Browsing by Author "Watson, Taylin"
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Item Does Cognitive Restructuring Improve Postural Control in Older Adults?(2018-03-14) Papa, Evan; Bugnariu, Nicoleta; Watson, TaylinPurpose: Falls are a major source of disability in the aging population. The cause of falls is multifactorial, but components such as fear of falling are often overlooked.1 Older adults that have a fear of falling also have an increased risk for future falls.2-3 Physical therapists use cognitive-behavioral therapy techniques such as cognitive restructuring, to enhance treatment and reverse the fear of falling.4-5 However, there is a paucity of evidence regarding the effects of cognitive restructuring on postural control. The purpose of this investigation was to determine if an 8-week cognitive restructuring program, designed to reduce the fear of falling, can improve postural control in older adults. Methods: 4 healthy older adults (avg age 73.3 + 8.5 yrs) who passed a screening test underwent postural control testing before (T0) and after (T1) an 8-week cognitive restructuring program. Clinical balance testing included the Activities-Specific Balance Confidence (ABC) Scale, Timed-Up and Go (TUG), and Four Square Step (FSST) tests. The experimental balance testing included static and dynamic balance using a 12-camera Motion Analysis system that tracked markers on the body for calculation of temporal and spatial kinematic movements. A V-GAIT CAREN system with dual-belt treadmill motion platform was used to create perturbations to balance. Paired samples t tests were used to compare before and after variables of each of the clinical and experimental tests. Significance was set at p Results: Clinical balance testing of the ABC (p=.672), TUG (p=.179), and FSST (p=.748), found no statistically significant differences. Statistical significance was found for experimental testing of dynamic backward-directed balance perturbations in two phases. The center of pressure-center of mass difference (COP-COM) was significantly increased at 1/3rd (p=.003) and 2/3rd (p=.009) of the recovery step from before (T0) to after (T1). The mean difference in scores was -.014mm for 1/3rd, -.027mm for 2/3rd, and -.065mm for 3/3rd of the recovery step. Conclusions: Experimental testing showed significant increases in COP-COM in two of three phases of stepping and approached significance for the complete task. Large differences in COP-COM are indicative of robust postural control.6 Our results demonstrate that a cognitive restructuring program can improve stability and control over falls in older adults.Item Does High Intensity Aerobic Exercise Improve Postural Control for Older Adults?(2019-03-05) Wilson-Garcia, Mary-Catherine; Salvatore, Michael F.; Bugnariu, Nicoleta; Watson, TaylinPurpose: While falls are a major source of disability in the aging population, walking has been linked to reduced risk of falls for older adults1-2. Treadmill walking has even been shown to positively impact muscle-strengthening, motor control, and balance3. The purpose of this investigation was to determine if a high intensity aerobic exercise program can improve postural control in older adults. Methods: Participants completed 36, 1-hour exercise sessions, 3 times a week over 3-4 months, consisting of 40 min fast pace walk/jog, with a 10 min warm-up and cool down. A high intensity at minimum 80% max heart rate was aimed for as long as possible in each session, and intensity was progressively increased during training. Postural control was assessed at baseline (V1), mid-point during exercise training (V2) and at the end of exercise training (V3) using a dynamic balance task. A V-GAIT dual-belt treadmill was used to create surface perturbations and a 12-camera Motion Analysis system collected body kinematics. Backward surface translation perturbations inducing a forward loss of balance were presented randomly at two levels (2 m/s2 and 5 m/s2). Primary outcome measures were: maximum Center of Pressure – Center of Mass (COP-COM) distance during the first compensatory step and reaction time for initiating the first compensatory step. Paired sampled t tests with significance set at p Results: Preliminary results show that maximum COP-COM distance during the first compensatory step increased significantly from an average of 9.87 ± 1.70 cm to 19.92 ± 2.40 cm as the level of perturbation increased. The reaction time for initiating the first compensatory step in response to the slowest perturbation decreased significantly between V1 (608 ± 63 ms) and V3 (543 ± 17 ms), with a similar trend but no significant change in response to the fastest perturbation. Conclusions: Larger COP-COM distances during the first compensatory step are indicative of a robust postural control.4 A high intensity aerobic consisting of walking/jogging exercise on a treadmill improved the reaction time for initiating the first compensatory step in response to balance perturbations by an average of 50 ms, which is clinically meaningful for preventing a fall.Item The Impact of High Intensity Aerobic Exercise on Cardiovascular Function in Older Adults(2019-03-05) Watson, Taylin; Salvatore, Michael; Bugnariu, Nicoleta; Wilson, Mary-Catherine1 Purpose Cardiovascular disease (CVD) is a leading cause of mortality in the United States, and age alone is a risk factor for developing CVD1. Regular aerobic exercise can help prevent arterial stiffening that occurs with age, thus decreasing the risk of CVD1,4. Regular exercise has also been found to reduce resting pulse rate, another risk factor for CVD and adverse outcomes5. This study investigated the impact of a 3-4 month high intensity aerobic exercise regimen upon baseline cardiovascular function in sedentary middle age adults. 2. Methods Subjects were randomly assigned to an exercise or non-exercise group. The exercise group completed 36, 1-hour exercise sessions, 3 times a week over 3-4 months. Exercise was standardized for each subject and consisted of a 10-minute warm-up (range of motion exercise, walking, stretching), followed by a fast pace walk/jog on a treadmill for 40 minutes, and concluded with a 10-minute cooldown. A high intensity exercise at minimum 80% max heart rate was aimed for as long as possible in each session. Exercise intensity was progressively increased over the weeks of training. Heart rate, blood pressure and oxygen levels were monitored throughout the exercise sessions. Data was analyzed and compared between pre- and post-intervention with T-tests. 3. Results Preliminary results from the exercise group show normalization of the cardiovascular function during exercise as measured by heart rate, blood pressure, and oxygen saturation. Compared to baseline values, after the exercise training, average resting heart rate measurement decreased significantly from 88 bpm to 75 bpm. The maximum blood pressure values at the highest exercise intensity also decreased significantly between the first and last session of exercise, from 248/180 to 189/145. The oxygen saturation at the highest exercise intensity increased from 91 in the first exercise session to 96 in the last exercise session. No changes in HR, BP or SpO2were observed in the non-exercise group 4. Conclusion A program of sustained, high intensity aerobic exercise, at the upper limits of currently prescribed maximum heart rate is feasible in middle age and older sedentary individuals without adverse effects. Total exercise time and maximum exercise intensity increased for all subjects in the experimental group.