@misc{GranacherGollhoferHortobagyietal.2013, author = {Granacher, Urs and Gollhofer, Albert and Hortobagyi, Tibor and Kressig, Reto W. and M{\"u}hlbauer, Thomas}, title = {The importance of trunk muscle strength for balance, functional performance, and fall prevention in seniors a systematic review}, series = {Sports medicine}, volume = {43}, journal = {Sports medicine}, number = {7}, publisher = {Springer}, address = {Auckland}, issn = {0112-1642}, doi = {10.1007/s40279-013-0041-1}, pages = {627 -- 641}, year = {2013}, abstract = {Background The aging process results in a number of functional (e.g., deficits in balance and strength/power performance), neural (e.g., loss of sensory/motor neurons), muscular (e.g., atrophy of type-II muscle fibers in particular), and bone-related (e.g., osteoporosis) deteriorations. Traditionally, balance and/or lower extremity resistance training were used to mitigate these age-related deficits. However, the effects of resistance training are limited and poorly translate into improvements in balance, functional tasks, activities of daily living, and fall rates. Thus, it is necessary to develop and design new intervention programs that are specifically tailored to counteract age-related weaknesses. Recent studies indicate that measures of trunk muscle strength (TMS) are associated with variables of static/dynamic balance, functional performance, and falls (i.e., occurrence, fear, rate, and/or risk of falls). Further, there is preliminary evidence in the literature that core strength training (CST) and Pilates exercise training (PET) have a positive influence on measures of strength, balance, functional performance, and falls in older adults. Objective The objectives of this systematic literature review are: (a) to report potential associations between TMS/trunk muscle composition and balance, functional performance, and falls in old adults, and (b) to describe and discuss the effects of CST/PET on measures of TMS, balance, functional performance, and falls in seniors. Data Sources A systematic approach was employed to capture all articles related to TMS/trunk muscle composition, balance, functional performance, and falls in seniors that were identified using the electronic databases PubMed and Web of Science (1972 to February 2013). Study Selection A systematic approach was used to evaluate the 582 articles identified for initial review. Cross-sectional (i.e., relationship) or longitudinal (i.e., intervention) studies were included if they investigated TMS and an outcome-related measure of balance, functional performance, and/or falls. In total, 20 studies met the inclusionary criteria for review. Study Appraisal and Synthesis Methods Longitudinal studies were evaluated using the Physiotherapy Evidence Database (PEDro) scale. Effect sizes (ES) were calculated whenever possible. For ease of discussion, the 20 articles were separated into three groups [i.e., cross-sectional (n = 6), CST (n = 9), PET (n = 5)]. Results The cross-sectional studies reported small-to-medium correlations between TMS/trunk muscle composition and balance, functional performance, and falls in older adults. Further, CST and/or PET proved to be feasible exercise programs for seniors with high-adherence rates. Age-related deficits in measures of TMS, balance, functional performance, and falls can be mitigated by CST (mean strength gain = 30 \%, mean effect size = 0.99; mean balance/functional performance gain = 23 \%, mean ES = 0.88) and by PET (mean strength gain = 12 \%, mean ES = 0.52; mean balance/functional performance gain = 18 \%, mean ES = 0.71). Limitations Given that the mean PEDro quality score did not reach the predetermined cut-off of >= 6 for the intervention studies, there is a need for more high-quality studies to explicitly identify the relevance of CST and PET to the elderly population. Conclusions Core strength training and/or PET can be used as an adjunct or even alternative to traditional balance and/or resistance training programs for old adults. Further, CST and PET are easy to administer in a group setting or in individual fall preventive or rehabilitative intervention programs because little equipment and space is needed to perform such exercises.}, language = {en} } @misc{GranacherMuehlbauerBridenbaughetal.2017, author = {Granacher, Urs and M{\"u}hlbauer, Thomas and Bridenbaugh, Stephanie A. and Wolf, Madeleine and Roth, Ralf and Gschwind, Yves and Wolf, Irene and Mata, Rui and Kressig, Reto W.}, title = {Effects of a salsa dance training on balance and strength performance in older adults}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-399962}, pages = {8}, year = {2017}, abstract = {Background: Deficits in static and particularly dynamic postural control and force production have frequently been associated with an increased risk of falling in older adults. Objective: The objectives of this study were to investigate the effects of salsa dancing on measures of static/dynamic postural control and leg extensor power in seniors. Methods: Twenty-eight healthy older adults were randomly assigned to an intervention group (INT, n = 14, age 71.6 +/- 5.3 years) to conduct an 8-week progressive salsa dancing programme or a control group (CON, n = 14, age 68.9 +/- 4.7 years). Static postural control was measured during one-legged stance on a balance platform and dynamic postural control was obtained while walking on an instrumented walkway. Leg extensor power was assessed during a countermovement jump on a force plate. Results: Programme compliance was excellent with participants of the INT group completing 92.5\% of the dancing sessions. A tendency towards an improvement in the selected measures of static postural control was observed in the INT group as compared to the CON group. Significant group X test interactions were found for stride velocity, length and time. Post hoc analyses revealed significant increases in stride velocity and length, and concomitant decreases in stride time. However, salsa dancing did not have significant effects on various measures of gait variability and leg extensor power. Conclusion: Salsa proved to be a safe and feasible exercise programme for older adults accompanied with a high adherence rate. Age-related deficits in measures of static and particularly dynamic postural control can be mitigated by salsa dancing in older adults. High physical activity and fitness/mobility levels of our participants could be responsible for the nonsignificant findings in gait variability and leg extensor power.}, language = {en} } @misc{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}, series = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, journal = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, number = {604}, issn = {1866-8364}, doi = {10.25932/publishup-42710}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-427104}, pages = {15}, 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} } @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} } @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} }