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Miles AF, Mulkey DC. Implementing Tai Chi Exercise in Long-Term Care to Reduce Falls. J Nurs Care Qual 2024; 39:220-225. [PMID: 38030147 DOI: 10.1097/ncq.0000000000000756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
BACKGROUND Falls are a frequent occurrence in older adults in long-term care facilities. LOCAL PROBLEM At our long-term care facility, the percentage of patients who fell increased from 45% in 2021 to 68% in 2022, indicating a need for an evidence-based solution. METHODS We used an evidence-based quality improvement framework to pilot a tai chi exercise program. INTERVENTIONS Residents were invited to participate in the Tai Ji Quan: Moving for Better Balance program for 12 weeks. Classes were 30 minutes long and included a 5-minute warm-up and 5-minute cooldown. RESULTS Seventy-five residents participated in the tai chi program. There was a significant 32.3% reduction in falls ( P =.001). Residents' fall risk scores decreased 14% ( P < .001). CONCLUSIONS Implementing a tai chi exercise project may affect falls and decrease the overall fall risk.
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Affiliation(s)
- Angela F Miles
- Nursing Department, Georgia War Veterans Home, Milledgeville (Dr Miles); and College of Nursing and Health Care Professions, Grand Canyon University, Phoenix, Arizona (Dr Mulkey)
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Freire I, Seixas A. Effectiveness of a sensorimotor exercise program on proprioception, balance, muscle strength, functional mobility and risk of falls in older people. Front Physiol 2024; 15:1309161. [PMID: 38694207 PMCID: PMC11061438 DOI: 10.3389/fphys.2024.1309161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 03/25/2024] [Indexed: 05/04/2024] Open
Abstract
Introduction Sensory systems provide the necessary information for a motor response to be provided. In this sense, the objective of this study is to evaluate the effectiveness of a sensorimotor exercise program on proprioceptive acuity, balance, muscle strength, functional mobility and risk of falls in institutionalized elderly. Methodology 56 participants (84.6 ± 8.4 years) were randomly distributed between the control (CG, n = 28) and intervention groups (IG, n = 28). The CG performed a protocol based on warm-up, muscle strengthening and warm down and the IG performed the same intervention, with the addition of sensorimotor exercises. Joint Position Sensation (JPS) was evaluated in both limbs at angles of 20° and 45°, balance, functional mobility, fear of falling in the elderly and muscle strength of quadriceps, hamstrings, adductors and abductors in both limbs, before and after the 12 weeks of intervention. Results Both groups showed gains in muscle strength. When analyzing functionality through Timed Up and Go (TUG), before and after for each group separately, both showed a significant difference (CG p = 0.002; IG p < 0.001). For the Short Physical Performance Battery (SPPB) variable, there were significant differences in IG in balance (p < 0.001), gait speed time (s) (p = 0.004) and sit-to-stand (p = 0.002). In JPS, significant differences were recorded for Absolute Error 45° Non-Dominant (p = 0.045) and Relative Error 45° Non-Dominant (p = 0.045) in the CG and Relative Error 45° Non-Dominant for IG (p = 0.018). In the Falls Efficacy Scale International (FES-I) variable there were significant improvements in the CG (p = 0.006) and in the GI (p = 0.002). However, only IG showed significant improvements (p = 0.013) for Activities-Specific Balance Confident (ABC) in a comparison between before and after the 12-week research period. When comparing the differences verified with the intervention between CG and IG, only balance SPPB (p < 0.001) and sit-to-stand SPPB (p = 0.022) showed significant values. Conclusion He effectiveness of sensorimotor exercises provides balance gain in the elderly (p < 0.001) and positively impacts their confidence (p = 0.013) when performing their duties. It is concluded that the protocol presented in its different levels of difficulty is effective and important for the quality of life of the institutionalized sedentary elderly.
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Affiliation(s)
- Ivelize Freire
- FP-I3ID, FP-BHS, Escola Superior de Saúde Fernando Pessoa, Porto, Portugal
| | - Adérito Seixas
- FP-I3ID, FP-BHS, Escola Superior de Saúde Fernando Pessoa, Porto, Portugal
- LABIOMEP, INEGI-LAETA, Faculdade de Desporto, Universidade do Porto, Porto, Portugal
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Lin J, Ning S, Lyu S, Gao H, Shao X, Tan Z, Zhu X, Chen Y. The effects of different types of Tai Chi exercises on preventing falls in older adults: a systematic review and network meta-analysis. Aging Clin Exp Res 2024; 36:65. [PMID: 38472538 PMCID: PMC10933200 DOI: 10.1007/s40520-023-02674-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 12/18/2023] [Indexed: 03/14/2024]
Abstract
OBJECTIVES Few studies comparing the effects of different types of Tai Chi exercises on preventing falls in older adults. We compared the effects for finding an optimal intervention. METHODS We searched 12 databases, including PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI) and so on, from their inception to January 13, 2023. Randomized controlled trials incorporating different types of Tai Chi for preventing falls in older adults were included. The outcome measures were the incidence of falls and Berg Balance Scale (BBS). Network meta-analysis (NMA) was conducted using Stata 15.1 based on a frequentist framework. RESULTS Seventeen trials were eligible, including 3470 participants and four types of Tai Chi. They were 24-form simplified Tai Chi (24-form), Yang style Tai Chi (Yang style), Sun style Tai Chi (Sun style) and Tai Chi exercise program (TCEP). In paired meta-analysis, for incidence of falls, 24-form (Relative Risk (RR) = 0.59, 95% confidence interval (CI) [0.40, 0.86]) was more efficient than the control group. For BBS outcome, 24-form (MD (mean difference) = 2.32, 95% CI [1.42, 3.22]) was better than the control group. In the NMA, the results of incidence of falls were as follows: 24-form > Yang style > Sun style > control > TCEP. The rank probability of BBS was as follows: 24-form > TCEP > Yang style > control. CONCLUSION Among the four types of Tai Chi studied, the 24-form simplified Tai Chi has shown better efficacy than other types.
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Affiliation(s)
- Jiaqi Lin
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Shuaiqi Ning
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Shaowei Lyu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Hainan Gao
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Xinxin Shao
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Zili Tan
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Xiangyu Zhu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China.
| | - Ying Chen
- Department of Encephalopathy, Beijing Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
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Krause-Sorio B, Siddarth P, Milillo MM, Kilpatrick L, Ercoli L, Narr KL, Lavretsky H. Grey matter volume predicts improvement in geriatric depression in response to Tai Chi compared to Health Education. Int Psychogeriatr 2023:1-9. [PMID: 38053398 DOI: 10.1017/s1041610223004386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
OBJECTIVES Geriatric depression (GD) is associated with cognitive impairment and brain atrophy. Tai-Chi-Chih (TCC) is a promising adjunct treatment to antidepressants. We previously found beneficial effects of TCC on resting state connectivity in GD. We now tested the effect of TCC on gray matter volume (GMV) change and the association between baseline GMV and clinical outcome. PARTICIPANTS Forty-nine participants with GD (>=60 y) underwent antidepressant treatment (38 women). INTERVENTION Participants completed 3 months of TCC (N = 26) or health and wellness education control (HEW; N = 23). MEASUREMENTS Depression and anxiety symptoms and MRI scans were acquired at baseline and 3-month follow-up. General linear models (GLMs) tested group-by-time interactions on clinical scores. Freesurfer 6.0 was used to process T1-weighted images and to perform voxel-wise whole-brain GLMs of group on symmetrized percent GMV change, and on the baseline GMV and symptom change association, controlling for baseline symptom severity. Age and sex served as covariates in all models. RESULTS There were no group differences in baseline demographics or clinical scores, symptom change from baseline to follow-up, or treatment-related GMV change. However, whole-brain analysis revealed that lower baseline GMV in several clusters in the TCC, but not the HEW group, was associated with larger improvements in anxiety. This was similar for right precuneus GMV and depressive symptoms. CONCLUSIONS While we observed no effect on GMV due to the interventions, baseline regional GMV predicted symptom improvements with TCC but not HEW. Longer trials are needed to investigate the long-term effects of TCC on clinical symptoms and neuroplasticity.
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Affiliation(s)
- Beatrix Krause-Sorio
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Prabha Siddarth
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Michaela M Milillo
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Lisa Kilpatrick
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Linda Ercoli
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Katherine L Narr
- Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
| | - Helen Lavretsky
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
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Gadhvi C, Bean D, Rice D. A systematic review of fear of falling and related constructs after hip fracture: prevalence, measurement, associations with physical function, and interventions. BMC Geriatr 2023; 23:385. [PMID: 37353752 PMCID: PMC10288814 DOI: 10.1186/s12877-023-03855-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 02/28/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND Hip fracture is a common and debilitating injury amongst older adults. Fear of falling (FoF) and related constructs (balance confidence and falls efficacy) may impede rehabilitation after hip fracture. An updated systematic review to synthesize existing literature on FoF after hip fracture is needed. This review focussed on four research questions: In the hip fracture population: (1) What is the prevalence of FoF?; (2) What FoF assessment tools are validated? (3) What is the relationship between FoF and physical function?; (4) What interventions are effective for reducing FoF? METHODS A systematic search was undertaken in EBSCO Health, Scopus and PsychINFO in January 2021 (and updated December 2022) for articles on FoF after hip fracture. Data in relation to each research question was extracted and analysed. The quality of the studies was appraised using the 'Risk of Bias Tool for Prevalence Studies', 'COSMIN Risk of Bias checklist for Patient-reported outcome measures', modified version of the 'Appraisal Tool for Cross-sectional studies', and the 'Cochrane Risk of Bias 2' tools for each research question, respectively. RESULTS 36 studies (37 articles) with 5099 participants were included (mean age 80.2 years and average 78% female). Prevalence rates for FoF after hip fracture ranged between 22.5% and 100%, and prevalence tended to decrease as time progressed post hip fracture. The 'Falls Efficacy Scale - International' (FES-I) and 'Fear of Falling Questionnaire - Revised' (FFQ-R) were found to be reliable, internally consistent, and valid tools in hip fracture patients. FoF after hip fracture was consistently associated with measures of physical function including balance, gait speed, composite physical performance measures and self-reported function. Ten of 14 intervention studies were considered high risk of bias. Exercise-based interventions with or without a psychological component were not effective in reducing FoF after hip fracture compared to a control condition. CONCLUSION FoF is prevalent after hip fracture and is consistently associated with poorer physical function. Only two instruments (FES-I and FFQ-R) have been validated for measuring FoF in the hip fracture population. However, there remains a need for larger, higher quality randomised controlled trials targeting FoF after hip fracture in order to guide clinical practice. TRIAL REGISTRATION PROSPERO registration: CRD42020221836.
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Affiliation(s)
- Chandini Gadhvi
- Health & Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
- Allied Health - Physiotherapy, Te Whatu Ora Health New Zealand - Te Toka Tumai, Auckland, New Zealand
| | - Debbie Bean
- Health & Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand.
- Department of Anaesthesiology & Perioperative Medicine, Te Whatu Ora Health New Zealand - Waitematā, Auckland, New Zealand.
| | - David Rice
- Health & Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
- Department of Anaesthesiology & Perioperative Medicine, Te Whatu Ora Health New Zealand - Waitematā, Auckland, New Zealand
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Zhang W, Sun J, Feng X, Zhang H, Zhang Y, Zhao M. Effectiveness of Tai Chi exercise on fear of falling and balance in older adults: A meta-analysis. Geriatr Nurs 2023; 51:194-201. [PMID: 37011491 DOI: 10.1016/j.gerinurse.2023.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/20/2023] [Accepted: 03/20/2023] [Indexed: 04/03/2023]
Abstract
OBJECTIVE To assess the effect of Tai Chi exercise on fear of falling (FOF) and balance in older adults. METHOD Chinese and English databases were searched for randomized controlled trials (RCTs) on the effect of Tai Chi on the fear of falling and balance of older adults. The search time limit was from inception until 13 December 2022. RESULTS A total of 13 RCTs were included and the overall quality was moderate. The results showed that Tai Chi exercise could significantly improve fear of falling [SMD = -0.54, 95%CI(-1.09, 0.01), Z =1.94, P = 0.05], dynamic balance [SMD = -2.23, 95%CI(-3.89, -0.75), Z=2.90, P = 0.004] and fall incidence [RR = 0.48, 95%CI(0.35, 0.65), Z =4.67, P <0.001] in older adults. However, its significant benefits in improving the static balance [MD = 4.16, 95%CI(-3.71, 12.04), Z =1.04, P = 0.30] in older adults were not found. The results of the subgroup analysis showed that the short-term effect of Tai Chi in reducing the fear of falling was more significant (P = 0.002). CONCLUSION Tai Chi could alleviate the FOF of older adults, improve balance and reduce fall incidence. However, large-sample, multi-center, high-quality randomized controlled studies are still verified in the future.
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Garbin AJ, Fisher BE. The Interplay Between Fear of Falling, Balance Performance, and Future Falls: Data From the National Health and Aging Trends Study. J Geriatr Phys Ther 2023; 46:110-115. [PMID: 34380981 DOI: 10.1519/jpt.0000000000000324] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE Fear of falling is common in older adults and greatly increases their risk for falls. Interventions aimed at reducing fall risk in older adults with a fear of falling typically aim to improve balance. However, this approach has limited success, and the idea that balance performance impacts fall risk in this population is largely based on research in the general older adult population. The aim of this study was to assess whether presence of fear of falling modifies the relationship between balance performance and future falls in a sample of nationally representative older adults. METHODS We analyzed data from 5151 community-dwelling Medicare beneficiaries (65 years or older) from waves 1 and 2 of the National Health and Aging Trends Study. In this prospective cohort study, balance performance and fear of falling were recorded during wave 1, while a report of a fall was recorded during wave 2 (1-year follow-up). The interplay between fear of falling, balance performance, and fall risk was analyzed using logistic regression with fear of falling as a moderating variable while controlling for common confounding variables. RESULTS Twenty-seven percent of participants reported a fear of falling at wave 1 while 32.7% reported a fall at wave 2. Reduced balance performance was significantly associated with increased future fall likelihood in individuals with and without a fear of falling ( P = .008). Further, the presence of fear of falling did not modify the association between balance and future falls ( P = .749). Fear of falling was associated with increased future fall likelihood independent of balance performance ( P < .001). CONCLUSION These findings demonstrate that fear of falling did not modify the relationship between balance performance and future fall risk, thus suggesting that balance training is appropriate to reduce falls in older adults with a fear of falling. However, balance training alone may be insufficient to optimally reduce falls in older adults with a fear of falling, as the presence of this fear increased future fall risk independent of balance performance.
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Affiliation(s)
- Alexander J Garbin
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles
| | - Beth E Fisher
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles
- Department of Neurology, University of Southern California, Los Angeles
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Wu J, Chen B, Mao Y, Li S, Zhao W, Meng D, Hu S, Wang J, Yu P, Zhang C, Wu J. Chinese expert consensus on prevention and control interventions for older adults with physical functional impairment (2022). Aging Med (Milton) 2023; 6:25-34. [PMID: 36911093 PMCID: PMC10000255 DOI: 10.1002/agm2.12242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 01/16/2023] [Accepted: 01/24/2023] [Indexed: 03/07/2023] Open
Abstract
Older adults are at high risk for functional impairment, which is closely related to sarcopenia, falls, and frailty. This seriously affects their quality of life and health, and places a heavy burden on society and families. Although domestic and foreign sports recommendations and prevention and control guidelines/expert consensus have been issued for healthy older adults and functional impairment-related diseases, there is no guidance on prevention and control interventions for older adults with physical functional impairment. In China, there is insufficient understanding of the importance of prevention and control interventions for functional impairment in older adults, and there are many drawbacks, such as unstandardized diagnosis and treatment, and relatively simple intervention methods. Therefore, the consensus expert group formulated a consensus based on domestic and foreign guidelines related to functional impairment in older adults to provide guidance for Chinese medical professionals working in the field of geriatrics.
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Affiliation(s)
- Jianqing Wu
- Department of Geriatrics, Jiangsu Province Hospital The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Bo Chen
- Department of Geriatrics, Jiangsu Province Hospital The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Yongjun Mao
- Department of Geriatrics The Affiliated Hospital of Qingdao University Qingdao China
| | - Siyuan Li
- Center of Gerontology and Geriatrics, China National Clinical Research Center for Geriatric Medicine West China Hospital, Sichuan University Chengdu China
| | - Weihong Zhao
- Department of Geriatrics, Jiangsu Province Hospital The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Dianhuai Meng
- Rehabilitation Medical Center, Jiangsu Province Hospital The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Song Hu
- Department of Geriatrics The Affiliated Hospital of Qingdao University Qingdao China
| | - Jianye Wang
- Beijing Hospital, National Center of Gerontology Institute of Geriatric Medicine, Chinese Academy of Medical Sciences Beijing China
| | - Pulin Yu
- Beijing Hospital, National Center of Gerontology Institute of Geriatric Medicine, Chinese Academy of Medical Sciences Beijing China
| | - Cuntai Zhang
- Department of Geriatrics, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan China
| | - Jinhui Wu
- Center of Gerontology and Geriatrics, China National Clinical Research Center for Geriatric Medicine West China Hospital, Sichuan University Chengdu China
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Sadeghian F, Zolaktaf V, Shigematsu R. A comparison between effects of Square-Stepping Exercise and Tai Chi Chuan on functional fitness and fear of falling in older women. Aging Clin Exp Res 2023; 35:827-834. [PMID: 36853504 DOI: 10.1007/s40520-023-02367-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 02/06/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND It is challenging to find exercise programs that are safe, effective, attractive, and feasible to reduce the risk of falls and fall-related injuries in older adults. AIMS We compared the effects of SSE (Square-Stepping Exercise) versus TCC (Tai Chi Chuan) on functional fitness and fear of falling in older women aged 60 years and above. METHODS It was a single blind randomized control trial. We purposefully selected 36 older women (aged 65.2 ± 3.82 years). They were then paired based on the criterion of functional reach test and randomly assigned to two groups (18 people) of TTC and SSE. The exercise program included 8 weeks of three 1-h-session training. We measured functional fitness and fear of falling. Functional fitness was assessed using the following tests: Single Leg-Stance-Eyes Open/Closed, Timed Up and Go, Functional Reach Test, Chair Stand, Arm Curl, and Back Scratch. Fear of falling was assessed using the Falls Efficacy Scale-International. RESULTS We analyzed the data using repeated measure ANOVA. Within-group comparisons revealed significant improvements for both groups in all nine measures of functional tests as well as fear of falling [Formula: see text]. Interaction comparisons revealed that improvements in measures of functional fitness were greater in the TTC group [Formula: see text]. Nevertheless, the groups were not significantly different in fear of falling [Formula: see text]. CONCLUSION Our findings showed that both TCC and SSE interventions improved functional fitness and fear of falling. The TCC is more effective than SSE, though the latter is easier to learn and perform.
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Affiliation(s)
- Farzaneh Sadeghian
- Department of Sport Injuries and Therapeutic Exercises, Faculty of Exercise Sciences, University of Isfahan, Isfahan, Iran
| | - Vahid Zolaktaf
- Department of Sport Injuries and Therapeutic Exercises, Faculty of Exercise Sciences, University of Isfahan, Isfahan, Iran.
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Kruisbrink M, Crutzen R, Kempen GIJM, Delbaere K, Ambergen T, Cheung KL, Kendrick D, Iliffe S, Zijlstra GAR. Disentangling interventions to reduce fear of falling in community-dwelling older people: a systematic review and meta-analysis of intervention components. Disabil Rehabil 2022; 44:6247-6257. [PMID: 34511009 DOI: 10.1080/09638288.2021.1969452] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Fear of falling (FoF) is a common and debilitating problem for older people. Most multicomponent interventions show only moderate effects. Exploring the effective components may help in the optimization of treatments for FoF. MATERIALS AND METHODS In a systematic review of five scientific literature databases, we identified randomized controlled trials with older community-dwelling people that included FoF as an outcome. There was no restriction on types of interventions. Two reviewers extracted information about outcomes and content of interventions. Intervention content was coded with a coding scheme of 68 intervention components. We compared all studies with a component to those without using univariate meta-regressions. RESULTS Sixty-six studies, reporting on 85 interventions, were included in the systematic review. In the meta-regressions (n = 49), few components were associated with intervention effects at the first available follow up after the intervention, but interventions with meditation, holistic exercises (such as Tai Chi or Pilates) or body awareness were significantly more effective than interventions without these components. Interventions with self-monitoring, balance exercises, or tailoring were less effective compared to those without these components. CONCLUSIONS The identified components may be important for the design and optimization of treatments to reduce FoF. Implications for rehabilitationFear of falling (FoF) is a common and debilitating issue among older people and multicomponent interventions usually show only small to moderate effects on FoF.This review and meta-analysis investigated 68 intervention components and their relation to intervention effects on FoF.Interventions with meditation, holistic exercises (such as Tai Chi), or body awareness are more effective than interventions without these components.Clinicians aiming to reduce FoF may recommend selected interventions to older people taking into account the current knowledge of intervention components.
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Affiliation(s)
- Marlot Kruisbrink
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Rik Crutzen
- Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Gertrudis I J M Kempen
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Kim Delbaere
- School of Public Health and Community Medicine, Neuroscience Research Australia, UNSW, Randwick, Australia
| | - Ton Ambergen
- Department of Methodology and Statistics, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Kei Long Cheung
- Department of Health Sciences, College of Health, Medicine and Life Sciences, Brunel University London, London, UK
| | - Denise Kendrick
- Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, UK
| | - Steve Iliffe
- Research Department of Primary Care & Population Health, University College London, London, UK
| | - G A Rixt Zijlstra
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
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Sooktho S, Songserm N, Woradet S, Suksatan W. A Meta-Analysis of the Effects of Dance Programs on Physical Performance: Appropriate Health Promotion for Healthy Older Adults. Ann Geriatr Med Res 2022; 26:196-207. [PMID: 36064303 PMCID: PMC9535373 DOI: 10.4235/agmr.22.0066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 08/26/2022] [Indexed: 11/22/2022] Open
Abstract
Background Dancing is a type of physical activity that has been associated with physical benefits in older adults. Regular dancing can help maintain physical function and improve the quality of life in this population. This review evaluated randomized control trials (RCTs) of the effectiveness of dance programs on the physical function of healthy older adults. Methods We systematically searched four databases (PubMed, Google Scholar, Embase, and ThaiLis) through December 2021 for primary studies evaluating dance programs in healthy older adults aged 60 years and over. The meta-analysis used a random-effects model to compute the effect sizes using a forest plot and Cochran’s Q and I2 statistics as heterogeneity measures. Results Eight types of dance programs showed significantly improved physical function. Muscle strength was assessed using the five times sit-to-stand test (I2=89%; p=0.003), chair-sit-to-stand-30S test (I2=75%; p=0.006), and 30-s arm curl test (I2=22%; p=0.260). Static balance was evaluated using the Berg-balance scales test (I2=0%; p=0.620) and the one-leg-stand test (I2=32%; p=0.220). Dynamic balance was tested based on the time up-and-go and eight-foot up-and-go tests (I2=51%; p=0.110). Flexibility was assessed based on the back-scratch (I2=56%; p=0.130) and sit-and-reach test (I2=0%; p=0.930). Conclusion Dance exercise programs improved muscle strength, balance, and flexibility. Such programs are effective and safe for healthy older adults for use as daily exercise to promote health. Therefore, researchers, healthcare providers, and policymakers should establish properly organized dance interventions to improve physical function in healthy older adults.
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Affiliation(s)
- Suparat Sooktho
- Department of Aesthetic Sciences and Health, Faculty of Thai Traditional and Alternative Medicine, Ubon Ratchathani Rajabhat University, Ubon Ratchathani, Thailand
| | - Nopparat Songserm
- Department of Health Sciences, Faculty of Public Health, Ubon Ratchathani Rajabhat University, Ubon Ratchathani, Thailand
- Corresponding Author: Nopparat Songserm, PhD Department of Health Sciences, Faculty of Public Health, Ubon Ratchathani Rajabhat University, Ubon Ratchathani, 34000, Thailand E-mail:
| | - Somkiattiyos Woradet
- Department of Public Health, Faculty of Health and Sports Science, Thaksin University, Phatthalung, Thailand
| | - Wanich Suksatan
- Department of Community Health Nursing, Faculty of Nursing, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
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Chen J, Xue X, Xu J, Zeng J, Xu F. Emerging Trends and Hotspots in Tai Chi Fall Prevention: Analysis and Visualization. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148326. [PMID: 35886172 PMCID: PMC9320470 DOI: 10.3390/ijerph19148326] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/29/2022] [Accepted: 07/05/2022] [Indexed: 02/04/2023]
Abstract
Recently, substantial studies have increased around the topic of the tai chi fall-prevention field. Few studies, however, have revealed the current progress and hotspots under a bibliometric analysis. Therefore, the present study aimed to conduct Citespace, a significant application for bibliometric analysis, to carry out the situation and trend in this field. This study has identified the core countries are the United States, China, Australia, and England, which are also the origins of the core institutions. Besides this, we also have found two large research groups led by Li and Sherrington. Moreover, the result has revealed that J Aging Phys Act and J Am Geriatr Soc are the primary journals. Geriatrics and gerontology, sport sciences, rehabilitation, and gerontology are the leading categories. Furthermore, one of the more important findings to come out in this study are that “elderly”, “Parkinson’s disease”, “vestibular rehabilitation”, “frail patient”, and “community fall prevention” are the research hotspots. “Women”, “proprioception”, “cognitive impairment”, “dementia”, “osteoarthritis”, and “stroke” are the potential research trend in the future. These findings suggest that the tai chi fall-prevention field has a broad research prospect. Although several questions remain uncertain currently, it is worthy for scholars to do further study.
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Affiliation(s)
- Jiesi Chen
- School of Physical Education, Hangzhou Normal University, Hangzhou 311121, China; (J.C.); (X.X.); (J.Z.)
| | - Xin Xue
- School of Physical Education, Hangzhou Normal University, Hangzhou 311121, China; (J.C.); (X.X.); (J.Z.)
| | - Jing Xu
- School of Physical Education, Nanjing Xiaozhuang University, Nanjing 211171, China;
| | - Jinshu Zeng
- School of Physical Education, Hangzhou Normal University, Hangzhou 311121, China; (J.C.); (X.X.); (J.Z.)
| | - Fei Xu
- School of Physical Education, Hangzhou Normal University, Hangzhou 311121, China; (J.C.); (X.X.); (J.Z.)
- Correspondence:
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13
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Smith L, Shin JI, Butler L, Barnett Y, Oh H, Jacob L, Kostev K, Veronese N, Soysal P, Tully M, López Sánchez GF, Koyanagi A. Physical multimorbidity and depression: A mediation analysis of influential factors among 34,129 adults aged ≥50 years from low- and middle-income countries. Depress Anxiety 2022; 39:376-386. [PMID: 35312125 DOI: 10.1002/da.23250] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/06/2022] [Accepted: 02/26/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND There is a scarcity of literature on the association between physical multimorbidity (i.e., ≥2 chronic physical conditions) and depression among older adults, especially from low- and middle-income countries (LMICs). In addition, the mediators in this association are largely unknown. Therefore, we aimed to examine this association among adults aged ≥50 years from six LMICs (China, Ghana, India, Mexico, Russia, and South Africa), and to identify potential mediators. METHODS Cross-sectional, nationally representative data from the Study on Global Ageing and Adult Health were analyzed. Depression was defined as past-12 months DSM-IV depression or receiving depression treatment in the last 12 months. Information on 11 chronic physical conditions were obtained. Multivariable logistic regression and mediation analyses were conducted. RESULTS Data on 34,129 individuals aged ≥50 years were analyzed [mean (SD) age 62.4 (16.0) years; maximum 114 years; 52.1% females]. Compared to no chronic conditions, 2, 3, 4, and ≥5 chronic conditions were associated with 2.55 (95% CI = 1.90-3.42), 3.12 (95% CI = 2.25-4.34), 5.68 (95% CI = 4.02-8.03), and 8.39 (95% CI = 5.87-12.00) times higher odds for depression. Pain/discomfort (% mediated 39.0%), sleep/energy (33.2%), mobility (27.5%), cognition (13.8%), perceived stress (7.3%), disability (6.7%), loneliness (5.5%), and food insecurity (1.5%) were found to be significant mediators in the association between physical multimorbidity and depression. CONCLUSIONS Older adults with physical multimorbidity are at increased odds of depression in LMICs. Future studies should assess whether addressing the identified potential mediators in people with physical multimorbidity can lead to reduction in depression in this population.
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Affiliation(s)
- Lee Smith
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Laurie Butler
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Yvonne Barnett
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Barcelona, Spain.,Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Versailles, France
| | - Karel Kostev
- University Hospital of Marburg, Marburg, Germany
| | - Nicola Veronese
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science King Saud University, Riyadh, Saudi Arabia.,Department of Internal Medicine, Geriatrics Section, University of Palermo, Palermo, Italy
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Mark Tully
- School of Health Sciences, Institute of Mental Health Sciences, Ulster University, Newtownabbey, Ireland
| | - Guillermo F López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Barcelona, Spain.,ICREA, Barcelona, Spain
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14
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The effectiveness of traditional Chinese medicine-based exercise on physical performance, balance and muscle strength among older adults: a systematic review with meta-analysis. Aging Clin Exp Res 2022; 34:725-740. [PMID: 34420189 DOI: 10.1007/s40520-021-01964-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 08/14/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Traditional Chinese medicine (TCM) based exercises have been widely used in the prevention and treatment of balance, cardiopulmonary, and other related diseases in older adults. However, there seems to be no consensus on the improvement and comparison of physical performance, balance, and muscle strength in the elderly population. OBJECTIVES To systematically examine the impact of different TCM-based exercises on physical performance, balance, and muscle strength outcomes in the elderly. METHODS We searched PubMed, EMBASE, Scopus, and Cochrane Center, CNKI and Wan Fang between their date of inception and March 2021. This meta-analysis was performed using RevMan5.3 software. Only randomized controlled trials (RCT) or controlled clinical trials (CCT) were considered in TCM-based exercises (Tai Chi, Ba Duan Jin, Qigong). The overall mean difference (MD) or standardized mean difference (SMD), and its 95% confidence interval (CI) were calculated. MAIN RESULTS A total of 27 studies with 2580 older adults met the inclusion criteria. The pooled analysis indicated that Tai Chi could be more effective in Times up and go (TUG) (MD = - 2.62, 95% CI - 4.00 to - 1.24, P = 0.0002), 5 times sit-stand (MD = - 1.89; 95%CI - 3.38 to - 0.40; P = 0.01), and handgrip strength outcomes (SMD = 0.69; 95%CI 0.52-0.86; P < 0.0001) compared to Ba Duan Jin and Qigong. The older adults performing Qigong could have a better benefit in Single-bed balance (SLB) with eyes closed compared to Tai Chi and Ba Duan Jin (MD = 3.42; 95%CI 1.55 to 5.29; P = 0.0003). Tai Chi also had benefits in terms of balance outcomes compared to those in the control group: Berg Balance scale (BBS) (MD = 1.41; 95% CI 0.03-2.85; P = 0.05), Functional reach test (FRT) (MD = 1.57; 95%CI 1.22-1.93; P < 0.0001). The Tai Chi study meta-analysis demonstrated significant effects on lower limb strength: knee extension (SMD = 0.56; 95%CI 0.26-0.86; P = 0.0003), ankle dorsiflexion (SMD = 0.67; 95%CI 0.02-1.31; P = 0.04) compared to the controls. CONCLUSION This systematic review reveals that TCM-based exercises can effectively improve physical performance outcomes, balance outcomes, and muscle strength in the elderly population. While there is limited evidence on the efficacy of other TCM-based lifestyle interventions, more high-quality clinical trials on this topic are warranted.
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15
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Kuo CC, Chen SC, Wang JY, Ho TJ, Lu TW. Best-Compromise Control Strategy Between Mechanical Energy Expenditure and Foot Clearance for Obstacle-Crossing in Older Adults: Effects of Tai-Chi Chuan Practice. Front Bioeng Biotechnol 2021; 9:774771. [PMID: 34926422 PMCID: PMC8675231 DOI: 10.3389/fbioe.2021.774771] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 11/22/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Obstacle-crossing increases the risk of falls in older people. This study aimed to identify the effects of long-term Tai-Chi Chuan (TCC) practice on the control strategies for obstacle-crossing in older people. Methods: A multi-objective optimal control technique with measured gait data was used to identify the control strategies adopted by 15 long-term TCC practitioners and 15 healthy controls when crossing obstacles of different heights, in terms of the best-compromise weighting sets for the conflicting objectives of minimizing energy expenditure and maximizing the toe-obstacle and heel-obstacle clearances. Results and Conclusions: The long-term TCC older practitioners adopted a best-compromise control strategy similar to those adopted by young adults, with greater weightings on the minimization of the mechanical energy expenditure and smaller weightings on foot-clearance as compared to non-TCC controls (TCC: 0.72, 0.14, 0.14; Control: 0.55, 0.225, 0.225). This strategy enabled the long-term TCC older practitioners to cross obstacles with significantly greater leading-toe clearances but with relatively less mechanical energy expenditure. With the current approach, further simulations of obstacle-crossing mechanics with a given weighting set will be useful for answering clinically relevant what-if questions, such as what abilities would be needed if the non-TCC older people were to cross obstacles using the crossing strategy of the TCC people.
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Affiliation(s)
- Chien-Chung Kuo
- Department of Orthopedics, China Medical University Hospital, Taichung, Taiwan.,Department of Orthopedics, School of Medicine, China Medical University, Taichung, Taiwan
| | - Sheng-Chang Chen
- Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Jr-Yi Wang
- Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan.,Department of Orthopedics, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Tsung-Jung Ho
- Integration Center of Traditional Chinese and Modern Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.,Department of Chinese Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.,School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
| | - Tung-Wu Lu
- Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
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16
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Chandrasekaran S, Hibino H, Gorniak SL, Layne CS, Johnston CA. Fear of Falling: Significant Barrier in Fall Prevention Approaches. Am J Lifestyle Med 2021; 15:598-601. [PMID: 34916878 PMCID: PMC8669901 DOI: 10.1177/15598276211035360] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Fear of falling is a critical component in fall prevention approaches; however, it is often overlooked in the majority of fall prevention exercises. Alternative fall prevention approaches that take fear of falling into account are necessary. This article discusses fall prevention activities that are feasible for individuals with limited mobility who have an increased fear of falling. Health care providers should consider the degree to which a patient has a fear of falling and recommend activities that fit most to their patient's comfort level.
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Affiliation(s)
| | - Hidetaka Hibino
- Department of Health and Human Performance, University of Houston, Houston, TX, USA (SC, HH, SLG, CSL, CAJ)
| | - Stacey L. Gorniak
- Department of Health and Human Performance, University of Houston, Houston, TX, USA (SC, HH, SLG, CSL, CAJ)
| | - Charles S. Layne
- Department of Health and Human Performance, University of Houston, Houston, TX, USA (SC, HH, SLG, CSL, CAJ)
| | - Craig A. Johnston
- Department of Health and Human Performance, University of Houston, Houston, TX, USA (SC, HH, SLG, CSL, CAJ)
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17
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Joseph A, Muliyil J. Community-based case control study on the risk of fall among elderly in Kaniyambadi block, Vellore, Tamil Nadu, India. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2021.100907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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18
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Kruisbrink M, Delbaere K, Kempen GIJM, Crutzen R, Ambergen T, Cheung KL, Kendrick D, Iliffe S, Zijlstra GAR. Intervention Characteristics Associated With a Reduction in Fear of Falling Among Community-Dwelling Older People: A Systematic Review and Meta-analysis of Randomized Controlled Trials. THE GERONTOLOGIST 2021; 61:e269-e282. [PMID: 32267498 PMCID: PMC8361503 DOI: 10.1093/geront/gnaa021] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Fear of falling (FoF) is associated with decreased physical functioning and an increased fall risk. Interventions generally demonstrate moderate effects and optimized interventions are needed. Intervention characteristics, such as setting or delivery method may vary. We investigated which overarching intervention characteristics are associated with a reduction in FoF in community-dwelling older people. RESEARCH DESIGN AND METHODS A systematic review and meta-analysis of randomized controlled trials (RCTs) in community-dwelling older people without specific diseases was performed. Associations between intervention characteristics and standardized mean differences (SMD) were determined by univariate meta-regression. Sensitivity analyses were performed. RESULTS Data on 62 RCTs were extracted, 50 intervention groups were included in the meta-analysis. Most intervention characteristics and intervention types were not associated with the intervention effect. Supervision by a tai chi instructor (SMD: -1.047, 95% confidence interval [CI]: -1.598; -0.496) and delivery in a community setting (SMD: -0.528, 95% CI: -0.894; -0.161) were-compared to interventions without these characteristics-associated with a greater reduction in FoF. Holistic exercise, such as Pilates or yoga (SMD: -0.823, 95% CI: -1.255; -0.392), was also associated with a greater reduction in FoF. Delivery at home (SMD: 0.384, 95% CI: 0.002; 0.766) or with written materials (SMD: 0.452, 95% CI: 0.088; 0.815) and tailoring were less effective in reducing FoF (SMD: 0.687, 95% CI: 0.364; 1.011). DISCUSSION AND IMPLICATIONS Holistic exercise, delivery with written materials, the setting and tailoring potentially represent characteristics to take into account when designing and improving interventions for FoF in community-dwelling older people. PROSPERO international prospective register of systematic reviews, registration ID CRD42018080483.
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Affiliation(s)
- Marlot Kruisbrink
- Care and Public Health Research Institute, Department of Health Services Research, Maastricht University, Maastricht, the Netherlands.,Neuroscience Research Australia, School of Public Health and Community Medicine, UNSW, Randwick, New South Wales, Australia
| | - Kim Delbaere
- Neuroscience Research Australia, School of Public Health and Community Medicine, UNSW, Randwick, New South Wales, Australia.,Care and Public Health Research Institute, Department of Methodology and Statistics, Maastricht University, Maastricht, the Netherlands
| | - Gertrudis I J M Kempen
- Care and Public Health Research Institute, Department of Health Services Research, Maastricht University, Maastricht, the Netherlands.,Neuroscience Research Australia, School of Public Health and Community Medicine, UNSW, Randwick, New South Wales, Australia
| | - Rik Crutzen
- Maastricht University, Care and Public Health Research Institute, Department of Health Promotion, Maastricht, the Netherlands
| | - Ton Ambergen
- Care and Public Health Research Institute, Department of Methodology and Statistics, Maastricht University, Maastricht, the Netherlands
| | - Kei-Long Cheung
- Department of Clinical Sciences, College of Health and Life Sciences, Brunel University, London, United Kingdom
| | - Denise Kendrick
- Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Steve Iliffe
- Research Department of Primary Care & Population Health, University College London, London, United Kingdom
| | - G A Rixt Zijlstra
- Care and Public Health Research Institute, Department of Health Services Research, Maastricht University, Maastricht, the Netherlands.,Neuroscience Research Australia, School of Public Health and Community Medicine, UNSW, Randwick, New South Wales, Australia
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19
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Gagen TM, Bulzacchelli MT. Improving Local Service Delivery to Prevent Falls in Community-Dwelling Older Adults: Translating Research to Practice. THE GERONTOLOGIST 2021; 61:819-825. [PMID: 32866970 DOI: 10.1093/geront/gnaa121] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Indexed: 11/13/2022] Open
Abstract
Unintentional falls are the leading cause of both fatal and nonfatal injuries among Americans 65 years of age and older and place an enormous burden on the health care system. As the population continues to age, preventing falls will be increasingly important for reducing morbidity, mortality, and medical costs. Evidence-based fall prevention interventions for older adults exist, but widespread adoption of these interventions is needed. Local health departments, Area Agencies on Aging, first responders, and health care professionals can all play important roles in implementing fall prevention programs. This article presents a conceptual model for local delivery of fall prevention programs for community-dwelling older adults. This model can serve as a guide for translating existing fall prevention research into practice.
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Affiliation(s)
- Travis M Gagen
- College of Health Professions - Health Sciences Program, Assumption University, Worcester, Massachusetts
| | - Maria T Bulzacchelli
- Undergraduate Program in Public Health Studies, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, Maryland
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20
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A secondary analysis of a randomised controlled trial to investigate the effect of Tai Chi on the instrumented timed up and go test in people with mild to moderate dementia. Aging Clin Exp Res 2021; 33:2175-2181. [PMID: 33141417 PMCID: PMC8302509 DOI: 10.1007/s40520-020-01741-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 10/13/2020] [Indexed: 02/05/2023]
Abstract
Background Previous research has identified that Tai Chi is effective for reducing risk of falls and improving timed up and go scores. However, our previous research identified no-significant difference in time to complete the timed up and go test following a Tai Chi intervention in people with dementia. Aim To conduct a secondary analysis to extend our understanding of the effect of Tai Chi on the instrumented Timed Up and Go test. Methods This is a secondary analysis of a randomised controlled trial set in the community. People with dementia, recruited from NHS databases, memory clinics, local charities and self-referral across the south of England, received either 20 weeks of Tai Chi plus normal care or normal care. Outcomes were assessed using the instrumented Timed Up and Go test, completed at baseline and after 6 months. Results From 83 people with dementia volunteering for the study, 67 complete datasets were available for analysis. Within-group pairwise comparison across time revealed no-significant gains for any of the instrumented Timed Up and Go variables, and no-significant difference for between-group pairwise comparisons. Discussion This suggests that Tai Chi had no effect on the instrumented Timed Up and Go in people with dementia. This lack of effect may be due to the lack of specificity of the training stimulus to the outcome measure. Conclusion Tai Chi had no effect on any instrumented Timed Up and Go variables, suggesting Tai Chi may not be best placed to enhance the sub-elements of the instrumented Timed Up and Go to reduce fall risk among community-dwelling people with dementia. Clinical trial registration number: NCT02864056.
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21
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Bruininks BD, Sage SK, Korak JA. Evaluation of short-term multi-component exercise programming on major variables that directly influence fall risk in older women: a pilot study. J Women Aging 2021; 34:415-428. [PMID: 34223809 DOI: 10.1080/08952841.2021.1942701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Falls are linked to gait and balance inconsistencies influenced by a combination of variables including muscle strength and power. Multicomponent athlete training models that incorporate high-intensity challenging activities have been shown to significantly improve strength, power, and balance. This study evaluated the efficacy of a short-term multi-component dynamic training program on strength, power, and balance in older women. Seventeen women participated in 8-weeks of specialized exercise training. Significant changes were observed in all performance variables from baseline. Results suggest short-term, high intensity multi-component programming can be used safely and effectively to improve major variables that influence falls in older women.
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Affiliation(s)
- Brett D Bruininks
- Department of Health & Exercise Science, University of St. Thomas, St. Paul, Minnesota, USA
| | - Starr K Sage
- Department of Health & Exercise Science, University of St. Thomas, St. Paul, Minnesota, USA
| | - J Adam Korak
- Department of Health & Exercise Science, University of St. Thomas, St. Paul, Minnesota, USA
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22
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Birimoglu Okuyan C, Deveci E. The effectiveness of Tai Chi Chuan on fear of movement, prevention of falls, physical activity, and cognitive status in older adults with mild cognitive impairment: A randomized controlled trial. Perspect Psychiatr Care 2021; 57:1273-1281. [PMID: 33184928 DOI: 10.1111/ppc.12684] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/22/2020] [Accepted: 10/31/2020] [Indexed: 12/22/2022] Open
Abstract
PURPOSE This study aimed to investigate the effectiveness of Tai Chi Chuan (TCC) on fear of movement, prevention of falls, physical activity, and cognitive status in older adults with mild cognitive impairment. DESIGN AND METHODS This controlled trial was conducted with 20 participants in the intervention group, and they did exercises for 35-40 min/session, twice a week for 12 weeks. FINDING The posttest scores of the scales indicated that the scores of cognitive adaptations, being observant, and changes in level subscales of the fall behavioral scale in the older adults who did Tai Chi exercise in the intervention group significantly increased (p < .01). PRACTICE IMPLICATIONS The nursing home provider can safely manage TCC exercise interventions for older adults with MCI.
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Affiliation(s)
- Canan Birimoglu Okuyan
- Department of Public Health Nursing, Faculty of Health Sciences, Sakarya University of Applied Sciences, Sakarya, Turkey
| | - Ebru Deveci
- Department of Anesthesia, Vocational School of Health Services, University of Hasan Kalyoncu, Gaziantep, Turkey
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23
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Individual analysis of dynamic stability for twenty-four Tai Chi forms among persons with knee osteoarthritis: A pilot study. Gait Posture 2021; 86:22-26. [PMID: 33668007 PMCID: PMC8085069 DOI: 10.1016/j.gaitpost.2021.02.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/20/2021] [Accepted: 02/23/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Tai Chi (TC) training has been increasingly used to prevent falls. However, the underlying biomechanical mechanisms of TC training which influence fall risk remain unknown. As a result, the selection of TC forms differs among studies, leading to inconsistent results. RESEARCH QUESTION Is dynamic stability different between the simplified 24 Yang-style TC forms among adults with knee osteoarthritis? METHODS Ten participants with mild to moderate knee osteoarthritis were recruited. Under one-on-one instruction by an experienced TC master, each participant learned how to correctly perform the 24-form TC movements. Participants' full-body kinematic and kinetic data was collected during walking trials and performance of the respective TC forms. Their dynamic stability was calculated in both sagittal and frontal planes and compared between each TC form and regular walking. RESULTS The results indicate that dynamic stability in both planes significantly varies among forms. Moreover, some forms pose a greater challenge to dynamic stability in comparison to others. The most challenging TC forms are Form 8 for stability in the sagittal plane and Form 10 in the frontal plane. Among all forms, Form 1 appears to be the least challenging. SIGNIFICANCE Our findings could provide foundational information to identify the best TC forms for optimizing the effectiveness of TC-based fall prevention interventions.
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24
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Wang LC, Ye MZ, Xiong J, Wang XQ, Wu JW, Zheng GH. Optimal exercise parameters of tai chi for balance performance in older adults: A meta-analysis. J Am Geriatr Soc 2021; 69:2000-2010. [PMID: 33769556 DOI: 10.1111/jgs.17094] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 02/10/2021] [Accepted: 02/12/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Tai chi is considered a safe and low-cost treatment for improving balance ability among an older population. However, there is no existing evidence on the optimal exercise parameters of tai chi for improving balance in older adults. OBJECTIVES To investigate the optimal parameters of a tai chi intervention to improve balance performance of older adults. DESIGN Systematic review and meta-analysis of randomized controlled trials (RCTs). SETTING PubMed, Embase, Cochrane Library, Web of Science, Scopus, China National Knowledge Infrastructure, Wanfang, Chinese Science and Technology Periodical and China Biology Medicine were searched from inception until November 30, 2020. PARTICIPANTS Adults aged 60 years and over. MEASUREMENTS Two reviewers independently extracted the data and assessed the quality of the included studies according to the Physiotherapy Evidence Database (PEDro) scale. Subgroup analyses and meta-regressions were conducted to elucidate the impact of tai chi training programs on balance measures. RESULTS Twenty-six eligible RCTs were included in the meta-analysis. Pooled results showed that tai chi has moderate effects for improving proactive balance (weighted mean standardized mean differences [SMDwm ] = 0.61, 95% CI 0.33-0.89) and static steady-state balance (SMDwm = 0.62, 95% CI 0.30-0.95) and small effects for improving dynamic steady-state balance (SMDwm = 0.38, 95% CI 0.03-0.73) and balance test batteries (SMDwm = 0.47, 95% CI 0.13-0.81) in adults over 60 years of age. The practice frequency could predict the effects of tai chi on static steady-state balance, and the 24-form simplified Yang style tai chi (45-60 min/session, more than four sessions per week and at least 8 weeks) was the most optimal. CONCLUSIONS Tai chi is effective at improving the balance ability of adults over 60 years of age. A medium duration and high frequency of 24-form tai chi may be the optimal program for improving balance, but this evidence should be recommended with caution due to limitations of the methodology and small sample sizes.
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Affiliation(s)
- Le-Cong Wang
- Graduate School of Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ming-Zhu Ye
- Graduate School of Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jian Xiong
- Graduate School of Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiao-Qian Wang
- Graduate School of Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jia-Wei Wu
- Graduate School of Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Guo-Hua Zheng
- Graduate School of Shanghai University of Traditional Chinese Medicine, Shanghai, China.,College of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai, China
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Clinical Evidence of Tai Chi Exercise Prescriptions: A Systematic Review. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:5558805. [PMID: 33777155 PMCID: PMC7972853 DOI: 10.1155/2021/5558805] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/26/2021] [Accepted: 03/03/2021] [Indexed: 12/22/2022]
Abstract
Objectives This systematic review aims to summarize the existing literature on Tai Chi randomized controlled trials (RCTs) and recommend Tai Chi exercise prescriptions for different diseases and populations. Methods A systematic search for Tai Chi RCTs was conducted in five electronic databases (PubMed, Cochrane Library, EMBASE, EBSCO, and Web of Science) from their inception to December 2019. SPSS 20.0 software and Microsoft Excel 2019 were used to analyze the data, and the risk of bias tool in the RevMan 5.3.5 software was used to evaluate the methodological quality of RCTs. Results A total of 139 articles were identified, including diseased populations (95, 68.3%) and healthy populations (44, 31.7%). The diseased populations included the following 10 disease types: musculoskeletal system or connective tissue diseases (34.7%), circulatory system diseases (23.2%), mental and behavioral disorders (12.6%), nervous system diseases (11.6%), respiratory system diseases (6.3%), endocrine, nutritional or metabolic diseases (5.3%), neoplasms (3.2%), injury, poisoning and certain other consequences of external causes (1.1%), genitourinary system diseases (1.1%), and diseases of the eye and adnexa (1.1%). Tai Chi exercise prescription was generally classified as moderate intensity. The most commonly applied Tai Chi style was Yang style (92, 66.2%), and the most frequently specified Tai Chi form was simplified 24-form Tai Chi (43, 30.9%). 12 weeks and 24 weeks, 2-3 times a week, and 60 min each time was the most commonly used cycle, frequency, and time of exercise in Tai Chi exercise prescriptions. Conclusions We recommend the more commonly used Tai Chi exercise prescriptions for different diseases and populations based on clinical evidence of Tai Chi. Further clinical research on Tai Chi should be combined with principles of exercise prescription to conduct large-sample epidemiological studies and long-term prospective follow-up studies to provide more substantive clinical evidence for Tai Chi exercise prescriptions.
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Ebner SA, Meikis L, Morat M, Held S, Morat T, Donath L. Effects of Movement-Based Mind-Body Interventions on Physical Fitness in Healthy Older Adults: A Meta-Analytical Review. Gerontology 2021; 67:125-143. [PMID: 33503630 DOI: 10.1159/000512675] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 10/22/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Declines in physical fitness can notably affect healthy aging of older adults. Multimodal exercise training regimen such as mind-body interventions (MBIs) has been reported to mitigate these aging-related declines of physical function. This meta-analytical review aimed at pooling the effects of MBIs on physical fitness indices compared to active control (AC) and inactive control (IC) conditions in healthy older adults. METHODS The literature search was conducted in 3 databases using search terms with Boolean conjunctions. Randomized controlled trials applying MBIs focusing on improving physical fitness parameters in healthy seniors over 65 years of age were screened for eligibility. Eligibility and study quality were assessed by 2 researchers using the PEDro scale. Standardized mean differences (SMD) adjusted for small sample sizes (Hedges' g) served as main outcomes for the comparisons of MBIs versus IC and MBIs versus AC. RESULTS Thirty trials with 2,792 healthy community dwellers (mean age: 71.2 ± 4.7 years) were included. Large overall effects were found for strength (p < 0.001, SMD: 0.87 [90% CI: 0.43, 1.30], I2 = 94%), medium effects were observed for functional mobility (p = 0.009, SMD: 0.55 [90% CI: 0.20, 0.89], I2 = 83%), and small overall effects were found for static balance (p = 0.02, SMD: 0.35 [90% CI: 0.10, 0.60], I2 = 77%), endurance (p = 0.0001, SMD: 0.44 [90% CI: 0.25, 0.62], I2 = 0%), and flexibility (p = 0.003, SMD: 0.46 [90% CI: 0.21, 0.72], I2 = 54%) in favor of MBIs compared to IC. Small effects of strength slightly favoring AC (p = 0.08, SMD: -0.22 [90% CI: -0.43, -0.01], I2 = 52%) were found, whereas static balance moderately improved in favor of MBIs (p < 0.001, SMD: 0.46 [90% CI: 0.16, 0.76], I2 = 73%). DISCUSSION/CONCLUSION MBIs induce small to moderate effects in relevant domains of physical fitness in healthy older adults. Strength should be better targeted with traditional resistance training routines, whereas balance seems to sufficiently benefit from MBIs. However, large variability between the studies was observed due to differences in methodology, intervention content, and outcomes that affect conclusive evidence.
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Affiliation(s)
- Sophia A Ebner
- Institute of Sport and Movement Gerontology, German Sport University Cologne, Cologne, Germany
| | - Lilly Meikis
- Institute of Sport and Movement Gerontology, German Sport University Cologne, Cologne, Germany
| | - Mareike Morat
- Department of Intervention Research in Exercise Training, German Sport University Cologne, Cologne, Germany
| | - Steffen Held
- Department of Intervention Research in Exercise Training, German Sport University Cologne, Cologne, Germany
| | - Tobias Morat
- Institute of Sport and Movement Gerontology, German Sport University Cologne, Cologne, Germany
| | - Lars Donath
- Department of Intervention Research in Exercise Training, German Sport University Cologne, Cologne, Germany,
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Brown LM, Sawyer LM, Lensing SY, Taylor T, Bopp MM, Ferrier I, Sullivan DH. An outpatient Tai Chi program: Effects on veterans' functional outcomes. Nurs Forum 2020; 56:448-452. [PMID: 33241873 DOI: 10.1111/nuf.12532] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/12/2020] [Accepted: 11/15/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate the effectiveness of an evidence-based 12-week Tai Chi course designed to improve balance and physical function in a population of older veterans. METHODS Community dwelling veterans of all ages with gait and balance problems were invited to participate in the Tai Chi program. Participants completed the Berg Balance Scale (BBS), the Timed Up and Go (TUG) test, and the Falls Efficacy Scale-International (FES-I) at baseline and again at the end of the program. Descriptive statistics were used to summarize study participants' characteristics. The change from baseline to the end of the 12-week program was calculated for each of the three primary outcome variables (BBS, TUG, FES-I). RESULTS Twenty-two veterans, aged 58 years and above, with perceived gait and/or balance issues were enrolled in the program with completion by 11 veterans. Veterans who completed their final assessments showed the BBS, improved significantly (p = 0.004) from baseline to the 12-week assessment. The TUG scores improved by a median of 1.3 s (p = 0.022). There was not a significant change in the FES-I. CONCLUSIONS Preliminary findings provide evidence of the effectiveness of a 12-week Tai Chi program to improve functional outcomes for older veterans with mild to moderate gait and balance problems.
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Affiliation(s)
- Lana M Brown
- Geriatric Research Education, and Clinical Center (GRECC), Central Arkansas Veterans Healthcare System, North Little Rock, Arkansas, USA.,College of Nursing, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Linda M Sawyer
- Geriatric Research Education, and Clinical Center (GRECC), Central Arkansas Veterans Healthcare System, North Little Rock, Arkansas, USA.,College of Nursing, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Shelly Y Lensing
- Geriatric Research Education, and Clinical Center (GRECC), Central Arkansas Veterans Healthcare System, North Little Rock, Arkansas, USA.,Department of Biostatistics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Tanya Taylor
- Geriatric Research Education, and Clinical Center (GRECC), Central Arkansas Veterans Healthcare System, North Little Rock, Arkansas, USA
| | - Melinda M Bopp
- Geriatric Research Education, and Clinical Center (GRECC), Central Arkansas Veterans Healthcare System, North Little Rock, Arkansas, USA
| | - Ileina Ferrier
- Geriatric Research Education, and Clinical Center (GRECC), Central Arkansas Veterans Healthcare System, North Little Rock, Arkansas, USA
| | - Dennis H Sullivan
- Geriatric Research Education, and Clinical Center (GRECC), Central Arkansas Veterans Healthcare System, North Little Rock, Arkansas, USA.,Donald W. Reynolds Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
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Weber M, Schnorr T, Morat M, Morat T, Donath L. Effects of Mind-Body Interventions Involving Meditative Movements on Quality of Life, Depressive Symptoms, Fear of Falling and Sleep Quality in Older Adults: A Systematic Review with Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186556. [PMID: 32916879 PMCID: PMC7559727 DOI: 10.3390/ijerph17186556] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/02/2020] [Accepted: 09/04/2020] [Indexed: 12/11/2022]
Abstract
Background: The aim of the present systematic meta-analytical review was to quantify the effects of different mind–body interventions (MBI) involving meditative movements on relevant psychological health outcomes (i.e., quality of life (QoL), depressive symptoms, fear of falling (FoF) and sleep quality) in older adults without mental disorders. Methods: A structured literature search was conducted in five databases (Ovid, PsycINFO, PubMed, SPORTDiscus, Web of Science). Inclusion criteria were: (i) the study was a (cluster) randomized controlled trial, (ii) the subjects were aged ≥59 years without mental illnesses, (iii) an intervention arm performing MBI compared to a non-exercise control group (e.g., wait-list or usual care), (iv) psychological health outcomes related to QoL, depressive symptoms, FoF or sleep quality were assessed and (v) a PEDro score of ≥5. The interventions of the included studies were sub-grouped into Tai Chi/Qigong (TCQ) and Yoga/Pilates (YP). Statistical analyses were conducted using a random-effects inverse-variance model. Results: Thirty-seven randomized controlled trials (RCTs) (comprising 3224 participants) were included. Small to moderate-but-significant overall effect sizes favoring experimental groups (Hedges’ g: 0.25 to 0.71) compared to non-exercise control groups were observed in all outcomes (all p values ≤ 0.007), apart from one subdomain of quality of life (i.e., social functioning, p = 0.15). Interestingly, a significant larger effect on QoL and depressive symptoms with increasing training frequency was found for TCQ (p = 0.03; p = 0.004). Conclusions: MBI involving meditative movements may serve as a promising opportunity to improve psychological health domains such as QoL, depressive symptoms, FoF and sleep quality in older adults. Hence, these forms of exercise may represent potential preventive measures regarding the increase of late-life mental disorders, which need to be further confirmed by future research.
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Affiliation(s)
- Manuel Weber
- Institute of Movement and Sport Gerontology, German Sport University, 50933 Cologne, Germany; (M.W.); (T.S.); (T.M.)
| | - Thiemo Schnorr
- Institute of Movement and Sport Gerontology, German Sport University, 50933 Cologne, Germany; (M.W.); (T.S.); (T.M.)
| | - Mareike Morat
- Institute of Exercise Science and Sport Informatics, German Sport University, 50933 Cologne, Germany;
| | - Tobias Morat
- Institute of Movement and Sport Gerontology, German Sport University, 50933 Cologne, Germany; (M.W.); (T.S.); (T.M.)
| | - Lars Donath
- Institute of Exercise Science and Sport Informatics, German Sport University, 50933 Cologne, Germany;
- Correspondence: ; Tel.: +49-221-4982-7700
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Chittrakul J, Siviroj P, Sungkarat S, Sapbamrer R. Multi-System Physical Exercise Intervention for Fall Prevention and Quality of Life in Pre-Frail Older Adults: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093102. [PMID: 32365613 PMCID: PMC7246743 DOI: 10.3390/ijerph17093102] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 04/27/2020] [Accepted: 04/28/2020] [Indexed: 12/22/2022]
Abstract
Effective interventions for indicated fall prevention are necessary for older adults with frailty. We aimed to determine the effectiveness of a Multi-system Physical Exercise (MPE) for fall prevention and Health-Related Quality of Life (HRQOL) in pre-frail older adults. This randomized control trial with allocation concealment included 72 adults aged 65 and above, identified as pre-frailty and with mild and moderate fall risk scores measured by the Physiological Profile Assessment (PPA). Randomly, using block randomization, participants were divided into two groups: an MPE group (n = 36) and a control group (n = 36). The intervention consisted mainly of proprioception, muscle strengthening, reaction time, and balance training and was carried out three days per week for 12 weeks. The primary outcome was fall risk assessed using PPA at 12 weeks post-baseline and at a 24 week follow-up. Significant differences were found in the improvement in fall risk, proprioception, muscle strength, reaction time and postural sway, and fear of fall scores in the MPE group compared with controls at week 12 and 24. In addition, HRQOL had increased significantly in the MPE group in comparison to controls. The MPE program significantly increased muscle strength and improved proprioception, reaction time, and postural sway leading to fall risk reduction in older adults with pre-frailty. Therefore, the MPE program is recommended for used in day-to-day primary care practice in the pre-frail population.
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Affiliation(s)
- Jiraporn Chittrakul
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (J.C.); (R.S.)
| | - Penprapa Siviroj
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (J.C.); (R.S.)
- Correspondence:
| | - Somporn Sungkarat
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Ratana Sapbamrer
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (J.C.); (R.S.)
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Yang F, Liu W. Biomechanical mechanism of Tai-Chi gait for preventing falls: A pilot study. J Biomech 2020; 105:109769. [PMID: 32278527 DOI: 10.1016/j.jbiomech.2020.109769] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/28/2020] [Accepted: 03/28/2020] [Indexed: 01/22/2023]
Abstract
Tai-Chi (TC) practice has been increasingly used to prevent falls in older adults. However, the biomechanical mechanisms underlying the effects of TC practice on fall risk among older adults remain unanswered. The objective of this pilot study was to examine how TC gait biomechanically impacts the human body in terms of dynamic gait stability and lower limb muscle strength in comparison with regular walking gait. Ten healthy adults performed five trials of TC gait following three to seven trials of regular walking. Full body kinematics and kinetics were collected, and then dynamic gait stability and lower limb joint moments were determined. During TC gait, individuals were less stable, moved more slowly and experienced a larger mediolateral movement in comparison with regular walking gait. The peak moment at the ankle joint on the sagittal and transverse planes, at the knee joint on all three planes, and at the hip joint on the frontal plane was significantly different when performing TC gait than during regular gait. The results indicate that TC gait challenges body balance and requires more muscle strength of the lower limb joints compared to regular walking gait. To cope with these challenges, the body could develop neuromuscular control strategies to maintain body balance and thus reduce the risk of falls. The findings and methodology in this study could provide preliminary guidance for identifying optimal TC forms in order to maximize the effects of TC-based fall prevention interventions among various populations with elevated risk of falls.
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Affiliation(s)
- Feng Yang
- Department of Kinesiology and Health, Georgia State University, Atlanta, GA 30303, United States
| | - Wei Liu
- Division of Osteopathic Rehabilitation, Edward Via College of Osteopathic Medicine, Auburn, AL 36832, United States.
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Leem SH, Kim JH, Lee BH. Effects of Otago exercise combined with action observation training on balance and gait in the old people. J Exerc Rehabil 2019; 15:848-854. [PMID: 31938708 PMCID: PMC6944869 DOI: 10.12965/jer.1938720.360] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 12/14/2019] [Indexed: 12/20/2022] Open
Abstract
This study aimed to investigate the effects of Otago exercise combined with action observation (AO) training on the balance, and gait in the old people to prevent falls in the community. A total of 30 old women participated and randomly assigned into three groups: AO plus Otago (n=10), Otago (n=10), or control (n=10). The AO plus Otago and Otago groups performed 50 min of strength training and balance exercises from the Otago Exercise Program 3 times a week for 12 weeks. The AO plus Otago group received an additional 20 min of training 3 times a week. We used the electronic muscle dynamometer to changes in strength, Timed Up and Go (TUG) test to evaluate dynamic balance, and the short version of the Falls Efficacy Scale-International was used to evaluate the fear of falls, and GAITRite was used to evaluate changes in the spatiotemporal parameters of walking. The muscle strength significantly increased in the AO plus Otago and Otago groups compared to the strength before training. The TUG test showed a significant improvement in the dynamic balance in both intervention groups. A significant increase was observed in the walking speed, cadence, step length, and stride length in both intervention groups. We also noted a significant change in the efficacy measures for falls. It is expected that Otago exercise combined with AO training will be used as an intervention method in hospital treatment programs and the old people facilities for preventing falls in the old people.
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Affiliation(s)
- Soo-Hyun Leem
- Graduate School of Physical Therapy, Sahmyook University, Seoul, Korea
| | - Jung-Hee Kim
- Department of Physical Therapy, Andong Science College, Andong, Korea
| | - Byoung-Hee Lee
- Department of Physical Therapy, Sahmyook University, Seoul, Korea
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