Analyzing the Use of Accelerometers as a Method of Early Diagnosis of Alterations in Balance in Elderly People: A Systematic Review

[EN] Alterations of balance are a growing public health problem as they affect one in three adults over the age of 65, and one in two over the age of 80. Identifying the factors that affect postural stability is essential in designing specific interventions to maintain the independence and mobility of older people. The aim of this review was to understand the use of accelerometers in order to assess the balance in older people. Analyzing the most appropriate evaluation methodology and protocolizing it will optimize the processes of early identification of balance alterations. However, quantitative assessment methods of balance are usually limited to a laboratory environment, a factor that can be overcome by accelerometers. A systematic search was carried out across eight databases where accelerometers were employed to assess balance in older people. Articles were excluded if they focused on sensor design and did not measure balance or apply the technology on targeted participants. A total of 19 articles were included for full-text analysis, where participants took part in the balance evaluation monitored by accelerometers. The analysis of spatio-temporal parameters and the magnitude of the accelerations recorded by the devices were the most common study variables. Accelerometer usage has potential to positively influence interventions based on physical exercise to improve balance and prevent falls in older people.S

Percentiles and Reference Values for Accelerometric Gait Assessment in Women Aged 50–80 Years

[EN] Background: The identification of factors that alter postural stability is fundamental in the design of interventions to maintain independence and mobility. This is especially important for women because of their longer life expectancy and higher incidence of falls than in men. We constructed the percentile box charts and determined the values of reference for the accelerometric assessment of the gait in women. Methods: We used a cross-sectional study with 1096 healthy adult women, who were asked to walk a distance of 20 m three times. Results: In all of the variables, a reduction in the magnitude of accelerations was detected as the age of the group advanced. The box charts show the amplitude of the interquartile ranges, which increases as the age of the participants advances. In addition, the interquartile ranges were greater in the variables that refer to the maximum values of the accelerations. Conclusions: The values obtained can be used to assess changes in gait due to aging, trauma and orthopaedic alterations that may alter postural stability and neurodegenerative processes that increase the risk of falling.S

Physical Activity Practice and Optimal Development of Postural Control in School Children: Are They Related?

[EN] Background: This study aims to analyze the effect of physical activity practice on the postural control state of school children. If such an effect was detected, the second aim of the study was to identify which specific capacities of postural control benefited the most from physical activity. Methods: A cross-sectional study was performed using a convenience sample of 118 healthy children (54 girls) with a mean age of 10.3 ± 1.2 years. Their weight and height were measured. The accelerometric assessment of balance included four different tests in static balance and walking. Results: Physical activity habit prevalence was 38.9% in girls and 60.9% in boys, and its frequency was 2.3 days per week in girls and 2.8 days in boys. The active children obtained lower accelerations, but the active and sedentary girls showed lower accelerometric values than the active boys. The logistic regression analysis demonstrated the influence of sex on the accelerations of the body (p < 0.001), regardless of the habit of physical activity. Conclusions: Active children have better postural control than sedentary children, although sedentary girls have better balance than active boys. Therefore, physical activity practice seems to favor a more efficient development of postural control, but it cannot level or reverse the effect of the neurophysiological factors that are conditioned by sex.S

Long-Term Influence of the Practice of Physical Activity on the Self-Perceived Quality of Life of Women with Breast Cancer: A Randomized Controlled Trial

[EN] Background: There is still no consensus on the most suitable interventions for exercise practice in breast cancer survivors. Therefore, the aim of this study was to evaluate the effect of a two-year physical activity intervention (strength, aqua fitness and aerobic exercise programs) on the self-perceived quality of life and physical functionality of female breast cancer survivors. Methods: A randomized, controlled, experimental trial with a sample of 316 women (63 ± 7 years), who had been diagnosed with breast cancer. The evaluations were performed using the Rikli & Jones Senior Fitness Test, and the Short Form 12 Health Survey (SF-12). Results: The participants in the strength program showed statistically significant improvements in all the items of the SF-12. The aqua fitness program obtained significant improvements in Physical Functioning and Limitations, Pain and Emotional Limitations, General Health, Vitality, Social Functioning and the physical and mental components of the SF-12. The participants in the aerobic program showed a progressive deterioration of Vitality and Mental Health. Conclusion: When assigning breast cancer survivors to an exercise program, the preferential or predominant activity should include strength exercises. On the other hand, as the second choice, those patients with particularly low levels of Vitality or Physical Limitations will show greater improvement with an aqua fitness program.S

Accelerometers: devices that contribute to healthy aging

[EN] In this paper accelerometers were used as a persuasive technology to monitor exercise training and to promote healthy habits in senior citizens. The sample was composed by 100 users of a nursing home. Subjects were randomly assigned to an experimental and a control group. The intervention program lasted four months. Both groups carried accelerometers on a daily bases during one month, with no prior indication about exercise practice. The procedure was repeated two months later, but the experimental group was encouraged to increase the amount of time devoted to physical activity. Results showed a statistically significant increase in the amount and intensity of physical activity, regardless of whether subjects received the incentive to do it. These findings support the efficiency of using accelerometers as persuasive technology, as well as for generating new opportunities for active and healthy agingS

Comparisons of the Health Benefits of Strength Training, Aqua-Fitness, and Aerobic Exercise for the Elderly

[EN] Objective. To compare strength training, aqua-fitness, and aerobic exercise programs to discern the differences in the benefits achieved by each of the activities in older people. Design. Double-blind randomized trial. Setting. Controlled clinical environment. Participants. 108 people: 54 female paired with a male of the same age (average age of 65.5 ± 5.6 years). Interventions. Three exercise programs (aqua-fitness, aerobic exercise, and strength training) for six months. Main Outcome Measures. Body Mass Index, Senior Fitness Test (which evaluated functional fitness), and the SF-12 Health Survey. Results. Men showed greater positive changes in the aerobic exercise group for general self-perceived mental health, leg strength, and flexibility of legs and arms. The largest improvements in overall self-perceived physical health and upper limb strength were in the men of the strength training group. The women participants in the strength training group obtained greater benefits, especially in self-perceived mental and physical health and in the strength of the four limbs. Conclusions. To maximise benefits, older people, in general, may want to consider participating in aerobic activity. Furthermore, older women would benefit greatly, both emotionally and physically, from exercise that includes strength training.S

Effects of exercise therapy using elastic bands on strength and pain in women with non-specific neck pain: A randomised controlled trial

[EN] Background: Cervical pain has a high incidence and worldwide socio-economic effect. Its inci- dence is lower in men than in women. Conservative and non-pharmacological therapeutic options include strength training. Elastic bands are commonly used in physiotherapy clinics for strength work in patients. Consequently, the objective of this research was to analyse the efficacy of an exercise therapy programme using elastic bands on decreasing pain and increasing strength of the neck flexor musculature, cervical extensor, and scapular stabilizing musculature in women suffering from non-specific cervical pain. Methods: A randomised clinical trial was carried out with 35 subjects with non-specific neck pain (age = 51.7 ± 9.5 and baseline intensity of pain in Visual Analogue Scale = 52.4 ± 9.6). The experimental group (n = 18) performed the exercise programme with elastic bands, consisting of a total of 16 sessions that lasted 45 min. The control group, consisting of 27 participants, reported that they maintained their usual lifestyle throughout the study. The evaluation tools used in this research included the Visual Analogue Scale, Neck Flexor Endurance Test, Neck Extensor Muscle Endurance Test, and Scapular Muscle Endurance Test. Results: The experimental group obtained significant improvements in the measurements taken using the Visual Analogue Scale (p < 0.001, d = 4.2), the Neck Flexor Endurance Test (p < 0.001, d = 3.4), the Neck Extensor Endurance Test (p < 0.001, d = 6.3), in the Scapular Muscle Endurance Test (p = 0.016, d = 0.9). Conclusions: The assessed exercise therapy program utilizing elastic bands demonstrated favorable outcomes in managing non-specific neck discomfort. This intervention resulted in pain reduction and enhanced endurance of the cervical flexor and extensor muscles, along with improved endurance of the scapular stabilizing muscles.S

Prevention of non-specific back pain through exercise and education: A systematic review and meta-analysis

[EN] BACKGROUND: Clinical practice guidelines stress the importance of prevention and treatment of non-specific back pain through exercise therapy. However, it has not yet been confirmed whether the combination of exercise plus education is more effective than such interventions taken separately. OBJECTIVE: To determine if the combination of exercise plus education is more effective for the prevention of non-specific back pain than exercise or education alone. METHOD: A systematic search of studies whose sample consisted of participants without non-specific back pain (primary prevention) and participants with non-specific back pain (secondary and tertiary prevention) was conducted in the following databases in March 2023: PubMed, Scopus, Web of Science and Medline. RESULTS: A total of 16 articles were selected. Statistically significant results were found in the pain variable with SMD = −2.02 (95% CI = −2.71 to −1.33; p < 0.001), the disability variable with SMD = −1.14 (95% CI = −1.63 to −0.65; p < 0.001), and the kinesiophobia variable with SMD = −1.8 (95% CI = −2.54 to −1.05; p < 0.001). CONCLUSION: Interventions that combine exercise and education seem to have a greater preventive effect on non-specific back pain, disability and kinesiophobia than those that include exercise or education in an isolated manneS

Evolution of the Habits of Physical Activity and Television Viewing in Spanish Children and Pre-Adolescents between 1997 and 2017

[EN] Background: Promoting healthy lifestyles in children, has become a priority for public health institutions. However, electronic devices with screens encourage sedentary behaviors. The aim of this study was to analyze the evolution of the habits of physical activity practice and television watching in a cohort of 20 years of research in Spanish children. Methods: A cross-sectional, observational study was based on data from the Spain National Health Surveys between 1997 and 2017 (N = 11,444). The dependent variables considered were the frequency with which the minor practiced physical activity (PA) in his/her spare time, the daily TV viewing habit, and the daily hours of TV viewing. Results: The children who practiced physical activity daily has decreased 7.3% throughout the study period. The proportion of children who watched the television daily for more hours increased significantly (6.3%). Such increase was constant throughout the years, and the analysis by sex showed that the proportion of boys who watched television for more than three hours per day increased three percent, and that of girls increased fourfold. Conclusions: The habits of physical activity practice and television viewing have changed towards sedentary lifestyle. Particularly, the girls and the children between 12 and 14 years showed the most sedentary behavior. Public health policies must consider the differences between sexes in order for such interventions to be effective in the population of pre-adolescents, in general, and girls, in particular.S

Identification of Body Balance Deterioration of Gait in Women Using Accelerometers

[EN] This study presents a simple methodology for the evaluation of gait with accelerometers, for rapid and simple application, in which we employ current balance tests in clinical practice (Timed Up and Go, Chair Stand Test and Six-Minute Walk Test). The aim was to determine whether the accelerometric valuation of gait can detect alterations in balance. The sample of this cross-sectional research, made during the months of May and June 2018, was composed of 145 healthy adult women (x = 63.8 ± 8.41 years), from the city of Ourense (Spain). They walked with a triaxial accelerometer at the fourth lumbar vertebra for a distance of 20 m. The test was repeated three times, and the mean of the three measurements was used in the analysis. There was a reduction in the values of acceleration recorded along all three of the axes and in the root mean square as the age increased. This reduction was very significant for the minimum values registered along the vertical and transverse axes, and for the maximum values along the mediolateral axis. Only the maximum values of the vector module demonstrated significant differences among the three age groups. A regression model allowed us to identify the values that give more information on the Timed Up and Go Test, namely: the maximum values of the root mean square and the mediolateral axis. An exhaustive analysis of the vertical and mediolateral axes and the vector module allows for the detection of early alterations in the automatic gait pattern.S