A B C D E F G H I J K L M N O P Q R S T U V W X Y Z All
Senthil Kumar, P.
- Efficacy of Balance and Mobility Exercises on Gait Speed and Energy Expenditure in Ageing Adults: A Quasi- Experimental Interventional Clinical Trial
Authors
1 Pioneer Physiotherapy College, Vadodara, IN
2 Department of Physiotherapy, KMC, Mangalore, IN
Source
Indian Journal of Physiotherapy & Occupational Therapy-An International Journal, Vol 7, No 4 (2013), Pagination: 172-176Abstract
Objective: To determine the effects of balance and mobility exercises on gait speed and energy expenditure (Physiological Cost Index) during walking in aging adults 65 years and older).Design: A quasi-experimental interventional clinical trial, using pretest-posttest design to test the effect of the intervention on gait-speed and energy expenditure.
Participants: 35 subjects (14 male and 21 female) were recruited using Convenience sampling from a day care centre. The mean age of subjects was 70.03 (S.D=4.71) years; range 65 to 87 years.
Intervention: Subjects participated in a program of structured balance and mobility exercises, sixty minutes per day, five days a week, for six weeks. This was a group based program supervised by a physiotherapist.
Main outcome measures: Gait speed (in meters per minute) and Physiological Cost Index (in beats per meter) during walking on 20 meter walkway.
Results: When the subjects were compared for improvement in gait speed between pre-exercise (46.79±09.96) to post-exercise (51.09±11.16) and Physiological Cost Index (PCI) between pre-exercise (0.36±0.10) to post-exercise (0.27±0.09), a significant difference obtained (p=.001).
Conclusion: The balance and mobility exercise intervention resulted in a significant improvement in gait-speed and reduction in the energy expenditure during walking in healthy ageing adults.
Keywords
Ageing Adult, Exercises, Gait-Speed, Physiological Cost Index
References
- Krishnaswamy B and Usha G. Falls in older people (National/regional review; India). [Online]. 2007; Available from: URL:www.who.int/entity/ageing/projects/ SEARO.pdf
- Chandana H.B. and Talwar P.P. Aging in India: Its Socioeconomic and Health Implications. Asia- Pacific Population Journal, Vol. 2, No. 3, 23-38
- Helbostad JL and Nilssen RM. The effect of gait speed on lateral balance control during walking in healthy elderly. Gait and Posture 2003;18:27- 36.
- Richards CL, Olney SJ. Hemiparetic gait following stroke. Part II: Recovery and physical therapy. Gait Posture. 1996:149-162.
- Steffen TM, Hacker TA, Mollinger L. Age- and gender-related test performance in communitydwelling elderly people: Six- Minute Walk Test, Berg Balance Scale, Timed Up & Go Test, and gait speeds. Phys Ther. 2002;82:128-137.
- Van Iersel MB, Munneke M, Esselink RA, Benraad CE, Olde Rikkert MG. Gait velocity and the Timed-Up-and- Go test were sensitive to changes in mobility in frail elderly patients. J Clin Epidemiol. 2008;61:186-191.
- Harada N, Chiu V, Damron-Rodriguez J, Fowler E, Siu A, Reuben DB. Screening for balance and mobility impairment in elderly individuals living in residential care facilities. Phys Ther. 1995;75:462-469.
- Perry J, Garrett M, Gronley JK, Mulroy SJ. Classification of walking handicap in the stroke population. Stroke. 1995;26:982-989.
- Mangione KK, Craik RL, Lopopolo R, Tomlinson JD, Brenneman S. Predictors of gait speed in patients after hip fracture. Physiother Can. 2007;59:10-18.
- Studenski S, Perera S, Wallace D, et al. Physical performance measures in the clinical setting. J Am Geriatr Soc. 2003;51:314-322.
- Purser JL, Weinberger M, Cohen HJ, et al. Walking speed predicts health status and hospital costs for frail elderly male veterans. J Rehabil Res Dev. 2005;42:535-546.
- Brach JS, VanSwearingen JM, Newman AB, Kriska AM. Identifying early decline of physical function in community- dwelling older women: performance-based and selfreport measures. Phys Ther. 2002;82:320-328.
- Montero-Odasso M, Schapira M, Soriano ER, Varela M, Kaplan R, Camera LA, Mayorga LM. Gait velocity as a single predictor of adverse events in healthy seniors aged 75 years and older. J Gerontol A Biol Sci Med Sci. 2005;60:1304-1309.
- Rabadi MH, Blau A. Admission ambulation velocity predicts length of stay and discharge disposition following stroke in an acute rehabilitation hospital. Neurorehabil Neural Repair. 2005;19:20-26.
- Salbach NM, Mayo NE, Higgins J, Ahmed S, Finch LE, Richards CL. Responsiveness and predictability of gait speed and other disability measures in acute stroke. Arch Phys Med Rehabil. 2001;82:1204-1212.
- Hardy SE, Perera S, Roumani YF, Chandler JM, Studenski SA. Improvement in usual gait speed predicts better survival in older adults. J Am Geriatr Soc. 2007;55:1727-1734.
- Goldie PA, Matyas TA, Evans OM. Deficit and change in gait velocity during rehabilitation after stroke. Arch Phys Med Rehabil. 1996;77: 1074-1082.
- Guimaraes RM, Isaacs B. Characteristics of the gait in old people who fall. Int Rehabil Med. 1980;2:177-180.
- Maki BE. Gait changes in older adults: predictors of falls or indicators of fear. J Am Geriatr Soc. 1997;45:313-320.
- MacGregor J. The evaluation of patient performance using long-term ambulatory monitoring technique in the domiciliary environment. Physiotherapy, 67. 1981:30-33.
- Jaiyesimi AO, Fashakin OG. Reliability of physiological cost index measurements. Afr J Med Med Sci. 2007 Sep;36(3):229-34.
- Jette AM, Lachman M, Giorgetti MM, et al. Exercise—it’s never too late: the strong-for-life program. Am J Public Health. 1999;89:66-72.
- Fiatarone MA. Fitness and function at the end of life. J Am Geriatr Soc. 1995;43:1439-1440.
- Nene AV. (1993). Physiological cost index of walking in able-bodied adolescents and adults. Clinical Rehabilitation, 7, 319-326.
- Means KM, Rodell DE, Sullivan and Patricia S. Balance, Mobility, and Falls Among Community- Dwelling Elderly Persons: Effects of a Rehabilitation Exercise Program. American Journal of Physical Medicine & Rehabilitation; 2005: 84(4):238-50.
- Thomas KJ, Pilon M, Hendrix K. Improvements in walking speed experienced by elders participating in a cardiovascular exercise program. J Geriatr Phys Ther. 2006;29(3):87-91.
- Rinsberg K, Gerdhem P, Johansson J and Obrant KJ. Is there a relationship between balance, gait performance and muscular strength in 75-yearold women? Age and Ageing 1999;28:289–93.
- Laufer Y. Effect of Age on Characteristics of Forward and Backward Gait at Preferred and Accelerated Walking Speed. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2005;60:627-32.
- Graham RC, Smith NM and White CM. The Reliability and Validity of the Physiological Cost Index in Healthy Subjects While Walking on 2 Different Tracks. Arch Phys Med Rehabil 2005;86:2041-46.
- Melatesta D, Simar D, Dauvilliers Y, Candau R, Borrani F, Prefaut C, and Caillaud C. Energy cost of walking and gait instability in healthy 65- and 80-yr-olds. J Appl Physiol 2003;95:2248–56.
- Waters RL and Mulroy S. The energy expenditure of normal and pathologic gait. Gait and Posture 1999;9:207–31.
- Efficacy of Tibial Nerve Neurodynamic Mobilization for Neuropathic Pain in Type II Diabetes Mellitus- A Randomized Controlled Trial
Authors
1 Musculoskeletal and Manual Therapy, Dept. of Physiotherapy, Kasturba Medical College, Mangalore, IN
2 Dept. of Medicine Unit-I, Kasturba Medical College, Mangalore, IN
3 Shri Ramashakti Mission Charitable Trust and Hospital, Shakti Nagar, Mangalore, IN
Source
Indian Journal of Physiotherapy & Occupational Therapy-An International Journal, Vol 5, No 4 (2011), Pagination: 189-192Abstract
To study the efficacy of tibial nerve neurodynamic mobilization as compared to control intervention on vibration thresholds, neuropathic pain severity, tibial nerve neurodynamic test range of motion and neuropathy specific quality of life (NeuroQoL) in type-II Diabetes Mellitus (DM) with neuropathic pain.
MethodsThirty two patients of age (60.12 ± 11.41years), both gender (13 male, 19 female) were selected on convenient sampling. Subjects were selected based on following: Physician diagnosed type-II DM of atleast two years duration; complaint of neuropathic pain (screened using neuropathic pain questionnaire- NPQ) in the legs and feet; mechanical behavior of neuropathic pain (aggravated and/or relieved by movements); ability to understand and co-operate for instructions of tester. The independent blinded observer then recorded neuropathic pain intensity on NPQ, tibial nerve neurodynamic test range of motion at initial resistance R1, vibration thresholds by Biothesiometry and NeuroQoL. The subjects then were randomized to receive either of two interventions- control and experimental. The control group received drugs for glycemic control, analgesics for neuropathic pain, lifestyle modification and walking exercise prescription. The experimental group received in addition, tibial nerve neurodynamic mobilization consisting of nerve massage, sliders and tensioners. The treatment session was of 45 min duration on five sessions (one session per week) for total study duration of five weeks. Data was collected twice- pre and post intervention and analyzed using students’ t-test.
ResultsThe experimental group showed significant improvements post treatment in all the four study outcomes. The betweengroup mean differences were NPQ (18.89 ± 2.46), neurodynamic range of motion (4.00 ± 3.85 degrees), vibration threshold (5.94 ± 1.12 volts) and NeuroQoL (15.93 ± 2.85) in favour of experimental group.
ConclusionTibial nerve neurodynamic mobilization comprising of nerve massage, sliders and tensioners was shown to be an effective treatment adjunct for diabetic peripheral neuropathic pain.