DOI QR코드

DOI QR Code

Balance Training Program for Community-Dwelling Elders with Risk of Falls: A Multi-center Randomized Controlled Trial

  • Yang Rae Kim (Department of Physical Therapy, College of Health Science, Kyungdong University)
  • Received : 2023.06.21
  • Accepted : 2023.06.28
  • Published : 2023.06.30

Abstract

Objective: This study aimed to assess the effectiveness of a balance training program in improving balance and functional independence to reduce fall risks among community-dwelling elders. Design: A multi-center randomized controlled trial Methods: A total of 66participants were randomly assigned to a balance training group or a control group. The balance training program, conducted three times a week for 32 weeks, included warm-up exercises, main balance training exercises, and cooldown stretch exercises. Outcome measures included the Berg Balance Scale (BBS), Timed Up and Go Test (TUGT), and Modified Barthel Index (MBI). Results: The balance training group demonstrated significant improvements in all outcome measures, indicating enhanced balance, improved functional mobility, and increased independence in activities of daily living. In contrast, the control group showed only slight improvements in BBS, TUGT and MBI scores. Conclusions: These findings provide evidence supporting the effectiveness of balance training programs in reducing fall risk and promoting health and wellbeing among community-dwelling elders. Future research should aim to refine the design of these programs and assess the sustainability of the observed improvements.

Keywords

References

  1. Rubenstein LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age and Ageing. 2006;35:ii37-ii41. https://doi.org/10.1093/ageing/afl084
  2. Yoshida-Intern S. A global report on falls prevention epidemiology of falls. Geneva: WHO. 2007.
  3. Friedman SM, Munoz B, West SK, Rubin GS, Fried LP. Falls and Fear of Falling: Which Comes First? A Longitudinal Prediction Model Suggests Strategies for Primary and Secondary Prevention. Journal of the American Geriatrics Society. 2002;50:1329-35. https://doi.org/10.1046/j.1532-5415.2002.50352.x
  4. Sherrington C, Tiedemann A, Fairhall N, Close JCT, Lord SR. Exercise to prevent falls in older adults: an updated meta-analysis and best practice recommendations. New South Wales Public Health Bulletin. 2011;22:78-83. https://doi.org/10.1071/NB10056
  5. Horak FB. Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls? Age and Ageing. 2006;35:ii7-ii11. https://doi.org/10.1093/ageing/afl077
  6. Lord SR, Menz HB, Sherrington C. Home environment risk factors for falls in older people and the efficacy of home modifications. Age and Ageing. 2006;35:ii55-ii9. https://doi.org/10.1093/ageing/afl088
  7. Shumway-Cook A, Woollacott MH. Motor control: translating research into clinical practice: Lippincott Williams & Wilkins; 2007.
  8. Sturnieks DL, Menant J, Vanrenterghem J, Delbaere K, Fitzpatrick RC, Lord SR. Sensorimotor and neuropsychological correlates of force perturbations that induce stepping in older adults. Gait & Posture. 2012;36:356-60. https://doi.org/10.1016/j.gaitpost.2012.03.007
  9. Tiedemann A, Sherrington C, Close JCT, Lord SR. Exercise and Sports Science Australia Position Statement on exercise and falls prevention in older people. Journal of Science and Medicine in Sport. 2011;14:489-95. https://doi.org/10.1016/j.jsams.2011.04.001
  10. Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson L, et al. Interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews. 2012.
  11. Cesari M, Vellas B, Hsu F-C, Newman AB, Doss H, King AC, et al. A Physical Activity Intervention to Treat the Frailty Syndrome in Older Persons-Results From the LIFE-P Study. The Journals of Gerontology: Series A. 2015;70:216-22. https://doi.org/10.1093/gerona/glu099
  12. Gill TM, Pahor M, Guralnik JM, McDermott MM, King AC, Buford TW, et al. Effect of structured physical activity on prevention of serious fall injuries in adults aged 70-89: randomized clinical trial (LIFE Study). BMJ. 2016;352:i245.
  13. Podsiadlo D, Richardson S. The Timed "Up & Go": A Test of Basic Functional Mobility for Frail Elderly Persons. Journal of the American Geriatrics Society. 1991;39:142-8. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
  14. Shah S, Muncer S. Sensitivity of Shah, Vanclay and Cooper's modified Barthel Index. Clin Rehabil. 2000;14:551-2. https://doi.org/10.1191/0269215500cr360oa
  15. Cheng Y-Y, Weng S-C, Chang S-T, Tan S-H, Tang Y-J. Evaluating functional independence in older adults using subscales of the Berg Balance Scale. Journal of Clinical Gerontology and Geriatrics. 2014;5:111-6. https://doi.org/10.1016/j.jcgg.2014.05.001
  16. Hohtari-Kivimai U, Salminen M, Vahlberg T, Kivela-L. Short Berg Balance Scale - correlation to static and dynamic balance and applicability among the aged. Aging Clinical and Experimental Research. 2012;24:42-6. https://doi.org/10.1007/BF03325353
  17. Neuls PD, Clark TL, Van Heuklon NC, Proctor JE, Kilker BJ, Bieber ME, et al. Usefulness of the Berg Balance Scale to Predict Falls in the Elderly. Journal of Geriatric Physical Therapy. 2011;34.
  18. Muir SW, Berg K, Chesworth B, Speechley M. Use of the Berg Balance Scale for Predicting Multiple Falls in Community-Dwelling Elderly People: A Prospective Study. Physical Therapy. 2008;88:449-59. https://doi.org/10.2522/ptj.20070251
  19. Podsiadlo D, Richardson S. The timed "Up & Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39:142-8. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
  20. Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther. 2000;80:896-903.
  21. Tinetti ME. Clinical practice. Preventing falls in elderly persons. N Engl J Med. 2003;348:42-9. https://doi.org/10.1056/NEJMcp020719
  22. Redzuan NS, Engkasan JP, Mazlan M, Abdullah SJF. Effectiveness of a video-based therapy program at home after acute stroke: a randomized controlled trial. Archives of physical medicine and rehabilitation. 2012;93:2177-83. https://doi.org/10.1016/j.apmr.2012.06.025
  23. Tan Z, Liu H, Yan T, Jin D, He X, Zheng X, et al. The effectiveness of functional electrical stimulation based on a normal gait pattern on subjects with early stroke: a randomized controlled trial. BioMed research international. 2014;2014.
  24. Ahn BR, Kang HJ, Choi EJ, Jang SW, Chung HS, Jeon KS. Correlation of the Korean Version of Falls Efficacy Scale-International With Quantitative Balance and Gait Parameters Through Exercise Program in Elderly Men. arm. 2019;43:195-203. https://doi.org/10.5535/arm.2019.43.2.195
  25. Tander B, Atmaca A, Ulus Y, Tura C Akyol Y, Kuru O Balance performance and fear of falling in older patients with diabetics: a comparative study with non-diabetic elderly. Turkish Journal of Physical Medicine & Rehabilitation/Turkiye Fiziksel Tip ve Rehabilitasyon Dergisi. 2016;62.
  26. Amarilla-Donoso FJ, Loez-Espuela F, Roncero-Marti R, Leal-Hernandez O, Puerto-Parejo LM, Aliaga-Vera I, et al. Quality of life in elderly people after a hip fracture: a prospective study. Health and Quality of Life Outcomes. 2020;18:71.