Gabriel Y. F. Ng

Whole body vibration was an effective training for improving muscle performance. The purpose of this study was to explore the effects of 12-week whole-body vibration training program on voluntary activation of quadriceps muscles of older people with age-related muscle loss (sarcopenia). Twelve community dwelling seniors with age-related muscle loss were randomly allocated into whole body vibration training group and control group. The training lasted for 12 weeks. Twitch interpolation were conducted to examine the voluntary activation of quadriceps at pre- and post-intervention. Although there was no significant difference between whole body vibration training group and control group on the absolute values of the interpolated twitch ratio after 12 weeks of training. The changed values of ratio (Post minus Pre) were significantly different between the two groups (p = 0.044). The voluntary activation of quadriceps muscles of older people with age-related muscle loss was facilitated after 12 weeks of WBV training with 40 Hz × 4 mm × 360 s. Considering the small sample size of this study, it may only provide a piece of evidence that WBV is effective for facilitating the central motor drive in seniors with age-related muscle loss. More subjects are needed to confirm the present finding. ISRCTN63583948 , registered on 16th January 2017, retrospectively registered.

The consequences of falls are devastating for patients with stroke. Balance problems and fear of falling are two major challenges, and recent systematic reviews have revealed that habitual physical exercise training alone cannot reduce the occurrence of falls in stroke survivors. However, recent trials with community-dwelling healthy older adults yielded the promising result that interventions with a cognitive behavioral therapy (CBT) component can simultaneously promote balance and reduce the fear of falling. Therefore, the aim of the proposed clinical trial is to evaluate the effectiveness of a combination of CBT and task-oriented balance training (TOBT) in promoting subjective balance confidence, and thereby reducing fear-avoidance behavior, improving balance ability, reducing fall risk, and promoting independent living, community reintegration, and health-related quality of life of patients with stroke. The study will constitute a placebo-controlled single-blind parallel-group randomized controlled trial in which patients are assessed immediately, at 3 months, and at 12 months. The selected participants will be randomly allocated into one of two parallel groups (the experimental group and the control group) with a 1:1 ratio. Both groups will receive 45 min of TOBT twice per week for 8 weeks. In addition, the experimental group will receive a 45-min CBT-based group intervention, and the control group will receive 45 min of general health education (GHE) twice per week for 8 weeks. The primary outcome measure is subjective balance confidence. The secondary outcome measures are fear-avoidance behavior, balance ability, fall risk, level of activities of daily living, community reintegration, and health-related quality of life. The proposed clinical trial will compare the effectiveness of CBT combined with TOBT and GHE combined with TOBT in promoting subjective balance confidence among chronic stroke patients. We hope our results will provide evidence of a safe, cost-effective, and readily transferrable therapeutic approach to clinical practice that reduces fear-avoidance behavior, improves balance ability, reduces fall risk, promotes independence and community reintegration, and enhances health-related quality of life. ClinicalTrials.gov, NCT02937532 . Registered on 17 October 2016.