An extensive review of more than 100 randomized controlled trials (RCTs) strongly supports exercise interventions as a way to reduce both the risk of falls among adults 65 and older and the actual number of those who experience a fall. What’s less clear are some of the nuances of that finding—such as the effectiveness of resistance training or walking programs, and the differences between interventions provided by “health professionals” versus “trained providers who were not health professionals.”
The recently published Cochrane systematic review focused on 108 RCTs involving 23,407 community-dwelling adults in 25 countries. Participants were an average age of 76, and 77% were women. The majority of participants lived in the community, and RCTs that focused on participants with conditions that increased the risk of falls—Parkinson disease, stroke, multiple sclerosis, dementia, hip fracture, and severe visual impairment—were excluded.
The Cochrane reviewers analyzed various categories of exercise interventions versus control, which consisted of either no change in usual activities or an intervention not anticipated to reduce falls, such as health education, social visits, “gentle” exercises, or sham exercises. The exercise interventions were categorized as balance and functional; resistance; flexibility training; “3D” exercise including Tai Chi and Qigong; “3D” dance-based exercise; walking programs; endurance; “other”; and exercise interventions that included more than 1 of the studied categories.
Could high-intensity treadmill exercise slow the progression of symptoms among individuals with Parkinson disease (PD)? Authors of a new study say that while more research needs to be done, their randomized clinical trial has proven the intervention to be safe, with indications that sufficiently vigorous treadmill work 3 times a week slowed severity at 6 months.
Their findings, published in JAMA Neurology, are based on a study of 128 patients with stage 1 or 2 PD who were within 5 years of diagnosis. Authors wanted to find out whether endurance exercise—particularly the high-intensity variety—had any effect on PD severity over time. Authors say the study is the first to evaluate the effects of exercise at 80% to 85% of maximum heart rate among patients with PD, and 1 of only a handful that focused on disease severity as an outcome, rather than fitness or functional measures.
While researchers and designers continue to work on advanced video games and hardware intended specifically for rehabilitation, a new systematic review says that there’s sufficient research to support the idea that off-the-shelf games available on commercial gaming systems are useful as an adjunct to more traditional rehab approaches.
Researchers writing in the International Journal of Rehabilitation Research described findings from their analysis of 126 research articles published between 2008 and 2015, all of which focused on the use of commercially available gaming systems (VGs)—Nintendo Wii, Sony PlayStation, and Microsoft Xbox—as a component of rehabilitation. A total of 4,240 patients were included in the studies, which looked at VG use in connection with stroke recovery, cerebral palsy (CP), Parkinson disease (PD), balance training, problems associated with aging, and weight control.
Researchers at the Cleveland Clinic are ready to begin human testing on the use of deep brain stimulation (DBS) for individuals poststroke, in hopes that the technology will help to “jump start” damaged areas of the brain and aid in physical rehabilitation.
According to an article in TIME magazine, the clinic has been federally approved to begin a human trial of a DBS technique that previously has been tested only on rats. The procedure involves sending electrical pulses from a power source implanted in the subject’s chest to electrodes implanted in the brain, a technology that has been successfully used for some time on individuals with Parkinson disease (PD).
But the intent of using DBS poststroke is not the same as its use for PD, according to Andre Machado, who heads up the project.