Efficacy of fine motor and balance exercises on fine motor skills in children with sensorineural hearing loss

Background: Childhood hearing impairment is a major disability associated with delayed motor development. The affected Fine motor performance in children with sensorineural hearing loss (SNHL) could be due to dynamic balance deficits and visual-motor incoordination. Objective: This study was designed to investigate the effects of fine motor exercises with or without balancing exercises on fine motor skills in children with SNHL. Methods: One hundred and eighty (180) children their age ranged from 8 to 18 years old diagnosed with SNHL were selected. They were divided into three groups, 60 children (control group) practiced only their ordinary activities of daily living, 60 children (fine motor exercises group) practiced fine motor exercises, and 60 children (fine motor and balance exercise) group practiced fine motor and balance exercises. The outcomes were assessed by the Bruininks Oseretsky Test of the motor proficiency second edition scale (BOT-2). Results: Generally, there was a statistically significant difference between control group and fine motor exercises group where (p < 0.05), besides, there was a statistically significant difference between control group and fine motor and balance exercises group where (p < 0.05). But, there was no statistically significant difference between fine motor exercises group and fine motor and balance exercises group where (p > 0.05). Conclusions: The Fine Motor performance of children with SNHL has been improved by Fine motor with or without balancing exercises according to (BOT-2).

Development of an exercise programme for balance abilities in people with multiple sclerosis: a development of concept study using Rasch analysis

Background People with multiple sclerosis (PwMS) frequently have impaired balance from an early stage of the disease. Balance difficulties can be divided into categories; although, to date, these lack scientific foundation. Impaired balance in PwMS can be addressed using specific and challenging exercises. Such exercises should provide an optimal challenge point; however, the difficulty of balance exercises is often unknown, making it difficult to target the exercises to an individual’s abilities. The aims of this study were: to develop an exercise programme for PwMS relating the exercises to the balance problem categories; to establish the order of difficulty of exercises in each category and; to evaluate the content and structural validity of the exercise programme. Methods A “construct map” approach was used to design and develop an exercise programme for PwMS. Potentially relevant balance exercises were identified, then a framework was set up, comprising four dimensions (subsequently reduced to three dimensions) of balance exercises. The relevance, comprehensibility, and comprehensiveness of the exercise programme were rated by 13 physiotherapists, who also linked 19 key exercises to balance categories. A total of 65 PwMS performed the 19 balance exercises, rated their difficulty and commented on the relevance and comprehensibility of each exercise. A Rasch model was used to evaluate the relative difficulty of the exercises. To assess fit of the data to the Rasch model a rating scale model was used, which is a unidimensional latent trait model for polytomous item responses. Results Evaluation by the physiotherapists and PwMS indicated that the content validity of the exercise programme was adequate. Rasch analysis showed that the latent trait “balance exercises in PwMS” comprised three subdimensions (“stable BOS”, “sway” and “step and walk”). The 19 balance exercises showed adequate fit to the respective dimensions. The difficulties of the balance exercises were adequate to cover the ability spectrum of the PwMS. Conclusion A balance exercise programme for PwMS comprising three dimensions of balance exercises was developed. Difficulty estimates have been established for each of the exercises, which can be used for targeted balance training. Content and structural validity of the programme was adequate.

Longitudinal observational study of boxing therapy in Parkinson’s disease, including adverse impacts of the COVID-19 lockdown

Background Parkinson’s Disease (PD) is a highly prevalent neurodegenerative disease whose incidence is increasing with an aging population. One of the most serious manifestations of PD is gait instability, leading to falls and subsequent complications that can be debilitating, even fatal. Boxing therapy (BT) uses gait and balance exercises to improve ambulation in people with PD, though its efficacy has not yet been fully proven. Methods In the current longitudinal observational study, 98 participants with idiopathic PD underwent twice-weekly BT sessions. Primary outcome was self-reported falls per month; secondary outcomes were quantitative and semi-quantitative gait and balance performance evaluations. Statistical methods included segmented generalized estimating equation with an independent correlation structure, binomial distribution, and log link. Results The average number of self-reported falls per month per participant decreased by 87%, from 0.86 ± 3.58 prior to BT, to 0.11 ± 0.26 during BT. During the lockdown imposed by COVID-19, this increased to 0.26 ± 0.48 falls per month. Females and those > 65 years old reported the greatest increase in falls during the lockdown period. Post-lockdown resumption of BT resulted in another decline in falls, to 0.14 ± 0.33. Quantitative performance metrics, including standing from a seated position and standing on one leg, largely mirrored the pattern of falls pre-and post-lockdown. Conclusions BT may be an effective option for many PD patients.

Adherence to Kinect Adventure Games in Individuals with Parkinson’s Disease – An Experimental Study from Mysore, India

BACKGROUND Individuals with Parkinson’s disease (PD) experience reduced balance ability and are prone to fall. As the disease advances with age, the traditional forms of physiotherapy are prone to fail in long-term exercise intervention as patients lose interest in performing the exercises. The use of virtual reality game technology consists of tasks in virtual environments that combine physical and cognitive demands in a fun and motivating manner which leads to adherence in a long-term exercise intervention. The objectives of the study were to know the adherence of Kinect adventure games in individuals with PD by attendance percentage of prescribed sessions and analyse the impact of balance after the games in them. METHODS An experimental study with pre-post design in which 11 individuals were selected, with a mean age of 67.8 years. Home-based balance exercises were given three days a week up to 6 weeks (18 sessions). Kinect adventure games were implemented for another six weeks. Adherence was measured by attendance percentage in terms of the frequency of sessions completed. The secondary outcome measure was to assess balance. Participants were evaluated before intervention and post-intervention using BESTest. Descriptive statistics were used to compare the BESTest scores of pre and post-intervention. RESULTS The adherence percentage of Kinect adventure game therapy was 38 %. The adherence percentage of home-based balance exercises was only 9 %. The best scores improved in home-based balance exercise compared to Kinect adventure game therapy. CONCLUSIONS The participants with Parkinson’s disease did not adhere to Kinect adventure game therapy. For the attended sessions the balance improved for home-based balance exercise compared to Kinect game therapy. KEY WORDS Exercise Barrier, Adherence, Balance Training, Virtual Reality, Video Games

Effect Vladimir Janda Balance Training on Postural Sway and Leg Muscle Strength

Background: The majority of people who work as tea plantation pickers are powerful. They carry heavy loads of tea on their backs while the roads are quite dangerous and sometimes cause problems. A balance training program has proven to reduce postural sway, increasing leg muscle strength and improving balance strategies. Objective:The aim of this study was to determine the effect of Vladimir Janda balance training methods with an external load on postural sway and leg muscle strength of tea pickers. Methods: The study design used was quasi-experimental with a randomized control group pretest-posttest design. Subjects were tea pickers consisting of a productive age group of 15 people and 15 people as a control treatment group. The Vladimir Janda method balance exercises were conducted over five weeks consisting of 5 phases. Phase I-IV were carried out 5 times a week, while the V phase was done 3 times a week and each session lasted 15 minutes. Postural sway was measured with a posturometer. Leg muscle strength was measured by a back-leg dynamometer. The statistical tests used were Independent T-test and the Mann-Whitney test. Results:The statistical test for the control and treatment groups using the Mann-Whitney test showed p = 0.001, meaning no external load effects on postural sway. Independent t-test showed p = 0.000, meaning there are differences in the effect between the treatment and control groups after being given balance exercises to increase leg muscle strength. Logistic regression test results obtained the ROC value of 0.917, meaning the Vladimir Janda balance training can affect the postural sway and knee extensor muscle strength by 91.7%. Conclusion: The Vladimir Janda balance exercise method can reduce postural sway and increase the strength of knee extensor muscles and ankle flexor Dorsi muscles. External loads can affect the postural sway.

Post-Drive Standing Balance of Vehicle Passengers Using Wearable Sensors: The Effect of On-Road Driving and Task Performance

Postural sway has been demonstrated to increase following exposure to different types of motion. However, limited prior studies have investigated the relationship between exposure to normative on-road driving conditions and standing balance following the exposure. The purpose of this on-road study was to quantify the effect of vehicle motion and task performance on passengers’ post-drive standing balance performance. In this study, trunk-based kinematic data were captured while participants performed a series of balance exercises before and after an on-road driving session in real-time traffic. Postural sway for all balance exercises increased following the driving session. Performing a series of ecologically relevant visual-based tasks led to increases in most post-drive balance metrics such as sway position and velocity. However, the post-drive changes following the driving session with a task were not significantly different compared to changes observed following the driving session without a task. The post-drive standing balance performance changes observed in this study may increase vulnerable users’ risk of falling. Wearable sensors offer an opportunity to monitor postural sway following in-vehicle exposures.

CHANGE IN KNEE SEPARATION DISTANCE IN ADOLESCENT ATHLETES AFTER A 6-WEEK NEUROMUSCULAR TRAINING PROGRAM

Background: Existing neuromuscular injury prevention programs have relied principally on lower extremity strengthening, agility, cutting and landing technique to improve jump landing mechanics in order to prevent non-contact knee ligament injuries. Purpose: To determine whether a 6-week neuromuscular training program emphasizing core (back & hip) strengthening and dynamic balance exercises can significantly improve normalized knee separation distance (nKSD) during a standard counter-movement jump landing maneuver. Methods: Fourteen adolescent athletes (11 boys, 3 girls, ages 12-15) volunteered to undergo a 2 day/week, 6-week off-season training program. On the first day of training, the athletes underwent assessments that included 2 trials of a counter-movement jump from a 40cm platform. The tests were recorded using a video camera in the frontal plane. Using Dartfish motion analysis software, knee separation distance (KSD) was measured as the distance (cm) between the femoral condyles at the lowest point of the jump landing, and intertrochanteric distance (ITD) as the distance (cm) between the femoral trochanters. Normalized knee separation distance was computed as nKSD = KSD/ITD. The training program focused on three progressions; increasing difficulty of core strengthening exercises, balance exercises, and agility drills. One-hour training sessions were subdivided as follows; 5 min dynamic warm-up, 10 min stretching, 10 min body weight core exercises, 15 min balancing exercises, 10 min dumbbell core exercises, 15 minute agility drills, 5 min of rest/hydration breaks. The athletes repeated the counter-movement jump test at the end of the 6 weeks. Results: There was a significant improvement (t = 2.740, p = 0.017) in nKSD between post-test (0.789 + 0.372) and pre-test (0.683 + 0.323) Conclusion: A 6-week neuromuscular training program focused on core strengthening and balance significantly improved jump landing mechanics which may reduce the risk of knee ligament injury.