Effect of exercise on postural sway in the elderly. A pilot study of a supervised group exercise programme as a rehabilitation treatment for women with breast cancer receiving adjuvant treatment. Feasibility of exercise during treatment for multiple myeloma. High-frequency whole-body vibration improves balancing ability in elderly women. The effect of acupressure on quality of sleep in Iranian elderly nursing home residents. Effectiveness of auricular therapy on sleep promotion in the elderly. Hypnotics as concurrent medication in depression. A placebo-controlled, double-blind comparison of flunitrazepam and lormetazepam in patients with major depression, treated with a (tri)cyclic antidepressant. Improvement in bronchial hyper-responsiveness in patients with moderate asthma after treatment with a hypnotic technique: a randomised controlled trial. Intervention against long-term use of hypnotics/sedatives in general practice.
Fifty female subjects, aged 72-92 (mean 82) years, were enrolled in a 12-week (36 classes) exercise program aimed at increasing postural stability. Subjects were residents of sheltered apartments, rest homes or nursing homes, well enough and mobile enough to participate in the classes. The subjects were randomized into an exercise or a control group. Their postural sway, standing at rest on a force platform, was measured with eyes open and eyes closed. The groups were well matched in all respects. The results showed no improvement in the postural sway as a result of the exercise program. We hypothesize that increasing postural sway in the elderly represents a deterioration in, for the most part, the nervous system and may at this extreme of life indicate an irreversible loss of function. For this reason no improvement in postural sway may be possible. This pilot study examined whether exercise as an adjunctive rehabilitation therapy could benefit women who have early stage breast cancer and are currently receiving chemotherapy/radiotherapy. The study was designed as a randomised controlled trial (RCT). Physical functioning, fatigue and Quality of Life (QoL) outcomes were evaluated pre and post a 12-week intervention. The results showed that after 12 weeks the women who participated in the exercise programme (n = 12) displayed significantly higher levels of physical functioning and reported higher QoL scores than the controls (n = 10). Changes in fatigue and satisfaction with life favoured the intervention group but did not reach significance. These results are encouraging and suggest that a structured group exercise programme during adjuvant treatment is a safe, well tolerated and effective way of providing physical and psychological health benefits to women during treatment for early stage breast cancer. Since this was a pilot study the numbers did not allow appropriately powered analyses of some variables of interest and favoured relatively young and socio-economically advantaged women. Future studies need to address these issues and determine if these short-term benefits can be sustained. Fatigue and insomnia are problems for patients with cancer. Research findings show that aerobic exercise decreases cancer-related fatigue. Because patients with cancer who have skeletal muscle wasting may not obtain maximum benefit from aerobic exercise training, exercise programs may need to include resistance training. Thus far, testing exercise as an intervention for fatigue has focused on patients with breast cancer and excluded patients with bone metastasis. There is a need to test the feasibility and effectiveness of exercise for patients with other types of cancer and with bone involvement. The effect of aerobic and strength resistance training on the sleep of patients with cancer has not been tested. A pilot/feasibility study with a randomized controlled design was conducted to investigate home-based exercise therapy for 24 patients receiving high-dose chemotherapy and autologous peripheral blood stem cell transplantation as treatment for multiple myeloma. None of the patients injured themselves. Because of the small sample size in the feasibility study, the effect of exercise on lean body weight was the only end point that obtained statistical significance. However, the results suggest that an individualized exercise program for patients receiving aggressive treatment for multiple myeloma is feasible and may be effective for decreasing fatigue and mood disturbance, and for improving sleep. To investigate the efficacy of high-frequency whole-body vibration (WBV) on balancing ability in elderly women.
                Randomized controlled trial. Subjects were randomized to either the WBV intervention or the no-treatment control group.
                Community-living elderly women.
                Sixty-nine elderly women aged 60 or above without habitual exercise.
                Side alternating WBV at 20Hz with 3 minutes a day and 3 days a week for 3 months in the WBV intervention group. Those in control group remained sedentary with normal daily life for the whole study period.
                Limits of stability in terms of reaction time, movement velocity, directional control, endpoint excursion, maximum excursion, and the functional reach test were performed at baseline and endpoint.
                Significant enhancement of stability was detected in movement velocity (P<.01), maximum point excursion (P<.01), in directional control (P<.05).
                WBV was effective in improving the balancing ability in elderly women. This also provides evidence to support our user-friendly WBV treatment protocol of 3 minutes a day for the elderly to maintain their balancing ability and reduce risks of fall. Sleep disturbances are very common in elderly people and Traditional Chinese acupressure a noninvasive technique that promotes health and comfort recently has been used in this regard. The purpose of the present study was to evaluate the potential beneficial effects of acupressure on a group of institutionalized elders experiencing sleep disturbances.
                A randomized controlled clinical trial was conducted to test the effectiveness of acupressure on quality of sleep of elderly residing in a Nursing home. The Pittsburgh Sleep Quality index (PSQI) questionnaire was used as a screening tool to select 90 residents with moderate to marked sleep disturbances. The elders were randomly assigned to an acupressure group, a sham acupressure group and a control group by Balanced randomization method.
                There were significant differences between the acupressure group and the control group in subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency and sleep disturbance. But no significant differences were found in sleep indices between the sham acupressure group and the control group. Sleep log data showed a significant decrease in nocturnal awakenings in acupressure group compared to other two groups.
                The findings of this study indicated that acupressure has an effect on improvement of sleep quality and endorsed it as a non-pharmacological and complementary therapy for sleep-disturbed elderly people.
                Crown Copyright 2009. Published by Elsevier Ltd. All rights reserved. Sleep disturbances are a particularly common problem in the elderly. The purpose of this study was to examine the effectiveness of auricular therapy on sleep behaviors in the elderly. One hundred and twenty participants of 60 years old or above and who were suffering from sleep disturbances were invited to participate in this study. Eligible participants were randomly allocated to receive auricular therapy using Junci Medulla (Group A = 30), Semen Vaccariae (Group B = 30) or magnetic pearls (Group C = 60). Groups A and B were the control groups, while Group C was the experimental group. Seven auricular points which are thought to have an effect on promoting sleep were selected. The total treatment course lasted for three weeks. Objective measurement using actigraphic monitoring was performed before the therapy commenced, in the middle period of the therapy, and within one week after the therapy had been completed. After the therapy, there were significant differences among the three groups in terms of the nocturnal sleep time (NST) (F(2,117) = 6.84, p < 0.05) and sleep efficiency (SE) (F(2,117) = 7.69, p < 0.05). Significant improvement in the sleep behaviors was observed in the experimental group using magnetic pearls. In a backward multiple regression, the effect of auricular therapy on SE after allowing for age in female participants is of high statistical significance (F(3,106) = 9.04, p < 0.001). The paper concludes that auricular therapy using magnetic pearls is an effective means of improving the quantity and quality of sleep in the elderly. The addition of benzodiazepine hypnotics to a treatment with tricyclic antidepressants has received little systematic study. In a double-blind placebo-controlled design, the effects on mood and on sleep of two benzodiazepine hypnotics (lormetazepam and flunitrazepam) were studied in patients with major depression who were also treated with maprotiline or nortriptyline. After 4 weeks of combined treatment, lormetazepam resulted in a significantly greater decrease in the score on the Hamilton Depression Subscale than placebo, while there was a non-significant trend in favour of lormetazepam in comparison with flunitrazepam. With respect to sleep EEGs, lormetazepam resulted in a significantly greater suppression of REM sleep. The differences between lormetazepam and flunitrazepam may be partly explained by the shorter half-live of lormetazepam. A prospective, randomised, single blind, and controlled trial of a hypnotic technique was undertaken in 39 adults with mild to moderate asthma graded for low and high susceptibility to hypnosis. After a six week course of hypnotherapy 12 patients with a high susceptibility score showed a 74.9% improvement (p less than 0.01) in the degree of bronchial hyper-responsiveness to a standardised methacholine challenge test. Daily home recordings of symptoms improved by 41% (p less than 0.01), peak expiratory flow rates improved by 5.5% (p less than 0.01), and use of bronchodilators decreased by 26.2% (p less than 0.05). The improvement in bronchial hyper-reactivity occurred without a change in subjective appreciation of the degree of bronchoconstriction. A control group 17 patients and 10 patients undergoing treatment with low susceptibility to hypnosis had no change in either bronchial hyper-responsiveness or any of the symptoms recorded at home. This study shows the efficacy of a hypnotic technique in adult asthmatics who are moderately to highly susceptible to hypnosis. The aim of the study was to evaluate the efficiency of different strategies of intervention to reduce prescription of hypnotics/sedatives in general practice. All 356 general practitioners in the county of Aarhus, Denmark, were divided in three groups. One group received personal information at meetings, another received written material about proper use of hypnotics/sedatives and information about their own prescription rate, and the third group constituted a control group. The prescription rate was recorded before and after the intervention. There was a general decline in the prescription rate recordings, but there were no significant differences between the intervention groups and the control group.
When the possible side-effects of standard treatment (hypnotics) are considered, there is an argument to be made for clinical use of alternative treatments in the elderly. Exercise, though not appropriate for all in this population, may enhance sleep and contribute to an increased quality of life. Research involving exercise programmes designed with the elderly in mind is needed.