Does vibration training reduce the fall risk profile of frail older people admitted to a rehabilitation facility? A randomised controlled trial

Effect of Whole-Body Vibration Training on Selected Intrinsic Risk Factors in Women Aged 60+ at Fall Risk: A Randomized Controlled Trial

The aim of the study was to determine whether Whole Body Vibration Training (WBVT) affects intrinsic risk factors for falls in women aged 60+ at fall risk.

DESIGN

Randomized controlled clinical trial. Blinding was applied to the persons in charge of evaluating the intervention's clinical results and statistical analysis.

METHODS

Forty-two women over 60 years old were randomly assigned to an experimental group (EG-12-week WBVT; n = 22) and a control group (CG-no additional physical activities; n = 20). Fear of falling was measured by the FES-I questionnaire, gait and dynamic balance using the Time-Up and Go test (TUG), aerobic endurance with the 6-Minute Walk Test (6MWT), and the functional strength of the lower body muscles with the 30-s Chair Stand Test (30SCST) at baseline and post-intervention. Additionally assayed were participants' blood concentrations of interleukin-6 (IL-6).

RESULTS

The 12-week WBVT improves gait and balance (TUG, p = 0.009), exercise tolerance (6MWT, p = 0.001), and functional strength (30SCST; p = 0.027) but does not reduce the intensity of fear of falling (FES-I, p = 0.655) and the IL-6 serum concentration (p = 0.377).

CONCLUSIONS

WBVT affects selected fall risk factors in women aged 60+ at fall risk.

Effects of vibration therapy on muscle mass, muscle strength and physical function in older adults with sarcopenia: a systematic review and meta-analysis

Background

Sarcopenia, a progressive loss of muscle mass and function with advancing age, is a prevalent condition among older adults. As most older people are too frail to do intensive exercise and vibration therapy has low risk and ease of participation, it may be more readily accepted by elderly individuals. However, it remains unclear whether vibration therapy would be effective among older adults with sarcopenia. This systematic review and meta-analysis examined the effect of vibration therapy including local vibration therapy and whole-body vibration therapy, for enhancing muscle mass, muscle strength and physical function in older people with sarcopenia.

Methods

A systematic literature search was conducted in March 2019 in the following 5 electronic databases: PubMed, CINAHL, Embase, PEDro, and the Cochrane Central Register of Controlled Trials, with no restriction of language or the year of publication. Randomized controlled trials and quasi-experimental studies examining effects of vibration therapy on muscle mass, muscle strength or physical function in older adults with sarcopenia were included in this systematic review. Two reviewers independently assessed the methodological quality of the selected studies.

Results

Of the 1972 identified studies, seven publications from six studies involving 223 participants were included in this systematic review. Five of them conducted whole-body vibration therapy, while two conducted local vibration therapy. A meta-analysis of randomized controlled studies indicated that muscle strength significantly increased after whole-body vibration therapy (SMD 0.69, 95% CI 0.28 to 1.11, I² = 0%, P = 0.001) and local vibration therapy (SMD 3.78, 95% CI 2.29 to 5.28, P < 0.001). Physical performance measured by the sit-to-stand test and the timed-up-and-go test were significantly improved after the intervention (SMD -0.79, 95% CI − 1.21 to − 0.37, I² = 0%, P < 0.001) and SMD -0.83, 95% CI − 1.56 to − 0.11, I² = 64%, P = 0.02, respectively).

Conclusion

Vibration therapy could be a prospective strategy for improving muscle strength and physical performance in older adults with sarcopenia. However, due to the limited number of the included studies, caution is needed when interpreting these results. More well-designed, large sample size studies should be conducted to further explore and validate the benefits of vibration therapy for this population.

A multicomponent intervention to decrease sedentary time during hospitalization: a quasi-experimental pilot study

Objective:

The aim of this study was to evaluate the feasibility and preliminary effects of a multicomponent intervention to decrease sedentary time during and shortly after hospitalization.

Design:

This is a quasi-experimental pilot study comparing outcomes in patients admitted before and after the implementation of the intervention.

Setting:

The study was conducted in a university hospital.

Subjects:

Participants were adult patients undergoing elective organ transplantation or vascular surgery.

Interventions:

In the control phase, patients received usual care, whereas in the intervention phase, patients also received a multicomponent intervention to decrease sedentary time. The intervention comprised eight elements: paper and digital information, an exercise movie, an activity planner, a pedometer and Fitbit Flex™, a personal activity coach and an individualized digital training program.

Measures:

Measures of feasiblity were the self-reported use of the intervention components (yes/no) and satisfaction (low–high = 0–10). Main outcome measure was the median % of sedentary time measured by an accelerometer worn during hospitalization and 7–14 days thereafter.

Results:

A total of 42 controls (mean age = 59 years, 62% male) and 52 intervention patients (58 years, 52%) were included. The exercise movie, paper information and Fitbit Flex were the three most frequently used components, with highest satisfaction scores for the fitbit, paper information, exercise movie and digital training. Median sedentary time decreased from 99.6% to 95.7% and 99.3% to 91.0% between Days 1 and 6 in patients admitted in the control and intervention phases, respectively. The difference at Day 6 reached statistical significance (difference = 41 min/day, P = 0.01). No differences were seen after discharge.

Conclusion:

Implementing a multicomponent intervention to reduce sedentary time appeared feasible and may be effective during but not directly after hospitalization.

Effect of physical interventions on physical performance and physical activity in older patients during hospitalization: a systematic review

Background

To counteract decline in physical performance and physical activity in older patients during hospitalization, multiple physical interventions were developed. However, it is unknown whether these are effective in this particular population. This systematic review aimed to identify the effect of physical interventions on physical performance and physical activity in older patients during hospitalization.

Methods

The systematic search included PubMed, EMBASE, Cinahl, the Trials database of The Cochrane Library and SPORTdiscus from inception to 22 November 2017. Studies were included if the mean age of the patient cohort was 65 years and older and the effect of physical interventions on physical performance or physical activity was evaluated during hospitalization.

Results

Fifteen randomized controlled trials met the inclusion criteria. Overall, the effect of physical interventions on physical performance was inconsistent. Patient tailored interventions, i.e. continuously adapted to the capabilities of the patient were not found to be superior over interventions that were not. Physical activity as outcome measure was not addressed. Reporting of intensity of the interventions and adherence were frequently lacking.

Conclusions

Evidence for the effect of physical interventions on physical performance in older patients during hospitalization was found uncertain. Further research on the efficacy of the intervention is needed, comparing types of intervention with detailed reporting of frequency, intensity and duration.

Electronic supplementary material

The online version of this article (10.1186/s12877-018-0965-2) contains supplementary material, which is available to authorized users.

Use of an Enactive Insole for Reducing the Risk of Falling on Different Types of Soil Using Vibrotactile Cueing for the Elderly

Background

Our daily activities imply displacements on various types of soil. For persons with gait disorder or losing functional autonomy, walking on some types of soil could be challenging because of the risk of falling it represents.

Methods

In this paper, we present, in a first part, the use of an enactive shoe for an automatic differentiation of several types of soil. In a second part, using a second improved prototype (an enactive insole), twelve participants with Parkinson’s disease (PD) and nine age-matched controls have performed the Timed Up and Go (TUG) test on six types of soil with and without cueing. The frequency of the cueing was set at 10% above the cadence computed at the lower risk of falling (walking over the concrete). Depending on the cadence computed at the lower risk, the enactive insole activates a vibrotactile cueing aiming to improve gait and balance control. Finally, a risk index is computed using gait parameters in relation to given type of soil.

Results

The frequency analysis of the heel strike vibration allows the differentiation of various types of soil. The risk computed is associated to an appropriate rhythmic cueing in order to improve balance and gait impairment. The results show that a vibrotactile cueing could help to reduce the risk of falling.

Conclusions

Firstly, this paper demonstrates the feasibility of reducing the risk of falling while walking on different types of soil using vibrotactile cueing. We found a significant difference and a significant decrease in the computed risks of falling for most of types of soil especially for deformable soils which can lead to fall. Secondly, heel strike provides an approximation of the impulse response of the soil that can be analyzed with time and frequency-domain modeling. From these analyses, an index is computed enabling differentiation the types of soil.