A short period of intensive PFMT induces clinical and morphological changes in PFMs at rest suggesting a decrease in IL volume and adipose content of PR. Although the results suggested that an intensive non-instrumented PFMT is as effective as an instrumented training, future controlled studies with greater sample sizes are needed to establish the relative and absolute effectiveness of each of the two interventions.
Background Side-stepping is a potential exercise program to reduce fall risk in community-dwelling adults in their seventies, but it has never been tested in nursing home residents. This was a pilot quasi-experimental study to examine the feasibility and potential mobility and balance benefits of an intervention based on voluntary non-targeted side-stepping exercises in nursing home residents who fall recurrently. Methods Twenty-two participants were recruited and non-randomly assigned to an intervention group ($$n=$$ n = 11, side-stepping exercises, STEP) participating in an 8-week protocol and to a control group ($$n =$$ n = 11, usual physiotherapy care, CTRL). They were clinically assessed at 4-time points: baseline, after 4 and 8 weeks, and after a 4-week follow-up period (usual physiotherapy care). Statistical differences between time points were assessed with a Friedman repeated measures ANOVA on ranks or a one-way repeated measures ANOVA. Results Compared to baseline, significant benefits were observed in the STEP group at 8 weeks for the Timed Up and Go ($$p =$$ p = 0.020) and 6-minute walking test ($$p =$$ p = 0.001) as well as for the Berg Balance Scale ($$p =$$ p = 0.041) and Mini motor test ($$p =$$ p = 0.026). At follow-up, the Tinetti Performance Oriented Mobility Assessment and Berg Balance Scale significantly worsened in the STEP group ($$p =$$ p = 0.009 and $$p<$$ p < 0.001, respectively). No significant differences were found between the groups at the same time points. Conclusions Our intervention was feasible and improved mobility and balance after almost 8 weeks. Studies with larger samples and randomized control trials are needed to consolidate our preliminary observations and confirm the deterioration of some tests when side-stepping exercises are discontinued. Trial registration Identifier: ISRCTN13584053. Retrospectively registered 01/09/2022.
Before and immediately after passive upper limb neurodynamic mobilizations targeting the median nerve, grip ($$G_F$$ G F ) and load ($$L_F$$ L F ) forces applied by the thumb, index and major fingers (three-jaw chuck pinch) were collected using a manipulandum during three different grip precision tasks: grip-lift-hold-replace (GLHR), vertical oscillations (OSC), and vertical oscillations with up and down collisions (OSC/COLL/u, OSC/COLL/d). Several parameters were collected or computed from $$G_F$$ G F and $$L_F$$ L F . Maximum pinch strength and fingertips pressure sensation threshold were also examined. After the mobilizations, $$L_F$$ L F max changes from 3.2 ± 0.4 to 3.4 ± 0.4 N (p = 0.014), d$$G_F$$ G F from 89.0 ± 66.6 to 102.2 ± 59.6 $$N~\text{s}^{-1}$$ N s - 1 (p = 0.009), and d$$L_F$$ L F from 43.6 ± 17.0 to 56.0 ± 17.9 $$N~\text{s}^{-1}$$ N s - 1 ($$p<$$ p < 0.001) during GLHR. $$L_F$$ L F SD changes from 0.9 ± 0.3 to 1.0 ± 0.2 N (p = 0.004) during OSC. $$L_F$$ L F peak changes from 17.4 ± 8.3 to 15.1 ± 7.5 N ($$p<$$ p < 0.001), $$G_F$$ G F from 12.4 ± 6.7 to 11.3 ± 6.8 N (p = 0.033), and $$L_F$$ L F from 2.9 ± 0.4 to 3.00 ± 0.4 N (p = 0.018) during OSC/COLL/u. $$G_F$$ G F peak changes from 13.5 ± 7.4 to 12.3 ± 7.7 N (p = 0.030) and $$L_F$$ L F from 14.5 ± 6.0 to 13.6 ± 5.5 N (p = 0.018) during OSC/COLL/d. Sensation thresholds at index and thumb were reduced (p = 0.001, p = 0.008). Precision grip adaptations observed after the mobilizations could be partly explained by changes in cutaneous median-nerve pressure afferents from the thumb and index fingertips.
Previous research on unstable footwear has suggested that it may induce mechanical noise during walking. The purpose of this study was to explore whether unstable footwear could be considered as a noise-based training gear to exercise body center of mass (CoM) motion during walking. Ground reaction forces were collected among 24 healthy young women walking at speeds between 3 and 6 km h with control running shoes and unstable rocker-bottom shoes. The external mechanical work, the recovery of mechanical energy of the CoM during and within the step cycles, and the phase shift between potential and kinetic energy curves of the CoM were computed. Our findings support the idea that unstable rocker-bottom footwear could serve as a speed-dependent noise-based training gear to exercise CoM motion during walking. At slow speed, it acts as a stochastic resonance or facilitator that reduces external mechanical work; whereas at brisk speed it acts as a constraint that increases external mechanical work and could mimic a downhill slope.
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