@article{GranacherLacroixRoettgeretal.2014, author = {Granacher, Urs and Lacroix, Andre and Roettger, Katrin and Gollhofer, Albert and M{\"u}hlbauer, Thomas}, title = {Relationships between trunk muscle strength, spinal mobility, and balance performance in older adults}, series = {Journal of aging and physical activity}, volume = {22}, journal = {Journal of aging and physical activity}, number = {4}, publisher = {Human Kinetics Publ.}, address = {Champaign}, issn = {1063-8652}, doi = {10.1123/JAPA.2013-0108}, pages = {490 -- 498}, year = {2014}, abstract = {This study investigated associations between variables of trunk muscle strength (TMS), spinal mobility, and balance in seniors. Thirty-four seniors (sex: 18 female, 16 male; age: 70 +/- 4 years; activity level: 13 +/- 7 hr/week) were tested for maximal isometric strength (MIS) of the trunk extensors, flexors, lateral flexors, rotators, spinal mobility, and steady-state, reactive, and proactive balance. Significant correlations were detected between all measures of TMS and static steady-state balance (r = .43.57, p < .05). Significant correlations were observed between specific measures of TMS and dynamic steady-state balance (r = .42.55, p < .05). No significant correlations were found between all variables of TMS and reactive/proactive balance and between all variables of spinal mobility and balance. Regression analyses revealed that TMS explains between 1-33\% of total variance of the respective balance parameters. Findings indicate that TMS is related to measures of steady-state balance which may imply that TMS promoting exercises should be integrated in strength training for seniors.}, language = {en} } @article{GranacherLacroixMuehlbaueretal.2013, author = {Granacher, Urs and Lacroix, Andre and M{\"u}hlbauer, Thomas and R{\"o}ttger, Katrin and Gollhofer, Albert}, title = {Effects of core instability strength training on trunk muscle strength, spinal mobility, dynamic balance and functional mobility in older adults}, series = {Gerontology}, volume = {59}, journal = {Gerontology}, number = {2}, publisher = {Karger}, address = {Basel}, issn = {0304-324X}, doi = {10.1159/000343152}, pages = {105 -- 113}, year = {2013}, abstract = {Background: Age-related postural misalignment, balance deficits and strength/power losses are associated with impaired functional mobility and an increased risk of falling in seniors. Core instability strength training (CIT) involves exercises that are challenging for both trunk muscles and postural control and may thus have the potential to induce benefits in trunk muscle strength, spinal mobility and balance performance. Objective: The objective was to investigate the effects of CIT on measures of trunk muscle strength, spinal mobility, dynamic balance and functional mobility in seniors. Methods: Thirty-two older adults were randomly assigned to an intervention group (INT; n = 16, aged 70.8 +/- 4.1 years) that conducted a 9-week progressive CIT or to a control group (n = 16, aged 70.2 +/- 4.5 years). Maximal isometric strength of the trunk flexors/extensors/lateral flexors (right, left)/rotators (right, left) as well as of spinal mobility in the sagittal and the coronal plane was measured before and after the intervention program. Dynamic balance (i.e. walking 10 m on an optoelectric walkway, the Functional Reach test) and functional mobility (Timed Up and Go test) were additionally tested. Results: Program compliance was excellent with participants of the INT group completing 92\% of the training sessions. Significant group x test interactions were found for the maximal isometric strength of the trunk flexors (34\%, p < 0.001), extensors (21\%, p < 0.001), lateral flexors (right: 48\%, p < 0.001; left: 53\%, p < 0.001) and left rotators (42\%, p < 0.001) in favor of the INT group. Further, training-related improvements were found for spinal mobility in the sagittal (11\%, p < 0.001) and coronal plane (11\%, p = 0.06) directions, for stride velocity (9\%, p < 0.05), the coefficient of variation in stride velocity (31\%, p < 0.05), the Functional Reach test (20\%, p < 0.05) and the Timed Up and Go test (4\%, p < 0.05) in favor of the INT group. Conclusion: CIT proved to be a feasible exercise program for seniors with a high adherence rate. Age-related deficits in measures of trunk muscle strength, spinal mobility, dynamic balance and functional mobility can be mitigated by CIT. This training regimen could be used as an adjunct or even alternative to traditional balance and/or resistance training.}, language = {en} } @article{LacroixKressigMuehlbaueretal.2016, author = {Lacroix, Andre and Kressig, Reto W. and M{\"u}hlbauer, Thomas and Gschwind, Yves J. and Pfenninger, Barbara and Bruegger, Othmar and Granacher, Urs}, title = {Effects of a Supervised versus an Uniupervised Combined Balance and Strength Training Program on Balance and Muscle Power in Healthy Older Adults: A Randomized Controlled Trial}, series = {Gerontology}, volume = {62}, journal = {Gerontology}, publisher = {Karger}, address = {Basel}, issn = {0304-324X}, doi = {10.1159/000442087}, pages = {275 -- 288}, year = {2016}, abstract = {Background: Losses in lower extremity muscle strength/power, muscle mass and deficits in static and particularly dynamic balance due to aging are associated with impaired functional performance and an increased fall risk. It has been shown that the combination of balance and strength training (BST) mitigates these age-related deficits. However, it is unresolved whether supervised versus unsupervised BST is equally effective in improving muscle power and balance in older adults. Objective:This study examined the impact of a 12-week BST program followed by 12 weeks of detraining on measures of balance and muscle power in healthy older adults enrolled in supervised (SUP) or unsupervised (UNSUP) training. Methods: Sixty-six older adults (men: 25, women: 41; age 73 4 years) were randomly assigned to a SUP group (2/week supervised training, 1/week unsupervised training; n = 22), an UNSUP group (3/week unsupervised training; n = 22) or a passive control group (CON; n = 22). Static (i.e., Romberg Test) and dynamic (i.e., 10-meter walk test) steady-state, proactive (i.e., Timed Up and Go Test, Functional Reach Test), and reactive balance (e.g., Push and Release Test), as well as lower extremity muscle power (i.e., Chair Stand Test; Stair Ascent and Descent Test) were tested before and after the active training phase as well as after detraining. Results: Adherence rates to training were 92\% for SUP and 97\% for UNSUP. BST resulted in significant group x time interactions. Post hoc analyses showed, among others, significant training-related improvements for the Romberg Test, stride velocity, Timed Up and Go Test, and Chair Stand Test in favor of the SUP group. Following detraining, significantly enhanced performances (compared to baseline) were still present in 13 variables for the SUP group and in 10 variables for the UNSUP group. Conclusion: Twelve weeks of BST proved to be safe (no training-related injuries) and feasible (high attendance rates of >90\%). Deficits of balance and lower extremity muscle power can be mitigated by BST in healthy older adults. Additionally, supervised as compared to unsupervised BST was more effective. Thus, it is recommended to counteract intrinsic fall risk factors by applying supervised BST programs for older adults. (C) 2015 The Author(s) Published by S. Karger AG, Basel}, language = {en} } @article{GschwindKressigLacroixetal.2013, author = {Gschwind, Yves J. and Kressig, Reto W. and Lacroix, Andre and M{\"u}hlbauer, Thomas and Pfenninger, Barbara and Granacher, Urs}, title = {A best practice fall prevention exercise program to improve balance, strength/power, and psychosocial health in older adults - study protocol for a randomized controlled trial}, series = {BMC geriatrics}, volume = {13}, journal = {BMC geriatrics}, number = {4}, publisher = {BioMed Central}, address = {London}, issn = {1471-2318}, doi = {10.1186/1471-2318-13-105}, pages = {13}, year = {2013}, abstract = {Background: With increasing age neuromuscular deficits (e.g., sarcopenia) may result in impaired physical performance and an increased risk for falls. Prominent intrinsic fall-risk factors are age-related decreases in balance and strength / power performance as well as cognitive decline. Additional studies are needed to develop specifically tailored exercise programs for older adults that can easily be implemented into clinical practice. Thus, the objective of the present trial is to assess the effects of a fall prevention program that was developed by an interdisciplinary expert panel on measures of balance, strength / power, body composition, cognition, psychosocial well-being, and falls self-efficacy in healthy older adults. Additionally, the time-related effects of detraining are tested. Methods/Design: Healthy old people (n = 54) between the age of 65 to 80 years will participate in this trial. The testing protocol comprises tests for the assessment of static / dynamic steady-state balance (i.e., Sharpened Romberg Test, instrumented gait analysis), proactive balance (i.e., Functional Reach Test; Timed Up and Go Test), reactive balance (i.e., perturbation test during bipedal stance; Push and Release Test), strength (i.e., hand grip strength test; Chair Stand Test), and power (i.e., Stair Climb Power Test; countermovement jump). Further, body composition will be analysed using a bioelectrical impedance analysis system. In addition, questionnaires for the assessment of psychosocial (i.e., World Health Organisation Quality of Life Assessment-Bref), cognitive (i.e., Mini Mental State Examination), and fall risk determinants (i.e., Fall Efficacy Scale -International) will be included in the study protocol. Participants will be randomized into two intervention groups or the control / waiting group. After baseline measures, participants in the intervention groups will conduct a 12-week balance and strength / power exercise intervention 3 times per week, with each training session lasting 30 min. (actual training time). One intervention group will complete an extensive supervised training program, while the other intervention group will complete a short version (` 3 times 3') that is home-based and controlled by weekly phone calls. Post-tests will be conducted right after the intervention period. Additionally, detraining effects will be measured 12 weeks after program cessation. The control group / waiting group will not participate in any specific intervention during the experimental period, but will receive the extensive supervised program after the experimental period. Discussion: It is expected that particularly the supervised combination of balance and strength / power training will improve performance in variables of balance, strength / power, body composition, cognitive function, psychosocial well-being, and falls self-efficacy of older adults. In addition, information regarding fall risk assessment, dose-response-relations, detraining effects, and supervision of training will be provided. Further, training-induced health-relevant changes, such as improved performance in activities of daily living, cognitive function, and quality of life, as well as a reduced risk for falls may help to lower costs in the health care system. Finally, practitioners, therapists, and instructors will be provided with a scientifically evaluated feasible, safe, and easy-to-administer exercise program for fall prevention.}, language = {en} }