A Five-Week Exercise Program Can Reduce Falls and Improve Obstacle Avoidance in the Elderly

Autor: B.C.M. Smits-Engelsman, Alexander C. H. Geurts, Jacques Duysens, Theo Mulder, Hennie Rijken, Vivian Weerdesteyn
Rok vydání: 2006
Předmět:
Male
Program evaluation
Aging
exercise programs
falls in the elderly
Poison control
Walking
Suicide prevention
Occupational safety and health
law.invention
obstacle avoidance
Randomized controlled trial
law
Task Performance and Analysis
Perception and Action [DCN 1]
Postural Balance
Aged
80 and over

Human Movement & Fatigue [NCEBP 10]
UMCN 3.2 Cognitive Neurosciences
TAI-CHI
WOMEN
RANDOMIZED CONTROLLED-TRIAL
Self Efficacy
humanities
COMMUNITY
Treatment Outcome
BALANCE
balance confidence
Female
medicine.medical_specialty
Physical exercise
Nijmegen Falls Prevention Program
Physical medicine and rehabilitation
Obstacle avoidance
Injury prevention
medicine
Humans
OLDER-PEOPLE
Exercise
METAANALYSIS
Aged
Action
intention
and motor control

business.industry
POSTURAL CONTROL
ADULTS
social sciences
YOUNG
Physical therapy
Accidental Falls
Geriatrics and Gerontology
business
Program Evaluation
Zdroj: Gerontology, 52, 131-141
Gerontology, 52, 131-41
Gerontology, 52, 3, pp. 131-41
Gerontology, 52, 3, pp. 131-141
Gerontology, 52(3), 131-141. KARGER
ISSN: 1423-0003
0304-324X
DOI: 10.1159/000091822
Popis: Background: Falls in the elderly are a major health problem. Although exercise programs have been shown to reduce the risk of falls, the optimal exercise components, as well as the working mechanisms that underlie the effectiveness of these programs, have not yet been established. Objective: To test whether the Nijmegen Falls Prevention Program was effective in reducing falls and improving standing balance, balance confidence, and obstacle avoidance performance in community-dwelling elderly people. Methods: A total of 113 elderly with a history of falls participated in this study (exercise group, n = 79; control group, n = 28; dropouts before randomization, n = 6). Exercise sessions were held twice weekly for 5 weeks. Pre- and post-intervention fall monitoring and quantitative motor control assessments were performed. The outcome measures were the number of falls, standing balance and obstacle avoidance performance, and balance confidence scores. Results: The number of falls in the exercise group decreased by 46% (incidence rate ratio (IRR) 0.54, 95% confidence interval (CI) 0.36–0.79) compared to the number of falls during the baseline period and by 46% (IRR 0.54, 95% CI 0.34–0.86) compared to the control group. Obstacle avoidance success rates improved significantly more in the exercise group (on average 12%) compared to the control group (on average 6%). Quiet stance and weight-shifting measures did not show significant effects of exercise. The exercise group also had a 6% increase of balance confidence scores. Conclusion: The Nijmegen Falls Prevention Program was effective in reducing the incidence of falls in otherwise healthy elderly. There was no evidence of improved control of posture as a mechanism underlying this result. In contrast, an obstacle avoidance task indicated that subjects improved their performance. Laboratory obstacle avoidance tests may therefore be better instruments to evaluate future fall prevention studies than posturographic balance assessments.
Databáze: OpenAIRE