of evidence in their analyses (Daryanti Saragih et al., 2022;Yeun, 2017). ...
... Similarly in a systematic review with meta-analysis on different modalities of resistance training in older people with sarcopenia on physical performance, a low certainty of evidence was presented (Lu et al., 2021). Some systematic reviews of EBT on flexibility, balance, and fragility (Daryanti Saragih et al., 2022;Yeun, 2017) in older people have been published; however, they have not included certainty of evidence in their analyses (Daryanti Saragih et al., 2022;Yeun, 2017). ...
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... In fact, even low-intensity, no-equipment eccentric muscle contractions are more effective than concentric training in enhancing physical function and health [11]. Moreover, resistance exercises performed across a wide range of motion (ROM), including eccentric training, have been demonstrated to offer additional benefits in terms of flexibility [12][13][14]. ...
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View
... Third, RT programs in 20 studies speci cally used elastic band, notably in MCI (81, 83-87). Previous meta-analyses have demonstrated that for frail old adults, RT with elastic bands was more bene cial (141,142). ...
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... Kim et al [33] mainly studied the influence of elastic band exercise on shoulder function in elderly individuals, but did not explore the influence of resistance training on mental health. Yeun [34] investigated the influence of resistance training with an elastic band on the flexibility and balance of elderly individuals in the community, and included an intervention of resistance training with an elastic band, plus other interventions. Lin et al [35] only included quantitative studies on the effects of elastic band exercise on the physiological function of elderly individuals and did not pay attention to the effects of resistance training on mental health. ...
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Article
Full-text available
Objectives Elastic band resistance training in elderly individuals can improve physical fitness and promote mental health in addition to other benefits. This systematic review aimed to review, summarize, and evaluate quantitative, qualitative, and mixed methodological studies on the use of elastic band resistance training in elderly individuals, and to investigate the influence of elastic band resistance training on the physical and mental health of elderly individuals, as well as their preferences and obstacles in training. Methods A convergent separation approach was used to synthesize and integrate the results, specifically the mixed systematic review approach recommended by the Joanna Briggs Institute. The extensive search strategy included electronic database searches in the Cochrane Library, PubMed, Embase, Web of Science, Google Scholar, MEDLINE, and CINAHL. The researchers rigorously screened the literature, extracted and analyzed the data, and evaluated the quality of the included studies using the Mixed Methods Appraisal Tool (MMAT). Results Twenty-eight studies were included, of which 25 were quantitative studies, 2 were qualitative studies, and 1 was a mixed-methods study. A total of 1,697 subjects were investigated across all studies. Quantitative evidence supports the notion that elastic band resistance training can improve upper and lower limb flexibility, endurance, upper strength, physical balance, and cardiopulmonary function and enhance the mental health of elderly individuals. Participants in the qualitative study reported some preferences and obstacles with band resistance training, but most participants reported physical benefits. Conclusions Despite the heterogeneity between studies, this review is the first systematic review to comprehensively evaluate the effectiveness of elastic band resistance training in older adults. It not only shows the influence of elastic band resistance training on the physical and mental health of the elderly, but also emphasizes the preference and obstacles of elderly individuals face.
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... Sendo assim TRE de força melhorou o desempenho físico e a qualidade muscular. Yeun et al., (2017) nos mostra no seu estudo que as estimativas do efeito mostraram que o exercício resistido com faixas elásticas aumentou significativamente a pontuação do teste de alcance funcional (diferença média: 0,48 a 1,89) e a pontuação do teste timed up and go (diferença média: 0,95 a 2,89). Com isso os resultados do estudo sugerem que o exercício resistido com faixas elásticas é eficaz para melhorar a flexibilidade e o equilíbrio dos idosos que vivem na comunidade. ...
Efeitos do treinamento com resistência elástica nos idosos: Revisão de literatura
Article
Full-text available
  • Nov 2023
Exercícios usando materiais para resistência elástica tem alcançado um lugar considerável na sistematização no treinamento resistido, contudo, dependendo da sua situação, use padrões de deslocamento mais funcionais compatíveis à máquina de musculação. Esta revisão teve como objetivo em analisar os métodos de treinamento resistido com faixa elástica em idosos, podendo assim avaliar o progresso do treinamento. Como metodologia, adotou-se a revisão bibliográfica sistemática e exploratória. Foram encontrados 65 artigos relacionados que foram publicados de 203 a 2021, todos selecionados a partir do banco de dados do PubMed e Google Acadêmico, usando os descritores: Elderly (idosos), elastic band (banda elástica), resistance training (treinamento de resistido) para selecionar 9 artigos para serem analisados neste estudo. Analisaram-se artigos focados em treinamento resistido com faixa elástica que são utilizados em idosos, que podem promover diferentes vantagens significativas quanto a melhora as capacidades físicas de idosos. Portanto, este tipo de treinamento pode ser facilmente adotado a vida diária dos idosos, assim chegando à conclusão de que o estudo mostra que o exercício com faixa de resistência é uma alternativa viável para o desenvolvimento de um programa de treinamento de resistência em idosos. Obtendo resultados significantes em proposta ao treinamento resistido.
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... Therefore, in elderly and patient populations, researchers are looking for effective methods to prevent or improve the deterioration of balance control. Systematic reviews and meta-analyses confirm that resistance exercise is an effective method for improving balance in older people [15,16]. The improved balance may be due, among other things, to the fact that resistance exercise attenuates muscle sarcopenia, which occurs as a result of aging [1]. ...
Effects of a 12-Week Low-Intensity Resistance Training Program on Force-Matching Task and Balance in Young Men
Article
Full-text available
  • Nov 2023
Featured Application Specialists promoting physical activity as a means of prevention of many diseases, including lifestyle diseases, and treating physical activity as an important element of public health, gain additional knowledge about the effects of resistance training. The systematic use of low-intensity resistance exercise, in addition to the well-known benefits, leads to improved accuracy in matching force to the demands of a motor task. Abstract Background: The effects of low-intensity resistance training on health and muscular performance have been widely reported, but its effects on motor skills such as balance and force matching have been overlooked. Hence, the purpose of this study was to determine the effects of low-intensity resistance training on a force-matching task and balance. Methods: The subjects from the intervention group (EXP; n = 20) participated in a 12-week low-intensity resistance training program. The measurements of balance and force-matching ability were conducted before and after the intervention. To determine the accuracy and steadiness (variability) in the force matching task, we calculated the values of three errors: (1) absolute error (AE), (2) constant error (CE), and (3) variable error (VE). Results: In the force-matching task performed after the training, the values of two errors decreased: (1) AE (right leg, p = 0.0008; left leg, p = 0.0008), and (2) CE (right leg, p = 0.0064; left leg, p = 0.0440). Resistance training did not significantly affect VE and the parameters characterizing COP sway in the balance test. Conclusions: The 12-week low-intensity resistance training improved the accuracy of the force-matching task but did not change postural stability or postural strategies.
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Elastic resistance exercise effects in gait kinematic characteristics and lower limb functional rehabilitation
Article
Full-text available
  • Aug 2024
Background: Elastic resistance exercise is a popular type of exercise. Elastic bands are widely used in pre-competition preparation and for sports performance improvement. Purpose: The purpose of the present review is the study of the effect using exercise with elastic resistance bands, in walking kinematics and functionality level after surgical repair of low extremity degenerative diseases. Methodology: A systematic literature review was carried out at Advanced Scholar Google, Cochrane, PubMed and Embase databases, a chronological range from 1999 to 2022. Terms used in the search were as follows: “elastic resistance exercise”, “elastic resistance bands”, “Thera-band”, “arthropathy”, “hip replacement”. Results: Systematic elastic resistance exercise in the frame of a rehabilitation program lasting 8-12 weeks, provides results comparable to an isotonic exercise program, using free weights or constant resistance devices. Elastic resistance bands are commonly used for increasing muscle strength and range of motion and also for static and dynamic balance, walking ability and functionality level improvement. Important benefits observed in metabolic biochemical health biomarkers in the elderly.
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COMPARAÇÃO DA FLEXIBILIDADE, EQUILÍBRIO E QUALIDADE DE VIDA DE IDOSOS PRATICANTES E NÃO PRATICANTES DE EXERCÍCIOS FÍSICOS PROMOVIDOS PELO NASF
Article
Full-text available
  • Feb 2024
Este estudo teve o objetivo de comparar a flexibilidade, o equilíbrio e a qualidade de vida de idosos praticantes e não praticantes de exercícios físicos em grupos promovidos pelo Núcleo de Assistência à Saúde da Família (NASF) no município de Terra Boa-PR. Estudo transversal, realizado com 40 idosos de ambos os sexos, sendo 20 praticantes do grupo de exercícios físicos e 20 não praticantes. Foram utilizados o teste Sentar e Alcançar, a Escala Motora para a Terceira Idade “EMTI”, e o SF-12. A análise dos dados foi conduzida por meio dos testes de Shapiro-Wilk e t de Student independente (p<0,05). Os resultados evidenciaram que não houve diferença significativa (p> 0,05) no equilíbrio, flexibilidade e qualidade de vida física e mental dos idosos em função da faixa etária. Verificou-se diferença significativa na flexibilidade (p=0,001), no equilíbrio (p=0,001), e na qualidade de vida física (p=0,001) e mental (p=0,004) entre os idosos praticantes e não praticantes de exercícios físicos, com valores superiores em todos os testes para os idosos praticantes de exercícios físicos. Concluiu-se que a prática de exercício físico promovida pelo NASF parece ser um fator interveniente nas capacidades física de equilíbrio, flexibilidade e na percepção de qualidade de vida de idosos.
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Feasibility, Psychosocial Effects, Influence, and Perception of Elastic Band Resistance Balance Training in Older Adults
Article
Full-text available
This study utilised feedback from older adults during balance-challenging, elastic band resistance exercises to design a physical activity (PA) intervention. Methods: Twenty-three active participants, aged 51-81 years, volunteered to perform a mini balance evaluation test and falls efficacy scale, and completed a daily living questionnaire. Following a 10 min warm-up, participants performed eight pre-selected exercises (1 × set, 8-12 repetitions) using elastic bands placed over the hip or chest regions in a randomised, counterbalanced order with 15 min seated rests between interventions. Heart rate (HR) and rate of perceived exertion (RPE) were measured throughout. Participant interview responses were used to qualify the experiences and opinions of the interventions including likes, dislikes, comfort, and exercise difficulty. Results: Similar significant (p < 0.01) increases in HR (pre- = 83-85 bpm, mid- = 85-88 bpm, post-intervention = 88-89 bpm; 5-6%) and RPE (pre- = 8-9, mid- = 10, post-intervention = 10-11) were detected during the PA interventions (hip and chest regions). Interview data revealed that participants thought the PA interventions challenged balance, that the exercises would be beneficial for balance, and that the exercises were suitable for themselves and others. Participants reported a positive experience when using the PA interventions with an elastic band placed at the hip or chest and would perform the exercises again, preferably in a group, and that individual preference and comfort would determine the placement of the elastic band at either the hip or chest. Conclusion: These positive outcomes confirm the feasibility of a resistance band balance program and will inform intervention design and delivery in future studies.
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Effects of physical exercise therapy on mobility, physical functioning, physical activity and quality of life in community-dwelling older adults with impaired mobility, physical disability and/or multi-morbidity: A meta-analysis
Article
Full-text available
  • Nov 2011
This is the first meta-analysis focusing on elderly patients with mobility problems, physical disability and/or multi-morbidity. The aim of this study is to assess the effect of physical exercise therapy on mobility, physical functioning, physical activity and quality of life. A broad systematic literature search was performed in the databases PubMed, CINAHL, Embase, PEDro and The Cochrane Library. Relevant study characteristics were reviewed and meta-analyses using standardized mean differences (SMDs) were performed. The results show that physical exercise therapy has a positive effect on mobility (SMD final value: 0.18; 95% CI: 0.05, 0.30; SMD change value: 0.82; 95% CI: 0.54, 1.10) and physical functioning (SMD final value: 0.27; 95% CI: 0.08, 0.46; SMD change value: 2.93; 95% CI: 2.50, 3.36). High-intensity exercise interventions seem to be somewhat more effective in improving physical functioning than low-intensity exercise interventions (SMD final value: 0.22; 95% CI: -0.17, 0.62; SMD change value: 0.38; 95% CI: -0.48, 1.25). These positive effects are of great value for older adults who are already physically impaired. The effect on physical activity and quality of life was not evident and no definite conclusions on the most effective type of physical exercise therapy intervention can be drawn.
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Exercise for improving balance in older people
Article
Full-text available
  • Nov 2011
In older adults, diminished balance is associated with reduced physical functioning and an increased risk of falling. This is an update of a Cochrane review first published in 2007. To examine the effects of exercise interventions on balance in older people, aged 60 and over, living in the community or in institutional care. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, CENTRAL (The Cochrane Library 2011, Issue 1), MEDLINE and EMBASE (to February 2011). Randomised controlled studies testing the effects of exercise interventions on balance in older people. The primary outcomes of the review were clinical measures of balance. Pairs of review authors independently assessed risk of bias and extracted data from studies. Data were pooled where appropriate. This update included 94 studies (62 new) with 9,917 participants. Most participants were women living in their own home.Most trials were judged at unclear risk of selection bias, generally reflecting inadequate reporting of the randomisation methods, but at high risk of performance bias relating to lack of participant blinding, which is largely unavoidable for these trials. Most studies only reported outcome up to the end of the exercise programme.There were eight categories of exercise programmes. These are listed below together with primary measures of balance for which there was some evidence of a statistically significant effect at the end of the exercise programme. Some trials tested more than one type of exercise. Crucially, the evidence for each outcome was generally from only a few of the trials for each exercise category. 1. Gait, balance, co-ordination and functional tasks (19 studies of which 10 provided primary outcome data): Timed Up & Go test (mean difference (MD) -0.82 s; 95% CI -1.56 to -0.08 s, 114 participants, 4 studies); walking speed (standardised mean difference (SMD) 0.43; 95% CI 0.11 to 0.75, 156 participants, 4 studies), and the Berg Balance Scale (MD 3.48 points; 95% CI 2.01 to 4.95 points, 145 participants, 4 studies).2. Strengthening exercise (including resistance or power training) (21 studies of which 11 provided primary outcome data): Timed Up & Go Test (MD -4.30 s; 95% CI -7.60 to -1.00 s, 71 participants, 3 studies); standing on one leg for as long as possible with eyes closed (MD 1.64 s; 95% CI 0.97 to 2.31 s, 120 participants, 3 studies); and walking speed (SMD 0.25; 95% CI 0.05 to 0.46, 375 participants, 8 studies).3. 3D (3 dimensional) exercise (including Tai Chi, qi gong, dance, yoga) (15 studies of which seven provided primary outcome data): Timed Up & Go Test (MD -1.30 s; 95% CI -2.40 to -0.20 s, 44 participants, 1 study); standing on one leg for as long as possible with eyes open (MD 9.60 s; 95% CI 6.64 to 12.56 s, 47 participants, 1 study), and with eyes closed (MD 2.21 s; 95% CI 0.69 to 3.73 s, 48 participants, 1 study); and the Berg Balance Scale (MD 1.06 points; 95% CI 0.37 to 1.76 points, 150 participants, 2 studies).4. General physical activity (walking) (seven studies of which five provided primary outcome data). 5. General physical activity (cycling) (one study which provided data for walking speed). 6. Computerised balance training using visual feedback (two studies, neither of which provided primary outcome data). 7. Vibration platform used as intervention (three studies of which one provided primary outcome data).8. Multiple exercise types (combinations of the above) (43 studies of which 29 provided data for one or more primary outcomes): Timed Up & Go Test (MD -1.63 s; 95% CI -2.28 to -0.98 s, 635 participants, 12 studies); standing on one leg for as long as possible with eyes open (MD 5.03 s; 95% CI 1.19 to 8.87 s, 545 participants, 9 studies), and with eyes closed ((MD 1.60 s; 95% CI -0.01 to 3.20 s, 176 participants, 2 studies); walking speed (SMD 0.04; 95% CI -0.10 to 0.17, 818 participants, 15 studies); and the Berg Balance Scale ((MD 1.84 points; 95% CI 0.71 to 2.97 points, 80 participants, 2 studies).Few adverse events were reported but most studies did not monitor or report adverse events.In general, the more effective programmes ran three times a week for three months and involved dynamic exercise in standing. There is weak evidence that some types of exercise (gait, balance, co-ordination and functional tasks; strengthening exercise; 3D exercise and multiple exercise types) are moderately effective, immediately post intervention, in improving clinical balance outcomes in older people. Such interventions are probably safe. There is either no or insufficient evidence to draw any conclusions for general physical activity (walking or cycling) and exercise involving computerised balance programmes or vibration plates. Further high methodological quality research using core outcome measures and adequate surveillance is required.
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Physical Activity Intervention Effects on Physical Function Among Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis
Article
  • Sep 2016
The purpose of this systematic review and meta-analysis was to determine the effects of supervised resistance and/or aerobic training physical activity interventions on performance-based measures of physical functioning among community-dwelling older adults, and to identify factors impacting intervention effectiveness. Diverse search strategies were used to identify eligible studies. Standardized mean difference effect sizes (d, ES) were synthesized using a random effects model. Moderator analyses were conducted using subgroup analyses and meta-regression. Twenty-eight studies were included. Moderator analyses were limited by inconsistent reporting of sample and intervention characteristics. The overall mean ES was 0.45 (k=38, p=<.01), representing a clinically meaningful reduction of 0.92 seconds in the Timed Up and Go for treatment versus control. More minutes per week (p<.01) and longer intervention session duration (p<0.01) were associated with larger effects. Interventions were especially effective among frail participants (d=1.09). Future research should clearly describe sample and intervention characteristics and incorporate frail populations.
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Effects of an integrated health education and elastic band resistance training program on physical function and muscle strength in community-dwelling elderly women: Healthy Aging and Happy Aging II study: Healthy aging and happy aging II study
Article
  • May 2016
Aim: In the present study, we determined the effect of an integrated health education and elastic band resistance training program on body composition, physical function, muscle strength and quality in community-dwelling elderly women. Methods: We recruited participants with eligibility inclusion criteria, and randomly assigned them to either the control group (n = 19) or the intervention group (n = 19). The integrated intervention program comprised of health education and individual counseling, and elastic band training for 18 weeks (8 weeks of supervised training and 10 weeks of self-directed training). We assessed body composition, muscle strength and quality, and physical function at pre-, after 8 weeks (mid-) and 18 weeks (post-training). Results: After the intervention, there were no significant changes in skeletal muscle index, fat free mass, total lean mass and total fat mass for both the control group and intervention group. However, the interaction effect was significantly different in SPPB score (P < 0.05), isokinetic strength (60 deg/s, P < 0.001; 120 deg/s; P < 0.05) and muscle quality (P < 0.05) after 18 weeks of intervention relative to the baseline of the control and intervention groups. The supervised elastic band training of 8 weeks did not improve short physical performance battery score and isokinetic strength, whereas there was a significant increase of those outcomes (10.6% improvement, 9.8~23.5% improvement) after 10 weeks of following self-directed exercise compared with the baseline. Conclusions: These results show the effectiveness of following self-directed resistance training with health education after supervised training cessation in improvement of short physical performance battery and leg muscle strength. This intervention program might be an effective method to promote muscle strength and quality, and to prevent frailty in elderly women. Geriatr Gerontol Int 2016; ••: ••-••.
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An elastic band exercise programme improves functional fitness in older adults
Article
  • Dec 2015
  • Evid Base Nurs
Commentary on : Yang HJ, Chen KM, Chen MD, et al. Applying the transtheoretical model to promote functional fitness of community older adults participating in elastic band exercises. J Adv Nurs 2015;71:2338–49.[OpenUrl][1][CrossRef][2][PubMed][3] Age-associated loss of skeletal muscle mass and function not only affects the ability to perform activities of daily living but increases the risks of morbidity and mortality in the elderly.1 It is recommended that older adults should engage in a … [1]: {openurl}?query=rft.jtitle%253DJ%2BAdv%2BNurs%26rft.volume%253D71%26rft.spage%253D2338%26rft_id%253Dinfo%253Adoi%252F10.1111%252Fjan.12705%26rft_id%253Dinfo%253Apmid%252F26059214%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1111/jan.12705&link_type=DOI [3]: /lookup/external-ref?access_num=26059214&link_type=MED&atom=%2Febnurs%2F19%2F2%2F64.atom
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Home-based resistance training for older adults: A systematic review
Article
  • Sep 2014
Home-based resistance exercise is commonly used for individuals who might not have access or the ability to use traditional resistance exercise. However, the extent to which home-based resistance exercise can improve both strength and functional ability has not been investigated in healthy older individuals using a systematic analysis. The current article systematically reviewed the effectiveness of home-based resistance exercise on strength and functional ability. Search engines included Academic Search Premier, CINAHL, PubMed, PsycINFO, MEDLINE, SPORTDiscus and Web of Science. A total of 649 articles were found using the key words “home-based” and “strength” and “older” or “elderly”, with eight articles meeting the final criteria. The average age of the participants was 76 years, with the average duration of exercise training ranging from 8 weeks to 120 weeks. Of the eight studies, a significant increase in knee extension strength was found in five studies. Functional ability significantly improved in seven of the eight studies, with the average decrease in Timed Up & Go test being −0.8 ± 0.5 s. Three studies included greater amounts of supervised visits compared with the other five studies (∼51% vs ∼7%). The more supervised studies had significant increases in strength and functional ability. Overall, home-based resistance exercise can improve both strength and functional ability, but the improvements are generally small. The intensity of the exercises might not progress sufficiently enough to produce large improvements in strength as a result of less supervision or a lack of motivation to increase the intensity further. Geriatr Gerontol Int 2014; ●●: ●●–●●.
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Effect of Exercise on Physical Function, Daily Living Activities, and Quality of Life in the Frail Older Adults: A Meta-Analysis
Article
  • Feb 2012
To determine the effect of exercise on the physical function, activities of daily living (ADLs), and quality of life (QOL) of the frail older adults. Relevant articles published between 2001 and June 2010 were searched in PubMed, MEDLINE, EMBASE, the Chinese Electronic Periodical Service, CINAHL, and the Cochrane Library databases. The participants were selected based on the predetermined frailty criteria and randomly assigned to either an exercise or control group. The intervention for the exercise group was a single or comprehensive exercise training program, whereas usual care was provided to the control group. The characteristics and outcome measures of the included studies were identified independently by 2 investigators. The effect sizes of physical function assessed by the timed up and go test, gait speed, the Berg Balance Scale (BBS), the ADL questionnaires, and QOL measured by the Medical Outcomes Study 36-Item Short-Form Health Survey were calculated, using a weighted mean difference (WMD) and a 95% confidence interval (CI) to represent the results. Compared with the control group, the exercise group increased their gait speed by .07 m/s (95% CI .02-.11), increased their BBS score (WMD=1.69; 95% CI .56-2.82), and improved their performance in ADLs (WMD=5.33; 95% CI 1.01-9.64). The exercise intervention had no significant effects on the Timed Up & Go test performance and the QOL between the groups. Exercise is beneficial to increase gait speed, improve balance, and improve performance in ADLs in the frail older adults.
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Effects of Thera-Band ® elastic resistance-assisted gait training in stroke patients: A pilot study
Article
  • May 2011
  • Eur J Phys Rehabil Med
In stroke patients, it is difficult to manually assist dorsi-flexion during the normal gait cycle as it is a distal component. Furthermore, it is nearly impossible to simultaneously guard the patient and manually assist dorsi-flexion during the swing phase of gait. However, one of the key benefits of Thera-Band® Elastic Resistance-Assisted Gait Training is that it offers distal control of lower extremity during the normal gait sequence without jeopardizing patient safety. Aim of this study was to compare and measure the effects of Thera-Band® Elastic Resistance-Assisted Gait Training in stroke patients with respect to quality of gait and functional mobility. This was a pilot study. The study was carried out at the Occupational Therapy Department, Mumbai, India. The study included 16 patients aged between 30-60 years with first episode of stroke or subacute stroke. Following informed consent, as per inclusion criteria patients were randomly assigned in two groups: 1) control group: Conventional Occupational Therapy Intervention and Conventional Gait Training; 2) experimental group: Conventional Occupational Therapy and Thera-Band® Elastic Resistance Assisted Gait Training. Patients were assessed on: 1) Wisconsin Gait Scale; 2) Rivermead Mobility Index. Patients were reassessed as done initially at the end of third and sixth week. Patients received therapy three times a week for six weeks. Each group separately was associated with statistically significant improvement in quality of gait (P<0.001) as well as functional mobility (P<0.001). Thera-Band® Elastic Resistance-Assisted Gait Training had a more positive effect on improving the quality of gait, functional mobility in a short duration as compared to the conventional gait training. The use of Thera-Band® Elastic Resistance-Assisted Gait Training contributed to faster recovery as compared to the control group. Functionally patients showed improvement as compared to conventional therapy. Thera-Band® Elastic Resistance-Assisted Gait Training facilitates dorsi-flexion during a single cycle of swing.
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One-Leg Balance Is an Important Predictor of Injurious Falls in Older Persons
Article
  • Jul 1997
To test the hypothesis that one-leg balance is a significant predictor of falls and injurious falls. Analysis of data from a longitudinal cohort study. Healthy, community-living volunteers older than age 60 enrolled in the Albuquerque Falls Study and followed for 3 years (N = 316; mean age 73 years). Falls and injurious falls detected via reports every other month. Baseline measures of demographics, history, physical examination, Iowa Self Assessment Inventory, balance and gait assessment, and one-leg balance (ability to stand unassisted for 5 seconds on one leg). At baseline, 84.5% of subjects could perform one-leg balance. (Impairment was associated with older age and gait abnormalities.) Over the 3-year follow-up, 71% experienced a fall and 22% an injurious fall. The only independent significant predictor of all falls using logistic regression was age greater than 73. However, impaired one-leg balance was the only significant independent predictor of injurious falls (relative risk: 2.13; 95% CI: 1.04, 4.34; P = .03). One-leg balance appears to be a significant and easy-to-administer predictor of injurious falls, but not of all falls. In our study, it was the strongest individual predictor. However, no single factor seems to be accurate enough to be relied on as a sole predictor of fall risk or fall injury risk because so many diverse factors are involved in falling.
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