The effect of physiotherapeutic programme on the balance and functional efficiency of seniors over 75 years of age

Original physiotherapeutic programme, structured as follows: EACH SESSION IS SUPERVISED BY A LICENSED PHYSIOTHERAPIST. TEST SESSION I - morning hours - establishing individual eligibility for attending the testing programme - 30 days prior to its commencement - 30 days since the eligibility screening - commencement of the programme, in the morning - in order to reduce potential for any adverse cardiovascular events, 3 times a week, on the same days, i.e. Mondays, Wednesdays, Fridays - 120 days since the commencement of the programme - completion of the intervention (i.e. 150 days since the commencement of the study itself) TEST SESSION II - takes place on the 121st day (i.e. 171 days since Test Session I), spans 2 days, i.e. pursued on Tuesdays and Thursdays, to preclude any inadvertent associations with the exercise regimen, which might otherwise be instrumental in higher muscle tension, and therefore become a confounding factor with regard to the actual effects of the exercise regimen applied TEST SESSION III - following another 120 days since Test Session II (i.e. 241 days since Test Session I), Test Session III commences - 291 days since Test Session I (plus minus 30 days, as not every patient would be tested upon the first day of eligibility screening), spans two days, i.e. pursued on Tuesdays and Thursdays, to preclude any inadvertent associations with the exercise regimen, which might otherwise be instrumental in higher muscle tension, and therefore become a confounding factor with regard to the actual effects of the long-term observation. Select implementation details of the study protocol: Group I (n=30) - Research Group (AB) - a programme of active free exercises and balance exercises (15 min) combined with stimulation through appropriately modulated sounds (15 min). Group II (n=30) - Research Group (VB) - a programme of free and equivalent active exercises (15 min) combined with visual stimulation (15 min). Group III (n=30) - Study group (AVB) - a programme of active free exercises and balance exercises (15 min) combined with audio-visual stimulation (15 min). DESCRIPTION OF THE INTERVENTION Group I - Study Group (BA) - n=30, i.e. 5 subgroups of 6 persons per 1 physiotherapist. A 16-weeks training, performed 3 times a week. A programme of free and active balance exercises (15 minutes), to be combined with appropriately modulated sound stimulation (15 minutes). Training intensity on an average level, determined against the Borg scale (10-11) 65% HRmax. The sound stimulation to be performed with variable amplitude and intensity alternating every 30 seconds between channels; sound intensity not to exceed 80 dB. Both assessment and regular monitoring of the participants throughout the project is specifically provided for in the intervention protocol - attendance checklists at each session. Group II - Study Group (BW) - n=30, i.e. 5 subgroups of 6 persons per 1 physiotherapist. The 16-weeks training, performed 3 times a week. The programme of free and active balance exercises (15 minutes) combined with visual stimulation (15 minutes). Training intensity determined on an average level using the Borg scale (10-11;) 65% HRmax. Visual stimulation is to be provided with the aid of a mobile phone. A game is to be activated for a participant on the phone, making use of a built-in accelerometer. A participant would be expected to move within the AP and ML plane in order to perform a pertinent visual exercise. The game consists in placing a ball into a virtual hole located on the screen. Both assessment and regular monitoring of the participants throughout the project is specifically provided for in the intervention protocol - attendance checklists at each session. Group III - Study Group (BAW) - n=30, i.e. 5 subgroups of 6 persons per 1 physiotherapist. A 16-weeks training, performed 3 times a week. Free and active balance exercise programme (15 min), visual and sound stimulation (15 min). Training intensity on an average level, determined against the Borg scale (10-11) 65% HRmax. Visual stimulation will be done with a mobile phone. A game is to be activated for a participant on the phone, making use of a built-in accelerometer. A participant would be expected to move within the AP and ML plane in order to perform a pertinent visual exercise. The game consists in placing a ball into a virtual hole located on the screen. The sound stimulation to be performed with variable amplitude and intensity alternating every 30 seconds between channels; sound intensity not to exceed 80 dB. Both assessment and regular monitoring of the participants throughout the project is specifically provided for in the intervention protocol - attendance checklists at each session. HERE ARE SOME EXAMPLES OF THE EXERCISES PROVIDED FOR IN THE ACTUAL STUDY INTERVENTION PROTOCOL. EXERCISES - BALANCE-ORIENTED ONE LEG STAND - HOLD SUPPORT 1. Stand up tall beside the chair 2. Hold on to the back of the chair looking ahead 3. Stand on one leg 4. Try to hold this position for 10 seconds 5. Stand on the other leg 6. Try to hold this position for 10 seconds ONE LEG STAND - NO SUPPORT 1. Stand on one leg 2. Try to hold this position for 10 seconds 3. Stand on the other leg 4. Try to hold this position for 10 seconds SIT TO STAND - TWO HANDS 1. Sit on a standard chair 2. Place the feet behind the knees 3. Lean forward over your knees 4. Push off with both hands to stand up 5. Repeat this a few times SIT TO STAND - NO HANDS 1. Sit on a standard chair 2. Place the feet behind the knees 3. Lean forward over your knees 4. Stand up without using your hands 5. Repeat this a few times ORIGINAL BALANCE-ORIENTED EXERCISE A participant would be expected to move within the AP (AP antero-posterio) and ML (ML medio-lateral) plane in order to perform a pertinent visual exercise. The game consists in placing a ball into a virtual hole located on the screen. The sound stimulation to be performed with variable amplitude and intensity alternating every 30 seconds between channels; sound intensity not to exceed 80 dB.