A Randomized Controlled Trial of an Enhanced Balance Training Program to Improve Mobility and Reduce Falls in Elderly Patients

ICL, Londinium, England, United Kingdom
Journal of the American Geriatrics Society (Impact Factor: 4.22). 07/2003; 51(6):847-52. DOI: 10.1046/j.1365-2389.2003.51268.x
Source: PubMed

ABSTRACT To evaluate the effectiveness of an enhanced balance training program in improving mobility and well-being of elderly people with balance problems.
Prospective, single-blind, randomized, controlled trial.
District general hospital.
One hundred ninety-nine patients aged 60 and older with a Berg Balance Scale (BBS) score of less than 45.
Six weeks enhanced balance training consisting of a series of repetitive tasks of increasing difficulty specific to functional balance. The control group received physiotherapy conforming to existing practice in elderly patients with mobility problems.
Ten-meter timed walk test (TWT), BBS, Frenchay Activities Index (FAI), Falls Handicap Inventory (FHI), and European Quality of Life questionnaire (Euroqol) measured at 6, 12, and 24 weeks after intervention.
The mean age +/- standard deviation of subjects was 82.7 +/- 5.6, and baseline characteristics were comparable between the groups. Both groups showed improvements in TWT (intervention: 22.5-16.5 seconds, P =.001; control: 20.5-15.8 seconds, P =.054), BBS (intervention: 33.3-42.7, P =.001; control: 33.4-42.0, P <.0001), FAI (18-21, P =.02 in both groups), FHI score (intervention: 31-17, P =.0001; control: 33-17, P =.0001) and Euroqol score (intervention: 58-65, P =.04; control: 60-65, P =.07). There were no intergroup differences at any time. More patients reported increased confidence in walking indoors (36% vs 28%; P =.04) and outdoors (27% vs 18%; P =.02) in the enhanced balance-training group.
Exercise programs significantly improve balance and mobility in patients with balance problems, independent of strategy. Enhanced balance training may, in addition, improve confidence and quality of life but needs further investigation.

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    • "However, only 3 out of 28 studies reviewed examined the effects of weighted vest on mobility, suggesting that more studies that compare weighted vest with other standardized physical activity programs are needed to recommend guidelines on the use of weighted vest in enhancing mobility in older adults. Older persons who participated in balance training showed significant improvement in walking speed and balance (Kammerlind, Hakansson, & Skogsberg, 2001; Steadman, Donaldson, & Kalra, 2003; Wolf et al., 2001). An approximately 10% increase in walking endurance was achieved by regular exercise training (Rubenstein et al., 2000), with ground walking noted as more effective than treadmill training (Marsh et al., 2006). "
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    • "Randomized controlled exercise interventions to reduce falls and the risk factors for falling have been successful in improving the balance of aged people with high risk for falling (Barnett et al., 2003; Brouwer et al., 2003; Song et al., 2003; Nitz and Low Choy, 2004), while others have not (Rubenstein et al., 2000; Latham et al., 2003; Lord et al., 2003; Steadman et al., 2003). Only a few randomized controlled multifactorial fall prevention studies including assessment of the effects of the intervention on postural control have been conducted among the community-dwelling aged. "
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    • "Regular balance training exercises for a period as short as 9 weeks improved postural control in a study group of persons aged 70–75, as measured by various clinical tests and dynamic posturography, when compared to age-matched control (Ledin et al 1991). A 6-week enhanced balance training program consisting of a series of tasks of increasing diffi culty which are related to functional balance versus " standard " physical therapy for adults with balance and mobility defi cits (Steadman et al 2003) reported positive results in a sample of 199 older adults. We could fi nd no evidence dealing with the dose or duration, of group balance classes. "
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