Effect of Progressive Head Extension Swallowing Exercise on Lingual Strength in the Elderly: A Randomized Controlled Trial

Lingual strengthening training can improve the swallowing function in older adults, but the optimal method is unclear. We investigated the effects of a new progressive resistance exercise in the elderly by comparing with a conventional isometric tongue strengthening exercise. Twenty-nine participants were divided into two groups randomly. One group performed forceful swallow of 2 mL of water every 10 s for 20 min, and a total of 120 swallowing tasks per session at 80% angle of maximum head extension. The other group performed five repetitions in 24 sets with a 30 s rest, and the target level was settled at 80% of one repetition maximum using the Iowa Oral Performance Instrument (IOPI). A total of 12 sessions were carried out by both groups over a 4-week period. Blinded measurements (for maximum lingual isometric pressure and peak pressure during swallowing) were obtained using IOPI before exercise and at four weeks in both groups. After four weeks, both groups showed a significant improvement in lingual strength involving both isometric and swallowing tasks. However, there was no significant difference between the groups in strength increase involving both tasks. Regardless of the manner, tongue-strengthening exercises substantially improved lingual pressure in the elderly with equal effect.

Download Full-text

Effect of Pilates exercise on the level of fatigue, cognition and knee proprioception in the elderly population of 60-80 years

International Journal of Physiotherapy and Research ◽

10.16965/ijpr.2020.188 ◽

2021 ◽

Vol 9 (2) ◽

pp. 3774-3779

Author(s):

Shradha Santosh Shah ◽

◽

Sandhya Wasnik ◽

Keyword(s):

Elderly Population ◽

The Elderly ◽

Exercise Group ◽

Control Group ◽

Significant Difference ◽

Strengthening Exercises ◽

Group A ◽

Randomized Control ◽

Group B ◽

Experimental Group

Aim: To evaluate the effect of Pilates exercise on the level of fatigue, cognition and knee proprioception in elderly population (60-80 years). Study design: experimental study; randomized control trial. Method: 40 subjects both male and female of age ranging from 60-80 years (66.578 ± 4.857 in group A and 69.4 ± 5.442 in group B) were assigned in to two groups. The objective of the study was explained, and the subjects were screened based on the inclusion and exclusion criteria. Pre-interventional and post-interventional data analysis was done for FSS, 6MWT, MoCA and KJPS error angle. Group A (Experimental group) received Pilates exercise. Group B (control group) received aerobic and strengthening exercises. Both the groups underwent exercises 3 times a week on alternate days for 6 weeks. Duration of exercise for both groups was 45-60 minutes. Results: Both the groups showed clinically and statistically significant improvement in FSS (p<0.0001 in both groups) 6MWT (p<0.0001 in both groups), MoCA (p<0.001 in both groups) and KJPS scores (p<0.0002 in group A and p<0.0001 in group B) at the end of 6 weeks of treatment. There was no significant difference between the groups for FSS (p=0.7226), 6MWT (p=0.813), MoCA (p=0.416) and KJPS (p=0.6213). Conclusion: A significant improvement were observed in both the groups; which concluded that both the groups are equally effective in improvement of FSS, 6MWT, MoCA and KJPS scores. KEY WORDS: Pilates exercise, elderly population, fatigue, cognition, knee proprioception.

Download Full-text

Full dose versus attenuated dose daunorubicin, cytosine arabinoside, and 6-thioguanine in the treatment of acute nonlymphocytic leukemia in the elderly.

Journal of Clinical Oncology ◽

10.1200/jco.1984.2.8.865 ◽

1984 ◽

Vol 2 (8) ◽

pp. 865-870 ◽

Cited By ~ 99

Author(s):

S B Kahn ◽

C B Begg ◽

J J Mazza ◽

J M Bennett ◽

H Bonner ◽

...

Keyword(s):

Median Survival ◽

Cytosine Arabinoside ◽

Controlled Trial ◽

Intensive Therapy ◽

Eastern Cooperative Oncology Group ◽

Early Death ◽

The Elderly ◽

Acute Nonlymphocytic Leukemia ◽

Survival Times ◽

Significant Difference

Between July 1, 1981 and November 1, 1982, 45 patients with acute nonlymphocytic leukemia (age, greater than or equal to 70 years) were randomly assigned to receive induction chemotherapy using either daunorubicin, cytosine arabinoside, and 6-thioguanine in full dosage (F DAT) or an attenuated schedule of the same drugs (At DAT) as part of an Eastern Cooperative Oncology Group controlled trial. Forty patients were deemed evaluable, 20 on each arm. The overall complete remission (CR) rate for all patients in both arms was 28% (11/40). There was no significant difference in CR rates between the two arms. There were 12 early deaths (less than 60 days) in the F DAT arm compared with only five early deaths on the At DAT arm (P = .05). Due primarily to this early death rate, the median survival for the F DAT group was 29 days v 159 days for the At DAT groups (P = .02). The range of survival of the patients in CR for the At DAT group given either one or two cycles of induction therapy was 121 to 414 days, while the survival range for the F DAT CR patients was 121-186 + days. The median survival for those not achieving CR was 14 days for the F DAT group v 80 days for the At DAT (P less than .02). Fifty-nine percent of the At DAT patients spent greater than 100 days out of the hospital v 12% for the F DAT group. Attenuated chemotherapy with lower doses of DAT is the preferred induction regimen for elderly patients with acute nonlymphocytic leukemia since it causes fewer early deaths, allows a better quality of life, and yields survival times as durable as intensive therapy.

Download Full-text

Effectiveness of Strengthening Exercises for the Elderly with Low Back Pain to Improve Symptoms and Functions: A Systematic Review

Scientifica ◽

10.1155/2016/3230427 ◽

2016 ◽

Vol 2016 ◽

pp. 1-10 ◽

Cited By ~ 2

Author(s):

Nor Azizah Ishak ◽

Zarina Zahari ◽

Maria Justine

Keyword(s):

Systematic Review ◽

Low Back Pain ◽

Back Pain ◽

Older People ◽

The Elderly ◽

Control Group ◽

Low Back ◽

Strengthening Exercise ◽

Strengthening Exercises ◽

Academic Search

Objective. To determine the effect of strengthening exercises for older people with low back pain (LBP).Methods. This study is a systematic review of experimental study which evaluated the evidence regarding exercises for older people with LBP by using EBSCO Academic Search Premier, EBSCO EconLit, Science Direct, PUBMED, and PEDro from 2006 to 2016. Search strategy for each database was conducted by using keywords such as “low back pain”, “older people”, and “strengthening exercise”. Boolean operators were used to combine keywords and manual exclusion was conducted to verify studies which met the inclusion criteria. The articles reviewed were evaluated and critically appraised by using PEDro scale and SPSS version 20 was used to analyze the data.Results. Three articles were found regarding strengthening exercise for older people with LBP whereas one study was conducted on multicomponent exercise. The mean, standard deviation, and variance of the PEDro score of all the studies were 5.67, 2.33, and 1.528, respectively. Overall, the qualities of all studies reviewed were fair. Two articles showed significant results when compared to control group (p<0.05).Conclusions. Strengthening exercise is a beneficial treatment for older people with LBP in reducing pain intensity, disability, and improved functional performances.

Download Full-text

Evaluation of an Experimental Pain Model by Noncompartmental Analysis of Results from a Randomized Placebo Controlled Trial

January 2018 - Pain Physician ◽

10.36076/ppj.2018.4.363 ◽

2018 ◽

Vol 1 (21;1) ◽

pp. 363-372

Author(s):

France Varin

Keyword(s):

Active Treatment ◽

Controlled Trial ◽

Experimental Pain ◽

The Elderly ◽

Pain Tolerance ◽

Age Group ◽

Noncompartmental Analysis ◽

Time Curve ◽

Pain Model ◽

Significant Difference

Background: Understanding analgesic pharmacodynamics (PD) in the elderly is key to optimising pain management. Electrically stimulated pain models (ESPM) permit assessment of pain responses in humans. C and Aδ sensory fibres convey pain and respond to low frequency electrical stimulus (5 and 250 Hz, respectively). Human research suggests pain tolerance threshold (PTT) is similar or decreases with age. Objectives: To determine whether an ESPM is able to detect a difference in PTT in elderly (≥ 75 years) and young (20-40 years) subjects after single dose administration of a placebo and tramadol, a low potency analgesic. Study Design: Two-cohort, randomized, placebo-controlled, cross-over study. Methods: A noncompartmental analysis of data at 17 timepoints on 5 Hz and 250 Hz PTT over 24 h. Results: Young (16) and elderly (13) patients showed similar baseline (E0) PTT between active and placebo both overall and by age group in both frequencies. Net drug effect took into account negative and positive changes from E0. In the elderly, net peak effect on PTT produced by active treatment was significantly greater for both 5 Hz (34%) and 250 Hz (30%). Net area under the 24-h effect-time curve during active treatment was significantly higher for both 5 Hz (163 %) and 250 Hz (175%) stimulations in the elderly. No clinically significant difference was observed in the young. Limitations: High variability in young subjects, despite efforts to remove outliers limited our ability to draw conclusions in that age group. Generalizability of results obtained from an experimental pain model in volunteers to treatment of elderly patients may be limited. Conclusion: ESPM can detect a difference for pain tolerance threshold between placebo and tramadol administration in the elderly. Although both 5 Hz and 250 Hz stimulations can detect a difference, the effect size for 5 Hz is larger and seems more precise and reliable, particularly in the elderly. Key words: Electrical pain model, elderly, geriatric, tramadol, placebo, opioid, area under the effect curve, noncompartmental analysis

Download Full-text

Comparison of Acute Level of CK After Five Weeks Eccentric vs Concentric High Intensity Strength Exercise in Healthy Subject

Surabaya Physical Medicine and Rehabilitation Journal ◽

10.20473/spmrj.v1i2.16171 ◽

2019 ◽

Vol 1 (2) ◽

pp. 38

Author(s):

Hasni Hasni ◽

Hening Laswati Putra ◽

Nuniek Nugraheni

Keyword(s):

Muscle Strength ◽

Eccentric Exercise ◽

High Intensity ◽

Test Group ◽

The Elderly ◽

P Value ◽

Strength Increase ◽

Muscle Injuries ◽

Muscle Strengthening ◽

Strengthening Exercise

Background: Musculoskeletal injuries both in sport and recreational activities, at each age level, can lead to immobilization. Injury and immobilization can lead to muscle strength decrease and deconditioning. These conditions can be addressed by provision of strength training therapy especially for people with low exercise tolerance such as the elderly and patients with chronic disease. Existing studies stated eccentric exercise can increase muscle strength with less energy expenditure compared to concentric exercise. However eccentric exercise can lead to muscle damage indicated with an acute CK level increase, and eccentric exercise has not been carried out regularly for post muscle injuries and deconditioned patients. The American College of Sport Medicine (ACSM) stated strength increase and muscle hypertrophy require high intensity load strengthening exercise with a minimum load of 70% 1 Maximum Repetition. The recommended load was given to the subjects in this research. Our pleriminary study intervention was well tolerated by healthy subjects.Aim: Comparing acute CK level alteration in high intensity eccentric and concentric muscle strengthening exercise on untrained healthy subjects.Methods: Randomized pre test and post test group design. Subjects of the study (n = 16) were untrained healthy males. CK level was evaluated by laboratory test.Results: Our study showed decline of acute CK level in both groups with p value 0.65 and 0.76, respectively. No significant differences found on both groups.Conclusion: The increase of acute CK level after five weeks of eccentric strengthening exercise is not higher than that in concentric strengthening exercise.

Download Full-text

REPRINTED WITH PERMISSION OF IASP – Pain assessment in advanced dementia. Validity of the German PAINAD – a prospective double-blind randomised placebo-controlled trial

Ból ◽

10.5604/01.3001.0013.2997 ◽

2019 ◽

Vol 19 (4) ◽

pp. 34-49

Author(s):

Albert Lukas ◽

Ulrich Hagg-Grün ◽

Benjamin Mayer ◽

Thomas Flscher ◽

Matthias Schuler

Keyword(s):

Pain Assessment ◽

Controlled Trial ◽

The Elderly ◽

Study Groups ◽

Advanced Dementia ◽

Double Blind ◽

Observation Instrument ◽

Significant Difference ◽

Pain Recognition ◽

Pain In The Elderly

Pain in combination with dementia is a common condition that makes pain recognition significantly more difficult. This results in undertreatment of pain in those suffering from dementia. The Pain Assessment in Advanced Dementia (PAINAD) scale currently represents one of the best approaches to pain detection in dementia. In a pilot study, strong inter-rater and retest reliability of the German version (PAINAD-G) was proven. However, the available data concerning the validity of this instrument were insufficient. The aim of the study was to validate the PAINAD-G scale by a double-blind randomised placebo-controlled trial in people with advanced dementia expected to be in pain. A second aim was to examine whether other observational tools (BISAD5 Observation Instrument for Assessing Pain in the Elderly with Dementia) (German: Beobachtungsintrument fur das Schmerzassessment bei alten Menschen mit Demenz, Checklist of Nonverbal Pain Indicators, Algoplus) were also able to demonstrate a significant difference between the study groups. Surprisingly, the study revealed no difference in „pain reduction” between those treated by oxycodone compared with those treated by placebo. Equally, none of the other 3 observational tools were able to demonstrate a significant difference between the study groups. However, correlations among the 4 observational tools were mostly moderate to high. A number of possible reasons for this observation, such as difficulties regarding sensitivity to change/responsiveness, consistence of the fundamental construct, influence of the early onset study, and efficacy of the analgesic in advanced dementia are discussed.

Download Full-text

Eel’s Head Powder Reduces Mild-Moderate Depression in Geriatric Individual: Result from Randomized Controlled Trial Study

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2020/4658514 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5

Author(s):

Karina Shasri Anastasya ◽

Shelly Iskandar ◽

Nur Atik

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Geriatric Depression Scale ◽

Depression Scale ◽

The Elderly ◽

Geriatric Depression ◽

Plasma Tryptophan ◽

Randomized Controlled ◽

Significant Difference ◽

Tryptophan Level

Depression is one of the major problems, and the prevalence is higher among the elderly. The underlying mechanism of depression among this set of the population is multifactorial, and one of the most important factors in the pathophysiology of depression is the level of brain serotonin. Protein deficiency is linked to tryptophan deficiency that is known to be the essential material for the synthesis of serotonin. This randomized controlled trial looked for the effectiveness of eel’s head powder administration on plasma tryptophan level and geriatric depression scale (GDS) scores among the elderly population who suffered from depression. The subjects were divided into three intervention groups, including groups that were given 2-week course of 5 mg/kg BW eel’s head powder, 10 mg/kg BW eel’s head powder, and placebo, respectively. There was a significant difference in plasma tryptophan level and geriatric depression scale between the 10 mg/kg BW group and 5 mg/kg BW group. There was also a significant difference between those given 10 mg/kg BW eel’s head powder and those receiving placebo; however, no such difference was found between those in the 5 mg/kg BW eel’s head powder group and placebo group. Eel’s head powder administration could increase plasma tryptophan level and reduce geriatric depression scale score among older individuals who suffered from depression. Administration of 10 mg/kg BW eel’s head powder was significant in increasing plasma tryptophan level and reducing GDS score.

Download Full-text

Effect of Strengthening Exercises Using the Agonist- Antagonist Paired Set and Traditional Set Methods on Single-Leg Hop Performance

Surabaya Physical Medicine and Rehabilitation Journal ◽

10.20473/spmrj.v3i1.20670 ◽

2021 ◽

Vol 3 (1) ◽

pp. 1

Author(s):

Gadiza Raiznintha Permatasari ◽

RA Meisy Andriana ◽

I Putu Alit Pawana

Keyword(s):

Dynamic Stability ◽

Quadriceps Femoris ◽

Hamstring Muscle ◽

Healthy Men ◽

Muscle Strengthening ◽

Functional Activities ◽

Antagonist Muscles ◽

Strengthening Exercise ◽

Significant Difference ◽

Strengthening Exercises

Background: Functional activities mostly done in daily life such as jumping, walking, running, and stairs ascending-descending require dynamic stability of the knee. The knee joint dynamic stability is required to have effective and efficient functional activities and to avoid injury when performing them. It can be achieved by increasing muscle strength through strengthening exercises with the aim of balancing the agonist muscles (quadriceps femoris) and antagonist muscles (hamstring) using the agonist- antagonist paired set (APS) method.Aim: The aim of this study is to find out the effect of strengthening exercise using APS method, compared to traditional set (TS) method, on single-leg hop performance.Material and Methods: The subjects of this study were 14 untrained healthy men aged 18-40 years old divided into 2 intervention groups, APS group and TS group. The variable evaluated was the distance of single-leg hop (SLH).Results: The results of this study showed a significant increase in SLH distance in APS group (p=0.005) and TS group (p<0.001) with no significant difference between the two groups (p = 0.933).Conclusion: Quadriceps femoris and hamstring muscle strengthening exercises in both APS and TS methods increase SLH distance although there is no difference between them. The APS method has an advantage compared to the TS method in terms of a relatively shorter time with comparable results.

Download Full-text

Effects of a muscular stretching and strengthening school-based exercise program on posture, trunk mobility, and musculoskeletal pain among elementary schoolchildren - a randomized controlled trial

Fisioterapia em Movimento ◽

10.1590/1980-5918.032.ao08 ◽

2019 ◽

Vol 32 ◽

Cited By ~ 1

Author(s):

Mariana Vieira Batistão ◽

Letícia Carnaz ◽

Roberta de Fátima Carreira Moreira ◽

Tatiana de Oliveira Sato

Keyword(s):

Musculoskeletal Pain ◽

Controlled Trial ◽

Statistical Significance ◽

Intervention Group ◽

Exercise Program ◽

Control Group ◽

School Based ◽

Postural Changes ◽

Significant Difference ◽

Strengthening Exercises

Abstract Introduction: The exercise benefits for the most prevalent postural changes require proper investigation, with large samples, control group, and concealed allocation. Objective: To assess the effects of a muscular stretching and strengthening school-based exercise program on posture, trunk mobility, and musculoskeletal pain among elementary schoolchildren. Method: Three hundred students from three schools in Brazil were evaluated. Stretching and strengthening exercises, twice a week, for eight weeks in group sessions were provided by one physiotherapist. The control group did not undergo any intervention. Head, back and shoulder posture were qualitatively evaluated. Head and trunk alignment were evaluated using the Posture Assessment Software. Cervical, thoracic, low back and upper limb pain were assessed for the last seven days. The trunk mobility was recorded through the flexibility of the posterior chain. Posture, pain and trunk mobility were recorded at baseline and after the intervention. Groups were compared using χ2 test, two-way MANOVA, and two-way ANOVA, with α set at 5%. Results: Shoulder posture showed significant results (P = 0.04), the intervention group showed the lower worsening rate. In the quantitative evaluation, a statistically significant difference was observed between assessments (P < 0.01 for head and trunk; ES = 0.53) but not between groups. The intervention group had a higher percentage of improvement in the overall musculoskeletal pain (P = 0.04; ES = 0.54). Mobility decreased an average of 1.8° in the control group and increased 5.0° in the intervention group, without statistical significance. Conclusion: The program was effective in reducing pain level and shoulder misalignment at the intervention group.

Download Full-text