Effects of Combined Balance and Strength Training on Measures of Balance and Muscle Strength in Older Women With a History of Falls

International audienceObjective: We investigated the effects of combined balance and strength training on measures of balance and muscle strength in older women with a history of falls. Methods: Twenty-seven older women aged 70.4 +/- 4.1 years (age range: 65 to 75 years) were randomly allocated to either an intervention (IG, n = 12) or an active control (CG, n = 15) group. The IG completed 8 weeks combined balance and strength training program with three sessions per week including visual biofeedback using force plates. The CG received physical therapy and gait training at a rehabilitation center. Training volumes were similar between the groups. Pre and post training, tests were applied for the assessment of muscle strength (weight-bearing squat [WBS] by measuring the percentage of body mass borne by each leg at different knee flexions [0 degrees, 30 degrees, 60 degrees, and 90 degrees], sit-to-stand test [STS]), and balance. Balance tests used the modified clinical test of sensory interaction (mCTSIB) with eyes closed (EC) and opened (EO), on stable (firm) and unstable (foam) surfaces as well as spatial parameters of gait such as step width and length (cm) and walking speed (cm/s). Results: Significant group x time interactions were found for different degrees of knee flexion during WBS (0.0001 < p < 0.013, 0.441 < d < 0.762). Post hoc tests revealed significant pre-to-post improvements for both legs and for all degrees of flexion (0.0001 < p < 0.002, 0.697 < d < 1.875) for IG compared to CG. Significant group x time interactions were found for firm EO, foam EO, firm EC, and foam EC (0.006 < p < 0.029; 0.302 < d < 0.518). Post hoc tests showed significant pre-to-post improvements for both legs and for all degrees of oscillations (0.0001 < p < 0.004, 0.753 < d < 2.097) for IG compared to CG. This study indicates that combined balance and strength training improved percentage distribution of body weight between legs at different conditions of knee flexion (0 degrees, 30 degrees, 60 degrees, and 90 degrees) and also decreased the sway oscillation on a firm surface with eyes closed, and on foam surface (with eyes opened or closed) in the IG. Conclusion: The higher positive effects of training seen in standing balance tests, compared with dynamic tests, suggests that balance training exercises including lateral, forward, and backward exercises improved static balance to a greater extent in older women

La santé à l'école

D’une conception traditionnelle fondée sur l’hygiène et la prévention des maladies à la prise en compte du bien-être global des enfants, la définition de la santé à l’école a beaucoup évolué au fil des deux derniers siècles, sous l’influence des grandes organisations internationales. Si nombre de recherches portent sur ce sujet, force est de constater que peu d’études examinent les relations établies entre les familles, l’école et les professionnels de santé. Ces trois acteurs également concernés partagent-ils les mêmes objectifs et les mêmes attentes ? Comment s’articulent les normes scolaires et les normes de santé ? Qui possède l’expertise et le pouvoir d’agir ? Le 89e dossier de la Revue internationale d’éducation de Sèvres s’intéresse aussi bien aux représentations et aux pratiques de chacun qu’aux effets des dispositifs mis en place, dans des pays aux contextes socioculturels et politiques variés. Même si les études de cas font ressortir une grande diversité de réponses et de situations, il est intéressant de souligner des éléments de convergence tels que l’approche des besoins spécifiques des enfants, l’attention portée aux troubles scolaires, la question de la prévention, ou encore la recherche du bien-être des élèves. L’équilibre entre les acteurs reste toutefois fragile et le sujet ne demande qu’à être davantage exploré. Études de cas : Allemagne, Belgique, Cameroun, Chine, Pays-Bas, Pologne, comparaison Québec-Flandre, Tunisie, Turquie. The scope of health in schools has changed significantly over the last two centuries under the influence of major international organisations: from a traditional focus on hygiene and disease prevention it has evolved to encompass children's overall wellbeing. While there is much research on this subject, few studies examine the relationships between families, schools and health professionals. While all three play a part in health education, do they share the same objectives and expectations? How do school and health standards relate to each other? Who has the expertise and the power to act? The 89th issue of the Revue internationale d'éducation de Sèvres focuses on the representations and practices of each of these actors as well as on the effects of the measures taken in ten countries with different socio-cultural and political contexts. Even if the case studies reveal a great diversity of responses and situations, it is worth highlighting elements of convergence such as a focus on the individual needs of the child, on special education needs, preventative interventions and pupils’ wellbeing. However, the balance between actors remains fragile and the topic requires further investigation. Case studies: Belgium, Cameroon, China, Germany, Netherlands, Poland, Quebec-Flanders comparison, Tunisia, Turkey. La definición de la salud en las escuelas ha conocido una notable evolución en los últimos dos siglos bajo la influencia de las grandes organizaciones internacionales, desde las concepciones tradicionales decimonónicas fundadas en la higiene y la prevención de las enfermedades hasta la consideración actual del bienestar global de los niños. Si no faltan las investigaciones sobre este particular, cabe constatar que son pocos los estudios que examinan las relaciones establecidas entre las familias, la escuela y los profesionales de la salud. ¿Comparten estos tres actores igualmente participantes del proceso los mismos objetivos y las mismas expectativas? ¿Cómo se articulan las normas escolares y las normas sanitarias? ¿Quién posee la pericia y el poder de actuar? El número 89 de la Revue internationale d’éducation de Sèvres se interesa tanto por las representaciones y las prácticas de cada uno como por los efectos de los dispositivos desarrollados en unos diez países con contextos socioculturales y políticos variados. Aunque se desprendan de los estudios de caso una gran diversidad de respuestas y de situaciones, es interesante subrayar la existencia de unos elementos de convergencia tales y como la aproximación de las necesidades específicas de los niños, la atención otorgada a los problemas escolares, el tema de la prevención o también la búsqueda del bienestar para los alumnos. Sin embargo, el equilibrio entre los actores sigue siendo frágil y el tema requiere más exploraciones. Estudios de caso: Alemania, Bélgica, Camerún, China, Países Bajos, Polonia, comparación Quebec-Flandes, Túnez y Turquía