Naoki Tomiyama

Pattern of age-associated decline of static and dynamic balance in community-dwelling older women

Falling is the leading cause of injury‐related deaths in older adults, and a loss of balance is often the precursor to a fall. However, little is known about the rate at which balance declines with age. The objective of the present study was to determine whether there is an age‐associated decline in static (SB) and/or dynamic (DB) balance in community‐dwelling older women.

Effects of Combined Balance and Resistance Exercise on Reducing Knee Pain in Community-Dwelling Older Adults

ABSTRACT The effects of a combined balance and resistance exercise program on knee joint pain (KJP) in community-dwelling older adults were determined. Twenty-eight participants with KJP were divided into an exercise group (EXG: n = 14, 77 ± 4 year) and a control group (n = 14, 77 ± 4 year). The EXG participated in 12 weeks of community-based training. The training program consisted of balance exercise and lower body resistance exercise using body weight. The EXG demonstrated significant improvements in KJP (46%), lower extremity muscular strength (5–26%), Chair Stand (27%), Up and Go (9%), and Functional Reach (17%).

Effects of periodic task-specific test feedback on physical performance in older adults undertaking band-based resistance exercise

The purpose of this study was to determine the effects of periodic task-specific test feedback on performance improvement in older adults undertaking community- and home-based resistance exercises (CHBRE). Fifty-two older adults (65–83 years) were assigned to a muscular perfsormance feedback group (MPG, n = 32) or a functional mobility feedback group (FMG, n = 20). Both groups received exactly the same 9-week CHBRE program comprising one community-based and two home-based sessions per week. Muscle performance included arm curls and chair stands in 30 seconds, while functional mobility was determined by the timed up and go (TUG) test. MPG received fortnightly test feedback only on muscle performance and FMG received feedback only on the TUG. Following training, there was a significant (P < 0.05) interaction for all performance tests with MPG improving more for the arm curls (MPG 31.4%, FMG 15.9%) and chair stands (MPG 33.7%, FMG 24.9%) while FMG improved more for the TUG (MPG-3.5%, FMG-9.7%). Results from this nonrandomized study suggest that periodic test feedback during resistance training may enhance task-specific physical performance in older persons, thereby augmenting reserve capacity or potentially reducing the time required to recover functional abilities.

Upper-limb motor and sensory function in patients with hip fracture: Comparison with community-dwelling older adults

BACKGROUND Upper-limb function is important in patients with hip fracture so they can perform activities of daily living and participate in leisure activities. Upper-limb function of these patients, however, has not been thoroughly investigated. OBJECTIVE The aim of this study was to evaluate the upper-limb motor and sensory functions in patients with hip fracture by comparing these functions with those of community-dwelling older adults (control group). METHODS We compared the results of motor and sensory function tests of upper-limb function - range of motion, strength, sensibility, finger dexterity, comprehensive hand function - between patients with hip fracture (n= 32) and the control group (n= 32). RESULTS Patients with hip fracture had significantly reduced grip strength, pinch strength, finger dexterity, and comprehensive hand function compared with the control group. CONCLUSIONS Most upper-limb functions are impaired in the patients with hip fracture. Thus, upper-limb function of patients with hip fracture should be considered during treatment.

Factors affecting the discharge destination of hip fracture patients who live alone and have been admitted to an inpatient rehabilitation unit.

[Purpose] (1) The aim of this study was to examine relations between clinical and functional assessment and discharge destination and (2) to identify the optimal cutoff point for estimating discharge to home after inpatient rehabilitation. [Subjects] The subjects were 54 hip fracture patients (15 males, 39 females; mean age 81.3 ± 7.4 years) living alone. [Methods] The patients were classified into two groups: those discharged to home and those admitted to an institution. Age, gender, side of fracture, fracture type, number of comorbidities, Functional Independence Measure motor score, and Functional Independence Measure cognitive score were compared between groups. Multiple logistic regression analysis was conducted with discharge to home as the dependent variable and age, gender, side of fracture, fracture type, number of comorbidities, Functional Independence Measure motor score, and Functional Independence Measure cognitive score as independent variables. A receiver operating characteristic curve analysis was used to identify a cutoff point for classification of the patients into the two groups. [Results] Multiple logistic regression analysis showed that the Functional Independence Measure cognitive score was a significant variable affecting the discharge destination. The receiver operating characteristic curve analysis revealed that discharge to home was predicted accurately by a Functional Independence Measure cognitive score of 23.5. [Conclusion] Information from this study is expected to be useful for determining discharge plans and for the setting of treatment goals.

Effects of Seated vs. Standing Exercises on Strength and Balance in Community-Dwelling Older Women

Aim. The purpose of this study was to compare the effects of a combined resistance and balance exercise (CRBE) program performed in both seated and standing positions with that of a program consisting only of resistance exercise (RE) performed in the seated position in older women. Methods. Fifty-two community-dwelling volunteers (CRBE: n = 27, RE: n = 25, mean ± SD age, height, and weight: = 68.3 ± 6.5 years, 67.6 ± 7.4 years, 149.8 ± 7.3 cm, 149.8 ± 5.5 cm, 54.7 ± 10.0 kg, and 51.7 ± 8.6 kg, respectively) participated in 12 weeks of either CRBE or RE. Strength (arm curl and chair stand), static balance (sway velocity [SV]) and dynamic balance (limits of stability [LOS]) were evaluated before and after intervention. Results. After training, both groups showed significant improvements in muscle strength. The improvement in SV was clinically significant in CRBE (13%) only and no improvement was observed in either group for LOS. Conclusion. These results suggest that a resistance exercise program utilizing elastic resistance, whether alone or in combination with balance exercise, will improve strength in relatively similar amounts over 12 weeks. With the addition of balance exercise, improvements in static balance are gained, which may have a positive effect on fall risk for older adults.