Effects of 8 Weeks of Balance Training, Virtual Reality Training, and Combined Exercise on Lower Limb Muscle Strength, Balance, and Functional Mobility Among Older Men: A Randomized Controlled Trial.

BACKGROUND: Poor muscle strength, balance, and functional mobility have predicted falls in older adults. Fall prevention guidelines recommend highly challenging balance training modes to decrease falls; however, it is unclear whether certain modes are more effective. The purpose of this study was to determine whether traditional balance training (BT), virtual reality balance training (VR), or combined exercise (MIX) relative to a waitlist control group (CON) would provoke greater improvements in strength, balance, and functional mobility as falls risk factor proxies for falls in older men. HYPOTHESIS: We hypothesized that 8 weeks of MIX will provoke the greatest improvements in falls risk factors, followed by similar improvements after BT and VR, relative to the CON. STUDY DESIGN: Single-blinded randomized controlled trial NCT02778841 (ClinicalTrials.gov identifier). LEVEL OF EVIDENCE: Level 2. METHODS: In total, 64 community-dwelling older men (age 71.8 ± 6.09 years) were randomly assigned into BT, VR, MIX, and CON groups and tested at baseline and at the 8-week follow-up. The training groups exercised for 40 minutes, 3 times per week, for 8 weeks. Isokinetic quadriceps and hamstrings strength on the dominant and nondominant legs were primary outcomes measured by the Biodex Isokinetic Dynamometer. Secondary outcomes included 1-legged stance on firm and foam surfaces, tandem stance, the timed-up-and-go, and gait speed. Separate one-way analyses of covariance between groups were conducted for each outcome using baseline scores as covariates. RESULTS: (1) MIX elicited greater improvements in strength, balance, and functional mobility relative to BT, VR, and CON; (2) VR exhibited better balance and functional mobility relative to BT and CON; and (3) BT demonstrated better balance and functional mobility relative to CON. CONCLUSION: The moderate to large effect sizes in strength and large effect sizes for balance and functional mobility underline that MIX is an effective method to improve falls risk among older adults. CLINICAL RELEVANCE: This study forms the basis for a larger trial powered for falls.

The effect of exercise on interferon gamma, body fat and bmi of kidney transplant patients / Efeito do exercício sobre interferon gama, gordura corporal e imc em pacientes com transplante renal / Efecto del ejercicio sobre el interferón gamma y el imc de los pacientes con trasplante de riñón

INTRODUCTION: Poor physical function and obesity are well documented in kidney transplant patients. Significant health benefits result from regular physical activity, many of which are important for kidney transplant patients. OBJECTIVE: The aim of this study was to investigate the effects of 10-week combined exercises on Interferon Gamma (IFNγ), body fat percentage (BF%) and body mass index (BMI) in kidney transplant patients. METHOD: In a randomized controlled experimental design, 44 kidney transplant patients aged 20-50 years were randomly divided into two groups of exercise (n=23) and control (n=21). The exercise group participated in a cumulative training program for 10 weeks, three days a week, 60­90 minutes per day at 40-65% of predicted maximal heart rate reserve. A 5 ml venous blood sample and anthropometric parameters were taken from the subjects at baseline and after 10 weeks. RESULTS: The exercise group showed an improvement in BF% (from 31.80±5.64 to 28.86 ± 5.82, p =0.001) and BMI (from 26.23 ± 1.81 to 25.45 ± 2.11, p = 0.001), but there was no significant change in the IFNγ level (from 0.06 ± 0.02 to 0.06 ± 0.02, p = 0.829). There was a significant difference between the control and exercise groups for BF% (p = 0.001) and BMI (p = 0.001). CONCLUSION: As a take-home message, it should be mentioned that combined exercise intervention is inexpensive and portable and can be performed at home or health centers for kidney transplant patients to reduce their weight and BF%. Evidence Level I; High quality randomized trial with or without statistically significant difference, but with narrow confidence intervals.

INTRODUÇÃO: A função física deficiente e a obesidade são bem documentadas em pacientes com transplante renal. A atividade física regular resulta em benefícios significativos para a saúde, muitos dos quais são importantes para os pacientes com transplante de rim. OBJETIVO: O objetivo deste estudo foi investigar os efeitos de 10 semanas de exercícios combinados sobre interferon gama (IFN-γ), percentual de gordura corporal (GC) e índice de massa corporal (IMC) nesses pacientes. MÉTODOS: Em um estudo randomizado experimental controlado, 44 pacientes com transplante renal com idade entre 20 e 50 anos foram divididos em um grupo exercício (n = 23) e um grupo controle (n = 21). O grupo exercício participou em um programa de treinamento cumulativo por 10 semanas, três dias por semana, 60 a 90 minutos por dia, com 40% a 65% da frequência cardíaca de reserva prevista. Foram coletadas amostras de sangue venoso de 5 ml, assim como os parâmetros antropométricos dos indivíduos no início do programa e depois de 10 semanas. RESULTADOS: O grupo exercício apresentou melhora do percentual de GC (31,80 ± 5,64 para 28,86 ± 5,82, p = 0,001) e do IMC (26,23 ± 1,81 para 25,45 ± 2,11, p = 0,001), mas não houve mudança significativa no nível de IFN-γ (0,06 ± 0,02 para 0,06 ± 0,02, p = 0,829). Houve diferença significativa entre os grupos controle e exercício no percentual de GC (p = 0,001) e no IMC (p = 0,001). CONCLUSÃO: A mensagem a ser lembrada é que a intervenção com exercícios combinados é de baixo custo e os aparelhos necessários são portáteis, e pode ser realizada em casa ou em centros de saúde pelos pacientes de transplante renal, visando reduzir o peso e o percentual de GC. Nível de Evidência I; Estudo clínico randomizado de alta qualidade com ou sem diferença estatisticamente significante, mas com intervalos de confiança estreitos.

INTRODUCCIÓN: el bajo funcionamiento físico y la obesidad están bien documentados en pacientes con trasplante de riñón. Los beneficios significativos para la salud son el resultado de la actividad física regular, muchos de los cuales son importantes para los pacientes con trasplante de riñón. OBJETIVO: El objetivo de este estudio fue investigar los efectos de los ejercicios combinados de 10 semanas sobre Interferón-Gamma (IFNγ), porcentaje de grasa corporal (% BF) e índice de masa corporal (IMC) en pacientes con trasplante renal. MÉTODO: en un diseño experimental controlado aleatorio, 44 pacientes con trasplante renal, de 20-50 años, se dividieron aleatoriamente en dos grupos de ejercicio (n = 23) y control (n = 21). El grupo de ejercicio participó en un programa de entrenamiento acumulativo durante 10 semanas, tres días a la semana, 60 a 90 minutos por dia, com 40 a 65% de la reserva máxima prevista para frecuencia cardiaca. Se tomaron 5 ml de muestra de sangre de Venus y parámetros antropométricos de los sujetos en la línea de base al inicio y luego de 10 semanas. RESULTADOS: El grupo de ejercicio mostró una mejora en el porcentaje de BF (de 31,80 ± 5,64 a 28,86 ± 5,82, p = 0,001) y el IMC (de 26,23 ± 1,81 a 25,45 ± 2,11, p = 0,001), pero no hubo un cambio significativo en el nivel de IFNγ (de 0.06 ± 0.02 a 0.06 ± 0.02, p = 0.829). Hubo una diferencia significativa entre el control y los grupos de ejercicio para BF% (p = 0.001) e IMC (p = 0.001). CONCLUSIÓN: como mensaje de inicio se debe mencionar que la intervención combinada con ejercicios es económica y portátil, y puede realizarse en el hogar o en centros de salud para que los pacientes con trasplante de riñón disminuyan su peso y BF%. Nivel de Evidencia I; Estudio clínico aleatorio de alta calidad, con o sin diferencia estadísticamente significativa, pero con intervalos de confianza estrechos.

The effect of exergaming on knee proprioception in older men: A randomized controlled trial.

BACKGROUND: Proprioception is the ability to sense the body position, muscle sense, joint stability and posture. As balance decreases during the process of aging, knee proprioception has a critical role in body balance and daily activities. Exergaming has shown to be a potentially effective and more enjoyable form of exercise delivery. OBJECTIVE: The purpose of this study was to determine the effect of an 8-week Xbox Kinect exercise program on knee proprioception in healthy older adults. METHODOLOGY: Thirty-two elderly men who were 65 years of age or older were randomly allocated to either a control or experimental group (allocation ratio 1:1). The experimental group received an exergame intervention that included Xbox Kinect with games focusing on movements of the knee joint for 8 weeks (three times per week and 40min per sessions). A Biodex Isokinetic Dynamometer was used to measure knee joint position sense before and after the exercise program. RESULTS: After eight weeks of training, knee proprioception significantly improved in the intervention group for several knee joint angles: 30° (3.5±1.1), 45° (3.1±0.9), and 60° (3.0±0.6) compared to the control group 30° (5.2±0.8), 45° (5.2±0.8), and 60° (6.2±0.9) (dominant leg F1, 28=23.469, p=0.001. ƞ2=0.456; non-dominant leg F1, 28=23.076, p=0.001. ƞ2=0.452). CONCLUSION: The results from this study indicate that exergame intervention can enhance knee proprioception in elderly men.