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IRCT20210505051181N4 IRCT 2023-02-09 Iran University of Medical Sciences Comparison of the effect of proprioceptive neuromuscular facilitation techniques and aerobic exercises in elderly The effect of proprioceptive neuromuscular facilitation techniques in comparison with aerobic exercises on functional balance, fear of falling and quality of life in elderly-a randomized controlled trial 2023-02-20 anticipated 58 Complete https://irct.ir/trial/67582 interventional Randomization: Randomized, Blinding: Not blinded, Placebo: Not used, Assignment: Parallel, Purpose: Supportive, Other design features: The present research will be based on the blinding method in which the assessor will unaware of the grouping, not only before the intervention but also after that, Randomization description: The people of both groups are identical in terms of demographic characteristics and are randomly divided into one of the two treatment groups with a ratio of 1:1. Random allocation is done using block balanced randomization, which includes 4-letter blocks of letters A and B. This treatment allocation is placed in numbered envelopes consisting of letters A and B. The person who sit up the randomization sequence will not involved in any of the phases of research process. Group A includes rhythmic stabilization and stabilizing reversal techniques. Group B includes aerobic exercises. After initial evaluations by the assessor, numbered envelopes which were prepared based on a consecutive number are provided to each person participating in the study. In addition, therapeutic intervention is adjusted according to the letters in the envelope. The assessor will not aware of this. N/A Aging. Intervention 1: Intervention group (group A):The elderly will treat 3 days a week for 4 weeks having a total of 12 sessions. Before starting the exercises, 5 to 7 minutes active warm-up is be done. Each exercise has 3 repetitions and each repetition takes 15 seconds. 1- Whole body stretch (clasped hands are stretched above the head). 2- Upper trapezius muscle stretch 3- Wrist flexor muscles stretch 4- Wrist extensor muscles stretch 5- Lunge movement. Then the rhythmic stabilization technique is performed in lower trunk. After 2 minutes of rest, the stabilizing reversal technique is performed in the same body part. Each technique is performed in 3 sets and there are 10 repetitions in each set. There are 60 seconds rest between sets and 30 seconds rest between repetitions. Performing and holding each repetition of both rhythmic stabilization and stabilizing reversal techniques takes 10 seconds. Rhythmic Stabilization Technique: This technique utilizes isometric agonist and antagonist muscles co-contraction. Performing this technique, we don’t have any movement. As a result, the older adult has a verbal command like: "Don't let me move you. Hold on." The person is in a sitting position and this technique will be perform on the trunk flexors and extensors. Stabilizing Reversal Technique: The position of the person to perform this technique is similar to rhythmic stabilization technique, there is just a difference. This technique utilizes alternating isotonic contractions of first agonist muscle, then without any rest antagonist muscle. The time needed to perform all PNF techniques is about 40 minutes. Ending the exercises we require a 6-minute cool-down, which includes:1. performing a stretching exercise in supine position, where the person bends the knees and holds them with both hands and will pull them towards himself. There are 2 repetitions, each repetition takes about 20-30 Seconds.2.The person will relax the body in supine position while closing eyes for 5 minutes (shavasana relaxation). Intervention 2: Control group (group B): The elderly will treat 3 days a week for 4 weeks and there will be a total of 12 sessions. Before starting the exercises, we have 5 to 7 minutes of active warm-up so that there are 3 repetitions of each exercise and each repetition holds for 15 seconds. 1. Whole body stretch (clasped hands are stretched above the head.) 2- Upper trapezius muscle stretch 3- Wrist flexor muscles stretch 4- Wrist extensor muscles stretch 5- Lunge movement. Then the elderly will walk for 40 minutes outdoors under the supervision of the therapist. While walking, the Accupedo Pedometer software will use as a step counter application. Consequently, the elderly will encourage to increase the number of steps. Ending the exercises, we have a 6-minute cool-down, which includes 1. Performing a stretching exercise in supine position, where the person bends the knees and holds them with both hands and will pull them towards themselves. There are 2 repetitions and each repetition takes 20-30 seconds.2.The person will relax the body in supine position closing eyes for 5 minutes (shavasana relaxation). Yes - There is a plan to make this available What will be shared: Data can be shared after making participants unrecognizable. When: Start access period 6 months after the results publication To whom: People in medicine and rehabilitation field Conditions: Performing any analysis to any data resulted form this study will be allowed only with the permission of corresponding author. Where to obtain: Email the researcher- Mina Ansari Eshlaghi- ansari77mina@gmail.com How to obtain: 6 months after the publication of the results, information will be given to the applicant within a week by emailing the researcher. Comments:
public Mina Ansari Eshlaghi
Department of Physiotherapy, School of Rehabilitation Science, Iran University of Medical Sciences, Madadkaran St., Shah Nazari Ave, Madar Square, Mirdamad Blvd
Tehran Iran (Islamic Republic of) 1545913487 +98 21 2222 2059 ansari77mina@gmail.com Iran University of Medical Sciences scientific Dr. Mehrnaz Kajbafvala
Shahid Dastgerdi (Zafar) Ave, Aliasghar Children Hospital
Tehran Iran (Islamic Republic of) 1919816766 +98 21 2304 6688 kajbafvala.m@iums.ac.ir Iran University of Medical Sciences Iran (Islamic Republic of) Iran (Islamic Republic of) People over 60 years old Mini-Mental state examination score ≥24 Not to use assistive devices during walking The ability to stand without assistive device Absence of any physical and movement restrictions in pelvic, hip and knee joints to participate in exercises and tests Ability to exercise for 30 min Walking 30 m or more without assistance Literate people Berg test score between 21 to 48 60 years no limit Both Neuromusculoskeletal disease, Severe and mobility limiting arthritis, Ankle surgery and instability, Lower limb nerve injury (neuropathy), Back and lower limb injury (symptoms within the last 6 months), Structural deficit, History of lower limb fracture within the last 10 years, Severe osteoporosis Neurological deficit, Psychological disease, Anticonvulsant drug use, Dementia, Sedative use General medical problem, Neuropathy according to diabetes, Renal and liver disease, Current acute illness or pain, Cancer and autoimmune disease Neurovestibular (vestibular) disease Unstable or ongoing cardiovascular/respiratory disorders Hearing loss (do not use hearing aids) and visual impairment (cannot see) Frequent performance of PNF in the past Rehabilitation Rehabilitation Intervention group (group A):The elderly will treat 3 days a week for 4 weeks having a total of 12 sessions. Before starting the exercises, 5 to 7 minutes active warm-up is be done. Each exercise has 3 repetitions and each repetition takes 15 seconds. 1- Whole body stretch (clasped hands are stretched above the head). 2- Upper trapezius muscle stretch 3- Wrist flexor muscles stretch 4- Wrist extensor muscles stretch 5- Lunge movement. Then the rhythmic stabilization technique is performed in lower trunk. After 2 minutes of rest, the stabilizing reversal technique is performed in the same body part. Each technique is performed in 3 sets and there are 10 repetitions in each set. There are 60 seconds rest between sets and 30 seconds rest between repetitions. Performing and holding each repetition of both rhythmic stabilization and stabilizing reversal techniques takes 10 seconds. Rhythmic Stabilization Technique: This technique utilizes isometric agonist and antagonist muscles co-contraction. Performing this technique, we don’t have any movement. As a result, the older adult has a verbal command like: "Don't let me move you. Hold on." The person is in a sitting position and this technique will be perform on the trunk flexors and extensors. Stabilizing Reversal Technique: The position of the person to perform this technique is similar to rhythmic stabilization technique, there is just a difference. This technique utilizes alternating isotonic contractions of first agonist muscle, then without any rest antagonist muscle. The time needed to perform all PNF techniques is about 40 minutes. Ending the exercises we require a 6-minute cool-down, which includes:1. performing a stretching exercise in supine position, where the person bends the knees and holds them with both hands and will pull them towards himself. There are 2 repetitions, each repetition takes about 20-30 Seconds.2.The person will relax the body in supine position while closing eyes for 5 minutes (shavasana relaxation). Control group (group B): The elderly will treat 3 days a week for 4 weeks and there will be a total of 12 sessions. Before starting the exercises, we have 5 to 7 minutes of active warm-up so that there are 3 repetitions of each exercise and each repetition holds for 15 seconds. 1. Whole body stretch (clasped hands are stretched above the head.) 2- Upper trapezius muscle stretch 3- Wrist flexor muscles stretch 4- Wrist extensor muscles stretch 5- Lunge movement. Then the elderly will walk for 40 minutes outdoors under the supervision of the therapist. While walking, the Accupedo Pedometer software will use as a step counter application. Consequently, the elderly will encourage to increase the number of steps. Ending the exercises, we have a 6-minute cool-down, which includes 1. Performing a stretching exercise in supine position, where the person bends the knees and holds them with both hands and will pull them towards themselves. There are 2 repetitions and each repetition takes 20-30 seconds.2.The person will relax the body in supine position closing eyes for 5 minutes (shavasana relaxation). Functional balance. Timepoint: Before starting the intervention and after the four weeks intervention. Method of measurement: Functional balance tests:1-Berg balance scale 2-Functional reach test 3-Timed up and go test. Fear of falling. Timepoint: Before starting the intervention and after the four weeks intervention. Method of measurement: Persian version of fall efficacy scale questionnaire-international form. Quality of life. Timepoint: Before starting the intervention and after the four weeks intervention. Method of measurement: Persian version of World Health Organization quality of life questionnaire-Older Adults Edition. Iran University of Medical Sciences Approved 2023-02-06 Ethics committee of Iran University of Medical Sciences Iran University of Medical Sciences, Near Milad Tower, Hemmat Highway Tehran Tehran Iran (Islamic Republic of)