What is the effect of a balance training protocol with the Biodex Balance System in institutionalised older people with fear of falling? Randomised controlled trial with concealed allocation and assessor blinding. Forty older people who lived in a nursing home and had fear of falling. The experimental group completed a 12-week balance training protocol based on balancing/rebalancing training with the Biodex Balance System, with two sessions per week. During the training period, participants in both groups received the same multidisciplinary care (such as physiotherapy, occupational therapy and nursing) that they usually received in the nursing home. The primary outcome was fear of falling (Falls Efficacy Scale International questionnaire). Secondary outcomes were dynamic balance (Fall Risk Test) and isometric strength (torque of knee flexor and extensor isometric strength measured with an isokinetic dynamometer). Outcome measures were taken before and after the training program protocol. Compared to the control group, the exercise group had significantly greater improvements at 12 weeks in fear of falling (by 8 points, 95% CI 4 to 12), in dynamic balance (by 2 degrees, 95% CI 1 to 3), and in isometric strength of the knee flexors (by 7Nm, 95% CI 3 to 11) and knee extensors (by 7Nm, 95% CI 1 to 13). The training program was feasible and effective in reducing fear of falling and improving dynamic balance and isometric strength in institutionalised older people with fear of falling. ISRCTN21695765.

Journal of Rehabilitation Medicine is an international peer-review journal published in English, with at least 10 issues published per year.

Test-Retest reliability of Biodex Balance SD on physically active old people

Objectives: This systematic review critically evaluates the effects of whole body vibration (WBV) exercises on gait, balance, proprioception, strength, and health-related quality of life in patients with common neurological diseases. It specifically focuses on assessing the quality of reported studies and comparing quantitative results. Design: This is a systematic literature review. Results: A specific search strategy of 11 databases identified 13 published articles (5 studies of patients with Parkinson disease, 2 with cerebral palsy, 3 with multiple sclerosis, and 3 with stroke) that fulfilled the selection criteria. The quality of the articles was evaluated using a Physiotherapy Evidence Database scale and Dutch Institute for Healthcare Improvement guidelines. Conclusions: There is moderate evidence that one session of WBV has positive effects on strength, whereas there is a weak level of evidence that WBV could improve proprioception and health-related quality of life measures in neurological patients. With respect to long-term effects of WBV, there is minor evidence from the studies with the best methodological quality that WBV improves strength, proprioception, gait, and balance. Further research on the intervention is strongly needed.

Strength is essential for carrying out the usual activities of daily life. As there is a loss of strength in elderly, many treatments are based on delaying the loss of strength or maintaining it. Isokinetic dynamometry is the gold standard for assessing strength. It is essential that studies are conducted to allow us to identify the reliability of isokinetic strength assessments in older people. This study aimed to test the absolute and relative intra-session reliability of peak torque and work of a concentric knee extension-flexion performed at 60°/s in elderly. Fifty-two elderly subjects performed three repetitions of bilateral concentric knee extension-flexion at 60°/s using an isokinetic dynamometer. The relative and absolute reliability were calculated between the second and third repetition. The intra-class correlation coefficient values were between 0.94 and 0.98 for peak torque and work in all measures, which is considered “excellent”, except for left leg flexors in women, with values between 0.85 and 0.88, which is considered “good”. The standard error of measurement (SEM) percentage oscillated from 3.9% to 10.5%, with a smallest real difference (SRD) percentage of 10.9% to 29.2% for peak torque. The relative reliability of peak torque and work were excellent for all measures except flexors in women, evidencing the utility of isokinetic dynamometry for monitoring lower limb maximal muscle strength and work of concentric knee extension-flexion at 60°/s/s in the elderly. In addition, an SRD > 19.9% in peak torque and an SRD > 23.1% in work is considered a true change.

To test the clinical effect of a web-based lower back pain intervention on quality of life and selected lower back pain outcomes. A prospective single-blinded randomized intervention. Occupational preventive service. One hundred office workers with non-specific subacute lower back pain. The 50 intervention group subjects were educated daily about sitting correctly and asked to perform exercises shown by video demonstrations on the university website. The exercise routines included strengthening, mobility and stretching exercises focused on the postural stability muscles. The 50 control group subjects only received standard occupational care. Outcomes were measured by the EuroQol questionnaire five dimensions three levels, the Oswestry Disability Index, and the StarT Back Screening Tool questionnaires. At nine months, the intervention group outcomes were compared to the baseline data and the control group outcomes. For 97% (n = 45) of the experimental group quality of life (clinical utility) improved significantly; 3.58 times greater than the control group. Oswestry Disability Index showed an odds ratio (OR) of 5.42 with a 37% (n = 17) change for the intervention group with respect to the control group. With regard to the StarT Back Screening Tool, 76% (n = 35) of the intervention group improved their clinical state (odds ratio = 3.04 with respect to the control group improvement). Logistic regression analysis revealed positive changes in EuroQol questionnaire, increasing the likelihood of observing positive changes in StarT Back Screening Tool (OR = 15.5) and Oswestry Disability Index (OR = 4.5). The intervention showed clinical improvements in quality of life and selected lower back pain outcomes in the experimental group compared to the control group.