Improving balance control and self-reported lower extremity function in community-dwelling older adults: a randomized control trial

• Published in: Clinical rehabilitation 2013-03, Vol.27 (3), p.195-206
• Main Authors: Melzer, Itshak, Oddsson, Lars IE
• Format: Article
• Language: English
• Subjects: Accidental Falls - prevention & control; Aged; Aged, 80 and over; Balance; Clinical trials; Community living; Elderly people; Execution; Exercise Therapy - methods; Falls; Female; Health care; Humans; Injuries; Intervention; Lower Extremity - physiology; Lower limbs; Male; Massachusetts; Older people; Physical Education and Training - methods; Postural Balance - physiology; Reference groups; Rehabilitation; Self report; Young adults
• ISSN: 0269-2155; 1477-0873
• DOI: 10.1177/0269215512450295

Objectives: To evaluate the effect of a group-based functional and specific balance training programme that included dual-task exercises on balance function in healthy older adults. Design: A single-blind randomized controlled trial. Setting: General community. Participants: Sixty-six community-dwelling older adults (age 77.0 ± 6.5 years), without functional balance impairment were recruited and allocated at random to an intervention group (n = 33) or a reference group (n = 33). Intervention: The intervention group received 24 training sessions over three months that included perturbation as well as dual-task exercises. The reference group received no intervention. Outcome measures: The voluntary step execution times during single- and dual-task conditions, stabilogram-diffusion analysis in upright standing, and self-reported physical function; all were measured assessed at baseline and at the end of intervention. The intervention group was retested after six months. Results: Compared with the reference group, participation in group-based functional and specific balance training led to faster voluntary step execution times under single-task (P = 0.02; effect size (ES) = 0.34) and dual-task (P = 0.036; ES = 0.55) conditions; lower transition displacement and shorter transition time of the stabilogram-diffusion analysis under eyes-closed conditions (P = 0.007, ES = 0.30 and P = 0.08, ES = 0.44, respectively); and improved self-reported lower extremity function (P = 0.006, ES = 0.37). Effects were lost at six-month follow-up. Conclusions: Functional and specific balance training can improve voluntary stepping and balance control in healthy older non-fallers, parameters previously found to be related to increased risk of falls and injury in older adults.