Background: Frail older adults are predisposed to multiple comorbidities and adverse events. Recent interventional studies have shown that frailty can be improved and managed. In this study, effective individualized home-based exercise and nutrition interventions were developed for reducing frailty in older adults. Methods: This study was a four-arm, single-blind, randomized controlled trial conducted between October 2015 and June 2017 at Miaoli General Hospital in Taiwan. Overall, 319 pre-frail or frail older adults were randomly assigned into one of the four study groups (control, exercise, nutrition, and exercise plus nutrition [combination]) and followed up during a 3-month intervention period and 3-month self-maintenance period. Improvement in frailty scores was the primary outcome. Secondary outcomes included improvements in physical performance and mental health. The measurements were performed at baseline, 1 month, 3 months, and 6 months.Results: At the 6-month measurement, the exercise (difference in frailty score change from baseline: − 0.23; 95% confidence interval [CI]: − 0.41, − 0.05; p = 0.012), nutrition (− 0.28; 95% CI: − 0.46, − 0.11; p = 0.002), and combination (− 0.34; 95% CI: − 0.52, − 0.16; p < 0.001) groups exhibited significantly greater improvements in the frailty scores than the control group. Significant improvements were also observed in several physical performance parameters in the exercise, nutrition, and combination groups, as well as in the 12-Item Short Form Health Survey mental component summary score for the nutrition group.
Conclusions:The designated home-based exercise and nutrition interventions can help pre-frail or frail older adults to improve their frailty score and physical performance. Trial registration: Retrospectively registered at ClinicalTrials.gov (identifier: NCT03477097);
Both VR and CB training improved sensory integration for postural control in people with PD, especially when they were deprived of sensory redundancy. However, the attentional demand for postural control was not changed after either VR or CB training.
To establish and compare the relationship between standing balance and walking performance, eight children with spastic diplegic cerebral palsy (CP) and 16 non-disabled, age-and sex-matched children were studied. The results showed that the children with CP had worse static balance stability in various sensory environments and dynamic balance (rhythmic shifting ability) than the non-disabled children.Moreover, the children with CP walked at a slower speed but at a greater physiological cost than the non-disabled children. In the children with CP, dynamic balance signiflcastly correlated with walking function. It is suggested that rhythmic weight-shift training should be encouraged to improve the walking performance of children with CP.C A I P~ rnl palsy (CP) is a no (1 -1) Bnx 1964). The niain motor fiinction problems of chiltlrcn with CP are tlie tlclay or arrest of motor tlevelopment,a s l o~ walking speed, a low endurance for wilking and an d~normal movement pattern (Bobafh and Hobatli 1978, Suthcrlantl 1984, Xordin antl Oderrick 1986, \\'hcel\\~ight et al. 1993).i~ogressivc ti is0 rtler of In ovenicnt antl 1)osture due to H. defect or lcsioil of t h r immature brain (The pro1)lerns of slo\v walking and low walking endurance usually C'BIISC severe functional limitations in afferted sul)-jects.According to ti previous study (\Vong u t al. 1983). \valking speed is strongly correlated with the severity ofCP I n stroie patients.guit velocity is a good outcome nirasure (Richards et al. 1995). Children with CP nlso suffer n high energy cost when \valking.as high as three to four times that of non-disabled children. a d this cost iisually increases \\ ith age. Over t ime,tlie high energy cost ill cause a deterioration in the. act
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