Jungjin Kim

Unsupervised Virtual Reality-Based Exercise Program Improves Hip Muscle Strength and Balance Control in Older Adults: A Pilot Study

OBJECTIVE To assess the effects of an unsupervised virtual reality (VR)-based exercise program on hip muscle strength and balance control in older adults. DESIGN Controlled cohort repeated-measures experimental design, a pilot study. SETTING University research laboratory. PARTICIPANTS Ambulatory older adults (N=32) from a local community. INTERVENTION The VR group (n=18; mean ± SD, 68.28±3.74y; 4 men) completed the VR-based exercise program, whereas the remaining subjects in the control group (n=14; mean ± SD, 66.21±3.87y, 1 man) were asked to continue their daily routine for 8 weeks. MAIN OUTCOME MEASURES Hip muscle strength was measured using a multimodal dynamometer, and ground reaction force using the backward stepping test and the results of the crossover stepping test were recorded using a force platform. RESULTS The VR group showed significant improvement in hip muscle strength of the extensors, flexors, adductors, and abductors after 8 weeks (all P≤.001). However, no significant improvement was observed in the control group. The VR group had significantly greater ground reaction force on the backward stepping test (with eyes opened and closed) (all P<.005) and the crossover stepping test (with eyes opened and closed) (all P≤.001) compared with those at baseline. However, no significant improvement was observed in the control group. CONCLUSIONS The VR-based exercise program includes the role of supervisor and feedback, which is important for older adults. Therefore, a VR-based exercise program may be a useful tool to improve decreased physical function in older adults as a home-based exercise.

Individualized feedback-based virtual reality exercise improves older women's self-perceived health: A randomized controlled trial

OBJECTIVES Individualized feedback-based virtual reality (IFVR) exercise is gaining attention as a cost-effective self-management strategy, however little is known about whether older adults themselves perceive IFVR exercise effective in improving their health. Therefore, we studied the effect of IFVR exercise on health-related quality of life (HRQoL) in older women. METHODS Fifty-four older women aged ≥65 years were randomized to either IFVR exercise group (IFVRG, n=26) or group-based exercise group (GG, n=28). Both groups received a 60-min intervention three times a week for eight weeks. The Short-Form Health Survey (SF-36) was administered. To identify the possible placebo effect, 30-Second Chair Stand Test (30SCST), 8-Foot Up-and-Go Test (8FUGT), and 2-Minute Step Test (2MST) were also administered. RESULTS intention-to-treat analysis with adjustment for baseline levels revealed that IFVRG showed greater improvement in mental health (p=0.029) and lower body strength (p=0.042), compared to GG. Within-group analysis for HRQoL revealed that IFVRG showed an increase in role-physical (p=0.015), bodily pain (p=0.017), general health (p=0.004), vitality (p=0.010), role-emotional (p=0.007), and mental health (p<0.001), whereas GG showed an increase in role-physical (p=0.022), general health (p=0.023), and social functioning (p = 0.023). Both groups showed an increase in 30SCST, 2MST and 8FUGT (all p<0.001). CONCLUSION IFVR exercise improved HRQoL in older women, in addition to improving physical fitness. Therefore, it might be recommended to older women as an effective self-management strategy.

Feasibility of a Self-Determination Theory-Based Exercise Program in Community-Dwelling South Korean Older Adults: Experiences from a 13-Month Trial

Little is known about the effectiveness of self-determination theory (SDT), a representative motivational theory, on exercise domain in older adults. This feasibility study used quantitative and qualitative approaches to evaluate the effectiveness of a 13-month group exercise program applying SDT-based motivational strategies on exercise adherence, physical fitness, and quality of life, and to explore factors affecting exercise adherence in South Korean older adults (N = 18). Exercise attendance rate was high (82.52%). There were significant differences in aerobic endurance (p < .001), lower body strength (p < .05), dynamic balance (p < .001), and perceived social functioning (p < .05) at 13 months compared with baseline. Factors affecting exercise adherence were related to the SDT-based motivational strategies. These results support the importance of health professionals applying SDT-based motivational strategies to exercise programs to help facilitate motivation for participation and to promote physical fitness and quality of life in older adults.

Intensive unilateral core training improves trunk stability without preference for trunk left or right rotation

BACKGROUND AND OBJECTIVES It is possible to increase multi-directional trunk stability using co-activation. However, it is unclear whether there is a preference for left or right trunk rotation after intensive unilateral stability training. The aim of this study was to examine the directional preference in trunk rotational stability after unilateral core training. MATERIAL AND METHOD This study was conducted on 16 female basketball players. For eight weeks, eight participants performed unilateral core training that focused on one side of the trunk. The remaining eight participants were not provided any additional training. To determine rotational trunk stability, all participants were requested to maintain an upright sitting posture against sudden, external, left or right rotational perturbations of the trunk. Angular displacement of the trunk was measured using a motion analyzer. RESULTS At the end of the training period, the angular displacement in response to the perturbation was reduced for both rotational directions (left: −26%, right: −24%) in the trained group (p < 0.05). CONCLUSION This study showed that trunk stability improved without particular directional preference in response to unilateral core training. This result adds to our understanding of the nature of trunk stability and multi-directional improvement. LEVEL OF EVIDENCE Intervention study, Level 1b.

The hypoalgesic effect of remote tactile sensory modulation on the mechanical sensitivity of trigger points: A randomized controlled study

BACKGROUND Sensitivity of the myofascial trigger point (MTrP) can be inhibited by electrical stimulation of remote site. However, it remains unclear whether remote pain control of the MTrP occurs in the same spinal segment or in the supraspinal system. OBJECTIVES The aims of this study were to identify whether the remote pain control occurs in the spinal segment corresponding to the MTrP or in the supraspinal system. METHODS Test subjects (n = 10) received transcutaneous electrical nerve stimulation for 5 minutes, whereas control subjects (n = 10) received no intervention. The threshold for tactile sensory modulation at the lateral elbow was assessed using Von Frey filaments. The pressure sensitivities of MTrPs in both the infraspinatus and upper trapezius muscles were quantified by algometry. Measurements were performed at baseline and 1 and 15 minutes after the intervention. RESULTS Increases of the tactile threshold at the remote site decreased the sensitivity of the MTrP innervated by same spinal segment. However, no changes were observed at MTrP sites innervated by contralateral fibers or those from different spinal segment. CONCLUSION MTrP sensitivity is more strongly affected by interventions at remote ipsilateral sites in the same spinal segment than by stimulation of extra-segmental sites.