Search Results (240)

Sufficient levels of physical activity are fundamental for preventing cardiovascular disease, dementia, and ultimately disability in older persons, yet this protective factor is nullified when excessive hours are spent in continuous sitting. Balancing physical activity and sedentary behavior is crucial for influencing metabolic parameters and vascular patterns, both central and peripheral, thereby reducing the risk of cardiovascular diseases, vascular dementia, and cognitive impairment. The primary goal of geriatric medicine is to improve quality of life and prevent disability by promptly identifying frail older individuals, thus mitigating both cognitive and motor impairments. Achieving this objective requires not only the optimization of pharmacological treatments but also the active promotion of a healthy lifestyle. In this context, investigating preclinical stages of disability, such as Motoric Cognitive Risk (MCR) Syndrome, which integrates physical and cognitive components of decline, becomes essential. However, despite robust evidence supporting these interventions, greater efforts are needed from the geriatric medical community to bridge the gap between scientific recommendations and everyday clinical practice. Integrating these guidelines into routine care is pivotal for delivering personalized interventions that address both physical inactivity and prolonged sedentary behavior. More research should aim to strengthen this balance, providing clearer, actionable strategies for clinicians to implement, thereby fostering the formation of evidence-based public health guidelines on physical activity specifically tailored for older persons. Full article

In wheelchair basketball, classes are based on competition observations. Since 2021, out-of-competition testing has been implemented; however, research remains limited. This study aimed to determine whether the quantified volume of action (VOA) can be an indicator for classification and examined the influence of a competitive wheelchair on VOA evaluation. This cross-sectional study included 47 wheelchair basketball players (21 able-bodied, 26 with physical impairments: class 1, n = 8; class 2, n = 5; class 3, n = 4; class 4, n = 9). Tests were performed in a wheelchair (wheelchair condition) and on a trainer bed (bed condition). Participants held a ball and rotated their trunks in various planes. Movements were recorded using four cameras, and position coordinates were extracted using the three-dimensional DLT method. Classes and sitting conditions were compared across five groups: classes 1, 2, 3, 4, and able-bodied. Comparisons between classes revealed significant differences in all planes, including wheelchair and bed conditions (p < 0.05). The VOA expanded in the wheelchair condition compared to the bed condition across multiple classes and planes (p < 0.05). Measuring the VOA outside the competition while sitting on a bed may effectively classify players by eliminating equipment influence. Full article

Background/Objectives: This clinical trial aimed to determine whether perturbation-based gait training (PBGT) on a split-belt treadmill enhances balance and muscle strength in older adults, comparing its effectiveness with walking-only training on a treadmill. Methods: This single-center, prospective, single-blind (assessor), randomized controlled trial included 24 older adults from the Rehabilitation Center of Jeonbuk National University Hospital. Participants were equally divided into the PBGT and control groups. Both groups underwent 12 training sessions, three times a week for 4 weeks, for a total of 43 min per session. The outcomes, including the Five Times Sit-to-Stand Test (FTSST), Falls Efficacy Scale International, timed up-and-go (TUG) test, functional reach test, and lower-extremity manual muscle test scores, were measured at three time points: pre-training, post-training, and four weeks after training. Results: While there were no significant differences between the two groups, the PBGT group demonstrated significant improvements in its FTSST and TUG values. Conclusions: Unpredictable perturbation training on a split-belt treadmill can be safely performed by older adults and may serve as an alternative exercise method to enhance physical performance and balance ability for fall prevention. Full article

Background: Ageing and sedentary lifestyles affect physical and cognitive function and markers of frailty, increasing the risk of falls in older adults and affecting their quality of life. The aim of this study was to evaluate the effects of a Square Step Exercise programme on physical and cognitive function and plasma SMP30 levels for the prevention of falls in older adults. Methods: A randomised controlled trial was designed with 44 participants assigned to an experimental group (SSE group) and a control group. The SSE group performed SSE sessions twice a week for three months, with a follow-up in the fourth month. The assessments of physical function included tests such as the Four-Square Step Test, Brisk Walking and its dual-task variant, Time Up and Go and its imagined and dual-task variants, 30 s Sit-to-Stand and its dual-task and imagined variants and a 6 min walking test. Questionnaires were also used to assess the risk and fear of falling. Resting EEG activity was also recorded to assess electrocortical brain activity. SMP30 levels were measured by Western blotting. Results: The SSE group showed significant improvements compared to the control group in the Four-Square Step Test (p < 0.001), Brisk Walking (p < 0.05) and reduction in the fear of falling (p < 0.001) after the training programme, but these adaptations were not maintained one month after the programme ended (p < 0.05). No significant changes were observed in the remaining variables of physical function, cognitive function, fall risk questionnaire, EEG activity or plasma levels of SMP30 compared to the control group (p > 0.05). Conclusions: The SSE programme showed efficacy in improving balance, gait speed and reducing fear of falling in older adults but did not show improvement over the control group in other areas of physical or cognitive function or plasma SMP30 levels for fall prevention. Full article

Background: Although a cross-legged sitting (CLS) posture has been commonly practiced as a daily activity, particularly in Arabic, Middle Eastern, and Asian societies, there is no medical study focusing on the effects of cross-legged sitting on body balance and muscular strength. Therefore, this study aimed to investigate the effect of CLS on lower extremity muscular strength, muscular electrical activity, and body balance. Methods: Thirty healthy volunteers participated in this research study by performing CLS for a 20 min duration. The balance tests included a static test, i.e., a single-leg-standing posture with eyes closed, to assess if the centre of the pelvis and centre of the shoulders (CoS) moved, and a dynamic test, i.e., four-square-returning, to assess if the moving speed changed. Regarding the muscular assessment, the electrical activity was assessed depending on the maximal value of activation and rooted mean of squared values, while the muscular strength was assessed according to the maximum force by the lower limbs using a force sensor. The balance and muscular results were statistically compared before and after CLS. Results: The duration of the static balance after CLS decreased by an average of 2.5 s, or approximately 15.64%, compared to before CLS (p < 0.05 *). Further, the Centre of Pelvis moved greater distances in the medial–lateral direction after CLS compared to before, but CoS was not significantly changed in the static balance test. However, in the dynamic balance test, the duration significantly decreased by 0.2 s, or approximately 8.5%, after CLS compared to before, meaning that dynamic balance ability improved. Considering the muscle results, only the lateral gastrocnemius muscle was noticeably electrically activated after CLS, while the hip extensor and knee flexor muscles became significantly stronger after CLS compared to before, roughly by about 14%, and the ankle plantar flexor maximum force increased noticeably, by about 4%, after CLS. Conclusions: CLS had a positive impact on the dynamic balance; the strength of the hip extensor, knee flexor, and ankle plantar flexion; and all lower limb muscles, in terms of electrical stimulation, except for the lateral gastrocnemius post-CLS compared to pre-CLS. Therefore, CLS can be safely included in one’s daily routine and in any rehabilitation programme, except for patients who are suffering from static balance disturbance. Although this posture is commonly used in many societies, because this is the first study focused on the impact of CLS on body balance and muscular status, the results would supply knowledge and new understanding, as well as provide clear insight for sitting posture research. Full article

(1) Background: Aging is associated with a progressive decline in physical capacity, which is further exacerbated by conditions such as arthritis and chronic joint pain. This study aimed to compare the effects of aquatic and land-based exercise on the functional fitness of older adult women. (2) Methods: Sixty older women (mean age 66.9 ± 3.8 years) participated in this study, divided into two groups: aquatic exercise and land-based exercise. Both groups completed functional fitness tests, including flexibility (Back Scratch and Chair Sit-and-Reach Tests), lower body strength (Chair Stand Test), and dynamic balance (8-Foot Up-and-Go Test). Statistical analyses compared group performance. (3) Results: Improvements in flexibility were observed in the aquatic group, with trends toward significance for the Back Scratch Test (−0.2 ± 1.0 cm vs. −2.0 ± 0.0 cm, p = 0.08) and the Chair Sit-and-Reach Test (2.87 ± 2.0 cm vs. 0.27 ± 1.0 cm, p = 0.07). No statistically significant differences were observed between the groups in measures of lower body strength (Chair Stand Test: 19.1 ± 4.47 reps vs. 18.97 ± 3.77 reps, p = 0.9) or dynamic balance (8-Foot Up-and-Go Test: 6.28 ± 6.2 s vs. 6.03 ± 5.83 s, p = 0.07). (4) Conclusions: Aquatic exercise showed greater improvements in flexibility, particularly in the upper and lower body, although these differences did not reach statistical significance. Both training modalities were equally effective in maintaining lower body strength and dynamic balance in older adult women. These findings support the inclusion of tailored exercise programs in aging populations to address specific functional needs. Full article

Background: There has been a growing interest in using inertial sensors to explore the temporal aspects of the Timed Up and Go (TUG) test. The current study aimed to analyze the spatiotemporal parameters and phases of the TUG test in patients with knee osteoarthritis (KOA) and compare the results with those of non-arthritic individuals. Methods: This study included 20 patients with KOA and 60 non-arthritic individuals aged 65 to 84 years. All participants performed the TUG test, and 17 spatiotemporal parameters and phase data were collected wirelessly using the BTS G-Walk inertial sensor. Results: Significant mobility impairments were observed in KOA patients, including slower gait speed, impaired sit-to-stand transitions, and reduced turning efficiency. These findings highlight functional deficits in individuals with KOA compared to their non-arthritic counterparts. Conclusions: The results emphasize the need for targeted physiotherapy interventions, such as quadriceps strengthening, balance training, and gait retraining, to address these deficits. However, the study is limited by its small sample size, gender imbalance, and limited validation of the BTS G-Walk device. Future research should include larger, more balanced cohorts, validate sensor reliability, and conduct longitudinal studies. Despite these limitations, the findings align with previous research and underscore the potential of inertial sensors in tailoring rehabilitation strategies and monitoring progress in KOA patients. Full article

Background: Pusher behavior after stroke is an important sequela that interferes with rehabilitation and independence in activities of daily living. As represented by visual or vestibular feedback, conventional methods require substantial assistance and time commitments, but have limited effectiveness. A recent case series suggests that prone posture may alleviate pusher behavior in patients with acute stroke. This study was conducted to retrospectively investigate the effects of prone posture maneuvers. Methods: This retrospective cross-sectional observational study was conducted in a stroke care unit at a university hospital. In total, 37 acute stroke cases presenting with pusher behavior were included from 787 eligible patients. Individuals with pusher behavior were conditioned with prone posturing for 10 min for 2 consecutive days, in addition to regular daily rehabilitation training. The Scale for Contraversive Pushing (SCP) values, Stroke Impairment Assessment Set (SIAS), and functional activities were assessed before, immediately after, and three days after the intervention. Results: The SCP value and the ability to roll over and sit balanced significantly improved compared with the baseline (p < 0.05) and persisted for 3 days after the intervention. Multiple regression analysis identified the SIAS motor score as a determinant of SCP changes. Conclusions: The prone posture maneuver promptly and consistently suppressed pusher behavior, particularly in patients with mild paresis, as indicated by SCP values in acute stroke cases. The uncontrolled, single-site, and retrospective features of the current study require further investigation. Full article

Background/Objectives: An optimal physical condition has beneficial effects in adults at risk of chronic diseases. However, research data on how adverse reactions to food (ARFSs) are linked to physical performance are lacking. The aims of this study were (a) to investigate the prevalence of ARFS according to age; (b) to analyze physical performance level according to the type of ARFS; and (c) to determine the probability of having a positive ARFS according to physical performance levels. Methods: A cross-sectional study with 254 Spanish adults (61% women; mean age 43.7 ± 13 y) scoring ≥ 6 in PSIMP-ARFSQ-10 (pathologies and symptomatology questionnaire associated with adverse reactions to foodstuffs) was conducted in the region of Madrid, Spain, following the ALASKA study protocol. Immune-mediated variables used to measure ARFS were sIgE and sIgG₄ antibody reactions (AbR) (type 1 and type 2 food hypersensitivities, respectively); non-immune-mediated variables used to measure ARFS were lactose intolerance and fructose malabsorption. Physical performance variables were body balance, leg power, sit-to-stand speed, resting heart rate, handgrip strength, and cardiorespiratory fitness. Statistical significance was set at 0.05. Results: The most prevalent sIgE- and sIgG₄-mediated ARFSs were against legumes (53% and 46%; 60% and 68% in subjects with ≤45 y and >45 y, respectively). Handgrip strength was significantly lower in subjects positive for lactose intolerance compared to subjects negative for lactose intolerance (p < 0.05). Both the positive mean sIgE and sIgG₄ AbR were significantly associated with high physical performance (p < 0.05). Subjects with high physical performance showed a 1.5-fold increase in the odds of the positive mean total sIgE and positive sIgG₄ AbR against legumes. Conclusions: In conclusion, subjects aged 45 or younger had a higher prevalence of total type 1 and type 2 food hypersensitivities than subjects older than 45 y. Positive lactose intolerance was linked to lower values of handgrip strength. Subjects with high physical performance, whether male or female, aged ≤45 years, or with a BMI of ≥25, showed significant odds of experiencing type 1 food hypersensitivity to nuts. Full article

The knee is one of the joints most vulnerable to disease and injury, particularly in athletes and older adults. Surface temperature monitoring provides insights into the health of the analysed area, supporting early diagnosis and monitoring of conditions such as osteoarthritis and tendon injuries. This study presents an innovative approach that combines infrared thermography techniques with a Resnet 152 (DeepLabCut based) to detect and monitor temperature variations across specific knee regions during repeated sit-to-stand exercises. Thermal profiles are then analysed in relation to weight distribution data collected using a Wii Balance Board during the exercise. DeepLabCut was used to automate the selection of the region of interest (ROI) for temperature assessments, improving data accuracy compared to traditional time-consuming semi-automatic methods. This integrative approach enables precise and marker-free measurements, offering clinically relevant data that can aid in the diagnosis of knee pathologies, evaluation of the rehabilitation progress, and assessment of treatment effectiveness. The results emphasize the potential of combining thermography with DeepLabCut-driven data analysis to develop accessible, non-invasive tools for joint health monitoring or preventive diagnostics of pathologies. Full article

Background/Objectives: This study aimed to assess and compare the effects of an adapted taekwondo (TKD) program, multicomponent training (MCT), walking exercise (WE), and inactive control group (CG) on blood pressure, morphological variables, frequency of food consumption, cognitive status, health-related quality of life (HRQoL), physical fitness tests, and postural balance in independent older females. Methods: A randomized controlled trial study was conducted with the following groups: TKD (n = 13), MCT (n = 12), WE (n = 12), and CG (n = 14), considering three/weekly 60-min/sessions for 16-weeks. A two-factor mixed analysis of the variance model with repeated measures was performed. Results: TKD improved significantly more in phonetic fluency (p = 0.021; ES = 1.89) than WE and in general health (p = 0.033; ES = 1.11) than CG. Both TKD and MCT improved significantly more than CG in the 30 s chair stand, arm curl, chair sit-and-reach, timed up-and-go, maximal isometric handgrip strength, and postural balance for the eyes closed condition in the area and anteroposterior velocity (p < 0.05). Conclusions: Only TKD improved the area (p = 0.008; ES = 1.00) and mediolateral velocity (p = 0.019; ES = 0.79) for the eyes open condition, and mediolateral velocity (p = 0.021; ES = 1.57) for the eyes closed condition. Blood pressure, morphological variables, and food consumption frequency showed no significant intragroup or intergroup interactions. TKD equivalently improved HRQoL and physical fitness to MCT, with better postural balance in older females. Full article

The Modified Functional Reach Test (mFRT) was developed to assess sitting balance in individuals with spinal cord injury (SCI). No studies have explored which mFRT reach directions correlate with the center of pressure (CoP) variables in patients with motor-complete SCI (mcSCI). Addressing this gap is important for improving the clinical usefulness of the mFRT. Thus, this study aims to determine the correlation between seated balance parameters based on CoP and the mFRT in individuals with MCSCI. A total of 10 individuals with mcSCI (9 males and 1 female; range 20–42 years; 4 high paraplegia and 6 low paraplegia). Individuals were tested using a force platform during the sitting postural balance test (SPBT) and the mFRT with/without force plate with three measures of reach: forward (FR), right (RR), and left (LR). The sway parameters investigated were the area CoP sway (CoP_Sway), the average velocity of CoP displacements along the anterior–posterior (V_AP) and medial-lateral (V_ML) directions, and standard deviation in both directions (SD_AP and SD_ML). The Pearson correlation test was used to analyze the data. Significant correlations were found between the mediolateral reaches of the mFRT and corresponding CoP variables. The rightward and leftward reaches of the mFRT both showed strong correlations with CoP variables during the leftward reach. Additionally, the leftward mFRT exhibited moderate correlations with CoP variables in the same, rightward, and forward directions. The mFRT medio-lateral direction correlates with CoP at medio-lateral directions in paraplegic individuals with mcSCI. Full article

Background/Objectives: Dementia involves the loss of cognitive abilities and impairs functional abilities in daily life. In motor imagery (MI) techniques, motor acts are mentally rehearsed without any overt body movements. The purpose of the randomized controlled trial was to examine the effects of MI on the motor function of older adults with dementia. Methods: Overall, 160 participants (43 men, 117 women, MMSE M = 23.20, SD = 0.15) from an Athens Day Care Center of the Alzheimer Association were randomized to (a) the MI and exercise group (experimental group) (n = 55), (b) the only exercise group (1st control group) (n = 52) and (c) the neither MI nor exercise group (2nd control group) (n = 53). The exercise session comprised 24 physiotherapy exercise sessions, lasting 45 min each, twice a week for 12 weeks. The exercises were selected from the Otago Exercise Program. Three assessments were performed: (a) one week prior to the program, (b) at one and a half months and (c) after the program. The experimental group performed a 30-minute MI with exercise program content after the end of every physiotherapy exercise session. The Multidirectional Reach Test, Five Times Sit-to-Stand Test (FTSST), Timed Up and Go test (TUG), Functional Gait Assessment (FGA) and Berg Balance Scale (BBS) were used to assess participants’ balance and functional status. Results: In the intention to treat analysis (18 participants dropped out), the 3 × 3 repeated measures ANOVA indicated statistically significant results between the three groups on (a) the TUG (F = 3.06, df (2), p = 0.04), (b) the FTSST (F = 3.00, df (2), p = 0.05), (c) the forward direction test (F = 4.14 df (2), p = 0.02), the lateral right and the lateral left direction tests (F = 3.90, df (2), p = 0.02 and F = 7.87, df (2), p = 0.00, respectively), and (d) the FGA (F = 4.35, df (2), p = 0.01). The Friedman test showed significant statistical significant differences among the three groups for BBS (X² = 7.62, df = 2, p = 0.22), and an effect size of partial η² coefficient for F-tests was found. Post hoc comparisons using a Bonferroni test for ANOVA and Wilcoxon test for Friedman indicated that the mean scores for the experimental group and the 1st control were significantly better than the 2rd control group in many dependent variables. Conclusions: The study showed a positive effect of MI on balance and the functional status of older adults with early stages of dementia with possible beneficial effects on maintaining independence and reducing physical decline. Full article

Background/Objectives: Individuals with subjective cognitive decline (SCD) have an increased risk of developing dementia, while non-pharmacological multicomponent lifestyle interventions are recommended for prevention/management. The Greek Interventional Geriatric Initiative to Prevent Cognitive Impairment and Disability (GINGER) is such a multicomponent approach, encompassing simultaneous interventions (cognitive training, depression and sleep management, etc.). Exercise/Physical activity (PA) is suggested as one such intervention. This study (i) presents the exercise protocol developed for GINGER and (ii) explores its feasibility (acceptability, applicability, adherence, users’ satisfaction and reliability). Methods: Exercise/PA protocol development, targeting SCD individuals aged > 55 years, utilized relevant guidelines/literature followed by focus group involving exercise specialists. Data were synthesized through consensus to design optimal exercise interventions prescribed on participant’s physical capacity (heart rate, exertion, etc.), comprising 6-month combined aerobic, strengthening, balance and dual-task exercises, delivered 3 times/weekly in two group-based supervised sessions (in-person and online) and one home-based session. Physical outcomes include balance, aerobic capacity [2-Minute Walk Test (2 MWT), IPAQ-7], strength [Hand Grip Strength (HGS), Sit-to-Stand], fear of falling. Eligibility for entering intervention is low IPAQ-7, 2 MWT or HGS scoring. Feasibility was explored with adherence (exercise diaries and Exercise Adherence Rating Scale) and satisfaction (Patient Satisfaction Questionnaire) Results: Intervention was easily delivered with good reliability across testers’ assessments on 13 SCD participants (ICCs = 0.62–0.99), and improved physical outcomes, whereas users’ adherence and satisfaction scored highly. Conclusions: The exercise protocol for SCD was feasible, acceptable, applicable, reliable, demonstrating adherence and satisfaction, while improving physical parameters. It is thus integrated in the GINGER study, where multiple simultaneous interventions will take place to prevent/enhance cognitive function. Full article

Introduction: Stroke is a leading cause of mortality and long-term disability worldwide, often resulting in low levels of physical activity post-discharge. A comprehensive exercise program could be a safe method to increase stroke patients’ physical activity and exercise volume. This pilot study examines the effectiveness, safety, and feasibility of a comprehensive exercise regimen for stroke patients residing in the community after discharge. Methods: This single-group pilot study included patients who received inpatient rehabilitation for motor impairment following a stroke. Community-dwelling participants engaged in a comprehensive exercise program, which was structured and individualized, consisting of stretching, aerobic exercise, strength training, and balance exercises, conducted under the supervision of a health exercise specialist in a dedicated living lab within the hospital. The program involved 20 sessions, each lasting 50 min, conducted three to five times weekly. The pre- and post-intervention evaluations were comprehensive, including safety and validity assessments, along with physical function tests such as cardiopulmonary exercise testing and various fitness tests (6 min walk test, timed up and go test, chair stand test, figure-of-8 walk test, grip strength test, and sit-and-reach test). Depression levels were assessed using the Geriatric Depression Scale (GDS). Results: A total of 22 subjects were recruited, with 21 completing the study after one dropout due to fatigue and visiting distance. Among the 21 completers, one subject experienced a mild adverse event (hypoglycemia), which was not serious, confirming the program’s safety. The exercise participation rate was 95.5%, and the adherence rate averaged 95.2%, with all completers achieving over 80% adherence. Significant improvements were observed in VO₂ peak (p = 0.000), 6 min walk test (p = 0.000), timed up and go test (p = 0.000), chair stand test (p = 0.000), figure-of-8 walk test (p = 0.000), and grip strength (p = 0.001). However, changes in the peak respiratory exchange ratio (p = 0.078), sit-and-reach test (p = 0.228) and GDS scores (p = 0.275) were not significant. Conclusion: This study demonstrates that the comprehensive exercise program is sufficiently safe and valid for stroke rehabilitation patients. The program significantly enhances cardiopulmonary endurance, walking ability, balance, muscle strength, muscle endurance, and coordination. Further research with larger sample sizes and control groups is needed to confirm these findings and explore additional benefits. Full article