Comparison of multisensory and strength training for postural control in the elderly.

OBJECTIVE: The objective of this study was to analyze the efficacy of multisensory versus muscle strengthening to improve postural control in healthy community-dwelling elderly. PARTICIPANTS: We performed a single-blinded study with 46 community-dwelling elderly allocated to strength (GS, n = 23; 70.18 ± 4.8 years 22 women and 1 man) and multisensory exercises groups (GM, n = 23; 68.8 ± 5.9 years; 22 women and 1 man) for 12 weeks. METHODS: We performed isokinetic evaluations of muscle groups in the ankle and foot including dorsiflexors, plantar flexors, inversion, and eversion. The oscillation of the center of pressure was assessed with a force platform. RESULTS: The GM group presented a reduction in the oscillation (66.8 ± 273.4 cm(2) to 11.1 ± 11.6 cm(2); P = 0.02), which was not observed in the GS group. The GM group showed better results for the peak torque and work than the GS group, but without statistical significance. CONCLUSION: Although the GM group presented better results, it is not possible to state that one exercise regimen proved more efficacious than the other in improving balance control.

Uso de testes clínicos para verificação do controle postural em idosos saudáveis submetidos a programas de exercícios físicos / Use of clinical tests for verification of postural control in healthy elderly submitted to physical exercise programs

O controle postural no envelhecimento diminui e a prática de exercícios físicos pode melhorar esta importante função. A fim de medir estas possíveis melhoras, podem ser usados diversos testes. O objetivo deste estudo foi o de analisar o uso de testes clínicos de medidas indiretas para verificar as alterações sobre o controle postural de idosos saudáveis submetidos a programas de exercícios físicos. O desenho do estudo foi um ensaio clínico simples-cego e aleatorizado com braços paralelos. Participaram da pesquisa 46 idosos divididos aleatoriamente em dois grupos de exercícios: multissensoriais (GMS, n=23, 68,8±5,9 anos) e de fortalecimento (treino resistido) (GR, n=23, 70,18±4,8). Ambos os grupos realizaram 12 semanas (2dias/semana, 50m/dia) de exercícios. Para avaliação do controle postural foram utilizados os testes: Timed up and go (TUG), teste de apoio unipodal, bateria de testes de Guralnik e escala de equilíbrio funcional de Berg. Os indivíduos do GMS apresentaram melhora significativa nos testes TUG e bateria de testes de Guralnik e o GR não apresentou melhora em nenhum dos testes. A melhora no tempo de execução do teste TUG do GMS que foi de 9,1±8,04 para 8,0±1,0 segundos após a intervenção, foi estatisticamente superior ao resultado do GR. Acreditamos que o teste TUG e a bateria de testes de Guralnik são boas opções para avaliar o controle postural de idosos submetidos a programas de intervenção. Embora o TUG não possa ter seu tempo diminuído indefinidamente, permite verificar até mesmo dentro de um tempo de normalidade, alterações promovidas por exercícios físicos.

With aging, postural control diminishes, but the practice of physical exercises can improve this important function. Various tests can be used to measure these possible improvements. The objective of this study is to analyze the use of clinical tests of indirect measurements to verify the alterations in the postural control of healthy elderly submitted to physical exercise programs. The study´s design is a randomized, simple-blind clinical test with the subjects´ arms parallel. In the research there were 46 elderly divided randomly into two groups of exercises: multi-sensorial (MSG, n=23, 68.8±5.9 years) and strengthening (resistance training) (RTG, n=23, 70.18±4.8). Both groups performed 12 weeks (2 days/week, 50minutes/day) of exercises. To evaluate their postural control the following tests were utilized: Timed up and go (TUG), unipodal support test, battery of Guralnik tests, and the Berg functional balance scale. The MSG individuals showed significant improvement in the TUG tests and Guralnik battery of tests, and the RTG individuals did not show improvement in any of the tests. The improvement in the time of execution of the TUG test of the MSG group was 9.1±8.04 to 8.0±1.0 seconds after intervention, and it was statistically higher than the RTG group result. We believe the TUG test and the Guralnik battery of tests are good options to evaluate the postural control of the elderly submitted to the intervention programs. Although the TUG cannot have its time diminished indefinitely, it allows the verification, even within a normalcy time, of alterations brought on by physical exercises.

Functional mobility and balance in community-dwelling elderly submitted to multisensory versus strength exercises.

It is well documented that aging impairs balance and functional mobility. The objective of this study was to compare the efficacy of multisensory versus strength exercises on these parameters. We performed a simple blinded randomized controlled trial with 46 community-dwelling elderly allocated to strength ([GST], N = 23, 70.2-years-old +/- 4.8 years) or multisensory ([GMS], N = 23, 68.8-years-old +/- 5.9 years) exercises twice a week for 12 weeks. Subjects were evaluated by blinded raters using the timed 'up and go' test (TUG), the Guralnik test battery, and a force platform. By the end of the treatment, the GMS group showed a significant improvement in TUG (9.1 +/- 1.9 seconds (s) to 8.0 +/- 1.0 s, P = 0.002); Guralnik test battery (10.6 +/- 1.2 to 11.3 +/- 0.8 P = 0.009); lateromedial (6.1 +/- 11.7 cm to 3.1 +/- 1.6 cm, P = 0.02) and anteroposterior displacement (4.7 +/- 4.2 cm to 3.4 +/- 1.0 cm, P = 0.03), which were not observed in the GST group. These results reproduce previous findings in the literature and mean that the stimulus to sensibility results in better achievements for the control of balance and dynamic activities. Multisensory exercises were shown to be more efficacious than strength exercises to improve functional mobility.