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Sánchez-Sánchez ML, Ruescas-Nicolau MA, Arnal-Gómez A, Iosa M, Pérez-Alenda S, Cortés-Amador S. Validity of an android device for assessing mobility in people with chronic stroke and hemiparesis: a cross-sectional study. J Neuroeng Rehabil 2024; 21:54. [PMID: 38616288 PMCID: PMC11017601 DOI: 10.1186/s12984-024-01346-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 03/22/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Incorporating instrument measurements into clinical assessments can improve the accuracy of results when assessing mobility related to activities of daily living. This can assist clinicians in making evidence-based decisions. In this context, kinematic measures are considered essential for the assessment of sensorimotor recovery after stroke. The aim of this study was to assess the validity of using an Android device to evaluate kinematic data during the performance of a standardized mobility test in people with chronic stroke and hemiparesis. METHODS This is a cross-sectional study including 36 individuals with chronic stroke and hemiparesis and 33 age-matched healthy subjects. A simple smartphone attached to the lumbar spine with an elastic band was used to measure participants' kinematics during a standardized mobility test by using the inertial sensor embedded in it. This test includes postural control, walking, turning and sitting down, and standing up. Differences between stroke and non-stroke participants in the kinematic parameters obtained after data sensor processing were studied, as well as in the total execution and reaction times. Also, the relationship between the kinematic parameters and the community ambulation ability, degree of disability and functional mobility of individuals with stroke was studied. RESULTS Compared to controls, participants with chronic stroke showed a larger medial-lateral displacement (p = 0.022) in bipedal stance, a higher medial-lateral range (p < 0.001) and a lower cranio-caudal range (p = 0.024) when walking, and lower turn-to-sit power (p = 0.001), turn-to-sit jerk (p = 0.026) and sit-to-stand jerk (p = 0.001) when assessing turn-to-sit-to-stand. Medial-lateral range and total execution time significantly correlated with all the clinical tests (p < 0.005), and resulted significantly different between independent and limited community ambulation patients (p = 0.042 and p = 0.006, respectively) as well as stroke participants with significant disability or slight/moderate disability (p = 0.024 and p = 0.041, respectively). CONCLUSION This study reports a valid, single, quick and easy-to-use test for assessing kinematic parameters in chronic stroke survivors by using a standardized mobility test with a smartphone. This measurement could provide valid clinical information on reaction time and kinematic parameters of postural control and gait, which can help in planning better intervention approaches.
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Affiliation(s)
- M Luz Sánchez-Sánchez
- Physiotherapy in Motion. Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Gascó Oliag n 5, 46010, Valencia, Spain
| | - Maria-Arantzazu Ruescas-Nicolau
- Physiotherapy in Motion. Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Gascó Oliag n 5, 46010, Valencia, Spain.
| | - Anna Arnal-Gómez
- Physiotherapy in Motion. Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Gascó Oliag n 5, 46010, Valencia, Spain
| | - Marco Iosa
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185, Rome, Italy
- Smart Lab, Santa Lucia Foundation IRCCS, Via Ardeatina 306, 00179, Rome, Italy
| | - Sofía Pérez-Alenda
- Physiotherapy in Motion. Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Gascó Oliag n 5, 46010, Valencia, Spain
| | - Sara Cortés-Amador
- Physiotherapy in Motion. Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Gascó Oliag n 5, 46010, Valencia, Spain
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Hager AGM, Mathieu N, Carrard S, Bridel A, Wapp C, Hilfiker R. Partially supervised exercise programmes for fall prevention improve physical performance of older people at risk of falling: a three-armed multi-centre randomised controlled trial. BMC Geriatr 2024; 24:311. [PMID: 38570773 PMCID: PMC10993430 DOI: 10.1186/s12877-024-04927-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 03/28/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Falls have a major impact on individual patients, their relatives, the healthcare system and related costs. Physical exercise programmes that include multiple categories of exercise effectively reduce the rate of falls and risk of falling among older adults. METHODS This 12-month, assessor-blinded, three-armed multicentre randomised clinical trial was conducted in adults aged ≥ 65 years identified as at risk of falling. Four hundred and five participants were randomly allocated into 3 groups: experimental group (n = 166) with the Test&Exercise partially supervised programme based on empowerment delivered with a tablet, illustrated manual and cards, reference group (n = 158) with the Otago partially supervised programme prescribed by a physiotherapist delivered with an illustrated manual and control group (n = 81) with the Helsana self-administrated programme delivered with cards. Experimental and reference groups received partially supervised programmes with 8 home sessions over 6 months. Control group received a self-administered program with a unique home session. The 3 groups were requested to train independently 3 times a week for 12 months. Primary outcome was the incidence rate ratio of self-reported falls over 12 months. Secondary outcomes were fear of falling, basic functional mobility and balance, quality of life, and exercise adherence. RESULTS A total of 141 falls occurred in the experimental group, 199 in the reference group, and 42 in the control group. Incidence rate ratios were 0.74 (95% CI 0.49 to 1.12) for the experimental group and 0.43 (95% CI 0.25 to 0.75) for the control group compared with the reference group. The Short Physical Performance Battery scores improved significantly in the experimental group (95% CI 0.05 to 0.86; P = 0.027) and in the reference group (95% CI 0.06 to 0.86; P = 0.024) compared with the control group. CONCLUSION The self-administered home-based exercise programme showed the lowest fall incidence rate, but also the highest dropout rate of participants at high risk of falling. Both partially supervised programmes resulted in statistically significant improvements in physical performance compared with the self-administered programme. TRIAL REGISTRATION NCT02926105. CLINICALTRIALS gov. Date of registration: 06/10/2016.
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Affiliation(s)
- Anne-Gabrielle Mittaz Hager
- School of Health Sciences, HES-SO Valais-Wallis, University of Applied Sciences and Arts Western Switzerland, Valais, Sion, Switzerland.
- School of Health Sciences, HES-SO Valais-Wallis, Rathaustrasse 25, 3941, Leukerbad, Switzerland.
| | - Nicolas Mathieu
- School of Health Sciences, HES-SO Valais-Wallis, University of Applied Sciences and Arts Western Switzerland, Valais, Sion, Switzerland
| | - Sophie Carrard
- School of Health Sciences, HES-SO Valais-Wallis, University of Applied Sciences and Arts Western Switzerland, Valais, Sion, Switzerland
| | - Alice Bridel
- Bern University of Applied Sciences, Department of Health Professions, Bern, Switzerland
| | - Christina Wapp
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Roger Hilfiker
- School of Health Sciences, HES-SO Valais-Wallis, University of Applied Sciences and Arts Western Switzerland, Valais, Sion, Switzerland
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Ekici DK, Inal HS. Effectiveness of Wii-Fit Combined with Conventional Exercises on the Functional Mobility and Balance of Children with Cerebral Palsy and Their Typically Growing Peers. Games Health J 2024. [PMID: 38527255 DOI: 10.1089/g4h.2023.0113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024] Open
Abstract
Nintendo Wii Fit is an accessible, affordable, and productive inclusion into rehabilitation programs for children with cerebral palsy (CP) as a physical activity intervention; however, to our knowledge, there are no comparative studies 8 investigating the effects on the functional mobility and balance of children with CP compared to typically growing (TG) children. We evaluated the effects of Nintendo Wii Fit video exercises on static and dynamic balance, functional capacity, and walking endurance in children with CP compared to their TG peers. Children with CP and their TG peers were trained with Nintendo Wii Fit Balance Board games and conventional exercises (40 minutes each) for 16 weeks, twice a week. Their static and dynamic balance, functional capacity, and walking endurance were evaluated at the beginning and end of the study. The improvement achieved within the groups in all parameters, as well as between the groups, was significant, except for the dynamic balance and walking endurance. Standing Nintendo Wii Fit exercises combined with conventional exercises can be included as axial exercises in the physiotherapy program for children with CP as an enjoyable physical activity. TG children may also benefit, increasing their functional mobility and walking endurance in a fun way.
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Affiliation(s)
- Derya Kardes Ekici
- Kardes Special Education and Rehabilitation Centre, Tuzla; Health Sciences Institute, Yeditepe University, Istanbul, Turkey
| | - Habibe Serap Inal
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Galata University, Istanbul, Turkey
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Aakrann EB, Brincks J. The psychometric properties of the Six-Spot Step Test - a systematic review using the COSMIN guidelines. Clin Rehabil 2024:2692155241236609. [PMID: 38425190 DOI: 10.1177/02692155241236609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
OBJECTIVE Accurate and reliable balance measures are important for prescribing fall prevention treatments and monitoring their effectiveness. Thus, we aimed to systematically review the psychometric properties of the Six-Spot Step Test, an increasingly used measure of dynamic balance. DATA SOURCES A literature search using the free-text term "Six-Spot Step Test" was performed on 12 February 2024, in Medline, Embase, Rehabilitation & Sports Medicine and SPORTDiscus. Eligibility criteria were adults aged 18 or more, trials evaluating the psychometric properties of the Six-Spot Step Test, and English-language articles. Conference abstracts were excluded. REVIEW METHODS Two investigators screened and selected data independently and assessed the methodological quality and evidence using the COSMIN Risk of Bias checklist and modified GRADE approach. One investigator extracted study characteristics such as design, population and psychometric properties. RESULTS Of the 159 articles identified, 16, evaluating multiple measurement properties, were included in the final analysis. A total of 1319 people participated, including people affected by Stroke, multiple sclerosis, Parkison's disease, chronic inflammatory polyneuropathy and older adults with balance problems. Eight articles assessing reliability (n = 618, intraclass correlations coefficient ≥0.7, minimal detectable change = 22%) and 12 construct validity (n = 1082, 83% true hypothesis, area under the curve >0.7) exhibited sufficient methodological quality with high-level evidence, while two studies (n = 167) examining responsiveness showed very low evidence. CONCLUSION Apart from responsiveness, robust evidence supports the reliability and validity of the Six-Spot Step Test for assessing dynamic balance in a specific group of individuals with neurological diseases and older adults. Further, it is considered feasible for clinical use.
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Affiliation(s)
- Endre Bakke Aakrann
- Faculty of Health Science, VIA University College, Research Centre for Health and Welfare Technology - Programme for Rehabilitation, Aarhus N, Denmark
| | - John Brincks
- Faculty of Health Science, VIA University College, Research Centre for Health and Welfare Technology - Programme for Rehabilitation, Aarhus N, Denmark
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Yakut H, Karadibak D, Metin SK, Karabay DÖ, Gençpınar T. Predictors of walking capacity in patients with peripheral arterial disease. Wien Klin Wochenschr 2024; 136:94-100. [PMID: 36074178 DOI: 10.1007/s00508-022-02078-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 08/02/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Walking capacity is severely impaired in patients with peripheral arterial disease (PAD). Given the prognostic importance of walking capacity, the level of evidence on possible predictors of walking capacity in patients with PAD is insufficient. AIMS To investigate the predictors of walking capacity in patients with PAD. METHODS A total of 51 patients with PAD were included in this cross-sectional study. Walking capacity was determined with 6‑minute walk test (6MWT) and walking impairment questionnaire (WIQ). Functional mobility was assessed with repeated sit-to-stand test (RSS) and timed up and go test (TUG). Hand-held dynamometer was used to measurement lower extremity muscle strength. Balance was assessed with Biodex Balance System-limit of stability (BBS-LOS). Fatigue was evaluated with fatigue impact scale (FIS). RESULTS There was a strong correlation between 6MWT walking distance and WIQ, two methods of assessing walking capacity (r = 0.835 p < 0.001). The 6MWT was correlated with RSS, TUG, lower extremity muscle strength, BBS-LOS and FIS. The WIQ was correlated with RSS, TUG, BBS-LOS and FIS. The RSS and FIS were independent determinants of the 6MWT and WIQ, accounting for 68% and 57% of the variance, respectively. CONCLUSION This study demonstrated that functional mobility and fatigue were independent predictors of walking capacity in patients with PAD. Both subjective and objective measurement methods can be used for determining the level of walking capacity in the patients with PAD.
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Affiliation(s)
- Hazal Yakut
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Eskişehir Osmangazi University, Eskişehir, Turkey.
| | - Didem Karadibak
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey
| | - Sadık Kıvanç Metin
- Department of Cardiovascular Surgery, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Dündar Özalp Karabay
- Department of Cardiovascular Surgery, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Tuğra Gençpınar
- Department of Cardiovascular Surgery, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
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Gonçalves HR, Branquinho A, Pinto J, Rodrigues AM, Santos CP. Digital biomarkers of mobility and quality of life in Parkinson's disease based on a wearable motion analysis LAB. Comput Methods Programs Biomed 2024; 244:107967. [PMID: 38070392 DOI: 10.1016/j.cmpb.2023.107967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 11/13/2023] [Accepted: 12/01/2023] [Indexed: 01/26/2024]
Abstract
BACKGROUND AND OBJECTIVE Functional mobility, an indicator of the quality of life (QoL), requires fast and flexible changes during motion, which are limited in Parkinson's disease (PD). Recent body-worn sensors have emerged in the last decades as potential solutions to produce digital biomarkers able to quantify mobility outside routine consultations and during real-life scenarios for multiple days at a time. The proposed research aims to study the ability of a wearable motion analysis lab, developed by our team, to produce digital biomarkers of mobility and QoL levels in patients with PD. METHODS A cross-sectional study was followed, including 40 patients stratified into three subgroups according to a clinic motor examination and a QoL questionnaire. RESULTS The achieved outcomes demonstrate the ability of the proposed high-tech solution to measure prototypical gait impairments and discriminate motor condition (AUC=0,890) and patients' QoL levels (AUC=0,950). Also, from the measured multiple gait-associated parameters, we identified the variables with the most potential to be applied as digital biomarkers of mobility (67 % of the metrics) and QoL (72 % of the metrics) in PD. CONCLUSIONS Overall, we confirmed our hypothesis of using our body-worn sensor-based solution for passive or active monitoring of mobility and QoL in PD to produce objective, feasible, and continuous digital biomarkers.
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Affiliation(s)
- Helena R Gonçalves
- Center for MicroElectroMechanical Systems, University of Minho, Guimarães, Portugal; LABBELS - Associate Laboratory, Braga/Guimarães, Portugal.
| | - André Branquinho
- Center for MicroElectroMechanical Systems, University of Minho, Guimarães, Portugal; LABBELS - Associate Laboratory, Braga/Guimarães, Portugal
| | - Joana Pinto
- Neurology Service, Hospital of Braga, Portugal
| | | | - Cristina P Santos
- Center for MicroElectroMechanical Systems, University of Minho, Guimarães, Portugal; LABBELS - Associate Laboratory, Braga/Guimarães, Portugal.
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Rekant J, Chambers A, Suri A, Hergenroeder A, Sejdic E, Brach J. Weekly minutes of moderate to vigorous physical activity is associated with movement quality in overweight and obese older adults, independent of age. Aging Clin Exp Res 2023; 35:2941-2950. [PMID: 37861959 PMCID: PMC10735209 DOI: 10.1007/s40520-023-02584-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 09/26/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Physical activity can improve function and decrease healthcare spending among overweight and obese older adults. Although unstructured physical activity has been related to cardiometabolic improvements, the relationship between unstructured activity and movement quality is unclear. AIMS This study aimed to evaluate the association of amount of unstructured free-living moderate-vigorous physical activity (MVPA) with measures of movement quality in overweight and obese older adults. METHODS The association of MVPA with movement quality was assessed in 165 overweight and obese older adults (Age: 77.0(8.0) years; Body mass index (BMI): 29.2(5.3) kg/m2). Participants performed overground walking, the Figure of 8 Walk test, and the Five-Times Sit to Stand. Weekly physical activity was measured using a waist-worn Actigraph activity monitor. RESULTS Movement quality during straight path [gait speed (ρ = 0.30, p < 0.01), stride length (ρ = 0.33, p < 0.01), double-limb support time (ρ = -0.26, p < 0.01), and gait symmetry (ρ = 0.17, p = 0.02)] and curved path [F8W time (ρ = -0.22, p < 0.01) and steps (ρ = -0.22, p < 0.01)] walking were associated with weekly minutes of MVPA after controlling for age. Five-Times Sit to Stand performance was not significantly associated with weekly minutes of MVPA (ρ = -0.10, p = 0.13). CONCLUSIONS Older adults with high BMIs who are less active also demonstrate poorer movement quality, independent of age. Physical activity engagement and task-specific training should be targeted in interventions to promote healthy aging, decrease falls, and delay disability development. Future work should consider the interconnected nature of movement quality with physical activity engagement and investigate if targeting one influences the other.
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Affiliation(s)
- Julie Rekant
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.
| | - April Chambers
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, PA, USA
| | - Anisha Suri
- Department of Electrical and Computer Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Andrea Hergenroeder
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ervin Sejdic
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Electrical and Computer Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jen Brach
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA
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Soke F, Aydin F, Karakoc S, Gulsen C, Yasa ME, Ersoy N, Gulsen EO, Yucesan C. Effects of backward walking training on balance, gait, and functional mobility in people with multiple sclerosis: A randomized controlled study. Mult Scler Relat Disord 2023; 79:104961. [PMID: 37683559 DOI: 10.1016/j.msard.2023.104961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 08/04/2023] [Accepted: 08/26/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND Backward walking training (BWT) can have a positive effect on balance, gait, and functional mobility in neurological diseases; however, the effectiveness of BWT has not been examined in multiple sclerosis (MS). Therefore, the study aimed to investigate the effects of BWT on balance, gait, and functional mobility in people with MS (PwMS). METHOD Nineteen PwMS were randomly allocated to either the experimental group (n=10) and the control group (n=9). The experimental group received BWT in addition to conventional walking training (CWT) while the control group only received CWT. Both groups performed training three times a week for 8 weeks. Participants were assessed with the Berg Balance Scale (BBS), four square step test (FSST), activities-specific balance confidence scale (ABC), timed 25-foot walk test (T25FW), dynamic gait index (DGI), 3-meter backward walk test (3MBWT), Multiple Sclerosis Walking Scale-12 (MSWS-12), and timed up and go test (TUG) before and after training. RESULTS After training, both groups showed significant improvements on the T25FW, and TUG (p<0.05) while only the experimental group showed significant improvements on the BBS, FSST, ABC, DGI, 3MBWT, and MSWS-12 (p<0.05). The experimental group significantly improved more than the control group in all outcomes (p<0.05) except for the T25FW (p=0.202). CONCLUSION BWT in addition to CWT is an effective way to improve balance, gait, and functional mobility for PwMS. These results suggest that BWT may be a potentially useful treatment approach when added to CWT in the rehabilitation of MS.
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Affiliation(s)
- Fatih Soke
- University of Health Sciences, Gulhane Faculty of Physiotherapy and Rehabilitation, Department of Physiotherapy and Rehabilitation, Ankara, Turkey.
| | - Fatma Aydin
- University of Health Sciences, Ankara Etlik City Hospital, Department of Neurology, Ankara, Turkey
| | - Selda Karakoc
- Ankara Yildirim Beyazit University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Ankara, Turkey
| | - Cagri Gulsen
- Osmangazi University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Eskisehir, Turkey
| | - Mustafa Ertugrul Yasa
- University of Health Sciences, Gulhane Faculty of Physiotherapy and Rehabilitation, Department of Physiotherapy and Rehabilitation, Ankara, Turkey
| | - Nursena Ersoy
- Ankara University, Faculty of Health Sciences, Department of Nutrition and Dietetic, Ankara, Turkey
| | - Elvan Ozcan Gulsen
- Anadolu University, Vocational School of Health Services, Elderly Care Program, Eskisehir, Turkey
| | - Canan Yucesan
- Ankara University, Faculty of Medicine, Department of Neurology, Ankara, Turkey
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Quasdorf T, Manietta C, Rommerskirch-Manietta M, Braunwarth JI, Roßmann C, Roes M. Implementation of interventions to maintain and promote the functional mobility of nursing home residents - a scoping review. BMC Geriatr 2023; 23:600. [PMID: 37752436 PMCID: PMC10523713 DOI: 10.1186/s12877-023-04213-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 08/02/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND To provide an overview of the available evidence on the implementation of direct and capacity-building interventions to promote and maintain the functional mobility of nursing home residents. METHODS We conducted a scoping review following the methodological guidance for the conduct of scoping reviews as described by the Joanna Briggs Institute. We searched for studies in MEDLINE (via PubMed) and CINAHL (via EBSCO). We conducted a qualitative content analysis of the included studies with deductive categories based on the Consolidated Framework for Implementation Research (CFIR). RESULTS Ultimately, we included 8 studies on direct interventions, 6 studies on capacity-building interventions, and 2 studies on both types of interventions in our review. Seven studies provided evidence on implementation strategies comprising discrete as well as multifaceted, multilevel strategies. Most of the studies did not systematically evaluate the strategies but remained at a descriptive level. All 16 studies provided evidence of influencing factors. We identified 32 of the 37 influencing factors of the CFIR. The five most frequent influencing factors were available resources (n = 14), access to knowledge and information (n = 12), patient needs and resources (n = 10), knowledge and beliefs about the intervention (n = 10) and compatibility (n = 9). CONCLUSIONS The available evidence on the implementation of functional mobility interventions in nursing homes is rather limited. This emphasizes the need for further research. Regarding implementation strategies, the systematic evaluation and further development of the reported promising approaches might be a starting point.
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Affiliation(s)
- Tina Quasdorf
- School of Health Science, Institute of Nursing, ZHAW Zürich University of Applied Science, Winterthur, Switzerland.
| | - Christina Manietta
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Standort Witten, Witten, Germany
- Fakultät für Gesundheit, Universität Witten/Herdecke, Witten, Germany
| | - Mike Rommerskirch-Manietta
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Standort Witten, Witten, Germany
- Fakultät für Gesundheit, Universität Witten/Herdecke, Witten, Germany
| | - Jana Isabelle Braunwarth
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Standort Witten, Witten, Germany
- Fakultät für Gesundheit, Universität Witten/Herdecke, Witten, Germany
| | - Christin Roßmann
- Bundeszentrale für gesundheitliche Aufklärung (BZgA), Köln, Germany
| | - Martina Roes
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Standort Witten, Witten, Germany
- Fakultät für Gesundheit, Universität Witten/Herdecke, Witten, Germany
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Jovic E, Ahuja KDK, Lawler K, Hardcastle S, Bird ML. Carer-supported home-based exercises designed to target physical activity levels and functional mobility after stroke: a scoping review. Disabil Rehabil 2023:1-12. [PMID: 37698010 DOI: 10.1080/09638288.2023.2256663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
PURPOSE To explore the literature on carer-supported home-based exercise programs for people after stroke, as a form of physical activity. The review focus was to examine the training carers receive, the content of programs, and investigate the physical activity levels and functional mobility of people after stroke. MATERIALS AND METHODS A scoping review was undertaken, guided by Joanna Briggs Institute methodology. The concept of home-based carer-supported exercise, in people after stroke, was searched across five databases. Outcomes of interest were physical activity levels and functional mobility. RESULTS We screened 2285 references and included 10 studies: one systematic review, five randomised controlled trials, one trial with non-equivalent control, and four uncontrolled studies. Carer training ranged from one to twelve sessions. Exercise interventions commonly including walking, other whole body functional exercises and balance activities. In eight studies interventions were in addition to standard care. Five studies reported significant between-group differences for functional mobility, favouring the intervention. One study reported physical activity levels. CONCLUSION There was large variation in the volume and content of training provided to carers. Physical activity levels were infrequently objectively reported. Future studies should include greater details on their protocols to allow for replication and implementation into clinical practice.
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Affiliation(s)
- E Jovic
- School of Health Sciences, College of Health Medicine, University of Tasmania, Launceston, Australia
| | - K D K Ahuja
- School of Health Sciences, College of Health Medicine, University of Tasmania, Launceston, Australia
| | - K Lawler
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
- Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, Hobart, Australia
| | - S Hardcastle
- School of Health Sciences, College of Health Medicine, University of Tasmania, Launceston, Australia
| | - M L Bird
- School of Health Sciences, College of Health Medicine, University of Tasmania, Launceston, Australia
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada
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Diao Y, Pan J, Xie Y, Liao M, Wu D, Liu H, Liao L. Effect of Repetitive Peripheral Magnetic Stimulation on Patients With Low Back Pain: A Meta-analysis of Randomized Controlled Trials. Arch Phys Med Rehabil 2023; 104:1526-1538. [PMID: 37116558 DOI: 10.1016/j.apmr.2023.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/08/2023] [Accepted: 03/09/2023] [Indexed: 04/30/2023]
Abstract
OBJECTIVE The purpose of this meta-analysis was to investigate the effects of repetitive peripheral magnetic stimulation (rPMS) on pain intensity, functional mobility, and kinesiophobia in individuals with low back pain (LBP). DATA SOURCES The PubMed, Physiotherapy Evidence Database, Embase, Cochrane Library, and Web of Science databases were systematically searched from inception until November 25, 2022. STUDY SELECTION Eligible randomized controlled trials contained information on the population (LBP), intervention (rPMS), and outcomes (pain intensity, functional mobility, and kinesiophobia). Participants in the rPMS intervention group were compared with those in sham or other control groups. Two independent researchers searched for, screened, and qualified the articles. DATA EXTRACTION Two independent researchers extracted key information from each eligible study. The authors' names, year of publication, setting, total sample size, rPMS parameters, baseline/mean difference (MD), and 95% confidence interval (CI) were extracted using a standardized form, and the methodological quality was assessed using the Physiotherapy Evidence Database score and GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) system. DATA SYNTHESIS Of 733 studies identified, 6 randomized controlled trials (n = 139) were included for meta-analysis. Compared with sham rPMS or other therapy, rPMS showed significant efficacy in reducing pain intensity (visual analog scale: MD, -1.89; 95% CI, -3.32 to -0.47; P<.05; very low-quality evidence). Significant efficacy was also found in terms of functional disability (Oswestry Disability Index: MD, -8.39; 95% CI, -13.65 to -3.12; P<.001; low-quality evidence). However, there was no statistically significant between-group difference on the Tampa scale of kinesiophobia (MD, -1.81; 95% CI, -7.60 to 3.98; P>.05; very low-quality evidence). CONCLUSIONS This meta-analysis found very low- to low-quality evidence that rPMS can be used to reduce pain intensity and improve functional disability in individuals with LBP. However, no significant effect of rPMS on kinesiophobia was found.
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Affiliation(s)
- Yingxiu Diao
- Rehabilitation Medicine Center, The First Dongguan Affiliated Hospital, Guangdong Medical University, Guangdong; School of Rehabilitation Medicine, Gannan Medical University, Jiangxi
| | - Jiaxin Pan
- School of Rehabilitation Medicine, Gannan Medical University, Jiangxi; School of Rehabilitation Medicine, Weifang Medical University, Shandong
| | - Yuhua Xie
- Rehabilitation Medicine Center, The First Dongguan Affiliated Hospital, Guangdong Medical University, Guangdong; School of Rehabilitation Medicine, Gannan Medical University, Jiangxi
| | - Manxia Liao
- Department of Rehabilitation, Yixing JORU Rehabilitation Hospital, Jiangsu
| | - Dongyu Wu
- Rehabilitation Medicine Center, The First Dongguan Affiliated Hospital, Guangdong Medical University, Guangdong
| | - Hao Liu
- School of Rehabilitation Medicine, Weifang Medical University, Shandong
| | - Linrong Liao
- Rehabilitation Medicine Center, The First Dongguan Affiliated Hospital, Guangdong Medical University, Guangdong.
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12
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Sinanoglu B, Ozdemir F. Evaluation of functional mobility, balance, and executive functions in children with epilepsy. Epilepsy Behav 2023; 143:109230. [PMID: 37146465 DOI: 10.1016/j.yebeh.2023.109230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 04/20/2023] [Accepted: 04/20/2023] [Indexed: 05/07/2023]
Abstract
OBJECTIVE It is known that motor skills and executive functions are interrelated in healthy children. The study aims to evaluate the functional mobility, balance and executive functions in children who are diagnosed with epilepsy and to determine whether they are related to each other. METHODS The study included 21 children who were diagnosed with epilepsy and have no additional comorbidities and 21 healthy children who had similar age and sex to those diagnosed with epilepsy. Their demographic data were collected using a descriptive information form. In addition, the Timed Up and Go Test (TUG) and the Stair Climb Test (SCT) were used to evaluate their functional mobility, the Pediatric Berg Balance Scale (PBSS) to evaluate their balance, and the Behavior Evaluation Inventory for Executive Functions Parent Form (BRIEF-P) to evaluate their executive functions. RESULTS Our study found a statistically significant difference between the children with epilepsy and their healthy peers in terms of functional mobility and executive functions (p < 0.05). However, there was no statistically significant difference between them in terms of balance parameters (p > 0.05). In addition, a statistically significant difference was found between the executive functions and functional mobility in children with epilepsy (p < 0.05). The coefficient of determinations (R2) indicating how differences in T and SCT scores explained by executive function domains were found as 0.718 and 0.725, respectively. CONCLUSIONS Epilepsy can negatively affect several aspects of functional mobility and executive functions in childhood. According to the results of our study, it is important to recognize the motor skills and executive functions problems of children with epilepsy who do not have additional comorbidities, and to direct them to appropriate healthcare programs. Our results support the need to raise awareness in both health professionals and families to encourage children with epilepsy to be more active.
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Affiliation(s)
- Bercem Sinanoglu
- Department of Physiotherapy and Rehabilitation, Institute of Health Sciences, Inonu University, Malatya, Turkey.
| | - Filiz Ozdemir
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Inonu University, Malatya, Turkey.
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13
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Kaya Y, Saka S, Tuncer D. Effect of hippotherapy on balance, functional mobility, and functional independence in children with Down syndrome: randomized controlled trial. Eur J Pediatr 2023:10.1007/s00431-023-04959-5. [PMID: 37186034 DOI: 10.1007/s00431-023-04959-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 02/24/2023] [Accepted: 03/30/2023] [Indexed: 05/17/2023]
Abstract
Impaired muscle strength, proprioceptive and vestibular deficits, and orthopedic dysfunction are common disorders associated with Down syndrome (DS). Hippotherapy uses the horses' multidimensional movement to improve posture, balance, and overall function, both motor and sensory. Research evidence supports hippotherapy as an effective, medically recognized intervention for the rehabilitation of gross motor skills. The aim of this study was to determine the effect of hippotherapy on balance, functional mobility, and functional independence in children with DS. Thirty-four children with DS were randomly assigned to the experimental (hippotherapy) and control groups after the initial assessment. Both groups received physiotherapy including balance exercises, and the experimental group also received hippotherapy as an integrative therapy. Pediatric Balance Scale (PBS), Timed Up and Go Test (TUG), and Functional Independence Measure for Children (WeeFIM) were used before and after the intervention. Baseline outcome measures (PBS, TUG, WeeFIM) were statistically similar between groups (p > 0.05). After the intervention, PBS and TUG scores improved in both groups (p < 0.05). On the other hand, WeeFIM scores improved just in the hippotherapy group (p < 0.05). Conclusion: Therefore, providing hippotherapy as an integrative therapy to physiotherapy will be more effective in improving the functional independence of children with DS. Trial registration: NCT05297149 (March 2022, retrospectively registered). What is Known: • Hippotherapy has an improvement effect on balance and functional independence in different diseases and age groups, but the evidence is limited in DS. • There is limited evidence about the effect of hippotherapy on functional mobility in different diseases and age groups, but there is no evidence in DS. What is New: • Hippotherapy is a safe and effective approach to support improvement in functional independence in children with DS.
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Affiliation(s)
- Yelda Kaya
- Physiotherapy Rehabilitation Department, Institute for Graduate Studies, Haliç University, Istanbul, Turkey
| | - Seda Saka
- Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Haliç University, Istanbul, Turkey.
| | - Deniz Tuncer
- Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bezmialem Vakif University, Istanbul, Turkey
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14
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Vriens A, Verschueren S, Vanrusselt D, Troosters T, Gielis M, Dirix V, Vanderhenst E, Sleurs C, Uyttebroeck A. Physical fitness throughout chemotherapy in children with acute lymphoblastic leukaemia and lymphoma. Eur J Pediatr 2023; 182:813-24. [PMID: 36482087 DOI: 10.1007/s00431-022-04741-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/19/2022] [Accepted: 11/27/2022] [Indexed: 12/13/2022]
Abstract
UNLABELLED Acute lymphoblastic leukaemia/lymphoma (ALL/LBL) and its treatment interfere with normal physical functioning. However, it remains unclear how physical fitness (PF) is affected throughout treatment for ALL/LBL. Sixty-two patients (2.1 to 18.3 years) treated for ALL/LBL underwent four physical tests at nine timepoints from baseline up to 6 months post-treatment. We assessed muscle strength of the quadriceps and tibialis anterior, standing broad jump test (SBJ) for functional mobility and six-minute walk test (6MWT) for endurance. One-sample t-tests were used to compare our results to the norm at each timepoint. Norm-referenced Z-scores were predicted based on time, risk group and age at diagnosis, using linear mixed models. Quadriceps strength, SBJ and 6MWT scores were significantly lower than norm values at all timepoints from diagnosis up to 6 months after maintenance therapy. Significant decreases over time were encountered for quadriceps strength and SBJ, mainly occurring after induction therapy (F = 3.568, p < 0.001 and F = 2.699, p = 0.008, respectively). Age at diagnosis was a significant predictor for tibialis anterior strength (F = 5.266, p = 0.025), SBJ (F = 70.422, p < 0.001) and 6MWT (F = 15.890, p < 0.001) performances, with lower results in adolescents at all timepoints. Six months after treatment, quadriceps strength, 6MWT and SBJ scores remained below expected levels. CONCLUSION The decreased quadriceps strength, functional mobility and endurance at all timepoints, with a large deterioration following induction therapy, suggest the need for early interventions, specifically in the adolescent population. The continued low results 6 months after therapy emphasise the importance of long-term rehabilitation. WHAT IS KNOWN •Acute lymphoblastic leukaemia is the most common type of cancer among children, with increasing survival rates due to therapeutic improvements. •Acute lymphoblastic leukaemia/lymphoma and its treatment can cause muscle weakness, neuromuscular toxicity and a decreased cardiopulmonary fitness. Together with physical inactivity, this can result in a decreased physical fitness. WHAT IS NEW •Quadriceps strength, functional mobility and endurance are decreased during treatment for acute lymphoblastic leukaemia/lymphoma. The lowest measurements are observed after induction therapy, suggesting the need for early interventions. •We observed continued lower results for quadriceps strength, functional mobility and endurance at the end of treatment, up to 6 months after therapy, supporting the need for long-term rehabilitation.
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15
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Gabrielle Dupuy E, Besnier F, Gagnon C, Breton J, Vincent T, Grégoire CA, Lecchino C, Payer M, Bérubé B, Olmand M, Levesque M, Bouabdallaoui N, Iglesies-Grau J, Juneau M, Vitali P, Gayda M, Nigam A, Bherer L. Cardiorespiratory Fitness Moderates the Age-Related Association Between Executive Functioning and Mobility: Evidence From Remote Assessments. Innov Aging 2022; 7:igac077. [PMID: 36846304 PMCID: PMC9950718 DOI: 10.1093/geroni/igac077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Indexed: 12/24/2022] Open
Abstract
Background and Objectives In older adults, executive functions are important for daily-life function and mobility. Evidence suggests that the relationship between cognition and mobility is dynamic and could vary according to individual factors, but whether cardiorespiratory fitness reduces the age-related increase of interdependence between mobility and cognition remains unexplored. Research Design and Methods One hundred eighty-nine participants (aged 50-87) were divided into 3 groups according to their age: middle-aged (MA; <65), young older adults (YOA; 65-74), and old older adults (OOA; ≥75). Participants performed Timed Up and Go and executive functioning assessments (Oral Trail Making Test and Phonologic verbal fluency) remotely by videoconference. Participants completed the Matthews questionnaire to estimate their cardiorespiratory fitness (VO2 max in ml/min/kg). A 3-way moderation was used to address whether cardiorespiratory fitness interacts with age to moderate the relationship between cognition and mobility. Results Results showed that the cardiorespiratory fitness × age interaction moderated the association between executive functioning and mobility (β = -0.05; p = .048; R 2 = 17.6; p < .001). At lower levels of physical fitness (<19.16 ml/min/kg), executive functioning significantly influenced YOA's mobility (β = -0.48, p = .004) and to a greater extent OOA's mobility (β = -0.96, p = .002). Discussion and Implications Our results support the idea of a dynamic relationship between mobility and executive functioning during aging and suggest that physical fitness could play a significant role in reducing their interdependency.
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Affiliation(s)
- Emma Gabrielle Dupuy
- Address correspondence to: Emma Gabrielle Dupuy, PhD, Centre ÉPIC of the Montreal Heart Institute, 5055 rue St Zotique Est, Montréal, Qc, H1T 1N6, Canada. E-mail:
| | - Florent Besnier
- Centre ÉPIC and Research Center, Montreal Heart Institute, Montreal, Quebec, Canada,Department of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Christine Gagnon
- Centre ÉPIC and Research Center, Montreal Heart Institute, Montreal, Quebec, Canada
| | - Juliana Breton
- Centre ÉPIC and Research Center, Montreal Heart Institute, Montreal, Quebec, Canada
| | - Thomas Vincent
- Centre ÉPIC and Research Center, Montreal Heart Institute, Montreal, Quebec, Canada
| | | | - Catia Lecchino
- Centre ÉPIC and Research Center, Montreal Heart Institute, Montreal, Quebec, Canada,Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
| | - Marie Payer
- Centre ÉPIC and Research Center, Montreal Heart Institute, Montreal, Quebec, Canada,Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada
| | - Béatrice Bérubé
- Centre ÉPIC and Research Center, Montreal Heart Institute, Montreal, Quebec, Canada,Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada
| | - Miloudza Olmand
- Centre ÉPIC and Research Center, Montreal Heart Institute, Montreal, Quebec, Canada,Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
| | - Marianne Levesque
- Centre ÉPIC and Research Center, Montreal Heart Institute, Montreal, Quebec, Canada,Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
| | - Nadia Bouabdallaoui
- Centre ÉPIC and Research Center, Montreal Heart Institute, Montreal, Quebec, Canada,Department of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Josep Iglesies-Grau
- Centre ÉPIC and Research Center, Montreal Heart Institute, Montreal, Quebec, Canada,Department of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Martin Juneau
- Centre ÉPIC and Research Center, Montreal Heart Institute, Montreal, Quebec, Canada,Department of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Paolo Vitali
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Mathieu Gayda
- Centre ÉPIC and Research Center, Montreal Heart Institute, Montreal, Quebec, Canada,Department of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Anil Nigam
- Centre ÉPIC and Research Center, Montreal Heart Institute, Montreal, Quebec, Canada,Department of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Louis Bherer
- Centre ÉPIC and Research Center, Montreal Heart Institute, Montreal, Quebec, Canada,Department of Medicine, Université de Montréal, Montreal, Quebec, Canada
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16
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Alayat MS, Almatrafi NA, Almutairi AA, El Fiky AAR, Elsodany AM. The Effectiveness of Telerehabilitation on Balance and Functional Mobility in Patients with Stroke: A Systematic Review and Meta-Analysis. Int J Telerehabil 2022; 14:e6532. [PMID: 38026563 PMCID: PMC10681061 DOI: 10.5195/ijt.2022.6532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
Objective The aim of this systematic review and meta-analysis was to investigate the effectiveness of telerehabilitation on improving balance and functional mobility in stroke survivors. Methods Comprehensive searching was conducted from inception to May 2022. The inclusion criteria were studies evaluating the effectiveness of telerehabilitation in stroke survivors. Data regarding participants, intervention, outcome measures, and main results were extracted. PEDro scale and the Grading of Recommendations Assessment Development and Evaluation (GRADE) were used to assess the methodological quality and quality of evidence, respectively. Data Analysis A total of fourteen articles) 594 patients) were included. A meta-analysis using a random-effect model was performed on thirteen studies )530 patients). Standardized mean difference (SMD) with 95% confidence interval (CI) was calculated for balance and functional mobility. Results: PEDro scale revealed ten good-quality studies, three fair-quality studies, and one poor-quality study. According to the available evidence, telerehabilitation has a small effect size in improving both balance (SMD 0.33 [95% CI 0.03 to 0.63]; P =0.03; low quality of evidence) and functional mobility (SMD 0.27 [95% CI 0.02 to 0.52]; P =0.03; low quality of evidence). Conclusion Telerehabilitation may improve balance and functional mobility in stroke survivors. However, it is evident that more high-quality research is required due to the existence of low to very low-quality evidence with limited confidence in the effect estimate. Registration PROSPERO registration number (CRD42022306410).
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Affiliation(s)
- Mohamed Salaheldien Alayat
- Department of Physiotherapy, Applied Medical Science College, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Nahla Ahmad Almatrafi
- Department of Physiotherapy, Applied Medical Science College, Umm Al-Qura University, Makkah, Saudi Arabia
| | | | - Amir Abdel Raouf El Fiky
- Department of Physiotherapy, Applied Medical Science College, Umm Al-Qura University, Makkah, Saudi Arabia
- Department of Physical Therapy for Neurological Disorders and its Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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17
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Srisaphonphusitti L, Manimmanakorn N, Manimmanakorn A, Hamlin MJ. Effects of whole body vibration exercise combined with weighted vest in older adults: a randomized controlled trial. BMC Geriatr 2022; 22:911. [PMID: 36443661 PMCID: PMC9703755 DOI: 10.1186/s12877-022-03593-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 11/07/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND To evaluate the training effects of whole body vibration (WBV) combined with weighted vest (WV) in older adults. METHODS This randomized controlled trial study was conducted in healthy older adults living in the community. Fifty-one participants were randomly allocated into 3 groups: group 1 (n = 17), WBV alone, training on WBV at a frequency 30 Hz, amplitude 2 mm, 10 sets of 1 min squats, with 60 s rest, group 2 (n = 15), WV alone, squat exercise, 10 sets of 1 min, with 60 s rest, while WV loaded with 10% body weight and group 3 (n = 19), WBV + WV, combining WBV exercise with the addition of a WV. All groups completed training 3 times per week for 8 weeks. The outcomes were total muscle mass, muscle thickness, maximal isometric strength, single-leg-stance and timed-up-and-go evaluated at baseline and after training. RESULTS As a result of training all groups improved their isometric muscle strength with little difference between groups. The single-leg-stance significantly improved only in WBV + WV group 25.1 ± 10.8 s (mean ± 95% CI, p < 0.01). The timed-up-and-go improved in all groups, but the improvement was significantly greater in the WBV + WV group (17.5 ± 6.9%) compared to the WV (8.5 ± 3.2%) and WBV groups (9.2 ± 5.4%, p = 0.043, 0.023 respectively). Rectus femoris muscle thickness and total muscle mass were significantly increased in all groups equally with little difference between groups. CONCLUSION The combined WBV + WV had a greater effect on the single-leg-stance and the timed-up-and-go compared to WV or WBV alone. TRIAL REGISTRATION TCTR20190306001. Thai Clinical Trials Registry ( www.thaiclinicaltrials.org ). Date of registration: 6 March 2019.
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Affiliation(s)
- Lertwanlop Srisaphonphusitti
- grid.9786.00000 0004 0470 0856Exercise and Sports Science Program, Graduate School, Khon Kaen University, Khon Kaen, Thailand ,grid.9786.00000 0004 0470 0856Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Khon Kaen University, Khon Kaen, Thailand
| | - Nuttaset Manimmanakorn
- grid.9786.00000 0004 0470 0856Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Khon Kaen University, Khon Kaen, Thailand ,grid.9786.00000 0004 0470 0856Department of Rehabilitation Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Apiwan Manimmanakorn
- grid.9786.00000 0004 0470 0856Department of Physiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Michael John Hamlin
- grid.16488.330000 0004 0385 8571Department of Tourism, Sport and Society, Lincoln University, Christchurch, New Zealand
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Da Silva KG, Nuvolini RA, Bacha JMR, De Freitas TB, Doná F, Torriani-Pasin C, Pompeu JE. Comparison of the Effects of an Exergame-Based Program with Conventional Physiotherapy Protocol Based on Core Areas of the European Guideline on Postural Control, Functional Mobility, and Quality of Life in Patients with Parkinson's Disease: Randomized Clinical Trial. Games Health J 2022; 12:228-241. [PMID: 36206023 DOI: 10.1089/g4h.2022.0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: Impairment of postural control and functional mobility are debilitating symptoms of Parkinson's disease (PD). In addition to limiting performance in activities of daily living, it is associated with a higher prevalence of falls in this population. Particularly, dysfunction in postural control does not respond to dopaminergic replacement therapy, but physiotherapy can improve this outcome in patients with PD. Objective: The aim of this study was to analyze the effects of training based on Kinect Adventures games compared with a conventional physiotherapy protocol based on the core areas of the European physiotherapy guideline in patients with PD on postural control, functional mobility, self-perception of confidence in the balance, quality of life (QoL), lower limb muscle strength, transfer skill and motor function, as well as to observe adherence and safety interventions. Methods: Thirty-eight patients diagnosed with idiopathic PD were randomized into two groups, and performed 14 training sessions, twice a week for 60 minutes. The primary outcome assessed postural control using the Mini-Balance Evaluation Systems Test (Mini-BESTest). The following were evaluated as secondary outcomes: limit of stability; balance functional reserve and center of pressure area by computerized posturography; functional mobility by the Timed Up and Go test; self-confidence in balance through the Activities-specific Balance Confidence scale; QoL through the Parkinson's Disease Questionnaire; lower limb muscle strength by the Five Times Sit-To-Stand test; and motor function by the Unified Parkinson's Disease Rating Scale. Results: Patients completed training sessions with high rates of safety and adherence. After training, there was a significant improvement in postural control, motor function, and QoL. Conclusion: Both interventions proved to be safe, applicable, and effective to improve postural control, QoL, and motor function in patients with PD. However, there was no difference between the effects of Kinect Adventures games and conventional physiotherapeutic protocol in patients with PD. Brazilian Registry of Clinical Trials (RBR-27kqv5).
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Affiliation(s)
- Keyte Guedes Da Silva
- Department of Physiotherapy, Speech and Occupational Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Rosemeyre Alcarde Nuvolini
- Department of Physiotherapy, Speech and Occupational Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Jéssica Maria Ribeiro Bacha
- Department of Physiotherapy, Speech and Occupational Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Tatiana Beline De Freitas
- Motor Behavior Laboratory, Department of Biodynamics of Human Body Movement, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Flávia Doná
- Department of Sciences of the Human Movement and Rehabilitation, Federal University of São Paulo, São Paulo, Brazil
| | - Camila Torriani-Pasin
- Motor Behavior Laboratory, Department of Biodynamics of Human Body Movement, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - José Eduardo Pompeu
- Department of Physiotherapy, Speech and Occupational Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
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Lathouwers E, Ampe T, Díaz MA, Meeusen R, De Pauw K. Evaluation of an articulated passive ankle-foot prosthesis. Biomed Eng Online 2022; 21:28. [PMID: 35477464 DOI: 10.1186/s12938-022-00997-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 04/08/2022] [Indexed: 11/17/2022] Open
Abstract
Background Current ankle prostheses for people with unilateral transtibial amputation (TTA) or transfemoral amputation (TFA) are unable to mimic able-bodied performance during daily activities. A new mechanical ankle–foot prosthesis was developed to further optimise the gait of people with a lower-limb amputation. This study aimed to evaluate the Talaris Demonstrator (TD) during daily activities by means of performance-related, physiological and subjective outcome measures. Materials and methods Forty-two participants completed a protocol assessing performance and functional mobility with their current prosthesis and the TD. The protocol comprised the L-test, 2 min of stair climbing, 2 min of inclined treadmill walking, 6 min of treadmill walking at 3 different speeds in consecutive blocks of 2 min, and a 3-m Backward Walk test (3mBWT). Heart rate was measured during each task, and oxygen uptake was collected during all tasks except for the L-test and 3mBWT. Time of execution was recorded on the L-test and 3mBWT, and the rate of perceived exertion (score = 6–20), fatigue and comfort (score = 0–100) were assessed after each task. Paired sample t-tests and Wilcoxon Signed-rank tests were performed to compare outcomes between prosthetic devices. Benjamini–Hochberg corrections were applied to control for multiple comparisons with a level of significance set at α = 0.05. Results Subjects with a TTA (N = 28) were faster with their current prosthesis compared to the TD on the L-test and 3mBWT (p = 0.005). In participants with a TFA (N = 14), we observed a tendency towards a higher heart rate during the L-test and towards increased comfort during inclined walking, with the TD compared to the participants’ current prosthetic device (0.05 < p < 0.10). Further, no significant results were observed. Conclusion The Talaris Demonstrator is a novel state-of-the-art passive ankle–foot prosthesis for both people with a TTA and TFA. Subjective measures indicate the added value of this device, while overall task performance and intensity of effort do not differ between the Talaris Demonstrator and the current prosthesis. Further investigations unravelling both acute and more prolonged adaptations will be conducted to evaluate the TD more thoroughly.
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20
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Melo LM, Ansai JH, Ferreira ACVG, Silva DCP, Vale FAC, Takahashi ACM, Andrade LP. Correlation between changes in Timed Up and Go performance and cognition in older people with mild cognitive impairment: A longitudinal study. Clin Biomech (Bristol, Avon) 2022; 94:105620. [PMID: 35325714 DOI: 10.1016/j.clinbiomech.2022.105620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 02/05/2022] [Accepted: 03/08/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Compare changes in performance on subtasks of the Timed Up and Go test over 32 months in older adults with and without mild cognitive impairment; analyze the correlation between frontal cognitive functions at baseline and changes in Timed Up and Go subtasks over time. METHODS A longitudinal study was conducted involving 31 older adults (15 with and 16 without cognitive impairment). Functional mobility was assessed at both evaluations using an adapted version of the Timed Up and Go test and the Qualisys motion system. The test was divided into five subtasks: sit-to-stand, walking forward, turn-to-walk, walking back and turn-to-sit. Cognition was assessed at baseline using the Frontal Assessment Battery and the Clock Drawing Test. FINDINGS Significant differences in changes in the sit-to-stand subtask over time were found between groups. The difference in the time required to conclude this subtask was greater in the older adults with cognitive impairment. However, the difference in kinematic variables (peak trunk speed and range of motion) was greater in the group without cognitive impairment. Strong and moderate correlations were found between frontal cognitive functions and changes in Timed Up and Go subtasks, especially those involving transitions (sit-to-stand, turn-to-walk and turn-to-sit) in both groups. INTERPRETATION Motor intervention protocols should incorporate the sit-to-stand subtask in older adults with mild cognitive impairment. Moreover, changes in more complex subtasks seem to be related to frontal cognitive performance at baseline. Therefore, treatments that combine motor and cognitive functions should be administered to older adults regardless of cognitive impairment.
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Affiliation(s)
- Laura M Melo
- Postgraduate Program in Physical Therapy, Physical Therapy Department, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Juliana H Ansai
- Postgraduate Program in Gerontology, Gerontology Department, Federal University of São Carlos, São Carlos, São Paulo, Brazil; Gerontology Department, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Ana C V G Ferreira
- Postgraduate Program in Physical Therapy, Physical Therapy Department, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Danielle C P Silva
- Postgraduate Program in Physical Therapy, Physical Therapy Department, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Francisco A C Vale
- Department of Medicine, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Anielle C M Takahashi
- Postgraduate Program in Physical Therapy, Physical Therapy Department, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Larissa P Andrade
- Postgraduate Program in Physical Therapy, Physical Therapy Department, Federal University of São Carlos, São Carlos, São Paulo, Brazil.
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21
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Zhang W, Low LF, Gwynn JD, Beveridge AH, Harper E, Mills N, Clemson L. A Safe Mobilisation Program to Improve Functional Mobility and Reduce Fall Risks in Cognitively Impaired Older Adults with Higher Level Gait Disorders: A Pilot Study. Dement Geriatr Cogn Disord 2021; 50:364-371. [PMID: 34569524 DOI: 10.1159/000519055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 08/15/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The association between gait and cognition, and their combined impact on postural stability may underlie the increased fall risk in older adults with dementia. However, there are few interventions to improve functional mobility and reduce fall risks in people with cognitive impairment. OBJECTIVES This study aims to investigate the feasibility and acceptability of a Safe Mobilisation Program for cognitively impaired older adults with higher level gait disorders. It also explores the potential effectiveness of the program on mobility and fall risks. METHODS Fifteen community-dwelling older adults participated in a 3-week pre-post intervention study. They were trained to take steady steps in transfers and mobilization using errorless learning and spaced retrieval teaching techniques. RESULTS The intervention program was feasible, all the participants completed the program and were able to mobilize safely. The program was acceptable and participants reported an increase in safety awareness, improvement in confidence while transferring and mobilising, and better quality of life. There was a trend of improvement in Falls Efficacy Scale-international (FES-I), 360° turn and Tinetti Performance Oriented Mobility Assessment (POMA), which may indicate improvement in balance and mobility. CONCLUSION The Safe Mobilisation Program was feasible and acceptable in older adults with cognitive impairment and gait disorders and warrants further evaluation.
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Affiliation(s)
- Weihong Zhang
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Department of Occupational Therapy, Wolper Jewish Hospital, Sydney, New South Wales, Australia
| | - Lee-Fay Low
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Josephine Diana Gwynn
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Alexander Harry Beveridge
- Department of Geriatric Medicine, St Vincent's Hospital, Sydney, New South Wales, Australia.,Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.,School of Medicine, University of Notre Dame, Sydney, New South Wales, Australia
| | - Elizabeth Harper
- Department of Geriatric Medicine, St Vincent's Hospital, Sydney, New South Wales, Australia
| | - Nicholas Mills
- Department of Geriatric Medicine, St Vincent's Hospital, Sydney, New South Wales, Australia.,Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Lindy Clemson
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
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22
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Aras B, Seyyar GK, Fidan O, Colak E. The effect of Tai Chi on functional mobility, balance and falls in Parkinson's disease: A systematic review and meta-analysis of systematic reviews. Explore (NY) 2021; 18:402-410. [PMID: 34952799 DOI: 10.1016/j.explore.2021.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 11/10/2021] [Accepted: 12/04/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND The aim of the study was to evaluate the effect of Tai Chi on functional mobility, balance and falls in Parkinson's disease. MATERIALS AND METHODS A comprehensive literature search was conducted to identify the systematic reviews and meta-analyses up to the end of October 2021. 601 studies were identified, and 16 of them were included in our study. RESULTS According to our meta-analysis; there was a significant effect of Tai Chi on balance (SMD, -0.777 95% CI -0.921 to -0.633; p = 0.000), functional mobility (SMD, -0.719 95% CI -0.944 to -0.494; p = 0.000), and falls (SMD, -0.456 95% CI -0.668 to -0.245; p = 0.000) in PD. CONCLUSION Our systematic review and meta-analysis found significant effects of Tai Chi on functional mobility, balance and falls in patients with PD.
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Affiliation(s)
- Bahar Aras
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Kutahya Health Sciences University, Kutahya, Turkey.
| | - Gulce Kallem Seyyar
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Kutahya Health Sciences University, Kutahya, Turkey
| | - Oznur Fidan
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Osmangazi University, Eskisehir, Turkey
| | - Ertugrul Colak
- Faculty of Medicine, Department of Biostatistics, Osmangazi University, Eskisehir, Turkey
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23
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Ebrahimzadeh M, Nakhostin Ansari N, Hasson S, Shariat A, Afzali SA. Effect of functional electrical stimulation combined with stationary cycling and sit to stand training on mobility and balance performance in a patient with traumatic brain injury: A case report. Ann Med Surg (Lond) 2021; 72:103122. [PMID: 34925819 PMCID: PMC8649209 DOI: 10.1016/j.amsu.2021.103122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/24/2021] [Accepted: 11/30/2021] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE This case study investigates the effects of functional electrical stimulation, stationary cycling, and sit-to-stand training in a patient with severe chronic traumatic brain injury. CASE PRESENTATION The participant was a 24-year-old man with a traumatic brain injury two years prior to the intervention described in this case report. The accident caused right hemiplegia, right foot drop, aphasia, and poor coordination of movement in both upper and lower limbs. He was using a wheeled walker for functional mobility and was receiving routine rehabilitation before the initiation of treatment. A four week intervention in this study included functional electrical stimulation of the quadriceps and tibialis anterior muscles combined with stationary cycling and sit-to-stand training. CLINICAL DISCUSSION Active and passive range of motion of right ankle dorsiflexion, strength of ankle dorsiflexor, balance performance, and mobility were measured before and after the intervention. Active range of motion of right ankle dorsiflexion increased by 8°. In addition, manual muscle test and Brief-BESTest scores increased from 3+ to 5 and from 7 to 9, respectively. Walking speed over the 10-m distance and timed up and go test score improved. CONCLUSION Functional electrical stimulation combined with stationary cycling and sit-to-stand training resulted in increased muscle strength and range of motion, improved balance performance, and improved mobility in an individual with a traumatic brain injury.
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Affiliation(s)
- Masoome Ebrahimzadeh
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Corresponding author.
| | - Noureddin Nakhostin Ansari
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for War-affected People, Tehran University of Medical Sciences, Tehran, Iran
| | - Scott Hasson
- Department of Physical Therapy, Augusta University, Augusta, GA, USA
| | - Ardalan Shariat
- Research Center for War-affected People, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Ahmad Afzali
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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24
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de Moura JA, Chowdhury TI, Leal JC, Pimentel Piemonte ME, Kopczynski MC, Quarles JP, Dos Santos Mendes FA. Virtual functional mobility test: A potential novel tool for assessing mobility of individuals with Parkinson's disease in a multitask condition. J Clin Neurosci 2021; 93:17-22. [PMID: 34656243 DOI: 10.1016/j.jocn.2021.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 07/20/2021] [Accepted: 08/15/2021] [Indexed: 10/20/2022]
Abstract
There are few instruments available for evaluating functional mobility during multitasking in people with Parkinson's Disease (PD). Virtual Reality is a potentially tool capable of aiding in the evaluation of functional mobility. The purpose of this study is to verify the potential of the Virtual Functional Mobility Test (VFMT) as a clinical tool to assess functional mobility of people with PD during multitasking condition. 25 people with PD and 25 people without PD, matched for age and sex, were recruited. Participants were evaluated through the Trail Making Test, Timed "UP and GO" test, Timed "UP and GO" test in dual task condition and through the VFMT, composed of 1) a simple task, and 2) a complex task. The VFMT and clinical tests were sensitive to differentiate the groups, except the trail making test part B (p = 0.332) and complex task (p = 0.052). Strong correlations were observed between parts A and B of the trail making test (r = 0.75) and complex task (r = 0.72); Moderate correlations between Timed Up and Go test and Timed Up and Go test in dual task condition with simple task (r = 0.47) and complex task (r = 0.55), respectively, were found. The complex task and simple task showed excellent and moderate reliability intra-rater, respectively. It was concluded that the novel VFMT is feasible, sensible, reliable and has potential as an instrument for the evaluation of functional mobility during multitasking in people with PD.
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Affiliation(s)
- Júlia Araújo de Moura
- Graduate Program in Rehabilitation Sciences, Faculty of Ceilândia, University of Brasilia, Brazil
| | | | | | - Maria Elisa Pimentel Piemonte
- Fonoaudiology, Physiotherapy and Occupational Therapy Department, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
| | | | - John P Quarles
- Department of Computer Science, University of Texas at San Antonio, San Antonio, TX, USA.
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25
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Lessard I, St-Gelais R, Hébert LJ, Côté I, Mathieu J, Brais B, Gagnon C. Functional mobility in walking adult population with ataxia of Charlevoix-Saguenay. Orphanet J Rare Dis 2021; 16:432. [PMID: 34649570 PMCID: PMC8515729 DOI: 10.1186/s13023-021-02054-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 09/19/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND This study aimed to describe lower limbs impairments, balance and activity limitations related to indoor mobility in adult walkers with autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS). RESULTS Twenty-five participants were recruited with a mean age of 32.2 (± 10.4) years with 45.7% using a walking aid. There is a significant difference between participants with and without a walking aid in terms of lower limbs coordination, balance and mobility. Although participants who walk without a walking aid perform better than the others and they are below predictive or reference values. Despite significant mobility limitations, only mild spasticity and passive range of motion limitations were observed. However, there is a significant difference between unaffected individuals and participants with ARSACS for lower limb muscle cocontraction. CONCLUSIONS Results show a high level of lower limb impairments, balance and mobility limitation in adults' participants with ARSACS that are still walking, including people not using a walking aid. One of the most original finding is the presence of excessive cocontraction and a relatively mild level of spasticity in the lower limbs muscles. Results of this study better circumscribes the impairments and activities that should be the focus of intervention including rehabilitation in ARSACS.
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Affiliation(s)
- Isabelle Lessard
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean, site Jonquière, 2230 de l'Hôpital, C.P. 1200, Jonquière, QC, G7X 7X2, Canada
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Raphaël St-Gelais
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean, site Jonquière, 2230 de l'Hôpital, C.P. 1200, Jonquière, QC, G7X 7X2, Canada
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Luc J Hébert
- Départements de réadaptation et de Radiologie et médecine nucléaire, Faculté de médecine, Université Laval, Quebec, QC, Canada
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), Institut de réadaptation en déficience physique de Québec, Quebec, QC, Canada
| | - Isabelle Côté
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean, site Jonquière, 2230 de l'Hôpital, C.P. 1200, Jonquière, QC, G7X 7X2, Canada
| | - Jean Mathieu
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean, site Jonquière, 2230 de l'Hôpital, C.P. 1200, Jonquière, QC, G7X 7X2, Canada
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Bernard Brais
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Cynthia Gagnon
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean, site Jonquière, 2230 de l'Hôpital, C.P. 1200, Jonquière, QC, G7X 7X2, Canada.
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada.
- Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé, Université de Sherbrooke, Sherbrooke, QC, Canada.
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26
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Lightsey P, Lee Y, Krenek N, Hur P. Physical therapy treatments incorporating equine movement: a pilot study exploring interactions between children with cerebral palsy and the horse. J Neuroeng Rehabil 2021; 18:132. [PMID: 34488800 PMCID: PMC8422664 DOI: 10.1186/s12984-021-00929-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 08/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physical therapy treatments incorporating equine movement are recognized as an effective tool to treat functional mobility and balance in children with cerebral palsy (CP). To date, only a few studies examined kinematic outputs of the horses and children when mounted. In this pilot study, to better understand the effectiveness of this type of treatment, we examined the interaction between the horses and children with CP during physical therapy sessions where equine movement was utilized. METHODS Four children with CP participated in eight physical therapy sessions incorporating hippotherapy as a treatment intervention. Functional mobility was assessed using the Timed Up Go or the 10 m Walk Test. Inertial measurement unit sensors, attached to children and horses, recorded movements and tracked acceleration, angular velocity, and body orientation. Correlation between vertical accelerations of children and horses were analyzed. In addition, peak frequencies of vertical accelerations of children and horses were compared. RESULTS Functional tests modestly improved over time. The children's movements, (quantified in frequency and temporal domains) increasingly synchronized to the vertical movement of the horse's walk, demonstrated by reduced frequency errors and increased correlation. CONCLUSIONS The findings suggest that as the sessions progressed, the participants appeared to become more familiar with the horse's movement. Since the horse's gait at a walk mimics the human gait this type of treatment may provide individuals with CP, who have abnormal gait patterns, an opportunity for their neuromuscular system to experience a typical gait pattern. The horse's movement at the walk are consistent, cyclical, rhythmical, reciprocal and multi-dimensional, all of which can facilitate motor learning. The increased synchronization between horse and the mounted participant suggests that physical therapy utilizing equine movement is a viable treatment tool to enhance functional mobility. This study may provide a useful baseline for future work. Trial registrationTexas A&M University Institutional Review Board. IRB2018-0064. Registered 8 March 2018. Link: https://rcb.tamu.edu/humans/irb and https://github.com/pilwonhur/HPOT.
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Affiliation(s)
| | - Yonghee Lee
- Department of Mechanical Engineering, Texas A&M University, TAMU, College Station, TX, 77843, USA
| | - Nancy Krenek
- Ride On Center for Kids (ROCK), Rockride Ln, Georgetown, TX, 78626, USA
| | - Pilwon Hur
- Department of Mechanical Engineering, Texas A&M University, TAMU, College Station, TX, 77843, USA. .,School of Mechanical Engineering, Gwangju Institute of Science and Technology, Cheomdangwagi-ro, Gwangju, 61005, South Korea.
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27
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Suárez-Iglesias D, Bidaurrazaga-Letona I, Sanchez-Lastra MA, Gil SM, Ayán C. Effectiveness of equine-assisted therapies for improving health outcomes in people with multiple sclerosis: A systematic review and meta-analysis. Mult Scler Relat Disord 2021; 55:103161. [PMID: 34329873 DOI: 10.1016/j.msard.2021.103161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 06/28/2021] [Accepted: 07/19/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Scientific evidence has shown that equine-assisted therapies (EAT) lead to improvements in the physical function and the quality of life (QoL) of people with disabilities through the practice of hippotherapy or therapeutic riding (TR). There is a need to confirm whether people with multiple sclerosis (PwMS) can also benefit from its practice. This review aimed to systematically evaluate and meta-analyze the available data on the potential health benefits of EAT in PwMS. METHODS Four electronic databases (MEDLINE/PubMed, Web of Science, SPORTDiscus, and Scopus) were searched systematically from their inception until June 2021 for randomized controlled trials (RCTs) and comparative studies that provided information regarding the effects of EAT on PwMS. The studies' methodological quality assessment was performed using the PEDro and the MINORS scales. For the meta-analysis, heterogeneity across studies was quantified using the I2 statistic. Fixed-effect or random-effects models were applied to obtain the pooled results in the case of low (I2 < 30%) or high (I2 > 30%) heterogeneity values, respectively. Standardized mean differences (SMD) and 95% confidence intervals (CIs) were calculated to assess the change in each outcome. RESULTS After removing duplicated studies, 234 results were retrieved by the literature search and 11 were eligible for full text search. Finally, 9 studies with a methodological quality ranging from good to low quality met the inclusion criteria. Six of them focused on hippotherapy and 4 of them were included in the quantitative analysis. Totally, 225 PwMS patients were evaluated. Findings from the meta-analysis indicated that this therapy improved static (SMD = 0.42; 95% CI: 0.05, 0.78) but not dynamic balance (SMD = 0.51; 95% CI: -0.04, 1.06), while significant benefits were observed on the patients' QoL (SMD = 0.37; 95% CI: 0.00, 0.73). Hippotherapy showed effectiveness for reducing self-perceived fatigue (SMD = 0.70; 95% CI: 0.33, 1.07), while TR showed mixed effects on balance and QoL. CONCLUSION The actual evidence on the effectiveness of EAT in PwMS is mainly limited to hippotherapy. This rehabilitation approach seems to have beneficial effects on static balance, QoL and fatigue, but not directly on gait and dynamic balance. Altogether, the findings suggest that hippotherapy could be incorporated as a complementary therapy when developing comprehensive care plans for PwMS.
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Affiliation(s)
- David Suárez-Iglesias
- VALFIS Research Group, Institute of Biomedicine (IBIOMED), Faculty of Physical Activity and Sports Sciences, University of León, Campus de Vegazana, s/n, León 24071, Spain
| | - Iraia Bidaurrazaga-Letona
- AgeingOn Research Group, Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, Leioa, Bizkaia E-48940, Spain.
| | - Miguel A Sanchez-Lastra
- Universidade de Vigo, Departamento de Didácticas Especiais, Facultade de Ciencias da Educación e do Deporte, Pontevedra 36005, Spain.
| | - Susana María Gil
- AgeingOn Research Group, Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, Leioa, Bizkaia E-48940, Spain.
| | - Carlos Ayán
- Universidade de Vigo, Departamento de Didácticas Especiais, Facultade de Ciencias da Educación e do Deporte, Pontevedra 36005, Spain; WellMove Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Spain.
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28
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Nemoto Y, Sakurai R, Ogawa S, Maruo K, Fujiwara Y. Effects of an unsupervised Nordic walking intervention on cognitive and physical function among older women engaging in volunteer activity. J Exerc Sci Fit 2021; 19:209-215. [PMID: 34306117 PMCID: PMC8281374 DOI: 10.1016/j.jesf.2021.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 06/27/2021] [Accepted: 06/29/2021] [Indexed: 02/01/2023] Open
Abstract
Background Nordic walking (NW) has been reported as a safe and effective exercise mode. However, the effects of NW on cognitive function are unknown. This study examined the effects of an unsupervised NW intervention on cognitive and physical function among older women engaging in volunteering. Methods Forty-seven women aged ≥70 years were enrolled and assigned into three groups (NW (n = 16); walking (n = 19); control group (n = 12)) based on residential areas. Participants in NW and walking groups received a pedometer and recorded daily step counts. The NW group received poles and 2 h of NW instruction. Participants were encouraged to perform the exercise individually more than once a week during the 3-month intervention. As baseline and follow-up assessments, cognitive function (Montreal Cognitive Assessment [MoCA-J] and Trail Making Test), physical function (handgrip strength, walking speed, balance ability, the Timed Up and Go test, and functional capacity), and objective physical activity were evaluated. Results In the NW group, physical activity, maximal walking speed, and MoCA-J scores were improved during the intervention period. In the walking group, physical activity was increased after the intervention. Analysis of covariance showed that maximal walking speed among the NW group significantly improved compared with the walking group. Sub-group analysis of participants who exercised more than once a week showed that handgrip strength, gait speed, and MoCA-J scores were significantly improved in the NW compared with the walking group. Conclusion NW intervention improved cognitive and physical function compared with simple walking among older women.
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Affiliation(s)
- Yuta Nemoto
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi, Tokyo, 173-0015, Japan
| | - Ryota Sakurai
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi, Tokyo, 173-0015, Japan
| | - Susumu Ogawa
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi, Tokyo, 173-0015, Japan
| | - Kazushi Maruo
- Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba Ibaraki, 305-8575, Japan
| | - Yoshinori Fujiwara
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi, Tokyo, 173-0015, Japan
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29
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Mulas I, Putzu V, Asoni G, Viale D, Mameli I, Pau M. Clinical assessment of gait and functional mobility in Italian healthy and cognitively impaired older persons using wearable inertial sensors. Aging Clin Exp Res 2021; 33:1853-1864. [PMID: 32978750 PMCID: PMC7518096 DOI: 10.1007/s40520-020-01715-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/09/2020] [Indexed: 12/14/2022]
Abstract
AIM The main purpose of the present study was to verify the feasibility of wearable inertial sensors (IMUs) in a clinical setting to screen gait and functional mobility in Italian older persons. In particular, we intended to verify the capability of IMUs to discriminate individuals with and without cognitive impairments and assess the existence of significant correlations between mobility parameters extracted by processing trunk accelerations and cognitive status. METHODS This is a cross-sectional study performed on 213 adults aged over 65 years (mean age 77.0 ± 5.4; 62% female) who underwent cognitive assessment (through Addenbrooke's Cognitive Examination Revised, ACE-R) instrumental gait analysis and the Timed Up and Go (TUG) test carried out using a wearable IMU located in the lower back. RESULTS Individuals with cognitive impairments exhibit a peculiar gait pattern, characterized by significant reduction of speed (- 34% vs. healthy individuals), stride length (- 28%), cadence (- 9%), and increase in double support duration (+ 11%). Slight, but significant changes in stance and swing phase duration were also detected. Poorer performances in presence of cognitive impairment were observed in terms of functional mobility as overall and sub-phase TUG times resulted significantly higher with respect to healthy individuals (overall time, + 38%, sub-phases times ranging from + 22 to + 34%), although with some difference associated with age. The severity of mobility alterations was found moderately to strongly correlated with the ACE-R score (Spearman's rho = 0.58 vs. gait speed, 0.54 vs. stride length, 0.66 vs. overall TUG time). CONCLUSION The findings obtained in the present study suggest that wearable IMUs appear to be an effective solution for the clinical assessment of mobility parameters of older persons screened for cognitive impairments within a clinical setting. They may represent a useful tool for the clinician in verifying the effectiveness of interventions to alleviate the impact of mobility limitations on daily life in cognitively impaired individuals.
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Affiliation(s)
- Ilaria Mulas
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Piazza d'Armi, 09123, Cagliari, Italy
| | - Valeria Putzu
- Center for Cognitive Disorders and Dementia, Geriatric Unit SS. Trinità Hospital, Via Romagna 16, 09127, Cagliari, Italy
| | - Gesuina Asoni
- Center for Cognitive Disorders and Dementia, Geriatric Unit SS. Trinità Hospital, Via Romagna 16, 09127, Cagliari, Italy
| | - Daniela Viale
- Center for Cognitive Disorders and Dementia, Geriatric Unit SS. Trinità Hospital, Via Romagna 16, 09127, Cagliari, Italy
| | - Irene Mameli
- Center for Cognitive Disorders and Dementia, Geriatric Unit SS. Trinità Hospital, Via Romagna 16, 09127, Cagliari, Italy
| | - Massimiliano Pau
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Piazza d'Armi, 09123, Cagliari, Italy.
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Abualait TS, Alnajdi GK. Effects of using assistive devices on the components of the modified instrumented timed up and go test in healthy subjects. Heliyon 2021; 7:e06940. [PMID: 34007923 DOI: 10.1016/j.heliyon.2021.e06940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 04/13/2021] [Accepted: 04/23/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction Evaluation of the changes in gait spatiotemporal parameters and functional mobility with using assistive devices (ADs) would provide useful information and mutual assistance when prescribing such ambulatory devices. This study aimed to investigate the spatiotemporal gait and functional mobility parameters in healthy adults when walking using different ADs. Methods A group of healthy subjects participated in the study. The instrumented modified Timed Up and Go test (iTUG) was used to investigate the impact of different types of ADs on spatiotemporal and functional mobility parameters. Results Subjects showed a significant difference in the gait task performance (P = .001) in stride velocity, stride length, and cadence when walking with and without ADs. A significant difference was also found in the performance of the turn-to-sit task (P = .001) in both velocity and duration when walking with and without ADs. The time to complete sit-to-stand was significantly slower when using a walker (98.3 ± 22.3°/sec, P = .004) and a cane (78.2 ± 21.9°/sec, P = .004) compared to walking without an AD (78.2 ± 21.8°/sec). No significant difference was found between walking with a cane group versus walking with a four-wheeled walker group (P = .94). Conclusion ADs altered gait and functional mobility parameters differently in healthy subjects. Using a four-wheeled walker showed a tendency to increase stride velocity, cadence, stride length, and slow sit-to-stand velocity compared to using a cane. The findings highlight using more caution clinically when prescribing ADs and providing gait training.
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Özkal Ö, Kısmet K, Konan A, Hayran M, Topuz S. Treadmill versus overground gait training in patients with lower limb burn injury: A matched control study. Burns 2021:S0305-4179(21)00108-X. [PMID: 34154896 DOI: 10.1016/j.burns.2021.04.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 03/27/2021] [Accepted: 04/18/2021] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Gait impairment is commonly seen in patients with a lower limb burn injury (LLBI). Therefore, the aim of this study was to investigate the effects of two different gait training modes on gait symmetry, functional mobility and kinesiophobia in patients with LLBI. METHODS This matched control study was conducted between January 2017 and August 2018. Patients with LLBI (n=28) were allocated to 2 different groups by matching according to burn localization, age, and gender. Group 1 (overground group: n=14) received overground gait training in addition to standard burn rehabilitation, and Group 2 (treadmill group: n=14) received treadmill gait training in addition to standard burn rehabilitation. The rehabilitation program and gait training were started when the patient was admitted to the hospital and ended on discharge. These physical therapy interventions were performed 5 days per week. The gait training intensity, including walking speed and duration, was determined according to patient tolerance. Gait parameters, functional mobility, kinesiophobia and pain values were evaluated with GAITRite, the timed up-and-go test (TUG), Tampa Kinesiophobia Scale and Visual Analogue Scale, respectively. These evaluations were made twice; on admission and immediately prior to discharge. Gait symmetry was calculated using the Symmetry Index. RESULTS The baseline characteristics of the groups and initial outcome values were similar. In the comparison of the differences between the overground and treadmill groups, the change in kinesiophobia and TUG values were significantly higher in the treadmill group (p=0.01, p=0.02, respectively). The intragroup comparisons showed significant differences in SI in respect of step length (p=0.004), swing (p=0.006), stance (p=0.008) and velocity (p=0.001), cadence (p=0.001), TUG (p=0.001), kinesiophobia (p=0.001) and pain (p=0.001) in the overground group. Statistically significant differences were determined in step length (p=0.01), swing (p=0.01), stance (p=0.02) and velocity (p=0.001), cadence (p=0.001), TUG (p=0.001), kinesiophobia (p=0.001) and pain (p=0.001) in the treadmill group, when pre and post-training values were compared. CONCLUSIONS The results of this study have shown that treadmill gait training was more effective in the improvement of functional mobility and reduction in kinesiophobia levels of patients with LLBI compared to overground gait training. Both overground and treadmill gait training also provide greater improvements in the velocity and cadence, and gait symmetry for step length, swing and stance in patients with LLBI. CLINICAL TRIAL REGISTRATION NUMBER NCT03217526.
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Moraes AG, Neri SGR, Motl RW, Tauil CB, von Glehn F, Corrêa ÉC, de David AC. Effects of hippotherapy on postural balance, functional mobility, self-perceived fatigue, and quality of life in people with relapsing-remitting multiple sclerosis: Secondary results of an exploratory clinical trial. Mult Scler Relat Disord 2021; 52:102948. [PMID: 33940496 DOI: 10.1016/j.msard.2021.102948] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 03/11/2021] [Accepted: 04/07/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) results in worsening of postural balance, functional mobility, and self-perceived fatigue as influences of quality of life. OBJECTIVE To examine the effects of hippotherapy on postural balance, functional mobility, self-perceived fatigue, and quality of life in people with MS. METHODS Participants were assigned into a hippotherapy intervention group (n= 17) or a control group (n= 16). The intervention included 16 sessions of 30-minutes of hippotherapy conducted twice a week whereas the control group was maintained their therapeutic routine. Postural balance was evaluated as CoP speed (cm/s) and CoP 95% elliptical area (cm2) using a force platform under 4 experimental conditions: stable surface/ eyes open, stable surface/ eyes closed, foam surface/ eyes open, and foam surface/ eyes closed. Functional mobility was evaluated by the Timed Up and Go (TUG) test. The Fatigue Severity Scale (FSS) and Modified Fatigue Impact Scale (MFIS) measured perceived fatigue, and the Functional Assessment of Multiple Sclerosis (FAMS) measured quality of life. The data were examined using mixed model ANOVA with Bonferroni post hoc. RESULTS CoP speed and CoP 95% elliptical area (p < .05) significantly decreased across all testing conditions for the intervention group compared with control. The TUG improved over time in the intervention group (p = .001) as did the FSS (p < .001). In addition, there was also an improvement for the score and all the MFIS domains (p < .005) for the intervention group compared with control and for FAMS improved over time in the intervention group (p < .05). CONCLUSION Hippotherapy improved postural balance, functional mobility, fatigue, and quality of life in people with relapsing-remitting MS. This suggests that hippotherapy may be a useful approach for complimentary treatment among people with MS.
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Bell M, Schein RM, Straatmann J, Dicianno BE, Schmeler MR. Functional Mobility Outcomes in Telehealth and In-Person Assessments for Wheeled Mobility Devices. Int J Telerehabil 2020; 12:27-34. [PMID: 33520092 PMCID: PMC7757644 DOI: 10.5195/ijt.2020.6335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The purpose of this study was to compare telehealth and in-person service delivery models for wheeled mobility devices in terms of functional outcomes. We hypothesized that clinically significant improvements in functional mobility measured by the Functional Mobility Assessment (FMA) will occur in individuals receiving both telehealth and in-person clinic evaluations. A total of 27 Veterans receiving telehealth visits were compared to 27 individuals seen in clinic, selected from a database, matching for age, gender, and primary diagnosis. All mean individual item and total FMA scores in both groups increased from Time 1 to Time 2. Within the telehealth group, all changes in individual item and total FMA scores were statistically significant, with changes in 8 of 10 items meeting threshold for clinical significance (change >1.85 points). Within the clinic group, changes in 7 of 10 individual items and total FMA scores were statistically significant, and these same 7 items met threshold for clinical significance. Change scores for individual item and total FMA scores did not differ significantly between the two groups. A larger and clinically significant change in transfer score was seen in the telehealth group, suggesting telehealth visits may confer an advantage in being able to assess and address transfer issues in the home.
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Affiliation(s)
- Mitchell Bell
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Richard M. Schein
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Joseph Straatmann
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Brad E. Dicianno
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Mark R. Schmeler
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Barbado D, Gomez-Illan R, Moreno-Navarro P, Valero-Conesa G, Reina R, Vera-Garcia FJ. Postural control quantification in minimally and moderately impaired persons with multiple sclerosis: The reliability of a posturographic test and its relationships with functional ability. J Sport Health Sci 2020; 9:677-684. [PMID: 33308819 PMCID: PMC7749221 DOI: 10.1016/j.jshs.2018.06.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 04/25/2018] [Accepted: 06/29/2018] [Indexed: 06/12/2023]
Abstract
BACKGROUND Postural control has been associated with the functional impairment in persons with multiple sclerosis (pwMS). However, there is a need for reliable methods to assess postural control in early stages of the disease, when subtle changes can be difficult to detect. The aims of this study were to assess the absolute and relative reliability of a standing and a sitting posturographic protocol in minimally (Expanded Disability Status Scale ≤ 2) and moderately (2.5 ≤ Expanded Disability Status Scale ≤ 4) impaired pwMS, and to analyze relationships among postural control and functional mobility and gait performance. METHODS To assess postural control in an upright stance, 14 minimally and 16 moderately impaired pwMS performed six 70 s trials in tandem stance, 3 with their weaker leg behind (TSWL) and 3 with their stronger leg behind (TSSL). Additionally, participants completed five 70 s trials using an unstable sitting protocol (US) to assess trunk stability. The mean radial errors of TSWL, TSSL, and US trials were calculated as postural control indexes. Furthermore, participants performed the Timed Up and Go test (TUG) and the Timed 25-foot Walk test (T25FW) to measure their functional mobility and gait speed, respectively. Reliability was evaluated using the intraclass correlation coefficient (ICC3,1) and the standard error of measurement (SEM). Analyses of variances were carried out to assess between-group differences. Hedges' g index (dg) was used to estimate the effect size of differences. Pearson correlation analyses (r) were performed to examine the relationships among the postural control and the functional tests. RESULTS Posturographic tests showed a high reliability in both minimally (0.87 ≤ ICC ≤ 0.92; 9.32% ≤ SEM ≤ 11.76%) and moderately (0.80 ≤ ICC ≤ 0.92; 10.33% ≤ SEM ≤ 15.33%) impaired pwMS. Similarly, T25FW and TUG displayed a high consistency in minimally (0.89 ≤ ICC ≤ 0.94; 3.43% ≤ SEM ≤ 5.17%) and moderately (0.85 ≤ ICC ≤ 0.93; 5.57% ≤ SEM ≤ 6.56%) impaired individuals. Minimally impaired pwMS showed a better performance on the TUG, T25FW, and TSWL than moderately impaired individuals (p < 0.05; dg ≥ 0.8). The TSWL, TSSL, and US variables correlated with TUG scores (0.419 ≤ r ≤ 0.604; p < 0.05), but TSWL also correlated with T25FW scores (r = 0.53; p < 0.01). Furthermore, US scores correlated with both tandem stance parameters (TSWL: r = 0.54, p < 0.01; TSSL: r = 0.43, p < 0.05). CONCLUSION Tandem and sitting posturographic tests provide reliable measures of postural control in pwMS, even in individuals with a homogeneous disease profile. Gait speed, functional mobility, and weaker leg status seem decisive in assessing the degree of physical activity limitation in pwMS. Finally, although trunk stability does not seem to be so affected by the course of the disease, it remains relevant for postural control and functional capacity.
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Affiliation(s)
- David Barbado
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, Elche (Alicante) 03202, Spain
| | - Ramon Gomez-Illan
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, Elche (Alicante) 03202, Spain
| | - Pedro Moreno-Navarro
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, Elche (Alicante) 03202, Spain
| | - Gregori Valero-Conesa
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, Elche (Alicante) 03202, Spain
| | - Raul Reina
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, Elche (Alicante) 03202, Spain
| | - Francisco J Vera-Garcia
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, Elche (Alicante) 03202, Spain.
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Nuñez Filha MC, Mascarenhas L, Messias D, Furtado C, Dias C, Dantas MC, Almeida LRS, Pinto EB. Stroke Severity and Maximum Inspiratory Pressure are Independently Associated with Functional Mobility in Individuals After Stroke. J Stroke Cerebrovasc Dis 2020; 29:105375. [PMID: 33039768 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105375] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 09/12/2020] [Accepted: 09/27/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Clinical changes after stroke can contribute to reduced mobility and negatively affect the survival of these individuals. The objective of this study was to verify factors associated with functional mobility in stroke individuals. METHODS Crosssectional study carried out with stroke individuals in an outpatient clinic. Demographic and clinical data were collected and the following measures were applied: National Institute of Health Stroke Scale (NIHSS), modified Barthel Index, Trunk Impairment Scale, Functional Reach Test, Timed Up and Go Test, and the International Physical Activity Questionnaire. Respiratory muscle strength was assessed by measuring the maximum inspiratory pressure (MIP) and the maximum expiratory pressure (MEP).Variables with p < .05 in univariate logistic regression analysis were included in the multivariate logistic regression model, using the backward stepwise method. RESULTS 53 individuals were enrolled with a mean age of 55 years (±13.43). 51% were male and the median NIHSS score was 2.25 (0-13). The final multivariate model included NIHSS (OR = 1.872; 95% CI 1.167-3.006; p = 0.009), physical therapy treatment (OR = 15.467; 95% CI 1.838-130.178; p = 0.012) and MIP (OR = 1.078; 95% CI 1.024-1.135; p = 0.004). CONCLUSION Stroke severity and inspiratory muscle strength were factros associated with functional mobility in individuals after stroke, regardless stroke time.
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Özkal Ö, Seyyah M, Topuz S, Konan A. Lower limb functional status and its determinants in moderate/major burns 3-6 months following injury: A two-center observational study. Burns 2020; 47:676-683. [PMID: 32859438 DOI: 10.1016/j.burns.2020.07.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 07/28/2020] [Accepted: 07/30/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Severe complications which may cause impaired physical functionoften develops over time following severe burn to the lower extremities. The purpose of this study was to clarify the clinical determinants of lower limb functional status, functional mobility and exercise capacity in moderate/major burns 3-6 months following the injury. METHODS The study included 42 patients, 12 with moderate injury and 30 with major injury, aged 19-59 years old. Lower Limb Functional Index was used to determine the lower limb functional status. Functional mobility and exercise capacity were evaluated with the Timed Up and Go test and the 6-min walk test, respectively. Scar quality and kinesiophobia were assessed with the Patient and Observer Scar Assessment Scale (POSAS) and the Tampa Scale for Kinesiophobia, respectively. Active range of motion (ROM) was measured with a universal goniometer. RESULTS Significant and independent predictors of lower limb functional status, functional mobility and exercise capacity related to POSAS score, kinesiophobia level, gender, burn severity, the number of operations, the presence of burnsinvolving any of the lower limb joints, knee ROM limitations, limitation in any of the lower limb joint ROMs, comorbidities, and truncal burns (p < 0.05). CONCLUSIONS Burn characteristics and clinical evaluations of patients are important determinants of the lower limb functional status, mobility and exercise capacity in burn patients. These predictors should be considered to improve physical functions related to the lower limb when creating a personalized rehabilitation program.
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Affiliation(s)
- Özden Özkal
- Bursa Uludağ University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Bursa, Turkey.
| | - Mine Seyyah
- University of Health Sciences, Kartal Dr. Lütfi Kırdar Education and Research Hospital, Burn and Wound Treatment Department, İstanbul, Turkey
| | - Semra Topuz
- Hacettepe University, Faculty of Physcial Therapy and Rehabilitation, Ankara, Turkey
| | - Ali Konan
- Hacettepe University, School of Medicine, Department of General Surgery, Ankara, Turkey
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Bårdstu HB, Andersen V, Fimland MS, Aasdahl L, Raastad T, Cumming KT, Sæterbakken AH. Effectiveness of a resistance training program on physical function, muscle strength, and body composition in community-dwelling older adults receiving home care: a cluster-randomized controlled trial. Eur Rev Aging Phys Act 2020; 17:11. [PMID: 32782626 PMCID: PMC7414534 DOI: 10.1186/s11556-020-00243-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/28/2020] [Indexed: 12/21/2022] Open
Abstract
Background Aging is associated with reduced muscle mass and strength leading to impaired physical function. Resistance training programs incorporated into older adults' real-life settings may have the potential to counteract these changes. We evaluated the effectiveness of 8 months resistance training using easily available, low cost equipment compared to physical activity counselling on physical function, muscle strength, and body composition in community-dwelling older adults receiving home care. Methods This open label, two-armed, parallel group, cluster randomized trial recruited older adults above 70 years (median age 86.0 (Interquartile range 80-90) years) receiving home care. Participants were randomized at cluster level to the resistance training group (RTG) or the control group (CG). The RTG trained twice a week while the CG were informed about the national recommendations for physical activity and received a motivational talk every 6th week. Outcomes were assessed at participant level at baseline, after four, and 8 months and included tests of physical function (chair rise, 8 ft-up-and-go, preferred- and maximal gait speed, and stair climb), maximal strength, rate of force development, and body composition. Results Twelve clusters were allocated to RTG (7 clusters, 60 participants) or CG (5 clusters, 44 participants). The number of participants analyzed was 56-64 (6-7 clusters) in RTG and 20-42 (5 clusters) in CG. After 8 months, multilevel linear mixed models showed that RTG improved in all tests of physical function and maximal leg strength (9-24%, p = 0.01-0.03) compared to CG. No effects were seen for rate of force development or body composition. Conclusion This study show that resistance training using easily available, low cost equipment is more effective than physical activity counselling for improving physical function and maximal strength in community-dwelling older adults receiving home care. Trial registration ISRCTN1067873.
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Affiliation(s)
- Hilde Bremseth Bårdstu
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, PB 133, 6851 Sogndal, Norway.,Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Vidar Andersen
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, PB 133, 6851 Sogndal, Norway
| | - Marius Steiro Fimland
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Unicare Helsefort Rehabilitation Centre, Rissa, Norway
| | - Lene Aasdahl
- Unicare Helsefort Rehabilitation Centre, Rissa, Norway.,Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Truls Raastad
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Kristoffer T Cumming
- Department of Sports, Physical Education and Outdoor Studies, Faculty of Humanities, Sports and Educational Science, University of South-Eastern Norway, Vestfold, Norway.,Faculty of Health and Welfare, Østfold University College, Fredrikstad, Norway
| | - Atle Hole Sæterbakken
- Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, PB 133, 6851 Sogndal, Norway
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Yenişehir S, Çıtak Karakaya İ, Sivaslıoğlu AA, Özen Oruk D, Karakaya MG. Reliability and validity of Five Times Sit to Stand Test in pregnancy-related pelvic girdle pain. Musculoskelet Sci Pract 2020; 48:102157. [PMID: 32560864 DOI: 10.1016/j.msksp.2020.102157] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 01/16/2020] [Accepted: 03/13/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Pelvic girdle pain (PGP) is a common musculoskeletal disorder during pregnancy, and functional mobility evaluation is very important in reflecting the treatment effects. OBJECTIVES To investigate reliability and validity of Five Times Sit-to-Stand (5TSS) test in pregnant women with and without PGP. DESIGN A cross-sectional observational study. METHODS One hundred sixty-seven women in the second or third trimester of pregnancy participated in two assessments one week apart. The 5TSS and Timed Up & Go (TUG) tests were used to assess functional mobility, in a randomized sequence, by two independent raters. Time to complete the tests were recorded. Perceived pain and difficulty during functional mobility tests were marked on two Visual Analogue Scales. Following tests of functional mobility, seven clinical tests were used to classify the subjects as with or without PGP. RESULTS The 25% of subjects had PGP. Inter-rater reliability of 5TSS was excellent for subjects with and without PGP (ICC = 0.999, 95% CI = 0.999-1.000; ICC = 0.999, 95% CI = 0.999-0.999, respectively). Test-retest reliability of 5TSS was also very high for subjects with and without PGP (ICC = 0.986, 95% CI = 0.959-0.995; ICC = 0.828, 95% CI = 0.632-0.920, respectively). The 5TSS scores were positively correlated with TUG scores (r = 0.420, p = 0.006 and r = 0.404, p = 0.000, respectively). The subjects reported higher pain (95% CI = 0.322-0.824) and difficulty (95%Cl = 0.500-1.042) during 5TSS than the TUG test. CONCLUSIONS The 5TSS test is a reliable and valid functional mobility outcome measure in pregnant women with and without PGP. Further psychometric properties of the measure such as responsiveness, should be investigated in the future.
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Affiliation(s)
- Semiha Yenişehir
- Muğla Sıtkı Koçman University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, 48000, Muğla, TURKEY; Muş Alparslan University, Department of Physiotherapy and Rehabilitation, 49250, Muş, TURKEY.
| | - İlkim Çıtak Karakaya
- Muğla Sıtkı Koçman University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, 48000, Muğla, TURKEY.
| | - Ahmet Akın Sivaslıoğlu
- Muğla Sıtkı Koçman University, Faculty of Medicine, Department of Obstetrics and Gynecology, 48000, Muğla, TURKEY.
| | - Dilara Özen Oruk
- Muğla Sıtkı Koçman University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, 48000, Muğla, TURKEY.
| | - Mehmet Gürhan Karakaya
- Muğla Sıtkı Koçman University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, 48000, Muğla, TURKEY.
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Hartley P, DeWitt AL, Forsyth F, Romero-Ortuno R, Deaton C. Predictors of physical activity in older adults early in an emergency hospital admission: a prospective cohort study. BMC Geriatr 2020; 20:177. [PMID: 32423418 PMCID: PMC7236296 DOI: 10.1186/s12877-020-01562-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 04/16/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Reduced mobility may be responsible for functional decline and acute sarcopenia in older hospitalised patients. The drivers of reduced in-hospital mobility are poorly understood, especially during the early phase of acute hospitalisation. We investigated predictors of in-hospital activity during a 24-h period in the first 48 h of hospital admission in older adults. METHODS This was a secondary analysis of a prospective repeated measures cohort study. Participants aged 75 years or older were recruited within the first 24 h of admission. At recruitment, patients underwent a baseline assessment including measurements of pre-morbid functional mobility, cognition, frailty, falls efficacy, co-morbidity, acute illness severity, knee extension strength and grip strength, and consented to wear accelerometers to measure physical activity during the first 7 days (or until discharge if earlier). In-hospital physical activity was defined as the amount of upright time (standing or walking). To examine the predictors of physical activity, we limited the analysis to the first 24 h of recording to maximise the sample size as due to discharge from hospital there was daily attrition. We used a best subset analysis including all baseline measures. The optimal model was defined by having the lowest Bayesian information criterion in the best-subset analyses. The model specified a maximum of 5 covariates and used an exhaustive search. RESULTS Seventy participants were recruited but eight were excluded from the final analysis due to lack of accelerometer data within the first 24 h after recruitment. Patients spent a median of 0.50 h (IQR: 0.21; 1.43) standing or walking. The optimal model selected the following covariates: functional mobility as measured by the de Morton Mobility Index and two measures of illness severity, the National Early Warning Score, and serum C-reactive protein. CONCLUSIONS Physical activity, particularly in the acute phase of hospitalisation, is very low in older adults. The association between illness severity and physical activity may be explained by symptoms of acute illness being barriers to activity. Interdisciplinary approaches are required to identify early mobilisation opportunities.
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Affiliation(s)
- Peter Hartley
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
- Department of Physiotherapy, Cambridge University Hospital NHS Foundation Trust, Cambridge, UK.
- Forvie Site, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, CB2 0SR, UK.
| | - Amanda L DeWitt
- Department of Medicine for the Elderly, Cambridge University Hospital NHS Foundation Trust, Cambridge, UK
| | - Faye Forsyth
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Roman Romero-Ortuno
- Discipline of Medical Gerontology, Trinity College Dublin, Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
| | - Christi Deaton
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
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Sen EI, Esmaeilzadeh S, Eskiyurt N. Effects of whole-body vibration and high impact exercises on the bone metabolism and functional mobility in postmenopausal women. J Bone Miner Metab 2020; 38:392-404. [PMID: 31897748 DOI: 10.1007/s00774-019-01072-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 11/26/2019] [Indexed: 12/19/2022]
Abstract
INTRODUCTION This study determined the effects of whole-body vibration (WBV) and high-impact exercises on postmenopausal women. MATERIALS AND METHODS In this randomized controlled 6-month interventional trial, 58 eligible postmenopausal women were assigned to WBV training group, high-impact training group, or control group. Bone mineral density (BMD) of the lumbar spine and femur were measured by dual-energy X-ray absorptiometry. Additionally, the serum osteocalcin (OC) and C-terminal telopeptide of type I collagen levels were also measured. The functional mobility was assessed using the Timed Up and Go (TUG) test, and fall index was measured using static posturography. The health-related quality of life (HRQoL) and depressive symptoms were assessed using the Quality of Life Questionnaire of the European Foundation for Osteoporosis and Beck Depression Inventory, respectively. RESULTS The BMD at the femoral neck (p = 0.003) and L2-L4 (p = 0.005) regions increased significantly in the WBV group compared to the control group. However, in the high-impact exercise group there were no significant effects on the lumbar spine and femoral neck. The serum OC decreased significantly in the WBV group and increased significantly in both the high-impact exercise and control groups (p < 0.001). The TUG scores decreased significantly in both training groups compared to the control group (p < 0.05). Finally, in both exercise groups, HRQoL and depressive symptoms improved (p < 0.001). CONCLUSIONS Our data suggest that the WBV can prevent bone loss in postmenopausal women. These findings also indicate that WBV and high-impact training programs improve functional mobility, HRQoL and depressive symptoms in postmenopausal women.
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Affiliation(s)
- Ekin Ilke Sen
- Department of Physical Medicine and Rehabilitation, Istanbul Faculty of Medicine, Istanbul University, Millet Cad, 34093, Istanbul, Turkey.
| | - Sina Esmaeilzadeh
- Department of Physical Medicine and Rehabilitation, Istanbul Faculty of Medicine, Istanbul University, Millet Cad, 34093, Istanbul, Turkey
| | - Nurten Eskiyurt
- Department of Physical Medicine and Rehabilitation, Istanbul Faculty of Medicine, Istanbul University, Millet Cad, 34093, Istanbul, Turkey
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Corregidor-Sánchez AI, Segura-Fragoso A, Rodríguez-Hernández M, Criado-Alvarez JJ, González-Gonzalez J, Polonio-López B. Can exergames contribute to improving walking capacity in older adults? A systematic review and meta-analysis. Maturitas 2019; 132:40-48. [PMID: 31883662 DOI: 10.1016/j.maturitas.2019.12.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 12/04/2019] [Accepted: 12/06/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND The accessibility, low cost and motivation generated by exergames has fostered its rapid expansion as a rehabilitation technique. OBJECTIVE To estimate the effectiveness of rehabilitation programs using IVGT in improving walking capacity of people aged 60 years and over. MATERIALS AND METHODS The electronic data research following the PRISMA Statement (Scopus, Cochrane, Web of Science, OT Seeker, National Guideline Clearinghouse, Trip Database, CSIC Spanish National Research Council) was completed in September 2018. The results of randomized clinical trials using exergames for rehabilitation of walking capacity were combined. The calculations have followed the guidelines of the Cochrane Handbook for Systematic Reviews of Interventions. The Grading of Recommendations Assessment, Development and Evaluation system was used to evaluate the quality of the evidence. RESULTS We obtained data from 14 trials, including 11 meta-analysis studies. The size of exergames effects on walking capacity is moderate, but significant (SMD -0.56; 95 % CI: -0.90, -0.21; p = 0.002). Effectiveness was greater to recover the ability to transfer from one position or place to another (SMD -1.02; CI 95 %: -1.70, -0.35; P = 0.003). The intervention protocols, their duration and intensity varied considerably. The lack of masking, the allocation concealment, the absence of assessor blinding were the main causes of bias so the final grade of evidence has been low for walking and very low for transfers. CONCLUSIONS Positive clinical effects of exergames have been found to improve walking capacity, but the quality of evidence to refute its effectiveness is weak with risk of bias. Further research is needed in order to know the actual magnitude of its effect.
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Affiliation(s)
| | - Antonio Segura-Fragoso
- Faculty of Health Sciences, University of Castilla la Mancha (UCLM), Talavera de la Reina, Toledo, Spain; Health Sciences Institute, Talavera de la Reina, Toledo, Spain
| | - Marta Rodríguez-Hernández
- Faculty of Health Sciences, University of Castilla la Mancha (UCLM), Talavera de la Reina, Toledo, Spain
| | - Juan José Criado-Alvarez
- Faculty of Health Sciences, University of Castilla la Mancha (UCLM), Talavera de la Reina, Toledo, Spain; Health Service of Castilla La Mancha, SESCAM, Toledo Spain
| | - Jaime González-Gonzalez
- Faculty of Health Sciences, University of Castilla la Mancha (UCLM), Talavera de la Reina, Toledo, Spain; Health Service of Castilla La Mancha, SESCAM, Toledo Spain
| | - Begoña Polonio-López
- Faculty of Health Sciences, University of Castilla la Mancha (UCLM), Talavera de la Reina, Toledo, Spain
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Wickstrom RJ, Wang YC, Wickstrom NE, Smith RL, Dunning KK. A new two square agility test for workplace health-reliability, validity and minimal detectable change. J Phys Ther Sci 2019; 31:823-830. [PMID: 31645814 PMCID: PMC6801334 DOI: 10.1589/jpts.31.823] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 07/27/2019] [Indexed: 12/28/2022] Open
Abstract
[Purpose] One promising strategy for workplace wellness programs is to emphasize functional mobility screening and coaching to promote suitable physical activity and reduce musculoskeletal risks. This study examined intra-rater reliability, test-retest reliability, concurrent validity, known-groups validity and minimal detectable change for a new Two Square Agility Test (TSAT) designed as a functional mobility measure to promote workplace health. [Participants and Methods] Two hundred forty eight non-disabled participants (ages 18-69) were measured for body size, physical activity and 3 trials of the Two Square Agility Test. 78 participants were tested a week later on the Two Square Agility Test and other functional mobility tests. [Results] Intra-rater reliability was excellent (ICC=0.94) and test-retest reliability was good (ICC=0.87). Two Square Agility Test correlated moderately with Timed Up and Go (r=0.63), Five Times Sit to Stand (r=0.62), and Maximum Step Length (r= -0.54), supporting its concurrent validity. Performances for Two Square Agility Test were better in males, younger age, higher physical activity, and non-obese groups. The minimal detectable change at a 95% confidence level (MDC95) was 1.37 s. [Conclusion] Preliminary results supported reliability and validity of Two Square Agility Test as a functional mobility measure to promote workplace health.
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Affiliation(s)
- Richard J Wickstrom
- WorkAbility Systems: 7665 Monarch Court, Suite 109, West Chester, OH 45069, USA
| | - Ying-Chih Wang
- College of Health Sciences, Department of Occupational Science & Technology, University of Wisconsin-Milwaukee, USA
| | - Nell E Wickstrom
- WorkAbility Systems: 7665 Monarch Court, Suite 109, West Chester, OH 45069, USA
| | - Rose L Smith
- College of Allied Health Sciences, Department of Rehabilitation, Exercise and Nutrition Science, University of Cincinnati, USA
| | - Kari K Dunning
- College of Allied Health Sciences, Department of Rehabilitation, Exercise and Nutrition Science, University of Cincinnati, USA
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Abstract
This review elaborates on multidisciplinary care for persons living with Parkinson disease by using gait and balance impairments as an example of a treatable target that typically necessitates an integrated approach by a range of different and complementary professional disciplines. Using the International Classification of Functioning, Disability, and Health model as a framework, the authors discuss the assessment and multidisciplinary management of reduced functional mobility due to gait and balance impairments. By doing so, they highlight the complex interplay between motor and nonmotor symptoms, and their influence on rehabilitation. They outline how multidisciplinary care for Parkinson disease can be organized.
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Serra-Añó P, Pedrero-Sánchez JF, Hurtado-Abellán J, Inglés M, Espí-López GV, López-Pascual J. Mobility assessment in people with Alzheimer disease using smartphone sensors. J Neuroeng Rehabil 2019; 16:103. [PMID: 31412893 PMCID: PMC6694667 DOI: 10.1186/s12984-019-0576-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 08/08/2019] [Indexed: 01/20/2023] Open
Abstract
Background Understanding the functional status of people with Alzheimer Disease (AD), both in a single (ST) and cognitive dual task (DT) activities is essential for identifying signs of early-stage neurodegeneration. This study aims to compare the performance quality of several tasks using sensors embedded in an Android device, among people at different stages of Alzheimer and people without dementia. The secondary aim is to analyze the effect of cognitive task performance on mobility tasks. Methods This is a cross-sectional study including 22 participants in the control group (CG), 18 in the group with mild AD and 22 in the group with moderate AD. They performed two mobility tests, under ST and DT conditions, which were registered using an Android device. Postural control was measured by medial-lateral and anterior-posterior displacements of the COM (MLDisp and APDisp, respectively) and gait, with the vertical and medial-lateral range of the COM (Vrange and MLrange). Further, the sit-to-stand (PStand) and turning and sit power (PTurnSit), the total time required to complete the test and the reaction time were measured. Results There were no differences between the two AD stages either for ST or DT in any of the variables (p > 0.05). Nevertheless, people at both stages showed significantly lower values of PStand and PTurnSit and larger Total time and Reaction time compared to CG (p < 0.05). Further, Vrange is also lower in CDR1G than in CG (p < 0.05). The DT had a significant deleterious effect on MLDisp in all groups (p < 0.05) and on APDisp only in moderate AD for DT. Conclusions Our findings indicate that AD patients present impairments in some key functional abilities, such as gait, turning and sitting, sit to stand, and reaction time, both in mild and moderate AD. Nevertheless, an exclusively cognitive task only influences the postural control in people with AD.
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Affiliation(s)
- Pilar Serra-Añó
- UBIC, Departament de Fisioteràpia de la Universitat de València, C/ Gascó Oliag, 5, 46010, Valencia, Spain
| | - José Francisco Pedrero-Sánchez
- Instituto de Biomecánica de Valencia, Universidad Politécnica de Valencia, Edificio 9C. Camino de Vera, s/n, 46022, Valencia, Spain
| | - Juan Hurtado-Abellán
- UBIC, Departament de Fisioteràpia de la Universitat de València, C/ Gascó Oliag, 5, 46010, Valencia, Spain
| | - Marta Inglés
- UBIC, Departament de Fisioteràpia de la Universitat de València, C/ Gascó Oliag, 5, 46010, Valencia, Spain
| | - Gemma Victoria Espí-López
- UBIC, Departament de Fisioteràpia de la Universitat de València, C/ Gascó Oliag, 5, 46010, Valencia, Spain
| | - Juan López-Pascual
- Instituto de Biomecánica de Valencia, Universidad Politécnica de Valencia, Edificio 9C. Camino de Vera, s/n, 46022, Valencia, Spain.
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Kim J, Shin JH, Ryu JK, Jung JH, Kim CH, Lee HB, Kim DH, Lee SK, Roh D. Physical performance is more strongly associated with cognition in schizophrenia than psychiatric symptoms. Eur Psychiatry 2019; 61:72-78. [PMID: 31349152 DOI: 10.1016/j.eurpsy.2019.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 06/24/2019] [Accepted: 06/27/2019] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Although neurocognitive dysfunction and physical performance are known to be impaired in patients with schizophrenia, evidence regarding the relationship between these two domains remains insufficient. Thus, we aimed to investigate the relationship between various physical performance domains and cognitive domains in individuals with schizophrenia, while considering other disorder-related clinical symptoms. METHODS Sixty patients with schizophrenia participated in the study. Cardiorespiratory fitness and functional mobility were evaluated using the step test and supine-to-standing (STS) test, respectively. Executive function and working memory were assessed using the Stroop task and Sternberg working memory (SWM) task, respectively. Clinical symptoms were evaluated using the Brief Psychiatric Rating Scale, Beck Depression Inventory, and State-Trait Anxiety Inventory. Multivariate analyses were performed to adjust for relevant covariates and identify predictive factors associated with neurocognition. RESULTS Multiple regression analysis revealed that the step test index was most strongly associated with reaction time in the Stroop task (β = 0.434, p = 0.001) and SWM task (β = 0.331, p = 0.026), while STS test time was most strongly associated with accuracy on the Stoop task (β=-0.418, p = 0.001) and SWM task (β=-0.383, p = 0.007). Total cholesterol levels were positively associated with Stroop task accuracy (β=-0.307, p = 0.018) after controlling for other clinical correlates. However, clinical symptoms were not associated with any variables in Stroop or SWM task. CONCLUSIONS The present findings demonstrate the relationship between physical performance and neurocognition in patients with schizophrenia. Considering that these factors are modifiable, exercise intervention may help to improve cognitive symptoms in patients with schizophrenia, thereby leading to improvements in function and prognosis.
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Affiliation(s)
- Jiheon Kim
- Mind-neuromodulation Laboratory and Department of Psychiatry, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, 77 Sakju-ro, Chuncheon, Gangwon-Do, 24253, Republic of Korea
| | - Ji-Hyeon Shin
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, 271 Cheonbo-ro, Uijeongbu, Gyungki-Do, 11765, Republic of Korea
| | - Jeh-Kwang Ryu
- Institute for Cognitive Science, College of Humanities, Seoul National University, 1 Gwanak-ro, Gwanak-Gu, Seoul, 08826, Republic of Korea
| | - Jae Hoon Jung
- Mind-neuromodulation Laboratory and Department of Psychiatry, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, 77 Sakju-ro, Chuncheon, Gangwon-Do, 24253, Republic of Korea
| | - Chan-Hyung Kim
- Department of Psychiatry, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea
| | - Hwa-Bock Lee
- Gwangmyeong Mental Health Welfare Center, 613 Ori-ro, Gwangmyeong-si, Gyungki-do, 14303, Republic of Korea
| | - Do Hoon Kim
- Mind-neuromodulation Laboratory and Department of Psychiatry, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, 77 Sakju-ro, Chuncheon, Gangwon-Do, 24253, Republic of Korea
| | - Sang-Kyu Lee
- Mind-neuromodulation Laboratory and Department of Psychiatry, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, 77 Sakju-ro, Chuncheon, Gangwon-Do, 24253, Republic of Korea
| | - Daeyoung Roh
- Mind-neuromodulation Laboratory and Department of Psychiatry, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, 77 Sakju-ro, Chuncheon, Gangwon-Do, 24253, Republic of Korea.
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Huang C, Sun S, Tian X, Wang T, Wang T, Duan H, Wu Y. Age modify the associations of obesity, physical activity, vision and grip strength with functional mobility in Irish aged 50 and older. Arch Gerontol Geriatr 2019; 84:103895. [PMID: 31228672 DOI: 10.1016/j.archger.2019.05.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 05/22/2019] [Accepted: 05/27/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To estimate whether the associations of obesity, physical activity, vision and grip strength with functional mobility were modified by age. METHODS Data from The Irish Longitudinal Study on Ageing (2009-2012) were analyzed and 5001 individuals were included in this study. Mobility was assessed by the timed up and go test (TUG-test). Main exposure variables were obesity, physical activity, visual acuity and grip strength at baseline. Multiple linear regression models were fitted to assess the associations of baseline main exposure variables with 2-year follow-up functional mobility and potential confounders were adjusted. Stratified analyses by age were used to assess the interaction between main exposures and age on functional mobility. RESULTS Multiple linear regression models identified significant interactions of obesity (P < 0.001), vigorous physical activity (P = 0.001), vision (P < 0.001) and grip strength (P < 0.001) with age on functional mobility. Stratified analyses suggested that the risk effect of obesity on functional mobility was greater in middle-aged group (β = 0.025, P < 0.001) than in older group (β = 0.016, P = 0.017). The protective effects of high level of physical activity and grip strength on functional mobility were stronger in older group (β = -0.023, P = 0.004 for physical activity; β = -0.002, P < 0.001 for grip strength) than in middle-aged group (β = -0.012, P = 0.008 for physical activity; β = -0.0015, P < 0.001 for grip strength). The benefit of better vision on functional mobility was observed in middle-aged group only (β = -0.032, P = 0.002). CONCLUSION Non-obesity, higher level of physical activity, vision and grip strength at baseline were associated with better mobility performance among middle-aged and older Irish. And these associations were modified by age.
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Gonzales A, Gates E, Bhunia N, Mehyar L, Hashem H, Stanek JR, Krebs B, Auletta JJ. Transplant Energize Me Patient Outcome (TEMPO): A Quality Improvement Project that Maintains Functional Mobility in Pediatric Patients Admitted for Allogeneic Hematopoietic Cell Transplantation. Biol Blood Marrow Transplant 2019; 25:1779-1785. [PMID: 31085304 DOI: 10.1016/j.bbmt.2019.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 04/17/2019] [Accepted: 05/05/2019] [Indexed: 12/24/2022]
Abstract
Allogeneic hematopoietic cell transplantation (HCT) remains the definite cure for many pediatric hematologic diseases but causes profound deconditioning, which impairs daily physical functioning and may lead to further health complications. The Transplant Energize Me Patient Outcome (TEMPO) project is a standard-of-care, quality improvement (QI) project whose primary objective is to maintain physical functional mobility and strength throughout admission for pediatric allogeneic HCT patients. Specifically, TEMPO incorporates individualized and developmentally appropriate exercises and activities that are administered by a multidisciplinary team, who objectively measure and record a patient's physical stamina at predetermined frequencies. Discipline-specific metrics at admission, at weekly intervals, at discharge, and at 100 days after graft infusion (D100) are recorded in templated flowsheets in the electronic medical record. As a secondary objective, resource utilization as measured by length of stay, duration of parenteral feeds and narcotics, readmission by D100, and infections was compared between TEMPO and historical control (pre-TEMPO) allogeneic HCT patients. TEMPO participation maintained physical endurance and functional strength throughout hospitalization, an effect that was significantly sustained or improved at D100. Resource utilization did not significantly differ between patient cohorts. Taken together, the TEMPO QI Project maintains physical functional mobility, strength, and endurance, thereby decreasing physical deconditioning in pediatric allogeneic HCT patients, an effect that is objectively sustained at D100.
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Affiliation(s)
- Anne Gonzales
- Clinical Therapy Services, Nationwide Children's Hospital, Columbus, Ohio.
| | - Erin Gates
- Clinical Therapy Services, Nationwide Children's Hospital, Columbus, Ohio
| | - Nabanita Bhunia
- Hematology/Oncology/Blood and Bone Marrow Transplant, Nationwide Children's Hospital, Columbus, Ohio
| | - Lubna Mehyar
- Hematology/Oncology/Blood and Bone Marrow Transplant, Nationwide Children's Hospital, Columbus, Ohio
| | - Hasan Hashem
- Hematology/Oncology/Blood and Bone Marrow Transplant, Nationwide Children's Hospital, Columbus, Ohio
| | - Joseph R Stanek
- Hematology/Oncology/Blood and Bone Marrow Transplant, Nationwide Children's Hospital, Columbus, Ohio
| | - Bonnie Krebs
- Hematology/Oncology/Blood and Bone Marrow Transplant, Nationwide Children's Hospital, Columbus, Ohio
| | - Jeffery J Auletta
- Hematology/Oncology/Blood and Bone Marrow Transplant, Nationwide Children's Hospital, Columbus, Ohio; Infectious Diseases, Nationwide Children's Hospital, Columbus, Ohio; Host Defense Program, Nationwide Children's Hospital, Columbus, Ohio; Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio; The Ohio State University Comprehensive Cancer Center, Columbus, Ohio
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Fling BW, Martini DN, Zeeboer E, Hildebrand A, Cameron M. Neuroplasticity of the sensorimotor neural network associated with walking aid training in people with multiple sclerosis. Mult Scler Relat Disord 2019; 31:1-4. [PMID: 30875527 DOI: 10.1016/j.msard.2019.03.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 02/27/2019] [Accepted: 03/04/2019] [Indexed: 01/03/2023]
Abstract
The objective of this pilot study was to identify neural descriptors and correlates of participation in a multicomponent walking aid program, the Assistive Device Selection, Training and Education Program (ADSTEP), in people with multiple sclerosis, as reflected by resting state functional MRI. Fourteen people with multiple sclerosis who used a walking aid at baseline and reported falling at least once in the prior year were recruited from the multiple sclerosis clinic in a Veterans Affairs and the surrounding community to participate in a trial of ADSTEP, a multicomponent program of walking aid selection, fitting and six weekly progressive task-oriented walking aid training sessions and undergo resting state functional brain MRI. The functional MRI was performed at baseline and at program completion to assess for changes in neural connectivity of the sensorimotor neural network. Compared to baseline, following ADSTEP participation, functional connectivity between the supplementary motor areas and both the primary somatosensory cortices and the putamen was increased; whereas functional connectivity between the supplementary motor areas and the cerebellum was decreased. This study provides preliminary support for supraspinal sensorimotor neuroplasticity in response to rehabilitation interventions such as task-oriented walking aid training, suggests specific neural targets for future mobility interventions, and supports the need for full-scale randomized controlled trials in this area.
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Affiliation(s)
- Brett W Fling
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA; Molecular, Cellular and Integrative Neuroscience Program, Colorado State University, Fort Collins, CO, USA.
| | - Douglas N Martini
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
| | - Eline Zeeboer
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
| | | | - Michelle Cameron
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA; Veterans Affairs Portland Health Care System, Portland, OR, USA
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Morales JS, Valenzuela PL, Rincón-Castanedo C, Takken T, Fiuza-Luces C, Santos-Lozano A, Lucia A. Exercise training in childhood cancer: A systematic review and meta-analysis of randomized controlled trials. Cancer Treat Rev 2018; 70:154-167. [PMID: 30218787 DOI: 10.1016/j.ctrv.2018.08.012] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 08/29/2018] [Accepted: 08/31/2018] [Indexed: 01/14/2023]
Abstract
INTRODUCTION Physical capacity and quality of life (QoL) are typically impaired in children/adolescents with cancer. Our primary objective was to examine the effects of exercise training performed after diagnosis of any type of pediatric cancer on physical capacity-related endpoints, survival, disease relapse and adverse effects. METHODS (a) Search and selection criteria: Systematic review in Pubmed and Web of Science (until August 2018) of randomized controlled trials (RCTs) of exercise interventions in children with cancer during treatment or within one year after its end. (b) Data collection: Two authors independently identified studies meeting inclusion criteria, extracted data, and assessed risk of bias using standardized forms. When needed, we contacted authors to request clarifications or additional data. (c) Statistical Analysis: The pooled standardized mean differences (SMD) were calculated for those endpoints for which a minimum of three RCTs used the same assessment method. We also calculated the pooled odds ratio (OR) of dying or having a tumor relapse. RESULTS Eight RCTs (n = 283 patients) were included in the systematic review. Of these, five studies (n = 173) could be meta-analyzed. Exercise training during pediatric cancer treatment significantly improves patients' functional mobility, as assessed with the timed up and down stairs test (SMD: -0.73, p < 0.001) and does not affect mortality (OR: 0.85, p = 0.76) or relapse risk (OR: 0.96, p = 0.94). CONCLUSIONS Exercise training in children with cancer improves functional mobility. More RCTs analyzing the effects of supervised exercise interventions are needed, as well as the development of a core-set of outcomes in pediatric oncology exercise research.
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Affiliation(s)
- Javier S Morales
- Universidad Europea de Madrid, Faculty of Sport Sciences, Madrid, Spain
| | - Pedro L Valenzuela
- Physiology Unit, Systems Biology Department, University of Alcalá, Madrid, Spain; Department of Sport and Health, Spanish Agency for Health Protection in Sport (AEPSAD), Madrid, Spain
| | | | - Tim Takken
- Child Development & Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Carmen Fiuza-Luces
- Universidad Europea de Madrid, Faculty of Sport Sciences, Madrid, Spain; Research Institute of the Hospital 12 de Octubre (i+12), Madrid, Spain.
| | - Alejandro Santos-Lozano
- Research Institute of the Hospital 12 de Octubre (i+12), Madrid, Spain; i+HeALTH, European University Miguel de Cervantes, Spain
| | - Alejandro Lucia
- Universidad Europea de Madrid, Faculty of Sport Sciences, Madrid, Spain; Research Institute of the Hospital 12 de Octubre (i+12), Madrid, Spain.
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Street BD, Adkin A, Gage W. Reported balance confidence and movement reinvestment of younger knee replacement patients are more like younger healthy individuals, than older patients. Gait Posture 2018; 61:130-134. [PMID: 29346081 DOI: 10.1016/j.gaitpost.2018.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 01/07/2018] [Accepted: 01/11/2018] [Indexed: 02/02/2023]
Abstract
This study focused on differences between the rapidly growing younger (<65 years old) and older (>65 years old) total knee replacement (TKR) patients for measures of balance confidence, movement reinvestment, and functional mobility. Fifty-nine participants, including twenty-nine primary unilateral TKR patients (six months post-TKR) formed the four experimental groups: 1) Younger TKR Patient (YP), 2) Younger Control (YC), 3) Older TKR Patient (OP), and 4) Older Control (OC). The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Oxford Knee Score (OKS), Activities-specific Balance Confidence scale (ABC), the Movement-Specific Reinvestment Scale (MSRS), and the Timed Up and Go (TUG) test were measured. The YP group reported a significantly lower WOMAC score (p < 0.001), and higher perceived knee joint function (p = 0.001), compared to the OP group. The YP group also reported significantly higher balance confidence (p < 0.001) and less movement reinvestment (p = 0.001) than the OP group. TUG durations revealed that the YP group had significantly higher functional mobility compared to the OP group (p = 0.001). The YP group did not differ from the YC group across any of these measures (p > 0.05). These results identify a clear distinction between younger and older TKR patients for fall risk and TKR outcome, which argues that age should be a factor clinicians take into account when addressing the management and care of individuals recovering from TKR.
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Affiliation(s)
- Brian D Street
- Department of Kinesiology, Gait and Posture Neuromuscular Laboratory,California State University, Mail Stop 22 EDUC, 9001 Stockdale Hwy, Bakersfield, CA, 93311-1022, USA.
| | - Allan Adkin
- Department of Kinesiology, Brock University, WC 237, 500 Glenridge Avenue, St. Catharines, Ontario, L2S 3A1, Canada.
| | - William Gage
- Research and Innovation Faculty of Health, Centre for Aging Research and Education, York University, 428D HNES, 4700 Keele Street, Toronto, Ontario, M3J 1P3, Canada.
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