Effects of Exergames and Conventional Physical Therapy on Functional Physical Performance in Older Adults: A Randomized Controlled Trial

Objective: To evaluate the effects of exergames added to a conventional physical therapy (CPT) program on functional fitness and dynamometric muscle performance for the sit-to-stand (STS) maneuver in older adults and to compare their results concerning a CPT-only intervention. Materials and Methods: Fifty independent older adults were randomly assigned to CPT and exergames (CPT+ExG group; n = 25; age = 71.8 ± 6.8 years) or CPT alone (CPT group; n = 25; age = 71.3 ± 7.4 years). CPT was performed twice a week (60 min/session) for 8 weeks. The CPT+ExG group added exergames for 30 minutes in each session. The Senior Fitness Test was applied, considering the 30-second chair stand test as the primary outcome. Additionally, dynamometric muscle performance during the STS maneuver was assessed. Results: The CPT+ExG group improved the 30-second chair stand (lower body strength), back scratch (upper body flexibility), and 8-foot up-and-go (agility/dynamic balance) tests (all P < 0.05). Both groups improved the kinetic dynamometric variables peak force, peak power, and total work (all P < 0.05). Also, both groups improved the 30-second arm curl test (upper body strength) (P < 0.05), although the increase was higher in the CPT+ExG group compared with the CPT group (time × group; P < 0.05). Conclusion: Adding exergames to a CPT program only significantly increases upper limb strength compared with CPT alone. The findings of this study have implications for the design of future exergame interventions focused on improving STS maneuver performance in older adults.

INFLUENCE OF MAXIMAL ISOMETRIC STRENGTH ON 20-METER SPRINT TIME

ABSTRACT Introduction The squat is an exercise that is widely used for the development of strength in sports. However, considering that not all sports gestures are vertical, it is important to investigate the effectiveness of propulsive force stimuli applied in different planes. Objective The main purpose of this study was to determine the influence of maximum isometric force (MIF) exerted on starting blocks over performance in 5, 10 and 20-meter sprints. Methods Seven high-level male sprinters (mean age ± SD = 28 ± 5.77 years) participated in this study. The variables were: a) MIF in squats and on starting blocks (measured using a functional electromechanical dynamometer [FEMD]), b) time in 5, 10 and 20-m sprints and c) jump height (measured by the squat jump test). For data analysis, a Pearson correlation was performed between the different variables. The criteria for interpreting the strength of the r coefficients were as follows: trivial (<0.1), small (0.1−0.3), moderate (0.3−0.5), high (0.5−0.7), very high (0.7−0.9), or practically perfect (>0.9). The level of significance was p < 0.05. Results There was very high correlation between MIF exerted on starting blocks and performance in the first meters of the sprint (5-m: r = -0.84, p = 0.01). However, there was small correlation between MIF in squats and performance in the first meters of the sprint (5-m: r = -0.22, p < 0.62). Conclusion The MIF applied on starting blocks correlates very high with time in the first meters of the sprint in high-level athletes. In addition, the use of the FEMD provides a wide range of possibilities for evaluation and development of strength with a controlled natural movement. Level of evidence IV; Prognostic Studies - Case series.

Reliability of a standing isokinetic shoulder rotators strength test using a functional electromechanical dynamometer: effects of velocity

Background

The evaluation of the force in internal rotation (IR) and external rotation (ER) of the shoulder is commonly used to diagnose possible pathologies or disorders in the glenohumeral joint and to assess patient’s status and progression over time. Currently, there is new technology of multiple joint isokinetic dynamometry that allows to evaluate the strength in the human being. The main purpose of this study was to determine the absolute and relative reliability of concentric and eccentric internal and external shoulder rotators with a functional electromechanical dynamometer (FEMD).

Methods

Thirty-two male individuals (21.46 ±  2.1 years) were examined of concentric and eccentric strength of shoulder internal and external rotation with a FEMD at velocities of 0.3 m s⁻¹ and 0.6 m s⁻¹. Relative reliability was determined by intraclass correlation coefficients (ICC). Absolute reliability was quantified by standard error of measurement (SEM) and coefficient of variation (CV). Systematic differences across velocities testing circumstances, were analyzed with dependent t tests or repeated-measures analysis of variance in case of 2 or more than 2 conditions, respectively.

Results

Reliability was high to excellent for IR and ER on concentric and eccentric strength measurements, regardless of velocity used (ICC: 0.81–0.98, CV: 5.12–8.27% SEM: 4.06–15.04N). Concentric outcomes were more reliable than eccentric due to the possible familiarization of the population with the different stimuli.

Conclusion

All procedures examined showed high to excellent reliability for clinical use. However, a velocity of 0.60 m s⁻¹ should be recommended for asymptomatic male patients because it demands less time for evaluation and patients find it more comfortable.

High-Performance Handball Player's Time-Motion Analysis by Playing Positions

The purpose of this study was to analyze the on-court demands of handball players during the European Handball Federation Champions League Final Four (VELUX EHF FINAL4) 2019 to define time-motion characteristics (played time; covered distances) both in offense and defense. Furthermore; we aimed to define position-specific demands and differences among them. Forty players from three teams were analyzed during the tournament using a local positioning system (LPS) for the first time in top handball. Players covered similar distances both in offense (1388.28 ± 2627.08 m), and in defense (1305.47 ± 5059.64 m) and remained on court for a similar average time (15.69 ± 8.02 min and 15.40 ± 8.94 min respectively). When locomotion activities were normalized according to the time they spent on court; significant differences were found for defense compared to offense in walking (+20%; p < 0.000; Cohen's effect size (ES) = 1.01) and jogging (-29.6%; p = 0.000; ES = 0.90), as well as a tendency for high-intensity running (+ 25.2%; p = 0.077; ES = 0.31). Per playing position; center and left back (CB = 94.86 ± 10.98 m·min-1; LB = 96.55 ± 24.65 m·min-1) showed the highest running pace in offense and mid-left; front center defender and outside right for the defense (ML = 90.38 ± 30.16 m·min-1; FCD = 87.04 ± 14.94 m·min-1; OR = 89.64 ± 34.93 m·min-1). In conclusion; profile differences existed among players' position activity; both in offense and defense; which should be taken into account when designing specific physical training programs.

Muscle quality index and isometric strength in older adults with hip osteoarthritis

Background

Older adults with hip osteoarthritis (OA) suffer a progressive loss of muscle quality and strength, affecting their daily activities and quality of life. The purpose of this study is to compare the levels of isometric strength among older adults with and without hip OA and healthy young adults, and to determine the relationship between muscle quality index (MQI) and isometric strength.

Methods

Fourteen subjects with hip OA (65.6 ± 3.0 years), 18 healthy older adults (66.6 ± 6.5 years) and 32 young adults (20.7 ± 2.0 years) participated in the study. MQI, isometric muscle strength of the hip, ten time sit-to-stand tests, and body composition were measured.

Results

The MQI was lower in subjects with hip OA, with no significant differences between groups (p > 0.054). Subjects with OA produced significantly less isometric strength in hip extension (p < 0.001), flexion (p < 0.001), abduction (p < 0.05), adduction (p < 0.001), external (p < 0.05) and internal rotation (p < 0.05). Subjects with OA demonstrated longer time in the execution of the sit-to-stand test (p < 0.001) in comparison with healthy older and young adults. High correlations between MQI, sit-to-stand (r =  - 0.76, p < 0.01) and peak force during hip abduction (r = 0.78, p < 0.01) where found in subjects with OA. Moderate correlation between MQI and peak force during hip flexion (r = 0.55, p < 0.05) and external rotation (r = 0.61, p < 0.05) were found in the OA group.

Conclusions

Subjects with OA have lower MQI than old and young healthy controls. In subjects with OA, there was a significant relationship between isometric strength of hip muscles and performance on the sit-to-stand test and the MQI.

Comparison of two incremental protocols for evaluation of hip extension

Abstract Introduction: The hip muscles play an important role in controlling the transverse and frontal plane of the femur during displacement. The hip extension and abduction/adduction exercises are among the most widely evaluated protocols both clinically and in research. Objective: To compare which assessment protocol in an isokinetic strength regime (distal grip-ankle vs. proximal grip-knee) best represents the action of hip extension and to analyze the test-retest reliability in the variables peak force (PF) and work (W). Methods: A total of 20 subjects participated in this research. All participants were female. The mean and standard deviations of age, weight and height were 21 ± 3.9 years, 65 ± 11 kg, 166 ± 3.4 cm, respectively. Results: Significant differences were found in both variables (PF and W) between protocols 1 and 2 (p < 0.05) on assessment days 1 and 2. No differences between days 1 and day 2 in either protocol (p < 0.05) were found. Index values of interclass correlation (ICC) of protocol 1 ranged between 0.38 and 0.86. In protocol 2 the ICC range was between 0.33 and 0.87. Conclusions: In light of these results, the hip extension exercise with a proximal grip best represents the strength of the muscle groups involved in this action.

[Association of grip strength with gender age and handedness in 116 older people]

BACKGROUND

Hand grip strength could be influenced by gender, age and handedness.

AIM

To describe differences in grip strength for age, gender and upper extremity handedness in non-disabled community-dwelling older adults.

MATERIAL AND METHODS

We studied 47 males aged 72.3 ± 5.6 years and 69 females 72.4 ± 6.0 years who were divided in two age groups (65-70 and ≥ 71 years old). Grip strength was determined by a standardized protocol using a hand dynamometer.

RESULTS

There was an inverse correlation between grip strength and age in both hands only among men (p ≤ 0.05). When analyzing both genders, there was a significant inverse correlation between grip strength and age only in the dominant hand (p ≤ 0.05). Strength was higher in the dominant hand in both genders (p ≤ 0.05). It was also higher in men, compared to women in the two age groups studied (p ≤ 0.05).

CONCLUSIONS

Grip strength is higher in men than women, it decreases with age and is higher in the dominant hand.

[Effects of small-sided exercises on body composition and maximal oxygen uptake in adolescents]

BACKGROUND

The regular practice of physical activity contributes to weight control and improves maximal oxygen uptake (VO2max), socialization and quality of life.

AIM

To determine the effect of moderate-to-vigorous physical activity on body composition and VO2max in a group of overweight school-age males.

MATERIAL AND METHODS

We studied fifty-five overweight males aged 15.6 ± 0.7 years. Participants were divided in two groups (experimental and control groups). The intervention in the experimental group was the practice of small-sided games during 60 minutes, two days per week and during 11 weeks. At baseline and the end of the intervention, body composition was measured using bioimpedance and VO2max was calculated using the Course Navette test.

RESULTS

A 7% reduction in the percentage of body fat and a 9% increase in VO2max were observed in the experimental group (p < 0.01). No changes were recorded in the control group.

CONCLUSIONS

Eleven weeks of small-sided exercises performed twice per week increased VO2max and reduced fat mass in overweight adolescents.