Sunday, July 29, 2007

Functional Exercise....

Comment - This is an interesting one. There is a good point that functional exercise - one that mimics real life movements / activities of daily life - are more effective than isolation resistance exercise. Well yeah, but I think the problem here is also that they picked a dodgy exercise - the leg extension. The article compares the effect of doing leg extensions with the effect of a "standing up" exercise. This is back to specificity again of course but I'd be interested to see what the result would have been if they used a squat or dead lift instead of the leg extension. The leg extension doesn't even use the muscles that you stand up with anyway - that is mostly glutes and hamstrings, only moderately involving the quads. Let's focus on the key thing though - do functional exercise!

Sit-to-stand as home exercise for mobility-limited adults over 80 years of age GrandStand SystemTM may keep you standing?
Rosie J, Taylor D.

Health and Rehabilitation Research Centre, School of Physiotherapy, AUT University, Auckland, New Zealand.

Purpose to compare the effects of functional home exercise of repeated sit-to-stands with low-intensity progressive resistance training, on performance measures in mobility-limited adults over 80 years of age. Setting participants' homes. Design community-dwelling older adults >/=80 years of age were invited to participate in a randomised controlled clinical trial. Baseline and outcome measures were: comfortable gait velocity, 30-s chair-stand test, 15-s step test, Berg Balance Scale, Modified Falls Efficacy Scale and the Late-Life Function and Disability Instrument-function component. Participants randomised to the intervention group performed repeated sit-to-stands using a GrandStand System(TM); a biofeedback device that recorded and displayed the number of repetitions performed. Participants randomised to the control group performed knee extensions using ankle cuff weights. Both groups performed the exercises daily for 6 weeks. Results sixty-six older adults took part. The intervention group had a statistically significant improvement in Berg Balance Scale mean score, 1.67 +/- 2.64 points, P = 0.001 (control group 0.73 +/- 3.63 points, P = 0.258), indicating an improvement in balance over the 6-week exercise period. There was no statistically significant effect of either intervention on the other outcome measures. Conclusions in a highly variable population of older adults with mobility limitations, low-intensity functional home exercise of repeated sit-to-stands using the GrandStand System(TM) improved Berg Balance Scale score while low-intensity progressive resistance training did not. While statistically significant, the improvement in Berg Balance Scale score was modest raising the issue of what extent of change in score is clinically significant in this population.

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