Effects of strength exercises combined with other training on physical performance in frail older adults: A systematic review and meta-analysis.

OBJECTIVES: Strength training is one of the most important protocols for frailty prevention in the older population. However, effects of adding other types of exercise to strength training in frail older adults remain unknown. Therefore, this review and meta-analysis determined the effects of strength exercise combined with other types of training on physical performance in frail older adults. METHODS: MEDLINE, PubMed, CINAHL, and Cochrane databases were searched through October 2021. In our study, we included both pre-frailty and frailty as frail older adults. The intervention was strength training combined with other exercise training, whereas the control group received usual care or light-intensity exercises. The included studies included at least one of the following outcomes: handgrip strength, knee extensor strength, gait speed, Timed Up and Go, and short physical performance battery. RESULTS: Ten articles met the inclusion criteria and were included. The results indicated that handgrip strength (SMD = 0.86, 95% CI= 0.01-1.70, p = 0.05), knee extensor strength (SMD = 0.61, 95%CI = 0.12-1.10, p = 0.01), TUG (SMD = -1.79, 95%CI = -3.16- -0.43, p=0.01), and SPPB (SMD = 0.53, 95%CI = 0.12-0.94, p = 0.01) improved significantly in the experimental group. CONCLUSIONS: Strength exercise combined with other exercise training improved muscle strength, TUG, and SPPB, but not gait velocity, in frail older adults.

Exploring Managers' Opinions on Planning and Designing Adult Day Care Centers.

OBJECTIVE: To explore managers' opinions on planning and design of location, building type, spatial layout, and interior design of adult day care centers (ADCCs). BACKGROUND: The planning and design of new ADCCs affect subsequent service users and workflows. Studies explore the factors affecting such planning and design using qualitative methods and from the perspective of users. Quantitative methods are rarely employed to explore factors affecting planning and opinions on the design of ADCCs from administrators' perspective. METHODS: Stratified sampling was used to collect data from managers of ADCCs in Taiwan. A mixed-method approach with an analytic hierarchy process was used to quantify the relative importance of factors affecting location and building type selections. Participants responded to open-ended interview questions followed by focus group interviews to examine the key points for spatial layout and interior design. RESULTS: The managers deemed support and attitudes from local residents (group weight = .208) and authorities (group weight = .187) as their first two critical location selection criteria. Regarding their opinions on the conditions of building type, those that prioritized the products and technologies of facility design were deemed the most critical (group weight = .193), followed by those that valued daylight quality (group weight = .161). Six key points of spatial layout and interior design were obtained from the focus group interviews. CONCLUSIONS: This study provides a reference for the effective planning of operations, including geographical location, building type, spatial layout, and interior refurbishment and design.

Comparison of segmental spinal movement control in adolescents with and without idiopathic scoliosis using modified pressure biofeedback unit.

BACKGROUND: Postural rehabilitation emphasizing on motor control training of segmental spinal movements has been proposed to effectively reduce the scoliotic spinal deformities in adolescent idiopathic scoliosis (AIS). However, information regarding the impairments of segmental spinal movement control involving segmental spinal stabilizers in adolescent idiopathic scoliosis remains limited. Examination of segmental spinal movement control may provide a window for investigating the features of impaired movement control specific to spinal segments that may assist in the development of physiotherapeutic management of AIS. OBJECTIVES: To compare segmental spinal movement control in adolescents with and without idiopathic scoliosis using modified pressure biofeedback unit. METHODS: Segmental spinal movement control was assessed in twenty adolescents with idiopathic scoliosis (AISG) and twenty healthy adolescents (CG) using a modified pressure biofeedback unit. Participants performed segmental spinal movements that primarily involved segmental spinal stabilizing muscles with graded and sustained muscle contraction against/off a pressure cuff from baseline to target pressures and then maintained for 1 min. Pressure data during the 1-minute maintenance phase were collected for further analysis. Pressure deviation were calculated and compared between groups. RESULTS: The AISG had significantly greater pressure deviations for all segmental spinal movements of cervical, thoracic, and lumbar spine than the CG. CONCLUSION: Pressure biofeedback unit was feasible for assessing segmental spinal movement control in AIS. AISG exhibited poorer ability to grade and sustain muscle activities for local movements of cervical, thoracic, and lumbar spine, suggesting motor control training of segmental spinal movements involving segmental spinal stabilizing muscles on frontal, sagittal, and transverse planes were required.

Effect of assistive reading software on high school students with learning disabilities: a pilot study.

OBJECTIVE: This research project was designed to test the immediate effect of using assistive reading software - Kurzweil 3000 (K-3000) for high school students with learning disabilities (LD) to improve their English reading and other school performances. PARTICIPANTS: 29 Taiwanese high school students with LD were randomly assigned to one of two groups: (1) use of the K-3000 or (2) control group (using a pen and paper). METHODS: Both groups were asked to complete the standardized measurements using pen and paper a pre-test. Students in experiment group used the K-3000 to do the post-test after they were familiarized with the K-3000, while the students in the control group used pen and paper for the post-test. The differences between the pre-test and post-test of two groups were analyzed. RESULTS: The results suggested that the K-3000 had an immediate impact on students' English word recognition and pronunciation. However, the use of K-3000 did not have a significant influence on the students' general English proficiency, learning adjustment, and academic self-perception. CONCLUSIONS: The use of K-3000 had a positive effect on students' English word recognition. The reason why there was no significant change in students' other performances could be due to the length of the intervention.

Examining changes in self-perceived quality of life in children and adolescents with physical disability using a longitudinal design.

PURPOSE: The study aimed to investigate the changes in self-perceived quality of life (QOL) of children and adolescents with physical disability (PD). METHOD: Two hundred students aged 10-18 with PD were recruited from primary and high schools in Taiwan to participate in this longitudinal study. The Student Version of the Comprehensive Quality of Life Scale (COMQOL-S) was used to measure self-perceived QOL, which was recorded at baseline, and 6, 12 and 18 months post-baseline. Statistically, linear mixed models were used to compare the QOL scores among the four time points. RESULTS: At the second, third and fourth visit, 192, 151 and 128 participants completed COMQOL-S, respectively. Significant changes over time were found in overall objective and subjective OQL scores (slope = 0.8, p = 0.002 and slope = -1.3, p < 0.001, respectively). Specifically, significant reductions of the subjective QOL scores over the period of the four visits were observed in five domains, namely, Productivity (slope  =  -1.7, p = 0.005), Intimacy (slope  =  -1.6, p = 0.004), Safety (slope = -1.6, p = 0.008), Place in community (slope  =  -1.4, p = 0.019) and Emotional wellbeing (slope  =  -2.5, p < 0.001). Age was negatively correlated with the change of overall subjective score. Positive correlation was found between the change in mean objective scores and mean subjective scores in the Intimacy and Productivity domains. CONCLUSIONS: Even though the conditions of material wellbeing and health can be kept steady, the overall QOL of children and adolescents with PD could still decline over time. This might be attributable to the fact that social life becomes more sophisticated when children become older.

A 3D mathematical model to predict spinal joint forces for a child with spina bifida.

Children with spina bifida (SB) can exhibit excessive arm swing, trunk sway, and pelvic tilt during walking. To understand the relationship between abnormal low back forces (LBF) and gait disorders in SB, we derived a mathematical model for evaluating LBF in this population. One unimpaired child and a child with SB were tested. A 3D motion analysis system and force plate were used to collect kinematic and ground reaction force data during walking. A mathematical model created using MATLAB software was used to calculate LBF for each child. The LBF for the child with SB was three times greater in the medio-lateral direction than for the unimpaired child. In the anterior-posterior direction, the LBF for the child with SB acted mostly towards the anterior trunk. In addition, the LBF of the child with SB increased by 24.5% of body weight at the fastest walking speed.

Do physical disabilities affect self-perceived quality of life in adolescents?

PURPOSE: We examined to what extent physical disabilities (PD) affect self-perceived quality of life (QOL) among adolescents. METHOD: A survey was conducted on 157 adolescents (aged 15.6 +/- 1.6 years) with PD, who were attending high schools in Taiwan; 855 students (15.3 +/- 1.6 years) from the same geographic regions and without a disability were recruited as controls. The Student Version of the Comprehensive Quality of Life Scale (COMQOL-S) was used to assess their subjective and objective well-being. RESULTS: No significant differences in overall objective QOL score were found between the two groups but the PD group was poorer in health and material well-being. Adolescents with PD scored significantly higher in overall subjective QOL and all the seven domains examined. Stratified analysis showed that older students and female students with PD had lower life satisfaction in some domains. There were no significant differences in overall objective (62.1 +/- 8.3 vs. 60.9 +/- 6.4; p = 0.55) or subjective (72.3 +/- 12.6 vs. 74.4 +/- 13.6; p = 0.15) QOL between students in mainstream and special schools. CONCLUSIONS: With national health care and educational coverage, the QOL of adolescents with PD in Taiwan do not seem to be affected by the disabilities, regardless of whether they are in mainstream or special schools. However, the negative effect of PD on QOL becomes a concern with increasing age; females with PD also appear to have a lower subjective QOL in health and emotion.

Establishment of resource portal of assistive technology in Taiwan.

PURPOSE: To establish an Assistive Technology (AT) resource portal for users, professionals and policy-makers in Taiwan to provide a new and versatile information network for AT popularization. METHOD: The Centre for AT Resources and Popularization (CATR@P), integrated the resources primarily from five AT Resource Centres of the Ministry of Interior in Taiwan. CATR@P invited representatives of organizations for people with disabilities, AT specialists and policy-makers to join the task force. A web company was responsible for website software design and collaboration with CATR@P, which included planning portal functions, all user-friendly interfaces and pilot testing. RESULTS: The Resource Portal of AT was officially online in October 2006. The portal was structured with 19 main functions and the contents of this new portal are versatile and multifunctional. It contains vast amounts of national and international resources such as archives of AT centres, AT products, a professionals directory, websites linkage, full text of the AT Companion Journal, E-paper, on-line consultation services, frequently asked questions, and on-line questionnaires. CONCLUSIONS: Integration of Taiwan AT resources in conjunction with the internet technology has made resources more available for people with disabilities and society.

Associations between the metabolic syndrome and its components, watching television and physical activity.

OBJECTIVE: To examine the associations between watching television and physical activity with the metabolic syndrome and its components. STUDY DESIGN: Cross-sectional study. METHODS: This study was conducted among 358 subjects recruited from the Department of Health Management of Chang Gung Medical Centre in Linkou. After adjustment for gender, age and body mass index (BMI), the odds ratios (ORs) of the metabolic syndrome and its components were analysed for relative daily energy expenditure groups and time spent watching television categories. RESULTS: After adjustment for gender, age and BMI, the OR of the metabolic syndrome in the most active subjects compared with the least active subjects was 0.27 [95% confidence interval (CI)=0.08-0.88; P=0.030]. There was inconclusive evidence of an association between watching television for more than 20h/week and presence of the metabolic syndrome (OR=2.99; 95% CI=0.83-10.84; P=0.095). CONCLUSIONS: Physical activity was a significant protective factor for presence of the metabolic syndrome and low levels of high-density-lipoprotein cholesterol. Watching television was positively associated with greater odds of high levels of triglycerides and fasting glucose. This study emphasized the importance of reducing the time spent watching television and increasing the level of physical activity for prevention of the metabolic syndrome.

Self-perceived quality of life for adolescents with physical disabilities - a preliminary study.

The purpose of this study was to explore the effect of physical disabilities (PD) on the quality of life (QoL) of adolescents aged from 10 to 18 years. Sixty-three adolescents with PD (aged 14.9 +/- 2.4 years) from primary (5th grade or above) to high schools in Kaohsiung City volunteered to participate in this research; 282 children without disability (aged 13.8 +/- 2.3 years) attending schools in the same geographical region were recruited as controls. The Student Version of the Comprehensive Quality of Life Scale was used in this study. This is a multidimensional self-report, global measure of subjective and objective QoL. Multivariate analysis of variance revealed that the two groups were significantly different in objective QoL (F = 11.53, p < 0.001). Material wellbeing was substantially lower in the PD group when compared to the control group. In contrast, domains such as productivity, safety, and emotion were higher in the PD group. Among the subjective scales, the PD group showed higher productivity and better emotion when compared to the control group. No significant correlation was observed between objective and subjective overall QoL scores (r = 0.20, p = 0.12) in the PD group. These findings showed that subjects with PD in regular schools demonstrated different patterns in objective and subjective QoL when compared to those without PD. Both subjective and objective domains are important when measuring QoL of adolescents with PD.

The effectiveness of an aerobic exercise intervention on worksite health-related physical fitness--a case in a high-tech company.

BACKGROUND: The major objective of this prospective study was to evaluate the effects of aerobic exercise intervention with goals of improving health-related physical fitness in one high-tech company in Taiwan. METHODS: This study was conducted as a quasi-experimental design. Among the 54 subjects enrolled in the study, 26 subjects of the volunteers agreed to participate in an aerobic exercise program. The control group was comprised of a similar sample of 28 subjects working at the same company. Subjects in the exercise group participated in a 12-week aerobic exercise program, while subjects in the control group did not participate. RESULTS: The results of analysis of variance with repeated measures of health-related physical fitness showed that the subjects in the exercise group had significantly more improvements in abdominal muscle strength and endurance than the subjects in the control group. CONCLUSIONS: This study indicated that one 12-week aerobic exercise program was effective in improving the abdominal muscle strength and endurance of employees of a high-tech company.

Presence of spinocerebellar ataxia type 2 gene mutation in a patient with apparently sporadic Parkinson's disease: clinical implications.

Among 242 patients with apparently sporadic Parkinson's disease, a 70-year-old man with a CAG repeat number of 37 in the SCA2 gene was identified. He has remained responsive to levodopa 14 years after onset and has had no overt signs suggesting cerebellar dysfunction. Although it is not possible to confirm if this patient has a de novo mutation of the SCA2 gene, this genetic defect seems to be contributing to his parkinsonian features and further supports the concept that apparently sporadic, late-onset, levodopa-responsive Parkinson's disease may have multiple causes.