Modified Functional Reach Test: Upper-Body Kinematics and Muscular Activity in Chronic Stroke Survivors

Effective control of trunk muscles is fundamental to perform most daily activities. Stroke affects this ability also when sitting, and the Modified Functional Reach Test is a simple clinical method to evaluate sitting balance. We characterize the upper body kinematics and muscular activity during this test. Fifteen chronic stroke survivors performed twice, in separate sessions, three repetitions of the test in forward and lateral directions with their ipsilesional arm. We focused our analysis on muscles of the trunk and of the contralesional, not moving, arm. The bilateral activations of latissimi dorsi, trapezii transversalis and oblique externus abdominis were left/right asymmetric, for both test directions, except for the obliquus externus abdominis in the frontal reaching. Stroke survivors had difficulty deactivating the contralesional muscles at the end of each trial, especially the trapezii trasversalis in the lateral direction. The contralesional, non-moving arm had muscular activations modulated according to the movement phases of the moving arm. Repeating the task led to better performance in terms of reaching distance, supported by an increased activation of the trunk muscles. The reaching distance correlated negatively with the time-up-and-go test score.

Association between serum 25-hydroxyvitamin D and physical performance measures in middle-aged and old Japanese men and women: The Unzen study

Purpose Regarding epidemiological studies, the role of vitamin D in musculoskeletal functionality (muscle weakness and physical performance) among elderly people is still controversial. The purpose of the present study was to investigate the associations between 25-hydroxyvitamin D [25(OH)D] and physical performance among community-dwelling middle-aged and old Japanese men and women. Methods The subjects were community-dwelling 297 men and 415 women aged 50 years and over. Data on height (m) and weight (kg) were collected. Serum 25(OH)D, parathyroid hormone, calcium, and albumin levels were measured. Serum 25(OH)D was classified into deficiency group: < 20 ng/mL, insufficiency group: 20–30 ng/mL, and sufficiency group: ≧ 30 ng/mL. Physical performance was assessed by grip strength, chair stand time, and functional reach. Information on current smoking, alcohol drinking, regular exercise, any comorbidities (hypertension, heart disease, diabetes mellitus, lung disease, and stroke), and pain (lumbar and knee) was collected. Results Vitamin D deficiency and insufficiency based on serum 25(OH)D levels were observed in 15.2% and 56.9% of men and 52.0% and 43.6% of women, respectively. In men, higher serum 25(OH)D levels were associated with better grip strength (p for trend = 0.003), chair stand time (p for trend = 0.042), and functional reach (p for trend <0.001). On the other hand, these parameters were not associated with serum 25(OH)D levels in women. Conclusion A higher level of serum 25(OH)D was associated with better physical performance in men but not in women.

Maximising Abilities, Negotiating and Generating Exercise options (MANAGE) in people with multiple sclerosis: A feasibility randomised controlled trial

Objective To investigate the feasibility and preliminary efficacy of a group self-management exercise and education program in people with multiple sclerosis. Design Feasibility randomised controlled trial. Setting Outpatient rehabilitation facility. Subjects Twenty-three adults (age 48.6 (11.7) years) recruited from a Multiple Sclerosis Clinic register. Interventions The intervention group undertook a 12-week group program incorporating behaviour change education, exercise and community integration. This was compared with a waitlist control group. Main measures Feasibility was measured by recruitment, adherence and safety. Efficacy outcomes included measures of physical function (6-metre and 6-min walk, Functional Reach) and self-report questionnaires (fatigue, quality of life, exercise benefits and barriers) at baseline, 6, 12 and 24 weeks. Results Of 74 individuals identified through the register, 48 (65%) were contacted and deemed eligible, and 23 (48%) agreed to participate. There was high adherence for attendance at education (57 of 72, 79%) and exercise (135 of 174, 78%) sessions. No adverse safety events occurred within the intervention sessions. Missed attendances at assessment sessions was high (5 to 8 participants missed at each time point) predominately due to health issues. The intervention group demonstrated positive changes in walking endurance, Functional Reach and fatigue, whereas the control had some reductions in walking speed and more perceived exercise barriers. Conclusions The MANAGE program appears feasible and safe for people with mild-to-moderate multiple sclerosis, with high adherence to exercise and education sessions. Future trials should consider strategies such as flexible scheduling or alternative methods of data collection to improve follow-up assessment attendance.

Implementation and initial evaluation of falls risk reduction resources in a rural Native American Community

Background Although falls are common and can cause serious injury to older adults, many health care facilities do not have falls prevention resources available. Falls prevention resources can reduce injury and mortality rates. Using the Centers for Disease Control and Prevention’s (CDC) Stopping Elderly Accidents, Deaths & Injuries (STEADI) model, a falls risk clinic was implemented in a rural Indian Health Service (IHS) facility. Methods A Fall Risk Questionnaire was created and implemented into the Provider’s Electronic Health Records system interface to streamline provider screening and referral of patients who may be at risk for falls to a group falls risk reduction class. Results Participants exhibited average improvements in the Timed Up and Go (6.8 s) (P = 0.0001), Five-Time Sit-to-Stand (5.1 s) (P = 0.0002), and Functional Reach (3.6 inches) (P = 1.0) tests as compared to their own baseline. Results were analyzed via paired t test. 71% of participants advanced out of an “increased risk for falls” category in at least one outcome measure. Of the participants to complete the clinic, all were successfully contacted and three (18%) reported one or more falls at the 90-day mark, of which one (6%) required a visit to the Emergency Department but did not require hospital admission. Conclusions In regards to reducing falls in the community, per the CDC STEADI model, an integrated approach is best. All clinicians can play a part in reducing elder falls.

Immediate Effect of Kinesiology Tape on Functionality, Static and Dynamic Balance, Exercise Capacity and Posture in Users of High-Heeled Shoes

Background: Using high-heeled shoes in daily life affects the stability of walking, body posture, and functionality. So, the present study was aimed to determine the immediate effect of Kinesio-taping (KT) on functionality, static and dynamic balance, exercise capacity, posture in young women using high-heeled shoes. Methods: Thirty-seven females who were used high-heeled shoes with a mean age of 20.32{plus minus}1.37 years were divided into two groups: control (n:20) and study group(n:17). The study group's both limbs were taped medially, laterally, and dorsally with KT; no application was made to the control group. Balance [Techno Body Postural Line], functionality [vertical jump and functional reach test], exercise capacity [6-min walk test], human body posture [New York Posture Rating Chart] was assessed. Results: Use of high-heeled shoes was 8(7-9) hours/day, 5(3-5) days/week, 3(2-6.5) years in the study group versus 6(6-8) hours/day, 4(2.5-5.75) days/week for 4(2.5-5.75) years in the control group. Statistical significance in functional reach distance (cm) was found within the control (p:0.010) and study groups (p:0.005) but not between the groups (p˃0.05). Stabilometric mono pedal right foot elips area (mm2; p:0.006) and perimeter (mm;p:0.009); left foot elips area (mm2;p:0.016), perimeter (mm;p:0.023) and front/backward standard deviation (p:0.018); dynamic balance area gap percentage (%; p:0.030) were significant within the study group. Posture, vertical jump distance, exercise capacity, stabilometric test results, bipedal closed-eye&opened eye results were similar within and between the groups (p˃0.05). Conclusions: Kinesio-taping has no immediate effect on exercise capacity, vertical jump function, posture, and bipedal static balance but can modulate the functional reach function, static mono pedal leg balance, and dynamic equilibrium. Further studies are recommended to investigate the additive effect of KT with high heels and after 45 minutes, 24 hours and 72 hours.

THE EFFECT OF THE STABILITY OF THE FREE ANKLE JOINT ON THE GAIT BALANCE OF CHRONIC STROKE PATIENTS BY THE ANKLE FOOT ORTHOSIS

Stroke patients have high foot instability and a high risk of falling down in walking and standing positions due to muscle and sensory disorders. There are many patients who complain of inconvenience in their daily lives, but independent walking is very difficult. In this work, we explore the effect on walking and dynamic balance by securing internal and external stability of the foot. Fifteen participants participated in the experiment, with 10m walk tests, timed and go tests, and functional reach tests. The walk 10m test was not statistically significant, with 0.59 ± 0.23 m/s before the device was worn and 0.66 ± 0.29 m/s after the device was worn. Timed up and Go tests were statistically significant 26.57 ± 6.12 seconds before wearing the device, 22.31 ± 4.32 seconds after wearing the device, 222.59 ± 10.31 cm before wearing the device, and 230.93 ± 11.33 cm after wearing the device. Securing internal and external stability of the foot can have a positive impact on securing a dynamic balance in which weight movement is performed.

A modified digital functional reach test device using an ultrasonic sensor for balance assessment: A test of validity and reliability

Study aim: Evaluation of dynamic balance is inferred to be compulsory for fall prevention in the elderly. Therefore, this study aimed to develop a modified digital functional reach test device using an ultrasonic sensor for balance assessment and to test validity and reliability of the newly developed tool to qualify psychometric properties. Material and methods: This study was a cross-sectional study of a convenient sample including 50 participants both males and females. Mean age of the participants was 51.20 ± 19.30 years. Reliability of the newly developed device was analysed using the intraclass correlation coefficient (ICC) and standard error of measurement (SEM). The criterion validity was also investigated using a yardstick mounted on the wall at a level of shoulder together with the MaxTraq® 2D motion analysis software. The modified digital functional reach test device using an ultrasonic sensor was correlated with the conventional FRT and the MaxTraq® 2D motion analysis. Results: The results presented that test-retest reliability of the modified digital functional reach test device was good reliability (ICC = 0.76) and low standard error of measurement (1.41) was found for test-retest reliability. The degree of agreement between the modified device, the conventional FRT, and the MaxTraq® 2D motion analysis was high (r = 0.71 and 0.77 respectively). Conclusions: The findings suggested that the modified digital functional reach test device using an ultrasonic sensor was a valid and reliable instrument for fall risk screening towards functional reach distance.

PENGARUH SENAM TAI CHI TERHADAP PENINGKATAN KESEIMBANGAN DINAMIS PADA LANJUT USIA

Introduction: Many elderly people experience a decrease in dynamic balance, a condition which increases the risk of falling. Tai chi is a renowned exercise that can improve the dynamic balance in elderly people. Purpose of the study: In order to prove the effect of Tai chi on the increase of dynamic balance in the elderly. Methods of the study: One group pretest posttest design with 23 subjects of elderly people aged 60-75 years old and given Tai chi twice a week for 30 minutes within one month (8 times). Measurement: Functional Reach Test (FRT) and Time Up and Go Test (TUG). Analysis: Normality test by Saphiro Wilk as well as pretest-posttest different test with paired T-test. Result: Based on the analysis of normality test by Saphiro Wilk on the pretest and posttest, the obtained result is p>0.05 which means the data is normally distributed. In the meantime, the analysis of pretest-posttest difference test with paired T-test results in dynamic balance value before and after Tai chi as much as p<0.05 (p=0.000); and, it also generates the dynamic balance value before and after Tai chi with TUG as much as p<0.05 (p=0.000). This means there is a significant difference between before and after the treatment when measured by Functional Reach Test (FRT) and Time Up and Go Test (TUG). Conclusion: Tai chi improves the dynamic balance in the elderly.