Balance, aging, and osteoporosis: effects of cognitive exercises combined with physiotherapy (original) (raw)
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.
British Journal of Sports Medicine, 2001
Objective-To test the eYcacy of a community based 10 week exercise intervention to reduce fall risk factors in women with osteoporosis. Methods-Static balance was measured by computerised dynamic posturography (Equitest), dynamic balance by timed figure of eight run, and knee extension strength by dynamometry. Subjects were randomised to exercise intervention (twice weekly Osteofit classes for 10 weeks) or control groups. Results-The outcome in 79 participants (39 exercise, 40 control) who were available for measurement 10 weeks after baseline measurement is reported. After confounding factors had been controlled for, the exercise group did not make significant gains compared with their control counterparts, although there were consistent trends toward greater improvement in all three primary outcome measures. Relative to the change in control subjects, the exercise group improved by 2.3% in static balance, 1.9% in dynamic balance, and 13.9% in knee extension strength. Conclusions-A 10 week community based physical activity intervention did not significantly reduce fall risk factors in women with osteoporosis. However, trends toward improvement in key independent risk factors for falling suggest that a study with greater power may show that these variables can be improved to a level that reaches statistical significance.
Rheumatology International, 2008
The aim of this study is to evaluate the eVect of submaximal aerobic exercise program on postural balance in postmenopausal women with osteoporosis. Twenty-Wve postmenopausal women without osteoporosis and 28 postmenopausal women with osteoporosis enrolled in this study. Balance ability of all subjects was measured by timed up and go test (TUG), four square step test (FSS), Berg balance scale (BBS) and Kinesthetic ability trainer 3000. After completion of initial measurements of balance, postmenopausal women with osteoporosis attended the submaximal aerobic exercise program on treadmill. At the end of the exercise program, balance tests were repeated. Balance tests of postmenopausal women without osteoporosis were repeated approximately 4-weeks after the initial measurement. There was statistically signiWcant improvement in all balance scores in the postmenopausal women with osteoporosis after exercise training whereas there were no statistically signiWcant diVerences in the scores of postmenopausal women without osteoporosis who did not exercise. This study showed that a 4-week submaximal aerobic exercise program provided signiWcant improvements in static and dynamic balances in postmenopausal osteoporotic women.
The Effect of Balance and Coordination Exercises on Quality of Life in Older Adults: A Mini-Review
Frontiers in Aging Neuroscience
The ability to control balance during activities of daily living (ADL) is impaired in older adults as a result of deterioration in the sensory systems (i.e., vestibular, visual, somatosensory), the cognitive system (central nervous system), and the musculoskeletal system. Consequently, many older adults face a risk of falling during their ADL. In most cases, falls and related injuries impair the quality of life and result in physical limitations, anxiety, loss of confidence, and fear of falling. Among a variety of fall prevention interventions, adapted physical activity programs have been suggested for improving balance control during ADL. These programs challenge the sensory, cognitive, and musculoskeletal systems while addressing balance constraints such as orientation in space, changes in direction, and the speed or height of the center of mass during static and dynamic situations resembling ADL. The above-mentioned elements can be dealt with through a combination of balance and coordination exercises that challenge the postural control systems in multiple dimensions-including vertical and horizontal changes of the center of mass, standing on unstable surfaces with a reduced base of support, and changing body directions. Consequently, such exercises require environmental information-processing. The combination of dual-task, functionoriented challenges while controlling balance stimulates the sensory and neuromuscular control mechanisms. Among older adults, these programs have been found to improve static and dynamic stability, as well as a number of aspects in the quality of life. Recently, they have also been found to improve cognitive functions such as memory and spatial cognition.
Physical activity programs for balance and fall prevention in elderly
Medicine
Background: Due to demographic changes the world's population is progressively ageing. The physiological decay of the elderly adult may lead to a reduction in the ability to balance and an increased risk of falls becoming an important issue among the elderly. In order to counteract the decay in the ability to balance, physical activity has been proven to be effective. The aim of this study is to systematically review the scientific literature in order to identify physical activity programs able to increase balance in the elderly. Methods: This review is based on the data from Medline-NLM, Pubmed, ScienceDirect, and SPORTDiscuss and includes randomized control trials that have analyzed balance and physical activity in healthy elderly over 65 years of age during the last decade. A final number of 8 manuscripts were included in the qualitative synthesis, which comprised 200 elderly with a mean age of 75.1 ± 4.4 years. The sample size of the studies varied from 9 to 61 and the intervention periods from 8 to 32 weeks. Results: Eight articles were considered eligible and included in the quantitative synthesis. The articles investigated the effects of resistance and aerobic exercise, balance training, T-bow© and wobble board training, aerobic step and stability ball training, adapted physical activity and Wii Fit training on balance outcomes. Balance measures of the studies showed improvements between 16% and 42% compared to baseline assessments. Conclusions: Balance is a multifactorial quality that can be effectively increased by different exercise training means. It is fundamental to promote physical activity in the aging adult, being that a negative effect on balance performance has been seen in the no-intervention control groups.
International Journal of Aging Health and Movement, 2019
Background of study: the incidence of falls only increases in the elderly, which makes fall a major public health problem. Objective: The objective of this study was to evaluate the effects of balance exercises on young old and old people presenting the risk of falling. Methodology: A total of 60 elderly subjects with an average age of 79.2 ± 8.18 years divided in two according to the age classification of the World Health Organization, with Group 1 aged 60-75 years (young old) and group 2 aged 75-90 years (old). The effects of 4 months of exercise were evaluated before and after the intervention program with the Timed get up and go test, the one leg test, the SF 32 short form, ruffier dickson index, and the six minutes' walk test. Results: After 4 months of intervention, we noticed the young old men significantly reduced their risk of falling (p <0.0001), improved their walking distance by six minutes' walk test (p <0.0001), balance (p <0.0001), physical function (p <0.0001), physical role (p <0.0001), emotional role (p <0.0001), mental health (p <0.0001), pain (p <0, 0001), while older men statistically significantly reduced their risk of falling (p <0.0001), improved walking distance by six minutes' walk test (p <0.0003), balance (p <0.022), adaptive ability to effort (p <0.0001), physical function (p <0.0001), physical role (p <0.0001), and pain (p <0.0001). This study also reveals that young old men significantly improved their functional capacity and quality of life more than the elderly (p <0.05). Conclusions: The balanced exercise program improves balance, cardiorespiratory endurance, quality of life and reduces the risk of falling young and old. These parameters have been much improved in young old men rather than old men.