Sensory-motor training targeting motor dysfunction and muscle weakness in long-term care elderly combined with motivational strategies: a single blind randomized controlled study

BackgroundThis study evaluated the effects of a combined innovative training regime consisting of stochastic resonance whole-body vibration (SR-WBV) and a dance video game (DVG) on physical performance and muscle strength in long-term-care dwelling elderly.MethodsThirthy long-term-care elderly were randomly allocated to an intervention group (IG; n = 16) receiving combined SR-WBV training and DVG, or a sham group (SG; n = 14). IG performed five sets one minute of SR-WBV, with one minute rest between sets (base frequency 3 Hz up to 6 Hz, Noise 4) during the first five weeks on three days per week. From week five to eight a DVG was added to SR-WBV for IG on three days per week. SG performed a five-set SR-WBV program (1 Hz, Noise 1) lasting five times one minute, with one minute rest in between, three days a week. From week five to eight stepping exercises on a trampoline were added on three days per week. Primary outcome: Short physical performance battery (SPPB). Secondary outcome: isometric maximal voluntary contraction (IMVC), and sub phases of IMVC (Fsub), isometric rate of force development (IRFD) and sub time phases of IRFD (IRFDsub) were measured at baseline, after four and eight weeks. ANOVA with repeated measures was used for analyses of time and interaction effects and MANOVA determined between group intervention effects.ResultsBetween group effects revealed significant effects on the SPPB primary outcome after four weeks F(1, 27) = 6.17; p = 0.02) and after eight weeks F(1,27) = 11.8; p = 0.002). Secondary muscle function related outcome showed significant between group effects in IG on IRFD, Fsub 30 ms, 100 ms, 200 ms and IRFDsub 0-30 ms, 0-50 ms, 0-100 ms and 100-200 ms compared to SG (all p < 0.05).ConclusionsEight weeks SR-WBV and DVG intervention improved lower extremity physical function and muscle strength compared to a sham intervention in long-term-care elderly. SR-WBV and DVG seems to be effective as a training regime for skilling up in long-term-care elderly.

[1]  R B Wallace,et al.  Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. , 1995, The New England journal of medicine.

[2]  J. Ploeg,et al.  Barriers to physical activity and restorative care for residents in long-term care: a review of the literature. , 2014, Journal of aging and physical activity.

[3]  E. D. de Bruin,et al.  Preliminary inconclusive results of a randomised double blinded cross-over pilot trial in long-term-care dwelling elderly assessing the feasibility of stochastic resonance whole-body vibration , 2015, European Review of Aging and Physical Activity.

[4]  A. Elfering,et al.  Stochastic resonance whole body vibration reduces musculoskeletal pain: A randomized controlled trial. , 2011, World journal of orthopedics.

[5]  C. Coch,et al.  Stochastic resonance therapy in Parkinson's disease. , 2011, NeuroRehabilitation.

[6]  Lebensstil-integrierte sportliche Aktivität: Ergebnisse der MoVo-LISA Interventionsstudie , 2010 .

[7]  Sabine M P Verschueren,et al.  Impact of whole-body vibration training versus fitness training on muscle strength and muscle mass in older men: a 1-year randomized controlled trial. , 2007, The journals of gerontology. Series A, Biological sciences and medical sciences.

[8]  P. Aagaard,et al.  Neuronal adaptation to strength training , 2007 .

[9]  Eling D. de Bruin,et al.  Feasibility of Strength-Balance Training Extended with Computer Game Dancing in Older People; Does it Affect Dual Task Costs of Walking? , 2011 .

[10]  C. Jessie Jones,et al.  Development and Validation of a Functional Fitness Test for Community-Residing Older Adults , 1999 .

[11]  Tony Mets,et al.  The feasibility of whole body vibration in institutionalised elderly persons and its influence on muscle performance, balance and mobility: a randomised controlled trial [ISRCTN62535013] , 2005, BMC geriatrics.

[12]  Suzanne G. Leveille,et al.  Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. , 2000, The journals of gerontology. Series A, Biological sciences and medical sciences.

[13]  Roger Hilfiker,et al.  Effects of whole-body vibration on postural control in elderly: a systematic review and meta-analysis , 2011, BMC geriatrics.

[14]  Brian C Clark,et al.  In vivo alterations in skeletal muscle form and function after disuse atrophy. , 2009, Medicine and science in sports and exercise.

[15]  D. Schmidtbleicher,et al.  The effects of random whole-body-vibration on motor symptoms in Parkinson's disease. , 2006, NeuroRehabilitation.

[16]  S. Mottram,et al.  Movement and stability dysfunction--contemporary developments. , 2001, Manual therapy.

[17]  Janet L. Taylor,et al.  Cast immobilization increases long‐interval intracortical inhibition , 2010, Muscle & nerve.

[18]  Liz Gill,et al.  Treating frailty-a practical guide , 2011, BMC medicine.

[19]  H. Seelig,et al.  Long-term effects of a psychological group intervention on physical exercise and health: the MoVo concept. , 2011, Journal of physical activity & health.

[20]  Frank Moss,et al.  Noise in human muscle spindles , 1996, Nature.

[21]  Karl O’Keeffe.  Dancing Monkeys ( Automated creation of step files for Dance Dance Revolution , 2003 .

[22]  J. Baeyens,et al.  European working group on sarcopenia in older people. Sarcopenia: European consensus on definition and diagnosis: report of the European working group on sarcopenia in older people , 2010 .

[23]  J. González‐Gallego,et al.  Whole‐body vibration training increases muscle strength and mass in older women: a randomized‐controlled trial , 2009, Scandinavian journal of medicine & science in sports.

[24]  Y. Rolland,et al.  How much exercise are older adults living in nursing homes doing in daily life? A cross-sectional study , 2015, Journal of sports sciences.

[25]  H. Baur,et al.  Effect of stochastic resonance whole body vibration on functional performance in the frail elderly: A pilot study. , 2014, Archives of gerontology and geriatrics.

[26]  L. M. Ward,et al.  Stochastic resonance and sensory information processing: a tutorial and review of application , 2004, Clinical Neurophysiology.

[27]  V. Hughes,et al.  Sarcopenia: current concepts. , 2000, The journals of gerontology. Series A, Biological sciences and medical sciences.

[28]  V. Baert,et al.  Motivators and barriers for physical activity in the oldest old: A systematic review , 2011, Ageing Research Reviews.

[29]  M. Bottaro,et al.  Effect of high versus low-velocity resistance training on muscular fitness and functional performance in older men , 2007, European Journal of Applied Physiology.

[30]  B. Clark,et al.  What is dynapenia? , 2012, Nutrition.

[31]  S. Katz,et al.  STUDIES OF ILLNESS IN THE AGED. THE INDEX OF ADL: A STANDARDIZED MEASURE OF BIOLOGICAL AND PSYCHOSOCIAL FUNCTION. , 1963, JAMA.

[32]  J. Collins,et al.  Noise-enhanced human sensorimotor function , 2003, IEEE Engineering in Medicine and Biology Magazine.

[33]  Silvio Lorenzetti,et al.  The effect of a cognitive-motor intervention on voluntary step execution under single and dual task conditions in older adults: a randomized controlled pilot study , 2012, Clinical interventions in aging.

[34]  Jeffrey M. Hausdorff,et al.  Association of muscle power with functional status in community-dwelling elderly women. , 2000, The journals of gerontology. Series A, Biological sciences and medical sciences.

[35]  Michael E. Miller,et al.  Effects of a physical activity intervention on measures of physical performance: Results of the lifestyle interventions and independence for Elders Pilot (LIFE-P) study. , 2006, The journals of gerontology. Series A, Biological sciences and medical sciences.

[36]  W. Uter,et al.  Effects of Strength Training versus Power Training on Physical Performance in Prefrail Community-Dwelling Older Adults , 2011, Gerontology.

[37]  J. R. Thomas,et al.  A generalized rank-order method for nonparametric analysis of data from exercise science: a tutorial. , 1999, Research quarterly for exercise and sport.

[38]  M. Pang,et al.  The effects of whole body vibration therapy on bone mineral density and leg muscle strength in older adults: a systematic review and meta-analysis , 2011, Clinical rehabilitation.

[39]  G. Piaggio,et al.  Consort 2010 statement: extension to cluster randomised trials , 2012, BMJ : British Medical Journal.

[40]  S. Studenski,et al.  Designing Randomized, Controlled Trials Aimed at Preventing or Delaying Functional Decline and Disability in Frail, Older Persons: A Consensus Report , 2004, Journal of the American Geriatrics Society.

[41]  G. Ostir,et al.  Measures of lower body function and risk of mortality over 7 years of follow-up. , 2007, American journal of epidemiology.

[42]  T. Manini,et al.  Longitudinal study of muscle strength, quality, and adipose tissue infiltration. , 2009, The American journal of clinical nutrition.

[43]  D. Schmidtbleicher,et al.  Changes in contractile properties of muscle after strength training in man , 2004, European Journal of Applied Physiology and Occupational Physiology.

[44]  T. Fukunaga,et al.  Changes in muscle size, architecture, and neural activation after 20 days of bed rest with and without resistance exercise , 2001, European Journal of Applied Physiology.

[45]  G. Ostir,et al.  Reliability and sensitivity to change assessed for a summary measure of lower body function: results from the Women's Health and Aging Study. , 2002, Journal of clinical epidemiology.

[46]  Thomas T. Imhoff,et al.  Noise-enhanced tactile sensation , 1996, Nature.

[47]  Stuart,et al.  Older people's recruitment, sustained participation, and adherence to falls prevention interventions in institutional settings: a supplement to the Cochrane systematic review , 2011 .

[48]  D M Buchner,et al.  Exercise: effects on physical functional performance in independent older adults. , 1999, The journals of gerontology. Series A, Biological sciences and medical sciences.

[49]  Frank Moss,et al.  Medical technology: Balancing the unbalanced , 2003, Nature.

[50]  Pranab Kumar Sen,et al.  A Class of Rank Order Tests for a General Linear Hypothesis , 1969 .

[51]  P. Lachenbruch.  Statistical Power Analysis for the Behavioral Sciences (2nd ed.) , 1989 .

[52]  P. Aagaard.  Training-Induced Changes in Neural Function , 2003, Exercise and sport sciences reviews.

[53]  Gina Browne,et al.  Conceptualizations of frailty in relation to older adults. , 2003, Journal of advanced nursing.

[54]  Miao Liu,et al.  Effect of whole-body vibration exercise on mobility, balance ability and general health status in frail elderly patients: a pilot randomized controlled trial , 2014, Clinical rehabilitation.

[55]  H. Sievänen,et al.  Feasibility of whole-body vibration training in nursing home residents with low physical function: a pilot study , 2014, Aging Clinical and Experimental Research.

[56]  Frank Huethe,et al.  Improved Sensorimotor Performance via Stochastic Resonance , 2012, The Journal of Neuroscience.

[57]  A. Jamurtas,et al.  Whole-body vibration and rehabilitation of chronic diseases: a review of the literature. , 2012, Journal of sports science & medicine.

[58]  A. Thorstensson,et al.  Effect of strength training on EMG of human skeletal muscle. , 1976, Acta physiologica Scandinavica.

[59]  Suzanne G. Leveille,et al.  Characteristics of Nondisabled Older Persons Who Perform Poorly in Objective Tests of Lower Extremity Function , 2000, Journal of the American Geriatrics Society.

[60]  Koen A.P.M. Lemmink,et al.  This material is the copyright of the original publisher. Unauthorised copying and distribution is prohibited. The Importance of Sensory-Motor Control in Providing Core Stability Implications for Measurement and Training , 2008 .

[61]  A. Hill.  The mechanics of active muscle , 1953, Proceedings of the Royal Society of London. Series B - Biological Sciences.

[62]  S. Studenski,et al.  Are estimates of meaningful decline in mobility performance consistent among clinically important subgroups? (Health ABC study). , 2014, The journals of gerontology. Series A, Biological sciences and medical sciences.

[63]  Eling D de Bruin,et al.  Does multicomponent physical exercise with simultaneous cognitive training boost cognitive performance in older adults? A 6-month randomized controlled trial with a 1-year follow-up , 2015, Clinical interventions in aging.

[64]  Ack,et al.  LOWER-EXTREMITY FUNCTION IN PERSONS OVER THE AGE OF 70 YEARS AS A PREDICTOR OF SUBSEQUENT DISABILITY , 2001 .

[65]  S. Kritchevsky,et al.  Sensory and motor peripheral nerve function and longitudinal changes in quadriceps strength. , 2015, The journals of gerontology. Series A, Biological sciences and medical sciences.

[66]  Per Julin,et al.  Whole-body vibration training compared with resistance training: effect on spasticity, muscle strength and motor performance in adults with cerebral palsy. , 2006, Journal of rehabilitation medicine.

[67]  P. Thompson,et al.  Relationships between physical activity and muscular strength among healthy adults across the lifespan , 2015, SpringerPlus.

[68]  S. Hollis,et al.  What is meant by intention to treat analysis? Survey of published randomised controlled trials , 1999, BMJ.

[69]  Suzanne G. Leveille,et al.  Preventing Disability and Managing Chronic Illness in Frail Older Adults: A Randomized Trial of a Community‐Based Partnership with Primary Care , 1998, Journal of the American Geriatrics Society.

[70]  N. Black.  CONSORT , 1996, The Lancet.

[71]  B. Clark,et al.  Adaptations in human neuromuscular function following prolonged unweighting: I. Skeletal muscle contractile properties and applied ischemia efficacy. , 2006, Journal of applied physiology.

[72]  Louis Bherer,et al.  The Effects of Combining Videogame Dancing and Pelvic Floor Training to Improve Dual-Task Gait and Cognition in Women with Mixed-Urinary Incontinence. , 2014, Games for health journal.

[73]  B. Clark,et al.  Effect of prolonged unweighting of human skeletal muscle on neuromotor force control , 2007, European Journal of Applied Physiology.

[74]  S. Studenski,et al.  Functional outcomes for clinical trials in frail older persons: time to be moving. , 2008, The journals of gerontology. Series A, Biological sciences and medical sciences.

[75]  G. Pichierri,et al.  Use of virtual reality technique for the training of motor control in the elderly , 2010, Zeitschrift für Gerontologie und Geriatrie.

[76]  Janet L. Taylor,et al.  Age-related changes in motor cortical properties and voluntary activation of skeletal muscle. , 2011, Current aging science.

[77]  J. Cholewicki,et al.  Impaired Postural Control of the Lumbar Spine Is Associated With Delayed Muscle Response Times in Patients With Chronic Idiopathic Low Back Pain , 2001, Spine.

[78]  S. Rogan,et al.  Stochastic resonance whole-body vibration training for chair rising performance on untrained elderly: a pilot study. , 2012, Archives of gerontology and geriatrics.

[79]  S. Studenski,et al.  What is a meaningful change in physical performance? Findings from a clinical trial in older adults (the LIFE-P study) , 2009, The journal of nutrition, health & aging.

[80]  B. Clark,et al.  Neuromuscular plasticity during and following 3 wk of human forearm cast immobilization. , 2008, Journal of applied physiology.

[81]  N. A. Borghese,et al.  Usability and Effects of an Exergame-Based Balance Training Program. , 2014, Games for health journal.

[82]  F. Chentli,et al.  Diabetes mellitus in elderly , 2015, Indian journal of endocrinology and metabolism.

[83]  Albert Gollhofer,et al.  Impact of sensorimotor training on the rate of force development and neural activation , 2004, European Journal of Applied Physiology.

[84]  E. Freiberger,et al.  Residual effects of muscle strength and muscle power training and detraining on physical function in community-dwelling prefrail older adults: a randomized controlled trial , 2012, BMC Geriatrics.

[85]  S. Kritchevsky,et al.  Sensory and Motor Peripheral Nerve Function and Incident Mobility Disability , 2014, Journal of the American Geriatrics Society.

[86]  Todd M Manini,et al.  Dynapenia and aging: an update. , 2012, The journals of gerontology. Series A, Biological sciences and medical sciences.

[87]  Douglas G Altman,et al.  Systematic reviews in health care: Assessing the quality of controlled clinical trials. , 2001, BMJ.

[88]  B. Resnick.  Functional Performance of Older Adults in a Long-Term Care Setting , 1998, Clinical nursing research.

[89]  Luigi Ferrucci,et al.  A comparison of leg power and leg strength within the InCHIANTI study: which influences mobility more? , 2003, The journals of gerontology. Series A, Biological sciences and medical sciences.

[90]  Ellen Freiberger,et al.  Physical activity, exercise, and sarcopenia – future challenges , 2011, Wiener Medizinische Wochenschrift.

[91]  Michael E. Miller,et al.  Relationship Between Physical Functioning and Physical Activity in the Lifestyle Interventions and Independence for Elders Pilot , 2010, Journal of the American Geriatrics Society.

[92]  D G Sale,et al.  Neural adaptation to resistance training. , 1988, Medicine and science in sports and exercise.

[93]  Attila Priplata,et al.  Noise-enhanced human balance control. , 2002, Physical review letters.

[94]  S. Studenski,et al.  Meaningful Change and Responsiveness in Common Physical Performance Measures in Older Adults , 2006, Journal of the American Geriatrics Society.

[95]  E. Simonsen,et al.  Increased rate of force development and neural drive of human skeletal muscle following resistance training. , 2002, Journal of applied physiology.

[96]  Suzanne G. Leveille,et al.  Lower extremity performance in nondisabled older persons as a predictor of subsequent hospitalization. , 2000, The journals of gerontology. Series A, Biological sciences and medical sciences.

[97]  S. Bolanowski,et al.  Adaptations in human neuromuscular function following prolonged unweighting: II. Neurological properties and motor imagery efficacy. , 2006, Journal of applied physiology.

[98]  L. Radlinger,et al.  Isometric rate of force development, maximum voluntary contraction, and balance in women with and without joint hypermobility. , 2008, Arthritis and rheumatism.

[99]  Eling D de Bruin,et al.  A cognitive-motor intervention using a dance video game to enhance foot placement accuracy and gait under dual task conditions in older adults: a randomized controlled trial , 2012, BMC Geriatrics.

[100]  A. Elfering,et al.  Stochastic Resonance Whole-Body Vibration, Musculoskeletal Symptoms, and Body Balance: A Worksite Training Study , 2013, Safety and health at work.

[101]  L. Ferrucci,et al.  Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. , 2004, The journals of gerontology. Series A, Biological sciences and medical sciences.

[102]  R. Enoka,et al.  Neural adaptations with chronic activity patterns in able-bodied humans. , 2002, American journal of physical medicine & rehabilitation.

[103]  Jacob Cohen.  Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[104]  L. Ferrucci,et al.  A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. , 1994, Journal of gerontology.

[105]  Mark D. McDonnell,et al.  The benefits of noise in neural systems: bridging theory and experiment , 2011, Nature Reviews Neuroscience.

[106]  I. Rosenberg,et al.  Sarcopenia: origins and clinical relevance. , 1997, The Journal of nutrition.

[107]  D. Schmidtbleicher,et al.  Immediate effects after stochastic resonance whole-body vibration on physical performance on frail elderly for skilling-up training: a blind cross-over randomised pilot study , 2014, Aging Clinical and Experimental Research.

[108]  E. D. de Bruin,et al.  Feasibility and effects of applying stochastic resonance whole-body vibration on untrained elderly: a randomized crossover pilot study , 2015, BMC Geriatrics.

[109]  T. Klockgether,et al.  A Randomized Pilot Study of Stochastic Vibration Therapy in Spinocerebellar Ataxia , 2013, The Cerebellum.

[110]  S. Scott.  Optimal feedback control and the neural basis of volitional motor control , 2004, Nature Reviews Neuroscience.

[111]  S. Studenski,et al.  Physical Performance Measures in the Clinical Setting , 2003, Journal of the American Geriatrics Society.

[112]  J. Taeymans,et al.  Effects of Whole-body Vibration with Stochastic Resonance on Balance in Persons with Balance Disability and Falls History – A Systematic Review , 2014, Research in sports medicine.

[113]  E. D. de Bruin,et al.  Effects of whole-body vibration on proxies of muscle strength in old adults: a systematic review and meta-analysis on the role of physical capacity level , 2015, European Review of Aging and Physical Activity.

[114]  T. Kaptchuk,et al.  Effect of interpretive bias on research evidence. , 2003, BMJ.

[115]  Peter Wolf,et al.  Cognitive and cognitive-motor interventions affecting physical functioning: A systematic review , 2011, BMC geriatrics.

[116]  X. Bonfill,et al.  Effects of a whole body vibration (WBV) exercise intervention for institutionalized older people: a randomized, multicentre, parallel, clinical trial. , 2015, Journal of the American Medical Directors Association.

[117]  U. Laessoe,et al.  Efficacy of Nintendo Wii training on mechanical leg muscle function and postural balance in community-dwelling older adults: a randomized controlled trial. , 2013, The journals of gerontology. Series A, Biological sciences and medical sciences.