Efficacy of an exercise program on balance and lower limb functional level among elderly population of Gujarat, India: A randomized controlled trial to prevent falls

Background: Altered balance and lower limb muscle weakness are the common risk factors associated with falls in elderly. Objectives: The purpose of this study was to assess the efficacy of an exercise program on balance and lower limb functional level in elderly population with moderate risk of fall. Materials and Methods: An exercise program, including warm-up exercises, balancing exercises, strengthening exercises, flexibility, and cool-down exercises, was designed for this interventional study. A total of 50 participants were selected by simple random sampling method from the physiotherapy department of the hospital, Ahmedabad, and they were randomly allocated into an interventional group of 25 and a control group of 25 participants. The inclusion criteria included, age: 60–80 years, both men and women, and Berg balance scale (BBS) score of ≤45. The intervention group received the exercise program for 4 times/week for up to 6 weeks and the control group was kept in waiting period. Pre- and post-exercise programs, a comparison of all measures was done with focus on BBS and lower extremity functional scale as primary outcome measures to find out the efficacy of the treatment protocol. The general linear model: Repeated measures analysis of variance and the independent t-test was used for analysis and values of P < 0.05 were considered statistically significant. Results: A total of 50 participants including 28 females and 22 males aged 60–80 years with an average age of 69.2 ± 6.6 years were included in the study. The balance and lower limb functional level of the intervention group were significantly higher than the baseline values with large effect size. Furthermore, the intervention group showed statistically significant improvement in balance and lower limb function when compared with the control group. Conclusion: The randomized controlled trial indicated that the designed exercise program for elderly was effective, and there was a significant improvement in balance and lower limb functional level in participants who received the exercise program. This study suggested that elderly people with moderate risk of fall can minimize falls and related fractures by better balance and strength with exercises.

Assessment of rotator cuff muscle strength and shoulder rotation range of motion in subjects with lateral epicondylitis

Background: Lateral epicondylitis (LE) is a common soft tissue condition treated by many physical therapists. It has poor long-term outcomes for the non-surgical management which suggests a less than optimal rehabilitation process, so there is a need to assess proximal kinetic chain. Objectives: The objective of the study is to compare shoulder rotator muscle strength and shoulder rotation range of motion (ROM) in patients with LE with age-matched healthy individuals. Materials and Methods: An observational study was conducted on 28 subjects with LE (Group A) and 28 age-matched healthy individuals (Group B), selected by convenience sampling. The strength of shoulder rotator muscles was assessed with the use of handheld dynamometer. Shoulder rotation ROM was assessed using standard goniometer. Results: Shoulder external rotators were 9% weaker on dominant side (P = 0.02) while no differences were seen for shoulder internal rotator (IR) strength (P = 0.2). For Group B, shoulder external rotators were 11% stronger on dominant side (P = 0.04), while No dominance difference was seen for shoulder IR strength (P = 0.5). For both Group A and Group B, shoulder rotation ROM showed no significant difference between dominant and non-dominant sides. For between-group analysis, shoulder rotation ROM and shoulder rotator strength showed no statistically significant difference between the Groups A and B. Conclusion: There is muscular imbalance of shoulder rotators in LE.

Correlation of core muscles endurance and balance in subjects with osteoarthritis knee

Background: Osteoarthritis (OA) is a chronic degenerative joint disease with a prevalence of about 29% in India. Reduced kinesthetic receptors in joint especially around the ligaments in the knee can lead to impaired proprioceptive information to an individual. Core muscle endurance deficiency leads to an increase in the loading of the knee, as well as in knee joint contact force during dynamic movement. Hence, poor core stability may be one of the contributing factors that lead to knee OA development as well as its progression. Objectives: The objective of this study was to find a correlation between core muscle endurance and balance in subjects with OA. Material and Methods: The observational study was conducted on 50 healthy, male and female subjects, age >40 years diagnosed with OA knee using convenience sampling. Subjects underwent core stability assessment consisting of plank, bilateral side bridge, Sorenson, and 60-degree trunk flexion endurance tests. Y-balance test -Lower quarter (YBT-LQ) was used to measure dynamic balance in individuals. The data were analyzed at a 5% level of significance using SPSS. Outcomes were correlated using Spearman’s correlation of coefficient. Results: Correlation was found between YBT-LQ and plank r = 0.402 (P = 0.004), YBT-LQ and right side bridge 0.425 (P = 0.002), YBT-LQ and left side bridge r = 0.490 (P = 0.001), YBT-LQ and 60° trunk flexion test r = 0.369 (P = 0.008), and YBT-LQ and Sorenson test r = 0.324 (P = 0.022). Conclusion: There is a weak to moderate correlation between core endurance and balance in subjects with OA knee.