Exergames Training Effects on Gait During Single and Dual Tasks in Sexagenarian Women.

Objective: This study was designed to analyze the effects of an exergames training program on gait parameters while holding a cellphone conversation at self-selected walking speed (SSWS) and fast walking speed (FWS). Materials and Methods: Twenty-one older women (66.3 ± 4.0 years) practiced exergames for 12 weeks and were assessed for spatiotemporal gait parameters at SSWS and FWS under single task and dual task. The strength of the lower limbs was measured by an isokinetic dynamometer (Byodex System 3). The cognitive function was assessed with the Montreal Cognitive Assessment (MoCA). The tests were assessed 4 weeks before the start of the exergames training (baseline, T0), immediately before (pretraining, T1), and at the end of 12 weeks of the exergame training (post-training, T2), except for the MoCA test that was assessed at T0 and T2. Results: The spatiotemporal gait parameters at SSWS and FWS showed extensive changes when a cellphone conversation was sustained (e.g., 6.5% and 5.8% reduction in walking speed, respectively). Exergames training was not effective in minimizing these changes or improving muscle strength after 12 weeks (<3.0%). Minor cognitive improvements (0.5 points) were observed in response to training. Conclusion: Holding a cellphone conversation while walking changed several gait parameters, irrespective of the walking speed. The spatiotemporal gait parameters and lower limb muscle strength in sexagenarian women remained unchanged after the exergames training program.

Perceptive-Cognitive and Physical Function in Prefrail Older Adults: Exergaming Versus Traditional Multicomponent Training.

Research highlights the benefits of regular traditional multicomponent training in older adults. The potential effect of exergames on perceptive-cognitive and physical function in prefrail older adults is still little explored. The study aimed to compare the effects of two physical exercise training programs (exergaming vs. traditional multicomponent) on perceptive-cognitive and physical functions of prefrail older adults. This study was a randomized controlled trial having 66 prefrail older adults assigned to two groups (exergame group [EG]: n = 32, 70.84 ± 4.53 years; multicomponent group [MG]: n = 34, 70.76 ± 5.60 years). Frailty phenotype, fall history, basic and advanced cognition, perceptual, physical (mobility, gait speed, and balance), and muscle (strength and power) functions were evaluated. Intervention was conducted during 12 weeks. The EG and MG performed similar exercise routines involving the main lower limb muscle groups required in daily activities. A mixed model analysis of variance (ANOVA) and effect size (d) revealed that both programs were effective in postponing frailty status, reducing the fear of falling (EG: d = 1.65; MG: d = 1.40), increasing fall risk awareness (EG: d = 2.14; MG: d = 1.60), improving cognitive status (EG: d = 0.83-2.61; MG: d = 0.86-1.43), muscle (EG: d = 0.54; MG: d = 0.51-0.73), and physical function (EG: d = 0.97-1.55; MG: d = 1.01-2.23). The exergame training might be a better alternative to improve cognition, whereas the multicomponent program may be a better option to provide physical function gains.

Is Handgrip Strength a Useful Measure to Evaluate Lower Limb Strength and Functional Performance in Older Women?

AIM: This study aimed to determine the association of handgrip strength with isometric and isokinetic strength (hip, knee and ankle extensor/flexor muscles), and functional capacity in older women. METHODS: The handgrip strength and lower limb strength of 199 older women (60-86 years) were measured using JAMAR and BIODEX dynamometers, respectively. Time Up and Go, Five-times-sit-to-stand and 6m-walk functional tests were evaluated. Pearson correlations were used to determine the relationship between variables. Regression analysis was applied to identify if HS was able to predict TUG performance. The effect of age was analyzed by splitting the participants in a group of older women (OLD; from 60 to 70 years old) and very old women (from 71 to 86 years old). RESULTS: The HS and isometric/isokinetic strength correlations were negligible/low and, in most cases, were non-significant. The correlation between handgrip strength and functional tests also ranged predominantly from negligible (r=0.0 to 0.3) to low (r=0.3 to 0.5), irrespective of the group age. The handgrip strength was not able to explain the variance of the TUG performance. CONCLUSION: Generalizing handgrip strength as a practical and straightforward measure to determine lower limbs and overall strength, and functional capacity in older women must be viewed with caution. Handgrip strength and standard strength measures of the lower limbs and functional tests present a negligible/low correlation.

The Effects of Different Exergame Intensity Training on Walking Speed in Older Women.

Objective: It is not known if the intensity in which exergames are performed can change gait parameters at different walking speeds. This study was designed to determine if a training program based on exergame exercises performed at different intensities (moderate vs. vigorous) influences walking speed and gait parameters in older adult women. Methods: After applying the inclusion criteria, 20 participants (69.5 ± 5.4 years) were randomized into two groups: moderate (11-13 perceived exertion) and vigorous (14-16 perceived exertion). Walking speed and gait parameters at self-selected walking speed (SSWS) and maximal walking speed (MWS) were evaluated before and after 3 months of exergame training. The walking speed and gait parameters were measured with an instrumented walkway. The walking speed reserve (WSR) was calculated as a difference and ratio. Results: There was pre-to-post effect of walking speed at self-selected walking pace (pre = 112.1 ± 16.4 cm.s-1; post = 124.8 ± 16.4 cm.s-1), in WSR calculated as ratio (pre = 1.35 ± 0.08; post = 1.28 ± 0.09), in a number of gait parameters at SSWS (step length, stride length, stride velocity, step time, stride time, swing time, stance time, single support, double support, gait cycle time, and cadence) and at MWS (step time, stride time, swing time, single support, double support, gait cycle time, and cadence). Conclusion: Irrespective of the exercise intensity, exergame training improved walking speed only at a self-selected walking pace and some gait parameters at self-selected and MWS in older women.

Effects of aquatic exercise on muscle strength and functional performance of individuals with osteoarthritis: a systematic review.

Water-based exercises are recommended for people with osteoarthritis (OA), due to the beneficial effects on physical function, quality of life and symptom reduction. However, the effects on muscle strength are still controversial. The aim of this review was to assess and compare the effects of aquatic exercise programs on muscle strength and physical function in people with OA. A systematic search was performed at Pubmed, Scopus and Web of Science databases. Clinical trials with interventions involving aquatic exercises for individuals with OA were included. The methodological quality of the studies was evaluated using the PEDro scale. 296 studies were found and twelve were selected: six studies comparing water-based exercises with land-based exercise, and six comparing water-based exercise groups with the control group. Exercise programs included muscle strengthening, aerobic, balance, flexibility and stretching exercises. Duration of the program, weekly frequency, intensity and progression varied between studies. Beneficial effects of aquatic exercise were found on physical function. However, only two of five studies that assessed muscle strength observed positive effect of aquatic exercise. Although it is difficult to compare studies and establish guidelines for the standardized protocol formulation, it was observed that water-based exercises can be effective on improving physical function and increasing muscle strength, since they are well-structured, with exercise intensity and overload controlled.

Effects of aquatic exercise on muscle strength and functional performance of individuals with osteoarthritis: a systematic review / Efeitos do exercício aquático na força muscular e no desempenho funcional de indivíduos com osteoartrite: uma revisão sistemática

ABSTRACT Water-based exercises are recommended for people with osteoarthritis (OA), due to the beneficial effects on physical function, quality of life and symptom reduction. However, the effects on muscle strength are still controversial. The aim of this review was to assess and compare the effects of aquatic exercise programs on muscle strength and physical function in people with OA. A systematic search was performed at Pubmed, Scopus and Web of Science databases. Clinical trials with interventions involving aquatic exercises for individuals with OA were included. The methodological quality of the studies was evaluated using the PEDro scale. 296 studies were found and twelve were selected: six studies comparing water-based exercises with land-based exercise, and six comparing water-based exercise groups with the control group. Exercise programs included muscle strengthening, aerobic, balance, flexibility and stretching exercises. Duration of the program, weekly frequency, intensity and progression varied between studies. Beneficial effects of aquatic exercise were found on physical function. However, only two of five studies that assessed muscle strength observed positive effect of aquatic exercise. Although it is difficult to compare studies and establish guidelines for the standardized protocol formulation, it was observed that water-based exercises can be effective on improving physical function and increasing muscle strength, since they are well-structured, with exercise intensity and overload controlled.

RESUMO Exercícios aquáticos são recomendados para pessoas com osteoartrite (OA), pois melhoram a funcionalidade e a qualidade de vida e reduzem os sintomas da doença. Entretanto, os efeitos na força muscular ainda são controversos. O objetivo desta revisão foi avaliar e comparar o efeito de programas de exercícios aquáticos na força muscular e na funcionalidade de pessoas com OA. Foi feita uma busca bibliográfica nas bases de dados Pubmed, Scopus e Web of Science. Foram incluídos ensaios clínicos feitos com intervenções que envolveram exercícios aquáticos para indivíduos com OA. A qualidade metodológica dos estudos foi avaliada por meio da escala PEDro. Foram encontrados 296 estudos. Desses, 12 foram selecionados, seis que compararam exercícios aquáticos com exercícios feitos em solo e seis que compararam um grupo de exercícios aquáticos com grupo controle. Os programas contemplaram exercícios de fortalecimento muscular, aeróbios, de equilíbrio, de flexibilidade e alongamento. A duração do programa, a frequência semanal, a intensidade e a progressão variaram entre os estudos. Foram encontrados efeitos benéficos do exercício aquático na funcionalidade, porém, dos cinco estudos que avaliaram a força muscular, apenas dois verificaram efeito positivo dos exercícios aquáticos. Embora haja dificuldades para comparar os estudos e estabelecer diretrizes para a formulação de protocolos padronizados, observou-se que exercícios aquáticos podem ser eficientes na melhoria da funcionalidade e no aumento da força muscular, desde que os programas sejam bem estruturados com intensidade e sobrecarga controlada e progressiva.