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Povzetek: Chronic bed rest (BR) serves as a model for studying the effects of prolongedimmobility on physiological and neuromotor functions, particularly postural control. ProlongedBR leads to significant deconditioning of postural balance control, characterized by increasedsway path lengths, sway velocity and fall risk, independent of muscle strength. These changes arelinked to neural adaptations at spinal and supraspinal levels, including structural and functionalbrain changes, such as alterations in grey and white matter, increased cerebellar activation,reduced spinal excitability and increased latencies within reflex circuitries. Additionally, BRdisrupts sensory integration from proprioceptive, visual and vestibular systems, impairing post-ural stability. Visual reliance remains stable during BR, though decreased visual acuity andcontrast sensitivity are noted. Moreover, BR-induced shifts in cerebrospinal fluid contribute toaltered brain activity, impacting sensorimotor function. Vestibular system adaptations, includingchanges in vestibulospinal reflexes, further exacerbate balance impairments. Understanding thesemechanisms is crucial for developing interventions to mitigate the adverse effects of BR onpostural control and prevent prolonged recovery times or increased risk of injury. This reviewhighlights the need for further research into the neural underpinnings of BR-induced posturalinstability, with a focus on sensory integration and neuroplasticity
Ključne besede: atrophy, balance, disuse, immobilization, muscle
Objavljeno v DiRROS: 18.04.2025; Ogledov: 203; Prenosov: 133
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Povzetek: Background and objectives This is a protocol for a living systematic review and meta-analysis. This review will assess the effects of state-of-the-art exercise interventions designed to promote functional mobility. Therefore, after identifying all potential interventions, we will use the F.I.T.T. principles (frequency, intensity, time, type) as well as the physical and health status of the participants as moderators to analyse the mechanisms for the positive benefits of exercise interventions. The main research questions are: Which exercise types are most beneficial for improving functional mobility in various populations of older adults? Which physical exercise characteristics in terms of frequency, intensity, time and duration will achieve the greatest benefit in terms of the defined outcomes, i.e, the functional mobility of older adults? Methods The systematic literature research according to PRISMA guidelines will search databases like MEDLINE, APA Psych-Info and Web of Science. Inclusion criteria are: healthy older people ≥ 50 years, randomized-controlled trials including exercise intervention and a walking or mobility assessments (eg., TUG, SPPB) as an outcome measure. A preliminary search revealed more than 33,000 hits that will be screened by pairs of independent reviewers. The results will be summarized according to the effects regarding functional mobility and potential dose-response relations via respective meta-analysis. Conclusion The systematic review will comprise the knowledge of the existing literature with regards to the effects of the physical activity interventions compared to an active or inactive control group. We will summarize the effects with respect to the F.I.T.T.. They provide a foundation for structuring an optimal exercise training program. If possible, we will also compare interventions from the different categories (eg. cardiovascular, resistance, motor-coordinative, multicomponent or mind-body exercise) as a network analysis and report the influence of moderator variables. Based on the results evidence-based guidelines following GRADE for physical exercise interventions to improve functional mobility in older adults will be provided. Functional mobility of older adults is a crucial determinant of health and independence. Mobility can reverse or delay age-related health issues and promote independence, while immobility or limitations in mobility (such as difficulty rising from a chair, balance problems, or reduced walking capacity) can cause or increase dependency. This underscores the significance of fostering mobility among the growing population of older adults. The development of tailored exercise programs targeting the independence of older adults is one of the motivators for the improvement of crucial policy action areas described by WHO in the Equity Policy Tool, namely ʻliving conditionsʼ and ʻsocial and human capitalʼ (WHO, 2019). The key outcomes related to functional mobility in older age include gait, walking capacity, and balance. Additionally, aspects of life-space mobility, such as the overall walking distance within the environment, are significant factors that characterize mobility in older adults. Exercise can be seen as a preventive measure, so that, without adequate physical activity levels, the ageing process may be associated with premature development of disease and dysfunction. However, different training types will enhance outcomes of functional mobility via specific pathways. For example, walking capacity has an endurance and a strength component. Accordingly, aerobic training will improve walking capacity by enhancing cardio-respiratory fitness, as shown within different clinical trials with older patient cohorts. Resistance training helps to increase muscle strength in the lower limb, which increases gait stability. However, recent literature reviews showed that a combination of both interventions might be more sufficient to gain most benefits on walking capacity. This review will systematically assess the effects of state-of-the-art exercise interventions designed to promote mobility. The ultimate aim is to provide evidence-based guidelines for the optimal type and dose of exercise to preserve and enhance functional mobility in diverse populations of older adults
Ključne besede: functional mobility, older adults, exercise programs, systematic review
Objavljeno v DiRROS: 10.03.2025; Ogledov: 342; Prenosov: 248
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Povzetek: Introduction: Sarcopenia is a multifaceted condition affecting between 10 and 16% of the global population, and although multiple classification algorithms exist, no prevalence has been reported for a representative sample of the Slovenian population. Furthermore, multiple behavioural factors, such as malnutrition, physical inactivity, sedentary lifestyle and lower cognitive function, can contribute to the risk of sarcopenia. This study aims to: a) determine sarcopenia prevalence among Slovenian older adults according to different classification algorithms, b) compare the agreement among the algorithms and c) evaluate the relationship between proposed risk factors and sarcopenia. Methods: 654 participants (≥60 years, 30.4% males) have been classified into sarcopenia groups according to eight algorithms, and agreement (Fleiss K) between them was calculated. Additionally, age, sex, nutritional status, physical activity, sedentary levels and cognitive function were assessed as sarcopenia risk/protective factors. Results: The prevalence of sarcopenia according to EWGSOP2 was 4.1%, ranging from 2.1% to 15.3%, when classified by all eight algorithms. Overall agreement between algorithms was weak (K=.429; 95% CI .414 to .444) with 0.6% of participants classified as sarcopenic by all eight algorithms. Adequate nutrition and physical activity were identified as protective factors, while age, lower cognitive function and sedentary lifestyle were considered risk factors. Conclusion: Sarcopenia prevalence among the Slovenian general population was lower than in the global population. We can conclude that different sarcopenia algorithms lead to a different prevalence of sarcopenia. It is of great importance to be cautious when comparing prevalences among studies and to further validate the classification algorithms.
Ključne besede: sarcopenia, prevalence, epidemiology, classification algorithms, risk factors
Objavljeno v DiRROS: 03.03.2025; Ogledov: 247; Prenosov: 120
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Povzetek: — Introduction: Parkinson’s disease (PD) is characterized by enhanced beta-band activity (13–30 Hz) in the motor control regions. Simultaneously, corticomuscular (CM) connectivity in the beta-band during isometric contractions tends to decline with age, in various diseases, and under dual-task conditions. Objective: This study aimed to characterize electroencephalograph (EEG) and electromyograph (EMG) power spectra during a motor task, assess CM phase connectivity, and explore how these measures are modulated by an additional cognitive task. Specifically, we focused on the beta-band to explore the relationship between heightened beta amplitude and reduced beta CM connectivity. Methodology: Early-stage people with PD and age-matched controls performed an isometric knee extension task, a cognitive task, and a combined dual task, while EEG (128ch) and EMG (2x32ch) were recorded. CM phase connectivity was assessed through phase coherence and a phase dynamics model. Results: The EEG power spectrum revealed no cohort differences in the beta-band. EMG also showed no differences up to 80 Hz. However, the combined EEG-EMG analysis uncovered reduced beta phase coherence in people with early PD during the motor task. CM phase coherence exhibited distinct scalp topography and frequency ranges compared to the EEG power spectrum, suggesting different mechanisms for pathological beta increase and CM connectivity. Additionally, phase dynamics modelling indicated stronger directional coupling from the cortex to the active muscle and less prominent phase coupling across people with PD. Despite high inter-individual variability, these metrics may prove useful for personalized assessments, particularly in people with heightened CM connectivity.
Ključne besede: electroencephalography, brain modeling, electromiography, coherence, motors, diseases, couplings, electrodes, oscillators, protocols
Objavljeno v DiRROS: 13.01.2025; Ogledov: 352; Prenosov: 187
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Povzetek: Objective: Parkinson’s patients will experience mobility disturbances with disease progression. Beneficial effects of physical therapy are short-lasting. Novel interventions are needed to maintain these benefits. Methods: Fourteen Parkinson’s patients (71±4.08 years) participated in a randomized controlled examiner-blinded feasibility clinical trial. After 12 physical therapy sessions, the intervention group received a height-adjustable desk that facilitates stepping while standing, for 4 months. Explorative outcome measures included MDS-UPDRS II, III, TUG, 8.5m walking test, PDQ-39, sABC, sFES, DEXA scans, and lower extremity strength. Results: Post-physical-therapy, everyone significantly improved on the MDS-UPDRS II, III, TUG, and 8.5m walking test, and PDQ-39. (p<0.05) After 4 months, the control group regressed towards pre-physical-therapy values. In the intervention group, sedentary behavior decreased beyond desk use, indicating a carry-over effect. MDS-UPDRS II, PDQ-39, sFES, sABC, TUG, 8.5m walking test, activity time, sitting time, hip strength all improved with clinically relevant effect sizes. Conclusion: Postphysical therapy in-home reduction of sedentary behavior was associated with maintenance of physical benefits and additional improvements in mobility, activity time, balance and quality of life
Ključne besede: Parkinson’s disease, physical therapy, sedentarism, sarcopenia, quality of life
Objavljeno v DiRROS: 05.12.2024; Ogledov: 329; Prenosov: 173
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