Balance training reduces fear of falling and improves dynamic balance and isometric strength in institutionalised older people: A randomised trial

Question What is the effect of a balance training protocol with the Biodex Balance System in institutionalised older people with fear of falling? Design Randomised controlled trial with concealed allocation and assessor blinding. Participants Forty older people who lived in a nursing home and had fear of falling. Intervention The experimental group completed a 12-week balance training protocol based on balancing/rebalancing training with the Biodex Balance System, with two sessions per week. During the training period, participants in both groups received the same multidisciplinary care (such as physiotherapy, occupational therapy and nursing) that they usually received in the nursing home. Outcome measures The primary outcome was fear of falling (Falls Efficacy Scale International questionnaire). Secondary outcomes were dynamic balance (Fall Risk Test) and isometric strength (torque of knee flexor and extensor isometric strength measured with an isokinetic dynamometer). Outcome measures were taken before and after the training program protocol. Results Compared to the control group, the exercise group had significantly greater improvements at 12 weeks in fear of falling (by 8 points, 95% CI 4 to 12), in dynamic balance (by 2 degrees, 95% CI 1 to 3), and in isometric strength of the knee flexors (by 7 Nm, 95% CI 3 to 11) and knee extensors (by 7 Nm, 95% CI 1 to 13). Conclusion The training program was feasible and effective in reducing fear of falling and improving dynamic balance and isometric strength in institutionalised older people with fear of falling. Trial registration ISRCTN21695765

Influence of Two Exercise Programs on Heart Rate Variability, Body Temperature, Central Nervous System Fatigue, and Cortical Arousal after a Heart Attack

Cardiovascular diseases (CVD) are the leading cause of death globally. Cardiac rehabilitation (CR) programs’ benefits are overall consensual; however, during exercise, progressive physiological effects have not been studied yet in cardiac patients. Our study aims to analyze physiological parameters of thermography, heart rate variability (HRV), blood pressure, central nervous system (CNS) fatigue, and cortical arousal in heart attack patients (HAP) who belong to CR programs of High-Intensity Interval Training (HIIT) and Moderate-intensity Continuous Training (MICT) compared to healthy participants. In this case control study, two HAP patients (both male, age 35 and 48, respectively) and two healthy people (both male, age 38 and 46, respectively) were randomly assigned in a 1:1:1:1 allocation ratio to one of four groups: cardiac MICT, cardiac HIIT, control MICT, and control HIIT. The HIIT at _85–95% of peak heart rate (HR) was followed by a one-minute recovery interval at 40% peakHR, and MICT at _70–75% of peakHR. Outcome measurements included thermography, HRV, blood pressure, CNS fatigue, and cortical arousal; The HAP presents more than twice the CNS fatigue in MICT than control participants, but HIIT has almost the same CNS fatigue in HAP and control. In addition, both of the HAP groups presented higher temperatures in the chest. The HIIT protocol showed better physiological responses during exercise, compared to MICT in HAP

Physical literacy in older adults: a scoping review protocol

Population aging is a prominent phenomenon worldwide. The increase in physical inactivity and co-morbid diseases poses a major challenge to current community health policies. Physical activity guidelines recommended for older people have not been met by this population group. For this reason, a new model, physical literacy, is being innovated and has gained global attention and has emerged as an effective and innovative active aging strategy to improve physical activity participation of this vulnerable group. However, the evidence on physical literacy in the older adult so far is brief and diffuse. Therefore, the aim was to conduct a scoping review protocol to identify and map physical literacy in older people. This scoping review protocol was based on the Joanna Briggs Institute Method. The search will be performed on Embase, IBSS ProQuest, Medline OVID, PsycINFO Ebsco, PubMed, ScienceDirect, Scopus, SPORTDiscus, Social Services Abstracts ProQuest, Sociological Abstracts ProQuest, Web of Science ISI, Wiley Online Library, Cochrane Library, and ERIC Ebsco databases. All types of studies published since 2001 in English, Spanish, and Portuguese examining physical literacy over the lifespan of older adults were included. Two independent reviewers will organize and select studies according to the objectives and questions of the scoping review. The selected publications will be organized and summarized using a checklist proposed by the PRISMA-ScR. Qualitative data analysis (thematic analysis) will be performed to identify meanings and patterns to answer the research question. The final scoping review will present the main evidence available, key concepts/definitions, research conducted, and knowledge gaps related to physical literacy in older adults, leading to strategies to improve the community health of this population, as well as health literacy

Heart Rate Variability Monitoring during a Padel Match

Padel, an increasingly popular sport, presents some associated cardiovascular risks, which can be prevented by heart rate variability (HRV) monitoring. However, there is no study worldwide that characterizes HRV during padel games. Therefore, this study aims to monitor HRV responses and characterize them using linear and non-linear metrics at three time points: at baseline, during a game, and during recovery. Twenty-seven amateur participants had their HRV monitored before, during, and after a 90 min padel game. We extracted time, frequency, and non-linear measures with MATLAB for baseline, rest period, and at three periods of 5 min during the game. The differences in measures were assessed through an ANOVA. The autonomic modulation was affected by the padel match in amateur players. In this regard, the root mean square of successive differences between normal heartbeats (RMSsd), Poincaré plot (perpendicular standard deviation (SD1) and horizontal standard deviation (SD2)), sample entropy (SampEn), low frequencies (LF), and very low frequencies (VLF) were significantly reduced during the game, whereas alpha-2, high frequencies (HF), and the ratio between low and high frequencies (LF/HF) increased during the game. Furthermore, an abrupt change was found in the autonomic modulation between game and recovery assessments, which suggests the need to rethink the practices of cool-down protocols. The multiple timepoints analyzed during this study allow us to investigate the evolution of different HRV measures in the time, frequency, and non-linear domains, clarifying the interpretation of the variables, especially the less-investigated ones such as the non-linear measures.Grant from the Universities Ministry and the European Union (NextGenerationUE) (MS-03)

"Acute Effects of a Session with The EXOPULSE Mollii Suit in a Fibromyalgia Patient: A Case Report"

Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain and associated fatigue, sleep disturbances, and other cognitive and somatic symptoms. A multidisciplinary approach including pharmacological therapies along with behavioral therapy, exercise, patient education, and pain management is a possible solution for the treatment of this disease. The EXOPULSE Mollii® method (EXONEURAL NETWORK AB, Danderyd, Sweden) is an innovative approach for non-invasive and self-administered electrical stimulation with multiple electrodes incorporated in a full-body suit, with already proven benefits for other diseases. Therefore, the present case report study aims to evaluate the effects that a 60 min session with the EXOPULSE Mollii suit has on a female fibromyalgia patient. After the intervention, we can conclude that a 60 min session with the EXOPULSE Mollii suit has beneficial effects on pain perception, muscle oxygenation, parasympathetic modulation, and function in a female fibromyalgia patient

Heart Rate Variability Monitoring during a Padel Match

Padel, an increasingly popular sport, presents some associated cardiovascular risks, which can be prevented by heart rate variability (HRV) monitoring. However, there is no study worldwide that characterizes HRV during padel games. Therefore, this study aims to monitor HRV responses and characterize them using linear and non-linear metrics at three timepoints: at baseline, during a game, and during recovery. Twenty-seven amateur participants had their HRV monitored before, during, and after a 90 min padel game. We extracted time, frequency, and non-linear measures with MATLAB for baseline, rest period, and at three periods of 5 min during the game. The differences in measures were assessed through an ANOVA. The autonomic modulation was affected by the padel match in amateur players. In this regard, the root mean square of successive differences between normal heartbeats (RMSsd), Poincaré plot (perpendicular standard deviation (SD1) and horizontal standard deviation (SD2)), sample entropy (SampEn), low frequencies (LF), and very low frequencies (VLF) were significantly reduced during the game, whereas alpha-2, high frequencies (HF), and the ratio between low and high frequencies (LF/HF) increased during the game. Furthermore, an abrupt change was found in the autonomic modulation between game and recovery assessments, which suggests the need to rethink the practices of cool-down protocols. The multiple timepoints analyzed during this study allow us to investigate the evolution of different HRV measures in the time, frequency, and non-linear domains, clarifying the interpretation of the variables, especially the less-investigated ones such as the non-linear measures

Assessment of spatiotemporal characteristics of gait, trough the Phyphox® app: a case series

Abstract Background Spatiotemporal characteristics from human locomotion can provide effective clinical metrics to assess motor control and brain function. This case report aims to assess the temporal structure of variability in stride-to-stride time and calculated the intrinsic fractal frame that is hidden below the repetitive structure of physiological gait through the “Phyphox” app. This is an innovative study from the perspective of analyzing gait variables through a mobile app. Case presentation Five older adults Caucasian (3 women; age = 73 ± 10,5 years; body mass = 62,2 ± 15,1 kg; height = 1,56 ± 0,1 m; 2 men; age = 75,5 ± 7,8 years; body mass = 86,3 ± 18,0 kg; height = 1,77 ± 0,1 m) participated in this study. Five participants were asked to walk with a natural cadence, two of the participants presented a value greater than 80 step’s/minute (81.14 ± 0.01; 86.67 ± 0.02); and the others had values between 55 and 65 step’s/minute (55.20 ± 0.02; 55.78 ± 0.05; 61.02 ± 0.05). Regarding the coefficient of variation, only one participant presented 10.08%. For the total number of steps, three of the participants had values greater than 1000 steps. The variability of these stride-to-stride time has been quantified through detrended fluctuation analysis; one participant presented a value above 1. Conclusions This study provides evidence that a smartphone might provide a valid measure to assess the spatiotemporal characteristics of gait

Test-retest reliability of isokinetic arm strength measurements in competitive swimmers

Swimming motor patterns lead internal rotators to grow stronger than antagonist muscles, what may increase the risk of injury in swimmers. Injury prevention often involves the improvement of external rotators strength, as well as the external rotation/internal rotation ratio. The current research aimed to evaluate the test-retest reliability of shoulder concentric rotation strength in competitive swimmers using an isokinetic dynamometer. The study enrolled 35 competitive swimmers aged between 13 and 19 years. Concentric movements were performed including internal and external rotations of the shoulder joint following the instructions of the standardized protocol. The angular velocity of the test was defined at 60º/s. Outcome measures were peak torque (Nm) and work (J), measured in both, the dominant and non-dominant arms. The external rotation/internal rotation ratio was also calculated. Reliability was excellent for peak torque and work. For the external rotation/internal rotation ratio, the ICC oscillated between 0.744 and 0.860 for the work ratio of the non-dominant arm and the peak torque ratio of the dominant arm, respectively. In general terms, better reliability was observed for peak torque compared with work, for external rotation compared with internal rotation, and for the dominant arm compared with the non-dominant one

Test-retest reliability of isometric and isokinetic knee extension and flexion in patients with fibromyalgia: Evaluation of the smallest real difference

Adsuar JC, Olivares PR, del Pozo-Cruz B, Parraca JA, Gusi N. Test-retest reliability of isometric and isokinetic knee extension and flexion in patients with fibromyalgia: evaluation of the smallest real difference. Objective: To investigate the reliability of isokinetic peak torque and work and isometric peak torque measurements for knee flexion and extension in fibromyalgia (FM) patients by determining the smallest real difference (SRD). Design: Test-retest reliability study. Setting: University laboratory. Participants: Women with FM (N=37) aged between 34 and 74 years. Interventions: Not applicable. Main Outcome Measures: The participants performed isometric, concentric, and eccentric tests of the knee. Unilateral maximal peak torque and average work were measured for each direction (flexion, extension) and contraction (isometric, concentric, eccentric) type. Relative reliability, absolute reliability, and SRD were calculated. The 3 tests were repeated after an interval of 7 days. Results: With the exception of eccentric flexion, all peak torque measures had an intraclass correlation coefficient (ICC) of > 0.90, and all work measures had an ICC of > 0.85. The SRD ranged between 21% and 37% for all peak torque measures and between 40% and 73% for all work measures. Conclusions: Isokinetic dynamometry provides reliable measurement of peak torque and work for isometric, concentric, and eccentric knee flexion and extension in patients with FM. The present study has generated novel SRD data, which will assist physicians, therapists, and clinicians in interpreting posttreatment changes in patients with FM

Tilting whole body vibration improves quality of life in women with fibromyalgia: A randomized controlled trial

Objectives: The aim of this study was to analyze the effect of 12-week tilting Whole Body Vibration therapy (WBV) on Health Related Quality of Life (HRQoL) in fibromylagia (FM) within the context of a randomized control trial (ISRCTN16950947). Subjects and methods: Thirty-six (36) women with FM were randomly allocated to either an exercise or a control group. The women in the exercise group were assigned to a 12-week course of tilting WBV (12.5-Hz frequency; 3-mm amplitude). HRQoL was assessed using the Fibromyalgia Impact Questionnaire (FIQ) and a 15D questionnaire. Results: A 12-week course of tilting WBV therapy was associated with improvements in FIQ scores (12%) but not in the 15D questionnaire. Conclusions: Tilting WBV was a feasible intervention that prevented the loss of HRQoL in previously physically untrained women with FM