Balance, aging, and osteoporosis: effects of cognitive exercises combined with physiotherapy (original) (raw)
Related papers
Physiotherapy, 2015
Objective: To evaluate the long-term effects of a progressive and specific balance group-based program in healthy elderly individuals with increased risk of falling. Design: Follow-up of a randomized controlled trial at nine and 15 months on a population that has previously been described at three months. Setting: The study was conducted in Stockholm, Sweden. Subjects: 59 community-dwelling elderly (age 67-93 years), recruited by advertisement, were randomly allocated to training or to serve as controls. Intervention: Group balance training three times per week during 12 weeks with a 15 month follow-up time.
Journal of Geriatric Physical Therapy, 2017
A randomized controlled trial with follow-up at 3, 9, and 15 months, including 91 participants with osteoporosis (75.6 ± 5.4 years), compared a balance training group (n = 61) with a control group (n = 30). The primary outcome was effect on habitual PA measured as steps/day, dichotomized into less than 5000 or 5000 or more steps/day. Physical activity was assessed with pedometers (Yamax) and accelerometers (Actigraph), HRQoL with the Short Form-36 (SF-36), gait with a GAITRite walkway, balance performance with Modified-Figure-Eight test and one-leg stance, fall-related concerns with Falls Efficacy Scale International, and physical function with the advanced lower extremity subscale of the questionnaire Late Life Function and Disability Instrument. Statistical methods used were multivariate logistic regression and logistic generalized estimating equation. Results: Sixty-eight participants completed the short-term follow-up at 3 months, and 53 participants completed the long-term follow-up at 15 months. Per-protocol analysis (n = 68) showed that the odds ratio for having a daily step count of 5000 or more at 3 months was 6.17 (95% confidence interval, 1.23-30.91), P = .027, for the intervention group compared with the control group. The longitudinal analysis (n = 91) showed that the odds ratio for having a daily step count of 5000 or more at 15 months was 2.02 (95% confidence interval, 0.88-4.64), P = .096, for the intervention group compared with the control group. The mental component sum of the SF-36 improved significantly from baseline to 3 months in the intervention group, and the physical component sum improved in both groups, but no statistically significant differences were found between groups. No associations were found between PA and changes in covariates. Discussion and Conclusions: The short-term evaluation showed that balance training increased habitual PA in communitydwelling older adults with osteoporosis. A significantly higher proportion of participants in the intervention group reached a level of 5000 or more steps/day, which is important for overall health. This effect was not associated with improvements in HRQoL, gait speed, balance performance, or fall-related concerns, and did not persist through the long-term follow-up. To accomplish a sustained PA change, a prolonged intervention or more support regarding habitual PA may be required, such as reinforcement with personalized behavior change counseling or PA on prescription.
Clinical rehabilitation, 2015
To evaluate the effects of a balance training program including dual- and multi-task exercises on fall-related self-efficacy, fear of falling, gait and balance performance, and physical function in older adults with osteoporosis with an increased risk of falling and to evaluate whether additional physical activity would further improve the effects. Randomized controlled trial, including three groups: two intervention groups (Training, or Training+Physical activity) and one Control group, with a 12-week follow-up. Stockholm County, Sweden. Ninety-six older adults, aged 66-87, with verified osteoporosis. A specific and progressive balance training program including dual- and multi-task three times/week for 12 weeks, and physical activity for 30 minutes, three times/week. Fall-related self-efficacy (Falls Efficacy Scale-International), fear of falling (single-item question - 'In general, are you afraid of falling?'), gait speed with and without a cognitive dual-task at preferre...
Journal of Rehabilitation Medicine
Loss of balance and falling are serious risk factors for patients with osteoporosis. Falls often result in fractures that require medical attention and may even be fatal. In addition to pharmacological therapy, there is clinical evidence to support the importance of exercise to prevent falls and improve balance. The effect of a 1-year complex balance-training programme, combining exercises to improve postural balance with aerobic elements, was studied in female patients with established osteoporosis. The women in the exercise group improved their postural control and balance, increased their aerobic capacity, and had fewer falls than those who did not undertake the exercise programme. Objective: To investigate the effect of a 12-month complex balance-training programme on static and dynamic postural balance, aerobic capacity and frequency of falls in women with established osteoporosis. Design: Randomized controlled trial in which the intervention group was assigned a 12-month exercise programme (3 times a week for 30 min) and the control group had no intervention. Subjects: A total of 100 osteoporotic women with at least one previous fracture. Methods: Performance-based Timed Up and Go (TUG), Berg Balance Scale (BBS) and stabilometric platform tests were used to evaluate balance. Aerobic capacity was measured by bicycle ergometry. Frequency of falls was assessed using a falls diary. Results: After 1 year, there was a statistically significant difference between the improvement achieved in the intervention and control groups on the performance-based TUG, BBS and stabilometric platform tests (p < 0.05). Mean metabolic equivalent (MET) value decreased in the intervention group, from 4.91 to 3.82 (a significant difference from the change achieved in the control group; p = 0.05). Relative risk of falls was 0.534 at 1 year (p = 0.17). Conclusion: The 12-month balance-training programme significantly improved postural balance and increased aerobic capacity in women with established osteoporosis.
Timisoara Physical Education and Rehabilitation Journal, 2021
Background: Osteoporosis is a metabolic disease widely spread both worldwide and in our country, being a major public health problem, with serious social and psychological consequences, by the huge costs involved, as well as by its high morbidity. Aim: We intend to prove the effectiveness of using physical exercise for improving static and dynamic balance in patients with osteoporosis. Methods: Our research includes 8 women aged between 50 and 70 years, diagnosed with postmenopausal osteoporosis. The patients were evaluated before and one month after the physical exercise program, using the "Timed Up and Go" Test and the Berg Balance Scale. Results: All patients included in this research experienced improvements in postural stability, static and dynamic balance. Conclusions: After performing a one-month program of specific physical exercise, with a frequency of 3-4 times a week, the risk of falls decreases, increasing the static and dynamic balance.
Clinical Interventions in Aging, 2017
Objective: To determine the effects of a simple exercise program on the balance and strength of postmenopausal women with osteoporosis. Methods: This program was based on low intensity strength and balance exercises, and was carried out with simple, readily available equipment. Sixty five women were randomly assigned to either the experimental group (EG; n=33, age: 57.4±4.8 years) or the control group (CG; n=32, age: 58.8±4.5 years). Participants in the EG underwent balance and strength training for 60 min, three times/week for 6 months. Each session consisted of warm-up exercises (10 min), balance training (20 min), strength training (20 min), and cooldown (10 min). Participants from the CG were asked not to modify their usual habits during the course of the study. Static balance was evaluated using the blind monopodal stance static balance test. In contrast, dynamic balance was assessed using the "8-foot up and go" test, whereas the strength of the upper and lower limbs was measured using the "arm curl" and "30 s chair stand" tests, respectively. All these variables were assessed at baseline and upon program completion. Results: The EG showed significant improvements (P,0.001) in static balance (21%), dynamic balance (36%), and in the strength of the upper (80%) and lower (47%) limbs in comparison to the CG after the sixth month. Participants in the CG showed significantly lower values (P,0.001) in the four tests. In addition, a significant inverse relationship between static balance and the strength of the upper (r=−0.390; P=0.001) and lower (r=−0.317; P=0.01) limbs was found. Conclusion: The present study demonstrates that a physical exercise program based on balance and strength exercises, carried out with simple and readily available equipment, is capable of significantly improving the strength and balance of women with osteoporosis.
Balance control in elderly people with osteoporosis
Journal of the Formosan Medical Association, 2014
Osteoporosis is a prevalent health concern among older adults and is associated with an increased risk of falls that incur fracture, injury, or mortality. Identifying the risk factors of falls within this population is essential for the development of effective regimes for fall prevention. Studies have shown that muscle quality and good posture alignments are critical for balance control in elderly individuals. People with osteoporosis often have muscle weakness and increased spine kyphosis leading to vertebral fractures and poor balance control, or even falls. Therefore, improving muscle quality, strengthening weak muscles, and correcting postural alignment are essential elements for the prevention of falls and fractures in older adults with osteoporosis. This review reports the necessary information regarding the critical factors of balance control in older adults with osteoporosis, as well as testing the clinical innovations of exercise training to improve the long-term prognosis of osteoporosis in this vulnerable population.
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2002
Exercise programs improve balance, strength and agility in elderly people and thus may prevent falls. However, specific exercise programs that might be widely used in the community and that might be "prescribed" by physicians, especially for patients with osteoporosis, have not been evaluated. We conducted a randomized controlled trial of such a program designed specifically for women with osteoporosis. We identified women 65 to 75 years of age in whom osteoporosis had been diagnosed by dual-energy X-ray absorptiometry in our hospital between 1996 and 2000 and who were not engaged in regular weekly programs of moderate or hard exercise. Women who agreed to participate were randomly assigned to participate in a twice-weekly exercise class or to not participate in the class. We measured baseline data and, 20 weeks later, changes in static balance (by dynamic posturography), dynamic balance (by a timed figure-eight run) and knee extension strength (by dynamometry). Of 93 wome...
Journal of Exercise Therapy and Rehabilitation, 2021
Purpose: This study aimed to examine the effects of single-task, dual-task and successive physical-cognitive training on fall risk, balance, and gait performances in elderly. Methods: A total of 45 healthy older adults (73.0±4.6 years; 6 male and 39 female) underwent one of three interventions 3 times a week for 4 weeks. Group-1 performed single-task balance and gait exercises. Group-2 performed cognitive activity, balance, and gait exercises simultaneously. Group-3 performed successive cognitive activities and balance and gait exercises. Gait speed under single-task and dual-task conditions, Berg Balance Scale, Timed up and Go test, and Tinetti's Falls Efficacy Scale scores were evaluated before and after 4 weeks of interventions. Results: Gait speed under single-task condition, Timed up and Go Test, and Berg Balance Scale scores were improved in all groups (p<0.05). Gait speed under dual-task condition was improved in Groups-2 and 3 (p<0.05). Group-3 had greater improvement in Berg Balance Scale and Timed up and Go test scores than Group-2. Tinetti's Falls Efficacy Scale was improved in Group-1 and 3 after training while the improvement was greater in Group-3 (p=0.001). Conclusion: The present study suggests that an intervention involving cognitive and physical activities results in greater improvement in gait speed than interventions involving physical activities alone. However, successive physical-cognitive training may be more effective in reducing fear of fall and improving balance skills in elderly.
Impact of Cognitive Training on Balance and Gait in Older Adults
The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 2013
Cognitive processing plays an important role in balance and gait and is a contributing factor to falls in older adults. This relationship may be explained by the fact that higher order cognitive functions such as executive functions are called upon while walking. The purpose of this study was to examine whether a cognitive training intervention leads to significant improvements on measures of balance and gait.