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1.
Improving Trip- and Slip-Resisting Skills in Older People: Perturbation Dose Matters.
Karamanidis, K, Epro, G, McCrum, C, König, M
Exercise and sport sciences reviews. 2020;(1):40-47
Abstract
Aging negatively affects balance recovery responses after trips and slips. We hypothesize that older people can benefit from brief treadmill-based trip and slip perturbation exposure despite reduced muscular capacities, but with neuropathology, their responsiveness to these perturbations will be decreased. Thus, to facilitate long-term benefits and their generalizability to everyday life, one needs to consider the individual threshold for perturbation dose.
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2.
Dancing for Healthy Aging: Functional and Metabolic Perspectives.
Rodrigues-Krause, J, Krause, M, Reischak-Oliveira, A
Alternative therapies in health and medicine. 2019;(1):44-63
Abstract
CONTEXT Dancing has been used as a form of exercise to improve functional and metabolic outcomes during aging. The field lacks randomized, clinical trials (RCTs) evaluating metabolic outcomes related to dance interventions, but dancing may be a form of exercise that could induce positive effects on the metabolic health of older adults. However, primary studies seem very heterogonous regarding the trial designs, characteristics of the interventions, the methods for outcomes assessments, statistical powers, and methodological quality. OBJECTIVE The current research team intended to review the literature on the use of dance as a form of intervention to promote functional and metabolic health in older adults. Specifically, the research team aimed to identify and describe the characteristics of a large range of studies using dance as an intervention, summarizing them and putting them into perspective for further analysis. DESIGN The research team searched the following data sources-MEDLINE, Cochrane Wiley, Clinical Trials.gov, the Physiotherapy Evidence Database (PEDRO), and the Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS)-for RCTs, quasi-experimental studies, and observational trials that compared the benefits of any style of dancing, combined with other exercises or alone, to nonexercising controls and/or controls practicing other types of exercise. SETTING The study took place at the Federal University of Rio Grande do Sul (Porto Alegre, Brazil). PARTICIPANTS Participants were aging individuals, >55 y, both with or without health conditions. INTERVENTIONS Interventions should be supervised, taking form as group classes, in a dance setting environment. Dance styles were divided into 5 categories for the review: (1) cultural dances developed by groups of people to reflect the roots of a certain region, such as Greek dance; (2) ballroom dance (ie, dances with partners performed socially or competitively in a ballroom, such as foxtrot); (3) aerobic dance with no partner required, which mixes aerobic moves with dance moves; (4) dance therapies, whichare special dance programs including emotional and physical aspects; and (5) classical dances, which are dances with a unique tradition and technique, such as ballet or jazz dance. OUTCOME MEASURES Studies needed to have evaluated functional and/or metabolic outcomes. Functional outcomes included (1) static and/or dynamic balance, (2) gait ability, (3) upper and/or lower muscle strength or power, (4) cardiorespiratory fitness, (5) flexibility, (6) risk of falls, and (7) quality of life. Metabolic outcomes included (1) lipid and glycemic profile; (2) systolic and diastolic blood pressure; (3) body composition; and (4) other specific cardiovascular risk factors or inflammatory or oxidative stress markers. RESULTS The research team retrieved 1042 articles, with 88 full texts assessed for eligibility, and 50 articles included in the analysis. Of the analyzed studies, 22 were RCTs evaluating dancing vs controls, and 3 were RCTs evaluating dancing vs other exercise. Regarding the participants of the reviewed studies: (1) 31 evaluated healthy individuals, (2) 7 evaluated patients suffering from Parkinson's disease, (3) 4 evaluated postmenopausal women, (4) 2 evaluated obese women, (5) 2 evaluated patients with chronic heart failure, (6) 1 evaluated frail older adults, (7) 1 evaluated individuals with visual impairments, (8) 1 evaluated persons with metabolic syndrome, and (9) 1 evaluated individuals with severe pain in the lower extremities. Regarding the interventions, most interventions were 12 wk long, 3 ×/wk, for 60 min each session. The dance styles most used were ballroom and cultural dances. Regarding the outcomes, functional and metabolic benefits were described in most of the included studies. Balance was the functional outcome most often assessed. CONCLUSIONS Any dance style can induce positive functional adaptations in older adults, especially related to balance. Metabolic improvements may also be a result of dancing; however, more RCTs are needed. Dancing may be a potential exercise intervention to promote health-related benefits for aging individuals.
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3.
Threshold of Energy Deficit and Lower-Body Performance Declines in Military Personnel: A Meta-Regression.
Murphy, NE, Carrigan, CT, Philip Karl, J, Pasiakos, SM, Margolis, LM
Sports medicine (Auckland, N.Z.). 2018;(9):2169-2178
Abstract
BACKGROUND Negative energy balance (EB) is common during military operations, diminishing body mass and physical performance. However, the magnitude of negative EB where performance would still be maintained is not well defined. OBJECTIVE Our objective was to explore relationships between EB and physical performance during military operations and define an acceptable negative EB threshold where performance may be maintained. METHODS A systematic search was performed for studies that measured EB and physical performance during military training. A total of 632 articles and technical reports were screened. Lower-body power and strength were the most common performance tests across investigations and were used as physical performance outcomes. Data were extracted from nine eligible studies containing 15 independent subgroups. Meta-regression assessed changes in performance in relation to study duration (days), average daily EB, and total EB (daily EB × duration). RESULTS Changes in physical performance were not associated with average daily EB or training duration. Total EB was associated with changes in lower-body power (r2 = 0.764, P < 0.001) and strength (r2 = 0.836, P < 0.001) independently and combined (r2 = 0.454, P = 0.002). Predictive equations generated from the meta-regression indicated that, for a zero to small (2%) decline in performance, total EB should be limited to - 5686 to - 19,109 kcal, for an entire operation, whereas total EB of - 39,243 to - 59,377 kcal will result in moderate (7%) to large (10%) declines in performance. CONCLUSION These data demonstrated that greater total negative EB is associated with declines in lower-body performance during military operations.
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4.
Motor learning in people with Parkinson's disease: Implications for fall prevention across the disease spectrum.
Paul, SS, Dibble, LE, Peterson, DS
Gait & posture. 2018;:311-319
Abstract
BACKGROUND Falls are a significant burden for people with Parkinson's disease (PD), however, individuals across the spectrum of disease severity respond differently to fall prevention interventions. Despite the multifactorial causes of falls in people with PD, recent work has provided insight into interventions that hold promise for fall prevention. Further, studies have begun to identify patient characteristics that may predict responsiveness to such interventions. RESEARCH QUESTION We discuss (i) the postural motor learning abilities of people with mild versus severe PD that could affect their ability to benefit from fall prevention interventions, (ii) how people with different severity of PD respond to such interventions, and (iii) the practical considerations of providing effective fall prevention interventions for people with PD across the spectrum of disease severity. METHODS This narrative review consolidates recent work on postural motor learning and fall prevention rehabilitation involving exercise in people with PD. RESULTS People with PD are able to improve postural motor control through practice, enabling them to benefit from exercise which challenges their gait and balance to reduce falling. Worsening of axial and cognitive symptoms may result in diminished learning, and those with more severe PD may require fully supervised, high intensity programs to reduce falls. SIGNIFICANCE Understanding how people with PD across the spectrum of disease severity differ in their postural motor learning ability and response to different fall prevention interventions will enable researchers and clinicians to refine such interventions and their delivery to minimize falls and their negative sequelae in people with PD.
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5.
Clinical measures of balance in people with type two diabetes: A systematic literature review.
Dixon, CJ, Knight, T, Binns, E, Ihaka, B, O'Brien, D
Gait & posture. 2017;:325-332
Abstract
Approximately 422 million people have diabetes mellitus worldwide, with the majority diagnosed with type 2 diabetes mellitus (T2DM). The complications of diabetes mellitus include diabetic peripheral neuropathy (DPN) and retinopathy, both of which can lead to balance impairments. Balance assessment is therefore an integral component of the clinical assessment of a person with T2DM. Although there are a variety of balance measures available, it is uncertain which measures are the most appropriate for this population. Therefore, the aim of this study was to conduct a systematic review on clinical balance measures used with people with T2DM and DPN. Databases searched included: CINAHL plus, MEDLINE, SPORTDiscus, Dentistry and Oral Sciences source, and SCOPUS. Key terms, inclusion and exclusion criteria were used to identify appropriate studies. Identified studies were critiqued using the Downs and Black appraisal tool. Eight studies were included, these studies incorporated a total of ten different clinical balance measures. The balance measures identified included the Dynamic Balance Test, balance walk, tandem and unipedal stance, Functional Reach Test, Clinical Test of Sensory Interaction and Balance, Berg Balance Scale, Tinetti Performance-Oriented Mobility Assessment, Activity-Specific Balance Confidence Scale, Timed Up and Go test, and the Dynamic Gait Index. Numerous clinical balance measures were used for people with T2DM. However, the identified balance measures did not assess all of the systems of balance, and most had not been validated in a T2DM population. Therefore, future research is needed to identify the validity of a balance measure that assesses these systems in people with T2DM.
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6.
Recent advances in the diagnosis and treatment of balance disorders.
Jahn, K, Dieterich, M
Journal of neurology. 2011;(12):2305-8
Abstract
Here we summarize the recent progress made in the diagnosis and treatment of balance and gait disorders. Focusing on work published in the Journal of Neurology in 2010 and 2011, we have found evidence for the following clinically relevant statements: (1) the exclusion of stroke in acute vestibular syndromes is based on the bedside clinical findings; (2) the risk of developing secondary somatoform vertigo is predictable; it is especially high in patients with vestibular migraine; (3) postural imbalance and falls in Parkinson syndromes are related to dysfunction of the cholinergic midbrain thalamic axis; (4) aminopyridines improve a variety of cerebellar parameters including central nystagmus and gait variability.
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7.
Effect of vitamin D supplementation on muscle strength, gait and balance in older adults: a systematic review and meta-analysis.
Muir, SW, Montero-Odasso, M
Journal of the American Geriatrics Society. 2011;(12):2291-300
Abstract
OBJECTIVES To systematically review and quantitatively synthesize the effect of vitamin D supplementation on muscle strength, gait, and balance in older adults. DESIGN Systematic review and meta-analysis. SETTING MEDLINE, EMBASE, Cochrane Library, bibliographies of selected articles, and previous systematic reviews were searched between January 1980 and November 2010 for eligible articles. PARTICIPANTS Older adults (≥60) participating in randomized controlled trials of the effect of supplemental vitamin D without an exercise intervention on muscle strength, gait, and balance. MEASUREMENTS Data were independently extracted, and study quality was evaluated. Meta-analysis using a fixed-effects model was performed and the I(2) statistic was used to assess heterogeneity. RESULTS Of 714 potentially relevant articles, 13 met the inclusion criteria. In the pooled analysis, vitamin D supplementation yielded a standardized mean difference of -0.20 (95% confidence interval (CI) = -0.39 to -0.01, P = .04, I(2) = 0%) for reduced postural sway, -0.19 (95% CI = -0.35 to -0.02, P = .03, I(2) = 0%) for decreased time to complete the Timed Up and Go Test, and 0.05 (95% CI = -0.11 to 0.20, P = .04, I(2) = 0%) for lower extremity strength gain. Regarding dosing frequency regimen, only one study demonstrated a beneficial effect on balance with a single large dose. All studies with daily doses of 800 IU or more demonstrated beneficial effects on balance and muscle strength. CONCLUSION Supplemental vitamin D with daily doses of 800 to 1,000 IU consistently demonstrated beneficial effects on strength and balance. An effect on gait was not demonstrated, although further evaluation is recommended.
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8.
[Musculoskeletal rehabilitation and bone. Static balance exercise for preventing falls and fractures].
Kita, K
Clinical calcium. 2010;(4):567-75
Abstract
There is an urgent need to establish measures for dealing with reduced life function in the elderly. Fractures caused by falls are one of the factors that prevent elderly people from living independently, and there is a need for exercises that provide superior balance and more effectively prevent falls. However, although several meta-analyses have been conducted regarding balance, there are few clear guidelines for balance exercises. In the present study, we clarified the development of balance ability by examining the motor development process, and discuss herein the significance of acquisition and maintenance of static balance. We also conducted a literature search regarding effective exercises for static balance impairment, and include a discussion of the effectiveness and limitations of static balance exercises.
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9.
[Prevention of falls].
Mutoh, Y, Ohta-Fukushima, M, Takasugi, S, Soyano, A
Clinical calcium. 2008;(11):1600-9
Abstract
Falls among the elderly mainly result from aging, lack of exercise, and physical and/or mental disorders. They cause fractures and other injuries. It is necessary that likelihood of falling should be evaluated from the view point of both decreased physical function and fear of falling. General exercise including balance training is considered to be most effective to reduce falls. We must take good care not to cause falling and resultant fracture due to exercise of falls prevention program. Many sided intervention, including a check and counseling on medication and environmental improvement, walking in the sunshine, which stimulates vitamin D biosynthesis and so on, are needed. Further studies on falls prevention among the elderly with dementia and males receiving hormonal therapy with prostatic cancer are necessary.
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10.
[Effects of unipedal standing balance exercise on the prevention of falls and hip fracture].
Sakamoto, K
Clinical calcium. 2006;(12):2027-32
Abstract
To prevent hip fracture there are three methods: 1) falls prevention, 2) treatment of osteoporosis and 3) hip protectors. The improvement of the osteoporosis of the proximal hip demands nutrition involved medication as bisphosphonate and mechanical stress. Unipedal standing captures the 2.75 times weight load to the femoral head. Unipedal standing for one minute is equivalent to the amount of integral load gained through walking for approximately 53 minutes. Unipedal standing balance exercise in one minute 3 times per one day is useful to create the proximal femoral bone density and to prevent falls but is not statistically definition to prevent hip fracture. We believe daily unipedal standing balance exercise should contribute toward overcoming prevention of hip fractures.