Fong SSM1, Wang H-K2,3, Yam TTT1, Cheng YTY1, Kwong KSC1
1The University of Hong Kong, School of Public Health, Hong Kong, Hong Kong, 2National Taiwan University, School and Graduate Institute of Physical Therapy, Taipei, Taiwan, 3National Taiwan University Hospital, Center of Physical Therapy, Taipei, Taiwan
Background: Falls in the elderly can have devastating consequences. Exercise interventions with a balance training component appear promising for reducing falls. However, many of these interventions emphasize improving volitional control of movement, while in reality many balance threats are unanticipated and beyond the individual's volitional control.
Purpose: This study aimed to explore the effects of a Ving Tsun (VT) Chinese martial art training program on specifically reactive standing balance performance, postural muscle reflex contraction latency, lower limb muscular performance, balance confidence and falls in community-dwelling older adults.
Methods: This was a randomized and controlled trial (ClinicalTrials.gov NCT03318289). Thirty-three healthy older adults were randomly assigned to either a VT group (mean age ± standard deviation = 67.5 ± 6.3 years; 2 males and 15 females) or a no-training control group (mean age ± standard deviation = 72.1 ± 10.3 years; 3 males and 13 females). The VT group received VT training (two one-hour training sessions per week) for 3 months. Measurements were taken before (pretest) and after (posttest) the intervention period. The primary outcomes were the electromyographic muscle activation onset latencies of the hamstring and gastrocnemius muscles and the center of pressure path, length and movement velocity in standing (i.e., reactive balance performance). The secondary outcomes included isometric peak force and time to isometric peak force of the knee extensors and flexors (measured using a hand-held dynamometer), the Activities-specific Balance Confidence Scale score and fall history.
Results: Two-way repeated measures analysis of variance results revealed that the gastrocnemius muscle activation onset latency was 22.53 ms longer in the VT group compared to the control group after the intervention (p = 0.017). The peak force of the knee flexors increased by 1.58 kg in the control group over time (p = 0.004), but such an increment was not observed in the VT group (p = 0.241). The time to reach peak force in the knee flexors was 0.51 s longer in the control group at posttest compared to the pretest value (p = 0.011). No significant group, time and group-by-time interaction effects were noted for all other primary and secondary outcomes.
Conclusion(s): Three months of VT training did not improve reactive standing balance performance, lower limb postural muscle reflex contraction latency, knee muscular performance, balance confidence or reduce falls in community-dwelling older adults. Future studies should explore other types of exercise to improve reactive balance performance and other physiological attributes of the elderly.
Implications: VT Chinese martial art is not a suitable exercise for improving reactive balance control, leg muscular performance, balance confidence or reduce falls in healthy older adults. Physiotherapist should recommend other types of exercise to the older adults instead.
Keywords: Martial exercise, postural control, elderly
Funding acknowledgements: This study was supported by a TY Chau Training and Research Scholarship (2017) from the HK College of Community Medicine.
Purpose: This study aimed to explore the effects of a Ving Tsun (VT) Chinese martial art training program on specifically reactive standing balance performance, postural muscle reflex contraction latency, lower limb muscular performance, balance confidence and falls in community-dwelling older adults.
Methods: This was a randomized and controlled trial (ClinicalTrials.gov NCT03318289). Thirty-three healthy older adults were randomly assigned to either a VT group (mean age ± standard deviation = 67.5 ± 6.3 years; 2 males and 15 females) or a no-training control group (mean age ± standard deviation = 72.1 ± 10.3 years; 3 males and 13 females). The VT group received VT training (two one-hour training sessions per week) for 3 months. Measurements were taken before (pretest) and after (posttest) the intervention period. The primary outcomes were the electromyographic muscle activation onset latencies of the hamstring and gastrocnemius muscles and the center of pressure path, length and movement velocity in standing (i.e., reactive balance performance). The secondary outcomes included isometric peak force and time to isometric peak force of the knee extensors and flexors (measured using a hand-held dynamometer), the Activities-specific Balance Confidence Scale score and fall history.
Results: Two-way repeated measures analysis of variance results revealed that the gastrocnemius muscle activation onset latency was 22.53 ms longer in the VT group compared to the control group after the intervention (p = 0.017). The peak force of the knee flexors increased by 1.58 kg in the control group over time (p = 0.004), but such an increment was not observed in the VT group (p = 0.241). The time to reach peak force in the knee flexors was 0.51 s longer in the control group at posttest compared to the pretest value (p = 0.011). No significant group, time and group-by-time interaction effects were noted for all other primary and secondary outcomes.
Conclusion(s): Three months of VT training did not improve reactive standing balance performance, lower limb postural muscle reflex contraction latency, knee muscular performance, balance confidence or reduce falls in community-dwelling older adults. Future studies should explore other types of exercise to improve reactive balance performance and other physiological attributes of the elderly.
Implications: VT Chinese martial art is not a suitable exercise for improving reactive balance control, leg muscular performance, balance confidence or reduce falls in healthy older adults. Physiotherapist should recommend other types of exercise to the older adults instead.
Keywords: Martial exercise, postural control, elderly
Funding acknowledgements: This study was supported by a TY Chau Training and Research Scholarship (2017) from the HK College of Community Medicine.
Topic: Older people; Older people
Ethics approval required: Yes
Institution: University of Hong Kong
Ethics committee: Human Research Ethics Committee
Ethics number: EA1602061
All authors, affiliations and abstracts have been published as submitted.
