| Objective The study consisted of two parts,the first one was cross section study,which was to(1)explore the average values of different age groups on mobility and proprioception in community-dwelling elderly by establishing the sport assessment system based on the large sample database in Shanghai,China,(2)explain the difference between age groups on mobility and ankle proprioception in community-dwelling elderly and then compare normative values with their western counterpart,and(3)demonstrate the correlation between age,BMI,mobility and ankle proprioception.The second randomized controlled trial intervention study was to decide whether the 5-week progressive cup-tap balance exercise or the 5-week lower limb strength exercise can improve the mobility and ankle proprioception in the old population.Methods In the first cross section study,two hundred and fifty-six elderly were recruited from 15 communities in Shanghai,China.Demographic information was recorded,the mobility was measured by timed up and go test(TUG)and 30-second sit to stand test(30STS),and the ankle proprioception was assessed by the active movement extent discrimination assessment(AMEDA).The second study was based on the physiotherapy evidence database(PEDro),which was a multi-center,randomized controlled and single-blind study.Besides,the elderly from 4 communities were randomly divided into 3 different groups: the progressive cup-tap balance exercise group(PCTBE)n=30,the lower limb strength exercise group(LLSE)n=30 and the education group(EC)n=40.What's more,the baseline tests were the same as the tests in the cross section study,then a 60 minutes per session,twice weekly cup-tap or strength exercise program was delivered for 5 weeks duration.After that,key outcome measures included mobility assessed by using TUG and 30 STS,and ankle proprioception measured by using AMEDA.Data analysis The data analysis was used by IBM SPSS V26.(1)the demographic information was described by mean±standard deviation(M±SD),(2)the area under the ROC curve was applied to decide the accuracy of AMEDA,and then transfer into the angle,(3)the Pearson's correlation was used to calculate the relationship between age,BMI,TUG,30 STS and AMEDA,(4)the ANOVA and post-hoc analysis were conducted to explore 1)the difference on mobility and ankle proprioception from different age groups,2)the difference between 3 therapeutic exercise intervention groups on demographic information,mobility and ankle proprioception in the baseline test and 3)the changes between 3 groups on demographic information,mobility and ankle proprioception between baseline tests and the post intervention tests,and(5)the paired sample t test was employed to exam the effects of different therapeutic exercise programs on mobility and proprioception.Results In the cross section study,the M±SD of 256 elderly was 71.07±7.04 years old,including 137 males and 119 females.The participants were divided into 5 groups: G1,60-64 years old,n=45;G2,65-69 years old,n=75;G3,70-74 years old,n=63;G4,75-79 years old,n=35;G5,over 80 years old,n=38.(1)the M±SD of TUG,30 STS and AMEDA in G1,G2,G3,G4,G5 were 7.49±1.57 s,8.08±1.51 s,8.65±2.06 s,9.70±2.13 s and 10.74±2.53s;17.33±4.44 reps,16.96±5.15 reps,15.04±5.5reps,15.30±4.81 reps and 14.29±5.07reps;1.54±0.51°,1.51±0.52°,1.63±0.57°,1.53±0.37°and 1.85±0.64°,respectively,(2)the Pearson's correlation analysis demonstrated that age was significantly correlated with TUG(r=0.489,p<0.001),30STS(r=-0.208,p=0.001)and AMEDA(r=0.152,p=0.015),and the TUG was strongly correlated with 30STS(r=-0.307,p<0.001),and(3)the ANOVA analysis showed that the scores in TUG,30 STS and AMEDA were all declined with age(F=75.351,p<0.001;F=9.799,p=0.002;F=6.441,p=0.012),and there was significant difference between age groups on TUG,30 STS and AMEDA(F=19.394,p<0.001;F=3.221,p=0.013;F=3.116,p=0.016).In the RCT intervention study,(1)total 87 of the elderly completed the trial(PCTBE,n=25;LLSE,n=27 and EC,n=35),and the churn ratio was 13%.(2)the ANOVA analysis showed in the baseline tests,there was no significant difference on TUG,30 STS,and AMEDA between PCTBE,LLSE and EC(F=2.329,p=0.104;F=0.103,p=0.902;F=2.980,p=0.056).However,in the post intervention tests,there were significant changes between 3 groups on 30 STS and AMEDA.(F=5.236,p=0.007;F=3.229,p=0.045),and the post-hoc analysis indicated that compared to the EC,the PCTBE had an increase tendency in the repetitions on 30 STS and the angles on AMEDA.Moreover,the LLSE can improve the 30 STS scores compared with EC,and(3)the paired sample t test illustrated the 5-week progressive cup-tap balance exercise can improve 30STS(p=0.019)and AMEDA(p=0.010)performance and the 5-week lower limb strength exercise significantly improved TUG(p=0.023)and 30STS(p=0.003)scores,but there was no significant improvement in the education group,Conclusions and Suggestions(1)there was a significant difference on mobility and proprioception performance in different age groups of community-dwelling elderly,increasingly,their mobility significantly dropped at 70 years old,the significant drop point of TUG and 30 STS was 75 years old and 70 years old,and ankle proprioception declined statistically at the age of 80,(2)the normative values in G1,G2,G3,G4,G5 on TUG and 30 STS were all better than the community-dwelling elderly in the western countries;(3)in community-dwelling elderly,age was correlated with mobility and ankle proprioception,and they all declined with age,and(4)the 5-week progressive cup-tap balance exercise can improve the mobility and ankle proprioception,as well as the 5-week lower limb strength exercise,improves the mobility in the old community-dwelling population.Above all,the average values of mobility and ankle proprioception in Shanghai community-dwelling elderly provide the standard norms for this population in the sports rehabilitation area,at the same time,it laid the theoretical foundation for the native sport assessment system in community-dwelling elderly in the future.Moreover,since plenty of studies have indicated mobility and ankle proprioception have an impact on balance control and fall prevention,it is necessary for community-dwelling elderly to evaluate their mobility and ankle proprioception by using TUG,30 STS and AMEDA.Based on the results of the current study,specific interventions should be promoted to improve the mobility before the age of 70 and ankle proprioception before 80 years old,so as to maintain mobility,proprioception and prevent adverse events in communitydwelling elderly. |
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