Effects of Taekkyon-based exercise program on balance, lower extremity strength, and gait parameters in community-dwelling older women: Randomized controlled trial.

BACKGROUND: As individuals age, they experience a decline in muscle strength and balance, leading to diminished functional capacity and an increased risk of falls. The purpose of the current study was to investigate the effects of the Taekkyon-based exercise program on balance, muscle strength, and gait ability in women aged over 65-year-old residing in the local community. METHODS: Forty-eight subjects were randomly allocated into the Taekkyon-based exercise program as an experimental group (EG = 25; mean age: 71.68 ±â€…3.26) or a fall prevention program as a control group (CG = 23; mean age: 73.65 ±â€…5.88). EG participants received 1-hour Taekkyon exercise sessions twice a week for 12 consecutive weeks. CG participants received a typical fall prevention program. The measurements in each group included assessments of balance levels (the timed up-and-go test, one-leg stance, and functional reach test), lower extremity strength (the 5-chair stand test and 30-second chair stand test), and gait parameters (cadence, step length, step width, stride length, stride time, and gait velocity) before and after the intervention. RESULTS: After the intervention, balance (timed up-and-go test, one-leg stance, and functional reach test), lower extremity strength (5-chair stand test and 30-second chair stand test), and gait parameters (cadence, stride time, and gait velocity) showed a significant improvement in EG participants compared to CG participants (P < .05). Compared to the normal value of balance ability and strength of elderly women over 65 years of age, most outcomes were greater than average normal values for those receiving Taekkyon exercise. CONCLUSION: Taekkyon-based exercise program was more effective in improving balance, lower extremity strength, and gait capacity than the usual fall prevention program in elderly women over 65 years of age. Its effects can approach normal values for women in this age group. The 12-week Taekkyon-based exercise program could be useful as part of a fall prevention program to elderly people.

Effect of automaticity induced by treadmill walking on prefrontal cortex activation and dual-task performance in older adults.

As individuals age, they may experience a decline in gait automaticity, which requires increased attentional resources for the control of gait. This age-related decline in gait automaticity has been shown to contribute to higher prefrontal cortex (PFC) activation and lower dual-task performance during dual-task walking in older adults. This study is to investigate the effect of treadmill walking on PFC activation and dual-task performance in older adults. A total of 20 older adults (mean age, 64.35 ± 2.74 years) and 20 younger adults (mean age, 30.00 ± 3.15 years) performed single- and dual-task walking in overground and treadmill conditions. A wearable functional near-infrared spectroscopy and gait analyzer were used to analyze PFC activation and dual-task performance, respectively. To determine the dual-task (gait and cognitive) performance, the dual-task cost (DTC) was calculated using the following formula: (single-task - dual-task)/single-task × 100. In both groups, dual-task treadmill walking led to reduced PFC activation and reduced DTC compared to dual-task overground walking. Furthermore, despite a higher DTC in gait variability, correct response, total response, response index and a higher error score in older adults than in younger adults during overground walking, there was no difference in treadmill walking. The difference in PFC activation between single- and dual-tasks was also observed only in overground walking. Performing dual-task walking on a treadmill compared to overground walking results in different levels of dual-task performance and PFC activity. Specifically, older adults are able to maintain similar levels of dual-task performance as younger adults while walking on a treadmill, with reduced PFC activation due to the automaticity induced by the treadmill. Therefore, older adults who exhibit low dual-task performance during overground walking may be able to improve their performance while walking on a treadmill with fewer attentional resources.

Change in activity patterns in the prefrontal cortex in different phases during the dual-task walking in older adults.

BACKGROUND: Studies using functional near-infrared spectroscopy (fNIRS) have shown that dual-task walking leads to greater prefrontal cortex (PFC) activation compared to the single-task walking task. However, evidence on age-related changes in PFC activity patterns is inconsistent. Therefore, this study aimed to explore the changes in the activation patterns of PFC subregions in different activation phases (early and late phases) during both single-task and dual-task walking in both older and younger adults. METHODS: Overall, 20 older and 15 younger adults performed a walking task with and without a cognitive task. The activity of the PFC subregions in different phases (early and late phases) and task performance (gait and cognitive task) were evaluated using fNIRS and a gait analyzer. RESULTS: The gait (slower speed and lower cadence) and cognitive performance (lower total response, correct response and accuracy rate, and higher error rate) of older adults was poorer during the dual task than that of younger adults. Right dorsolateral PFC activity in the early period in older adults was higher than that in younger adults, which declined precipitously during the late period. Conversely, the activity level of the right orbitofrontal cortex in the dual-task for older adults was lower than for younger adults. CONCLUSIONS: These altered PFC subregion-specific activation patterns in older adults would indicate a decline in dual-task performance with aging.

Effect of robot-assisted stair climbing training as part of a rehabilitation program to improve pulmonary function, gait performance, balance, and exercise capacity in a patient after severe coronavirus disease 2019: a case report.

BACKGROUND: Severe coronavirus disease 2019 (COVID-19) infection may decrease respiratory and physical functions. OBJECTIVE: To evaluate whether robot-assisted stair climbing training (RASCT) would improve pulmonary and physical functions in a patient post-severe COVID-19 infection. CASE DESCRIPTION: A 48-year-old woman who had experienced severe COVID-19 underwent a 6-week inpatient rehabilitation. She persistently exhibited impaired pulmonary and physical functions, including walking and balance impairment. We provided a 30-min outpatient RASCT biweekly for 6 weeks. OUTCOMES: After training, maximal inspiratory and maximal expiratory pressures improved from 81 and 74 cmH2O to 104 and 81 cmH2O, respectively. The walking speed improved from 1.15 to 1.21 m/s. In balance ability, physical performance battery score and timed up-and-go test improved from 8 to 11 s and 10.89 to 9.95 s, respectively. Regarding exercise capacity, the 6-min walk test distance improved from 453 to 482 m, and the number of 1-min sit-to-stand test improved from 20 to 23, with improved pulse rate and saturation level. The physical and psychological domain scores of the World Health Organization Quality-of-Life Scale-BREF improved from 44 to 63 and 69 to 81, respectively; Falls Efficacy Scale-International scores improved from 38 to 21. CONCLUSION: RASCT, as part of a rehabilitation plan, was feasible and effective for this patient after severe COVID-19 infection.

Impact of intensive rehabilitation on long-term prognosis after stroke: A Korean nationwide retrospective cohort study.

An increasing number of patients are receiving rehabilitation after stroke. But the impact of intensive rehabilitation on the long-term prognosis of patients with stroke remains to be elucidated. The purpose of this study was to identify the impact of intensive rehabilitation on the long-term prognosis of patients with stroke using data from the National Health Insurance Service database. This is a register-based, retrospective cohort study. Using data from the National Health Insurance Service database, we included the patients who received rehabilitation for stroke from 2006 to 2013. Of the 14,984 patients diagnosed with stroke, 2483 died within 1 year, and 2866 did not receive rehabilitation; hence, they were also excluded. The final sample included 9635 (49.2% men, 50.8% women) patients. After correcting for covariates, the Cox model was used to evaluate the effects of physical therapy (PT) and occupational therapy (OT) on survival. We estimated the independent contribution of each factor to the risk of death from the initiation of rehabilitation. Significant differences in mortality were observed according to age, Charlson comorbidity index (CCI), income level, and stroke type. Patients with stroke who received both PT and OT had a better long-term prognosis than those who received either treatment alone. Therapy performed by a physical therapist with more than 120 hours of training effectively improved the patients' long-term prognosis. Intensive PT and OT will help improve the long-term prognosis of patients with stroke. This study emphasizes the importance of intensive rehabilitation in these patients.

The effect of the degree of dual-task interference on gait, dual-task cost, cognitive ability, balance, and fall efficacy in people with stroke: A cross-sectional study.

ABSTRACT: This study was conducted to investigate the effects of the degree of dual-task (DT) interference on gait, dual-task cost (DTC), cognitive ability, balance, and fall efficacy in people with stroke.In this cross-sectional study, people with chronic stroke (N = 36) performed a DT gait assessment (gait and cognitive task). During the evaluation, DT interference in motor and cognition was evaluated simultaneously. Thus, the group with severe interference in both tasks (mutual interference) was compared with the group with mild interference in either.The main effects for the degree of motor interference were observed on gait performance, DTC in motor, time up and go, and trail-making test B. In the cognitive interference, the main effects were observed on correct response rate, DTC in cognition, time up and go, and trail-making test B. An interaction effect was observed in the trail-making test B.The degree of motor interference affected gait, balance ability, and executive function (EF), and the degree of cognitive interference influenced the correct response rate in the DT condition, balance ability, and EF. Furthermore, mutual interference led to a significant reduction in EF in people with stroke.

Effects of Dual-Task Gait Treadmill Training on Gait Ability, Dual-Task Interference, and Fall Efficacy in People With Stroke: A Randomized Controlled Trial.

OBJECTIVE: This study aimed to investigate the effects of dual-task gait training using a treadmill on gait ability, dual-task interference, and fall efficacy in people with stroke. METHODS: Patients with chronic stroke (N = 34) were recruited and randomly allocated to the experimental or control group. Both groups underwent gait training on a treadmill and a cognitive task. In the experimental group, gait training was conducted in conjunction with the cognitive task, whereas in the control group, the training and the cognitive task were conducted separately. Each intervention was provided for 60 minutes, twice a week, for a period of 6 weeks for both groups. The primary outcomes were as follows: gait parameters (speed, stride, variability, and cadence) under single-task and dual-task conditions, correct response rate (CRR) under single-task and dual-task conditions, and dual-task cost (DTC) in gait parameters and CRR. The secondary outcome was the Fall Efficacy Scale. RESULTS: Dual-task gait training using a treadmill improved all gait parameters in the dual-task condition, speed, stride, and variability in the single-task condition, and CRR in both conditions. A difference between the groups was observed in speed, stride, and variability in the dual-task condition. Furthermore, dual-task gait training on a treadmill improved DTC in speed, variability, and cadence along with that in CRR, indicating true improvement of DTC, which led to significant improvement in DTC in speed and variability compared with single-task training. CONCLUSIONS: Dual-task gait treadmill training was more effective in improving gait ability in dual-task training and dual-task interference than single-task training involving gait and cognitive task separately in people with chronic stroke.