Search Results (47)

Background: Falls among the elderly present significant physical, psychological, and economic challenges. Fall prevention strategies, such as balance and muscle strengthening exercises, are essential but often require long-term commitment. This study explores the potential of transcranial direct current stimulation (tDCS) as an adjunct to balance training to enhance physical performance in the elderly. Method: A randomized, double-blind, sham-controlled design was employed to compare balance training with active or sham tDCS. Participants underwent baseline assessments, followed by a six-week intervention period. The intervention protocol consisted of 2 mA, 20 min of anodal tDCS over the left primary motor cortex, three times weekly. Post-intervention assessments were conducted a few days after the intervention and follow-up at 4 weeks. Results: Following 18 sessions of anodal tDCS combined with balance exercise training, no significant group differences were observed for the Time Up and Go, One-Leg Standing, lower-limb strength, or the 6 min walk test (6MWT), although both the intervention and control groups demonstrated significant improvements over time. A significant group × time interaction was found only for the 6MWT, with participants in the intervention group exhibiting greater improvements in the 6MWT compared to controls. Conclusions: Anodal tDCS combined with balance exercise training selectively enhanced physical endurance but did not confer additional benefits for balance, gait, or leg strength in healthy older adults. These findings suggest that tDCS may serve as a promising adjunct to exercise for improving endurance-related outcomes in aging populations. Control of various variables for tDCS and exercise is necessary. Full article

The purpose was to design and validate a battery of physical tests, called EFEPD-1.0, adapted to assess functionality in people with disabilities. In addition, we sought to analyze the validity and reliability of this battery both for the total group and differentiated by sex. A total of 43 adults with disabilities (32 women and 11 men) participated (57.11 ± 10.12 years). The battery was composed of five blocks of functionality: neuromuscular, combined actions, acceleration, balance, and cardiovascular. The neuromuscular functionality was measured by the vertical and horizontal jump test using the optical system (Opto Jump Next^®, Microgate, Bolzano, Italy) as well as the Hand Grip (HG) test using a (5030J1, Jamar^®, Sammons Preston, Inc, Nottinghamshire, UK) hand dynamometer. The combined actions and balance functionality were assessed with the Time Up and Go (TUG) test, the 30 s Chair Stand (30CTS) test, and the One-Leg Stance (OLS) test measured by a manual stopwatch (HS-80TW-1EF, Casio^®, Tokyo, Japan). The acceleration functionality was evaluated through 20 m sprints and the 505 change of direction (COD505) test, using the (Microgate, Witty^®, Bolzano, Italy) photocell system. The cardiovascular functionality was evaluated with the Six-Minute Walking Test (6MWT), where heart rate was monitored using the (Polar Team Sport System^®, Polar Electro Oy, Kempele, Finland), and additional walking mechanics were recorded with Stryd (Stryd Everest 12 Firmware 1.18 Software 3, Stryd Inc., Boulder, CO, USA). The results showed that the intraclass correlation coefficients (ICCs) ranged from moderate to almost perfect (ICC = 0.65–0.98) between test repetitions. Some tests could significantly differentiate (p < 0.05) men and women, highlighting better neuromuscular capacity in men and better balance in women. The correlations between tests showed significant convergent validity. The Evaluation of Functionality in the Disabled Population (EFEPD-1.0) battery not only consistently measures functional capacities in people with disabilities, but it can also discriminate between different subgroups within this population. Full article

Background: This study aimed to investigate the effects of a 12-week body-weight-based resistance training program on balance ability and fear of falling in community-dwelling older women. Methods: Twenty-three older women were assigned to either an intervention group that performed the low-load resistance training with slow movement using the body weight (LRT group; n = 12) or a control group (CON group; n = 11). The LRT group participated in the exercise session twice weekly for 12 weeks, while the CON group maintained their daily routine. The 30 s chair stand test (CS-30) was applied to measure lower-extremity muscle strength, balance ability was evaluated using one-leg standing tests with eyes open (OLST-O) and closed (OLST-C), and fear of falling among all participants was assessed using the Falls Efficacy Scale International (FES-I) before (pre) and after (post) the intervention. A two-way analysis of variance with repeated measures [group (LRT and CON) × time (pre and post)] was carried out to evaluate the intervention effects. Results: Significant interactions were observed in the CS-30 (F = 9.503, p < 0.01, ${\eta }_p^2$ = 0.312), OLST-O (F = 5.211, p < 0.05, ${\eta }_p^2$ = 0.199), and OLST-C (F = 5.257, p < 0.05, ${\eta }_p^2$ = 0.200), though significant simple main effects from pre to post were observed only in the LRT group. The CS-30 scores (pre: 19.8 ± 3.8 times, post: 25.5 ± 5.6 times; p < 0.001), OLST-O time (pre: 78.8 ± 35.8 s, post: 96.2 ± 29.9 s; p < 0.01), and OLST-C time (pre: 10.2 ± 5.9 s, post: 17.4 ± 12.2 s; p < 0.01) were improved before and after the intervention. However, a significant interaction was not observed in FES-I (F = 1.335, p = 0.261, ${\eta }_p^2$ = 0.06). Conclusions: The 12-week body-weight-based resistance training program enhanced lower-extremity muscle strength and balance ability but did not lessen the fear of falling in community-dwelling older women. The study findings offer relevant information for fall prevention in older adults. Full article

Background/Objectives: One-leg standing test with eyes open (OLST), a well-known balance assessment, is simple to implement and requires no special measuring equipment or space. Prefrailty has greater reversibility than frailty, and early detection of prefrailty is essential for frailty prevention in older adults, especially women. However, the association between the OLST and prefrailty remains unclear. Therefore, this study aimed to verify the relationship between the OLST and prefrailty and to validate the effectiveness of the OLST as a screening tool for prefrailty in older Japanese women. Methods: This study included 208 community-dwelling older women (mean age: 74.4 ± 5.1 years; range: 65–89) who underwent frailty assessments and OLST. Prefrailty was assessed using the Japanese version of the Cardiovascular Health Study (J-CHS) criteria. The association between prefrailty and OLST was assessed by binary logistic regression analysis, and receiver operating characteristic analyses were performed to examine the effectiveness of OLST as a screening tool for prefrailty. Results: OLST time was significantly associated with prefrailty, and those with higher OLST times were less likely to have prefrailty (ORs: 0.98; 95% CI: 0.97–0.99; p < 0.001). The area under the curve of the OLST for prefrailty was 0.713 (p < 0.001), and the optimal OLST cut-off time for discriminating prefrailty was 24 s (sensitivity: 0.56, specificity: 0.77). Conclusions: OLST could be used as a screening tool for prefrailty in older Japanese women. These findings may contribute to the early detection and prevention of frailty. Full article

Objectives: Respiration plays an important function in sustaining life. The diaphragm is the primary muscle involved in respiration, and plays an important role in trunk stabilization. Although it has been reported that respiratory function is important for trunk muscle stability, the correlation between respiratory function and abdominal trunk muscle strength remains undetermined. This study aimed to clarify this correlation among middle-aged and older patients. Methods: This observational study included 398 patients scheduled for surgery for degenerative conditions of the lower extremities. Respiratory function was evaluated using forced vital capacity and forced expiratory volume in 1 s measured using spirometry. Each patient underwent a physical function test before surgery, which included the assessment of the abdominal trunk muscle strength, grip power, knee extensor strength, one-leg standing time, and gait speed. Correlations between abdominal trunk muscle strength, respiratory function, and physical function were evaluated. Results: Abdominal trunk muscle strength was significantly correlated with forced vital capacity, forced expiratory volume in 1 s, grip power, knee extensor strength, one-leg standing time, and gait speed. Multiple linear regression analyses revealed that sex, forced vital capacity, forced expiratory volume in 1 s, and knee extensor strength were significant factors associated with abdominal trunk muscle strength. Conclusions: In middle-aged and older patients, abdominal trunk muscle strength including that of the diaphragm, is associated with forced vital capacity and forced expiratory volume in 1 s. Full article

Objectives: The present study examined the agreement and associations of the 5-time sit-to-stand (5STS) test, the countermovement jump test, and lower-limb muscle power equations with a set of physical performance tests in older adults. Methods: Five hundred and thirty-four community-dwelling older adults were recruited for the study. Lower-limb muscle power measures included 5STS, the countermovement jump test, and muscle power equations. Isometric handgrip strength, timed “up-and-go!”, the 6 min walking test, one-leg stand, and walking speed at usual and fast paces were used to assess physical performance. Pearson’s correlations and Bland–Altman analyses were conducted to examine associations among muscle power measures. Linear and multiple regressions were run to explore associations of 5STS, the countermovement jump test, and muscle power equations with physical performance tests. Results: Weak correlations were observed among lower-limb muscle power measures. Bland–Altman results indicated important differences among the countermovement jump test, 5STS, and muscle power equations. Results of multiple linear regressions indicated that 5STS, the countermovement jump test, and muscle power equations were significantly associated with measures of muscle strength and mobility. However, only 5STS was significantly associated with balance. Conclusions: Our results indicate that the performance on the countermovement jump test and 5STS is weakly correlated with lower-limb muscle power equations. The only exception was the correlation found between the countermovement jump test and relative muscle power, highlighting the importance of accounting for body mass in muscle power evaluations. Muscle power measures were similarly associated with performance on handgrip strength, timed “up-and-go!”, and the 6 min walking test. The exclusive association of 5STS with balance suggests that a reassessment of 5STS muscle power equations may be warranted. Full article

This study investigated the relationship between subjective grip strength and physical function in community-dwelling older women. Subjective grip strength was assessed using a questionnaire, and physical function and body composition were compared between groups with strong and weak subjective grip strength. Additionally, the two groups were compared in those with mild cognitive impairment (MCI) and those with normal cognitive function, respectively. The results showed significant differences in grip strength (p < 0.001), 30 s chair–stand (CS-30) test (p = 0.039), timed up-and-go (TUG) test (p = 0.027), maximal gait speed (p = 0.029), and skeletal muscle mass (p < 0.001). Older adults with normal cognitive function showed significant differences in grip strength (p < 0.001), quadriceps muscle strength (p < 0.009), one-leg standing time (p = 0.041), CS-30 (p = 0.002), TUG (p = 0.014), gait speed (p = 0.006), and skeletal muscle mass (p = 0.003). Older adults with low subjective grip strength had lower physical function and skeletal muscle mass. However, no items showed significant differences between groups among older adults with MCI. Thus, subjective grip strength is an indicator of an overall decline in physical function and a reduction in skeletal muscle mass in older adults, and cognitive function should be considered when assessing subjective grip strength in older adults. Full article

Background: Frailty leads to vulnerability to stress, impaired daily functioning, and an increased need for care. Frailty is considered reversible, and it is crucial to detect the risk of frailty early and investigate factors that may delay its progression. Objectives: To identify tests that can explain frailty risk and compare the situation of local residents with and without frailty support. Methods: Participants were recruited in two ways: through public advertisements in Akita City (open recruitment group) and through invites from frailty supporters in their immediate communities (community-based group). We examined the differences in frailty risk and oral, motor, and social functions between the two groups and identified factors associated with frailty risk in both groups. Results: The community-based group exhibited a lower risk of frailty than the open recruitment group despite having more older members on average. Additionally, the community-based group demonstrated better social functioning than the open-recruitment group. Furthermore, factors such as oral diadochokinesis (ODK), one-leg stand test (OLS), and grip strength (GS) showed significant association with frailty risk. Conclusion: The ODK, OLS, and GS were identified as factors explaining frailty risk, and Frailty Supporters may reduce the risk of frailty. Full article

Background: The Balance Error Scoring System (BESS) is a commonly used method for clinically evaluating balance after traumatic brain injury. The utilization of force plates, characterized by their cost-effectiveness and portability, facilitates the integration of instrumentation into the BESS protocol. Despite the enhanced precision associated with instrumented measures, there remains a need to determine the clinical significance and feasibility of such measures within pediatric cohorts. Objective: To report a comprehensive set of posturographic measures obtained during instrumented BESS and to examine the concurrent validity, reliability, and feasibility of instrumented BESS in the pediatric point of care setting. Methods: Thirty-seven participants (18 female; aged 13.32 ± 3.31 years) performed BESS while standing on a force plate to simultaneously compute stabilometric measures (instrumented BESS). Ellipse area (EA), path length (PL), and sway velocity (VM) were obtained for each of the six BESS positions and compared with the respective BESS scores. Additionally, the effects of sex and age were explored. A second BESS repetition was performed to evaluate the test–retest reliability. Feedback questionnaires were handed out after testing to evaluate the feasibility of the proposed protocol. Results: The BESS total score was 20.81 ± 6.28. While there was no statistically significant age or sex dependency in the BESS results, instrumented posturography demonstrated an age dependency in EA, VM, and PL. The one-leg stance on a soft surface resulted in the highest BESS score (8.38 ± 1.76), EA (218.78 cm² ± 168.65), PL (4386.91 mm ± 1859.00), and VM (21.93 mm/s ± 9.29). The Spearman’s coefficient displayed moderate to high correlations between the EA (rs = 0.429–0.770, p = 0.001–0.009), PL (rs = 0.451–0.809, p = 0.001–0.006), and VM (rs = 0.451–0.809, p = 0.001–0.006) when compared with the BESS scores for all testing positions, except for the one-leg stance on a soft surface. The BESS total score significantly correlated during the first and second repetition (rs = 0.734, p ≤ 0.001), as did errors during the different testing positions (rs = 0.489–0.799, p ≤ 0.001–0.002), except during the two-legged stance on a soft surface. VM and PL correlated significantly in all testing positions (rs = 0.465–0.675, p ≤ 0.001–0.004; (rs = 0.465–0.675, p ≤ 0.001–0.004), as did EA for all positions except for the two-legged stance on a soft surface (rs = 0.392–0.581, p ≤ 0.001–0.016). A total of 92% of participants stated that the instructions for the testing procedure were very well-explained, while 78% of participants enjoyed the balance testing, and 61% of participants could not decide whether the testing was easy or hard to perform. Conclusions: Instrumented posturography may complement clinical assessment in investigating postural control in children and adolescents. While the BESS score only allows for the consideration of a total score approximating postural control, instrumented posturography offers several parameters representing the responsiveness and magnitude of body sway as well as a more differentiated analysis of movement trajectory. Concise instrumented posturography protocols should be developed to augment neuropediatric assessments in cases where a deficiency in postural control is suspected, potentially stemming from disruptions in the processing of visual, proprioceptive, and/or vestibular information. Full article

Background and Objectives: Fibromyalgia, a chronic condition, manifests as widespread musculoskeletal pain, fatigue, sleep disturbances, autonomic and cognitive dysfunction, hypersensitivity to stimuli, and various somatic and psychiatric symptoms. This study, a controlled and randomized experiment, aimed to evaluate and compare the immediate effects of different treatments on fibromyalgia patients. Materials and Methods: The treatments included the EXOPULSE Mollii suit, a combination of the EXOPULSE Mollii suit with a virtual reality (VR) protocol, and a physical exercise regimen. A cohort of 89 female fibromyalgia patients was randomly assigned to one of four groups: Control (n = 20), Suit only (n = 22), Suit combined with VR (n = 21), and Exercise (n = 26). Results: This study found notable differences across the groups in several key parameters. In the Control group, significant changes were observed in Forced Expiratory Volume (FEV 1/FEV 6), the Numeric Rating Scale (NRS) for pain, Pressure Pain Threshold (PPT) at the epicondyle, cortical arousal levels, the 10 m up-and-go test, and in all measured variables related to temperature and muscle oxygenation. For the group using the suit alone, there were significant differences noted in the NRS, the chair stand test, palm temperature, and all muscle oxygenation parameters. The Suit + VR group showed significant changes in the NRS, PPT at the knee, handgrip strength test, the 10 m up-and-go test, one-leg balance test with the right leg, muscle oxygen saturation (SmO₂), deoxygenated hemoglobin (HHb), and oxygenated hemoglobin (O₂Hb). Finally, the Exercise group exhibited significant differences in FEV 1/FEV 6, chest perimeter difference, NRS, PPT at both the epicondyle and knee, cortical arousal, the chair stand test, the 10-m up-and-go test, and in SmO₂, HHb, and O₂Hb levels. Conclusions: combining neuromodulation with VR and targeted exercise regimens can effectively alleviate fibromyalgia symptoms, offering promising avenues for non-pharmacological management. Full article

Background: The purpose of this study is to identify the relationship between locomotive syndrome (LS) status, physical performance and limb and trunk skeletal muscle mass before and after surgery in adult spinal surgery (ASD) patients. Methods: A retrospective observational investigation of 63 consecutive patients with ASD who underwent spinal surgery was conducted. The total skeletal muscle mass of the arms and legs was considered a measure of the total appendicular skeletal muscle mass measured with whole-body dual-energy X-ray absorptiometry. All data pertaining to the physical performance tests and LS were collected preoperatively with follow-up one year postoperatively. Results: Gait speed, the one-leg standing test and the stand-up test were significantly improved one year after surgery compared to preoperative measurements. The lower extremity skeletal muscle mass predominantly influences physical function improvement including gait stride, one-leg standing and the stand-up test after ASD surgery. Conclusions: This study is the first to show that assessing lower extremity muscles prior to ASD surgery is useful in predicting postoperative recovery. Full article

The primary aim of this study was to examine the relationships between smoking status and health-related physical fitness and balance ability in older males residing in Taiwan. This investigation adopted a cross-sectional design, utilizing data from 7688 older males who took part in the 2014–2015 wave of the National Physical Fitness Survey of Taiwan. Various data sources, including a standardized structured questionnaire, anthropometric measurements, health-related physical fitness assessments, and balance ability tests, were analyzed. The participants were divided into three categories based on their smoking habits: never smokers, former smokers, and current smokers. Multiple regression analyses were performed to evaluate the linear association between cigarette smoking status and health-related physical fitness and balance ability performance. Health-related physical fitness and balance performance were significantly greater (p < 0.05) in the never smoker group than in the current smoker group. Current smoking status was significantly negatively (p < 0.05) associated with cardiopulmonary function, muscular endurance, flexibility, and balance performance. A history of smoking (former smoker) was significantly negatively (p < 0.05) associated with the 2-min step test, 30-s arm curl and chair stand, as well as the 8-foot up-and-go test; however, the association was not significant for the back scratch, chair sit-and-reach, and one-leg stance with eyes open performance. These results suggest that current cigarette smoking is detrimental to health-related physical fitness and balance performance in older males. Quitting smoking may reverse the effects of smoking on overall body flexibility and static balance performance in Taiwanese older adults, thereby reducing the risk of falls and incapacity. Full article

Diamond step (DS) exercises are associated with multiple components of postural control and, thus, have the potential to efficiently improve balance ability. This study aimed to verify whether DS exercises contribute to improving balance ability. This study included 35 healthy young people and 29 older adults. DS exercises were performed continuously for 3 min, four times a week, for 1 month. Balance ability was assessed at baseline and after 1 and 2 months; eight items in total were examined: 30 s chair stand test, functional reach test, standing on one leg with eyes closed, time required for five rounds of DS, left–right DS, Y balance test, open–close stepping test, and finger-to-floor distance. The difficulty, achievement, and lightness/enjoyment of DS exercises were measured after the first practice and 1 month after beginning the exercises as subjective evaluations. Older adults showed improvement in seven of the eight items, with the exception being the one-legged stance with closed eyes. The subjective evaluation showed a decrease in the level of difficulty of DS exercises for older adults. DS exercises may improve balance by effectively utilizing various postural control strategies. These exercises can be effective and easy to implement, given their moderate difficulty level and self-efficacy. Full article

This study determined the cut-off time for the one-leg standing test (OLST) to simply screen the severity of locomotive syndrome (LS). We conducted this cross-sectional study on 1860 community-dwelling residents (age, 70.5 ± 9.5 years old; males, n = 826; females, n = 1034) who underwent the OLST and completed the 25-question geriatric locomotive function scale (GLFS-25). Multivariate linear regression and multivariate logistic regression analyses were conducted to assess the relationship between the OLST and the GLFS-25 score and LS after adjusting for age, sex, and body mass index. A receiver operating characteristic (ROC) curve analysis was performed to calculate the optimal cut-off time of the OLST for determining LS severity. The multivariate linear regression and multivariate logistic regression analyses showed that the OLST was significantly associated with the GLFS-25 score and a diagnosis of LS. The optimal cut-off times of the OLST to screen LS-1, LS-2, and LS-3 were 42 s (sensitivity 65.8%, specificity 65.3%), 27 s (sensitivity 72.7%, specificity 72.5%), and 19 s (sensitivity 77.4%, specificity 76.8%), respectively. We developed a simplified screening tool for the OLST to determine LS severity. Full article

This study’s aim was two-fold: (i) to test the intra-session reliability of the one-leg balance activity test; and (ii) to assess the influence of age on reaction time (RT) and the differences between dominant and non-dominant feet. Fifty young soccer players with an average age of 12.4 ± 1.8 years were divided into two groups: younger soccer players (n = 26; 11.6 ± 0.9 years) and older soccer players (n = 24; 14.2 ± 0.8 years). Each group then completed four trials (two with each leg) of the one-leg balance activity (OLBA) to evaluate RT under a single-leg stance. Mean RT and the number of hits were calculated, and the best trial was also selected. T-tests and Pearson correlations were performed for statistical analysis. Values for RT were lower, and the number of hits was higher while standing on the non-dominant foot (p = 0.01). MANOVA revealed that the “Dominant Leg” factor did not affect the multivariate composite (Pillai Trace = 0.05; F(4, 43) = 0.565; p = 0.689; Partial ETA Squared = 0.050; Observed Power = 0.174). The “Age” factor did not present an effect on the multivariate composite (Pillai Trace = 0.104; F(4, 43) = 1.243; p = 0.307; Partial ETA Squared = 0.104; Observed Power = 0.355). The results of the present investigation demonstrate that RT may be lower while standing on the non-dominant foot. Full article