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Background: Older people's participation in structured exercise programs to improve balance and mobility is low. Senior Dance is an alternative option, as it may provide a safe and fun way of targeting balance., Objective: The aim was to investigate the effect of Senior Dance on balance, mobility, and cognitive function compared with a control intervention., Design: The study was a randomized controlled trial., Setting/patients: Eighty-two community-dwelling older people aged 60 years or over and cognitively intact were recruited in Brazil., Intervention: Participants were randomly allocated to 2 groups: Dance plus education (intervention group) and education alone (control group). The Senior Dance program consisted of 12 weeks of twice-weekly group-based dance classes. Participants in both groups attended a single 1-hour educational session on prevention of falls., Measurements: The primary outcome was single-leg stance with eyes closed. Secondary outcomes were timed sit-to-stand test, standing balance test, timed 4-m walk, and cognitive function tests, for example, Trail Making Test and Montreal Cognitive Assessment., Results: Of the 82 participants randomized, 71 (87%) completed the 12-week follow-up. Single-leg stance with eyes closed (primary outcome) improved in the Senior Dance group (mean difference [MD] = 2.3 seconds, 95% confidence interval [CI] = 1.1 to 3.6) compared with the control group at follow-up. Senior Dance group performed better in the standing balance tests (MD = 3.7 seconds, 95% CI = 0.6 to 6.8) and were faster in the sit-to-stand test (MD = - 3.1 seconds, 95% CI = -4.8 to -1.4) and 4-m walk test (MD = -0.6 seconds, 95% CI = -1.0 to -0.1). There were no significant between-group differences for cognitive function tests., Limitations: Participants and therapists were not blinded., Conclusion: Senior Dance was effective in improving balance and mobility but not cognitive function in community-dwelling older people., (© 2020 American Physical Therapy Association.)

Background and Purpose: The gait, mobility and lower-limb strength alterations of diabetic elderly women without symptoms of diabetic neuropathy in different periods of the chronic disease can contribute to an early functional diagnosis, allowing prevention of adverse outcomes like falls and disability. This could also contribute to the development of interventions, cures and physiotherapy practice for this population. The aim of this study was to verify the impact of type-2 diabetes mellitus time since diagnosis on gait and functional status of elderly women., Methods: Eighty-two diabetic elderly women without neuropathic symptoms participated and divided in two groups: 1) 49 elderly (71.4 ± 4.8 years) with less than 10 years of type-2 diabetes mellitus diagnosis, and 2) 33 elderly (70 ± 4.5 years) with 10 or more years of type-2 diabetes mellitus diagnosis. Outcomes were spatiotemporal gait parameters (speed, cadence, step length, base of support, stance time, swing time, and double support time) assessed through GAITRite® system, and functional status assessed using the Timed Up and Go test and five times sit-to-stand test. To compare spatiotemporal gait variables and performance on functional tests between groups, multivariate analysis of variance and Mann-Whitney test were performed, respectively., Results: The group with 10 or more years of diagnosis showed lower gait speed and smaller step length (112.3 cm/s; 59.2 cm) compared with the group with less than 10 years of diagnosis (122.9 cm/s; 62.4 cm). In relation to Timed Up and Go test and five times sit-to-stand test, there were no statistically significant differences between the groups., Conclusion: Type-2 diabetes mellitus time since diagnosis has a negative impact on gait speed and step length, but not on functional status of the elderly women. Copyright © 2015 John Wiley & Sons, Ltd., (Copyright © 2015 John Wiley & Sons, Ltd.)

Introduction: Strong evidence shows that exercise is effective to improve fall risk factors among older people. However, older people's participation and adherence to exercise programmes is suboptimal. Type of exercise and apathy are reported to be barriers to exercise participation, suggesting that new effective interventions are needed. The primary aim of this randomised controlled trial is to investigate the effect of Senior Dance plus brief education for falls prevention on balance among people aged 60 years or over, compared with a control group receiving only brief education., Methods and Analysis: This single-blind randomised controlled trial will involve 82 community-dwelling older people aged 60 years or over who are cognitively intact. Participants allocated to the intervention group will attend a single educational class on strategies to prevent falls, and will participate in a 12-week, twice-weekly group-based programme of Senior Dance. The Senior Dance consists of different choreographies, which include rhythmic and simple movements with rhythmic folk songs. Participants allocated to the control group will attend the same educational class that intervention group participants will receive, and will be instructed not to take part in any regular exercise programme. The primary outcome will be single-leg stance with eyes closed. Secondary outcomes include: Short Physical Performance Battery, Falls Efficacy Scale, Trail Making Test and the Montreal Cognitive Assessment. Continuous outcomes will be reported using mean (SD) or median (IQR), depending on the distribution of the data. The linear regression approach to analysis of covariance will be used to compare the mean effect between groups. All patients will be included in the analyses following an intention-to-treat approach., Ethics and Dissemination: Ethics approval has been granted by the Human Ethics Committee of the São Paulo State University (CAAE 48665215.9.0000.5402). Outcomes will be disseminated through publication in peer-reviewed journals and presentations at conferences., Trial Registration Number: NCT02603523, Pre-results., Competing Interests: Conflicts of Interest: None declared., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.)

Background: Fear of falling is a common and potentially disabling problem among older adults. However, little is known about this condition in older adults with diabetes mellitus. The aims of this study were to investigate the impact of the fear of falling on clinical, functional and gait variables in older women with type 2 diabetes and to identify which variables could predict the fear of falling in this population., Methods: Ninety-nine community-dwelling older women with type 2 diabetes (aged 65 to 89 years) were stratified in two groups based on their Falls Efficacy Scale-International score. Participants with a score < 23 were assigned to the group without the fear of falling (n = 50) and those with a score ≥ 23 were assigned to the group with the fear of falling (n = 49). Clinical data included demographics, anthropometrics, number of diseases and medications, physical activity level, fall history, frailty level, cognition, depressive symptoms, fasting glucose level and disease duration. Functional measures included the Timed Up and Go test (TUG), the five times sit-to-stand test (5-STS) and handgrip strength. Gait parameters were obtained using the GAITRite® system., Results: Participants with a fear of falling were frailer and presented more depressive symptoms and worse performance on the TUG and 5-STS tests compared with those without a fear of falling. The group with the fear of falling also walked with a lower velocity, cadence and step length and increased step time and swing time variability. The multivariate regression analysis showed that the likelihood of having a fear of falling increased 1.34 times (OR 1.34, 95 % CI 1.11-1.61) for a one-point increase in the Geriatric Depression Scale (GDS-15) score and 1.36 times (OR 1.36, 95 % CI 1.07-1.73) for each second of increase in the TUG performance., Conclusions: The fear of falling in community-dwelling older women with type 2 diabetes mellitus is associated with frailty, depressive symptoms and dynamic balance, functional mobility and gait deficits. Furthermore, both the GDS-15 and the TUG test predict a fear of falling in this population. Therefore, these instruments should be considered during the assessment of diabetic older women with fear of falling.

Gait dysfunction is a strong issue in elderly women with a history of falls. The purpose of this study was to compare the temporal activity of the ankle muscles during gait in elderly women with and without a history of recurrent falls. Eighty-nine (89) elderly women - one group with a history of falls (45) and another group without (44) - participated in the study. The mean range of temporal activation of the gastrocnemius, tibialis anterior and soleus muscles during gait was obtained using electromyography. The muscles were considered active when the signal magnitude surpassed two standard deviations of the minimal magnitude of the average signal per individual. The results showed that the mean range of gastrocnemius muscle activation of the group of recurrent fallers was significantly shorter, 2.9% (16.9±5.7%) compared to the group without recurrent falls (19.8±6.6%) (p=0.004). The shorter duration in the gastrocnemius muscle activation during stance could possibly affect stability in the support phase, since the gastrocnemius is the main decelerator of the trunk. Clinically, this finding shows the importance of rehabilitation programs for elderly women that focus on strengthening the plantar flexor musculature aiming to reestablish the function and stability of gait and possibly avoiding falls., (Copyright © 2011 Elsevier B.V. All rights reserved.)

Falls are a major concern in the elderly population with chronic joint disease. To compare muscular function and functional mobility among older women with knee osteoarthritis with and without a history of falls, 15 elderly women with a history of falls (74.20 +/- 4.46 years) and 15 without a history of falls (71.73 +/- 4.73 years) were studied. Muscular function, at the angular speed of 60, 120, and 180 masculine/s, was evaluated using the Biodex Isokinetic Dynamometer. The sit-to-stand task was performed using the Balance Master System and the Timed Up and Go test was used to determine functional mobility. After collection of these data, the history of falls was investigated. A statistically significant difference was detected in the time taken to transfer the center of gravity during the sit-to-stand test (means +/- SD; non-fallers: 0.35 +/- 0.16 s; fallers: 0.55 +/- 0.32 s; P = 0.049, Student t-test) and in the Timed Up and Go test (medians; non-fallers: 10.08 s; fallers: 11.59 s; P = 0.038, Mann-Whitney U-test). The results indicated that elderly osteoarthritic women with a history of falls presented altered functional mobility and needed more time to transfer the center of gravity in the sit-to-stand test. It is important to implement strategies to guarantee a better functional performance of elderly patients to reduce fall risks.