Discussion
knee extensors, a disability, knee joint proprioception
ADVERSE EVENTS, ADVERSE EVENT
To the best of our knowledge, this was the first experimental study to explore the effects of VT sticking-hand training on lower limb sensorimotor performance among community-dwelling middle-aged and older adults. Three major inferences can be made from this randomized controlled trial: (1) VT sticking-hand training can improve the lower limb maximum muscle strength, particularly the maximum muscle strength of knee flexors, among community-dwelling middle-aged and older adults. (2) However, our VT sticking-hand training program could not shorten the time to maximum muscle strength in the lower limb major muscles of middle-aged and older adults. We found that after the intervention, both the VT and control groups required more time to achieve maximum muscle strength in the major lower limb muscles. (3) In addition, VT training did not improve knee joint proprioception among middle-aged and older adults.Finding 1 concurred with our hypothesis and partially corroborated the finding of previous studies that have reported that aged VT practitioners have greater knee flexor and extensor muscle strength than their counterparts [In the current study, we used a handheld dynamometer to assess the isometric muscular performance of middle-aged and older adults and found that VT could not improve the maximum muscle strength of the hip extensors, hip flexors, knee extensors, and ankle plantar flexors. These findings were in disagreement with those of our previous studies [Finding 2 also differed from the findings of our previous study, which showed that the time to maximum muscle strength in the knee flexor muscles was shorter in the VT group than in the control group [Contrary to our hypothesis, we found that VT training could not improve knee joint proprioception among middle-aged and older adults [finding 3]. Unlike TC, VT sticking-hand training does not involve any slow bodily movements or require practitioners to pay attention to and remember the position of the limbs in space [This study has three more limitations. First, the participants were not blinded to the group allocations owing to the nature of the VT exercise intervention. This may have introduced some bias in the results. Second, adverse events were reported orally by the participants, and we did not have a formal method of collecting adverse event data. Finally, the current study involved healthy middle-aged and older adults belonging to the Chinese community; thus, the study findings may not be generalizable to Chinese middle-aged and older adults having a disability or to Western populations.