Abstract
Background
Multicomponent intervention programs have been shown to be effective in reducing risk factors associated with falls, but the primary target population of these interventions is often low-functioning older adults.
Aims
The purpose of this study was to investigate the effectiveness of a multicomponent intervention program focusing on balance and muscle strength for independently functioning community-dwelling older adults.
Methods
Fifty-three independently functioning older adults, aged 80.09 ± 6.62 years, participated in a group exercise class (conducted 2 times/week for 8 weeks) emphasizing balance. Outcome measures were balance performance using the Fullerton Advanced Balance (FAB) scale and muscle strength using the Senior Fitness Test (SFT).
Results
The intervention improved balance (P < 0.001), and older adults who were classified as having high fall risks based on the FAB scores at pre-testing improved more than older adults who were classified as having low fall risks (P = 0.017). As a result, 22 participants transitioned from a high fall risk group at pre-testing to a low fall risk group at post-testing (P < 0.001). The intervention also enhanced both upper and lower muscle extremity strength based on SFT results (P < 0.001) regardless of participants’ classification of fall risk status.
Conclusions and discussion
The multicomponent intervention conducted two times per week for 8 weeks was effective in improving balance and enhancing muscle strength of independently functioning older adults. The results underscore the importance of providing fall prevention interventions to healthy older adults, a population often not a target of balance interventions.
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Acknowledgements
This research was supported by a SCAN Health Plan grant. We are grateful to the Osher Lifelong Learning Institute at the California State University, Long Beach, and the Leisure World® Seal Beach, CA, for their assistance in the participants recruitment. We also thank many student assistants from the Department of Physical Therapy and the Department of Psychology at the California State University, Long Beach for their help in data collection and data analysis.
Funding
This study was partially funded by a Grant from SCAN Health Plan.
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On behalf of all authors, the corresponding author states that there is no conflict of interest.
Ethical standards
All procedures performed in this project involving human participants were in accordance with the ethical standards of our institutional review board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standard.
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Informed consent was obtained from all individuals participants included in the study.
Appendix: Weekly progression of the exercise intervention
Appendix: Weekly progression of the exercise intervention
Activity | Week 1 | Week 2 Additions | Week 3 Additions | Week 4 Additions | Week 5 Additions | Week 6 Additions | Week 7 Additions | Week 8 Additions |
---|---|---|---|---|---|---|---|---|
Warm up (7 min) with music | Seated: Proper posture awareness Core muscle contraction Arm and shoulder movement Chest stretch | Seated: Sitting on a compliant surface (disc or ball) | Seated: Marching while sitting | Seated: Head turns with movement | Seated: Pass the potato | Seated: Balloon volleyball | Seated: Balloon volleyball | Seated: Balloon volleyball |
Walking: With music, arm movement | Walking: High stepping walking | Walking: Fast and slow walking Abrupt change of pace | Walking: Abrupt change of direction | Walking: Tossing a bean bag upward and catching it | Walking: Tossing a ball upward and catching it | Walking: Tossing a bean bag between two hands | Walking: Tossing balls between two hands | |
Balance and multisensory training (10 min) | Standing weight shifts (all directions, EO, EC) Diagonal weight shift (forward and backward) | Tandem standing Tandem weight shifts (forward and backward) | Toe and heel tapping(all directions) Foot drawing (first name with the right foot, last name with the left foot) Single limb stance | Marching in place with head turns Four corner marching with head turns | Teach how to get on and off foam pad Standing on foam weight shifts (all directions) | Standing on foam (EO, EC) | Standing on foam weight shifts (all directions, EO, EC) | Standing on foam on one foot (EO, EC) |
Semi-tandem weight shifts (all directions, EO, EC) | ||||||||
Walking activities and games (10 min) with music | Walking on toes Walking on heels | Walk in files (in line one behind the other) Walk in files across the midline | Walk with abrupt stop and change of direction Walking across tossing a bean bag then relay to opposite participant | Walk reading a script Passing a ball (forward, behind and to the side in a circle) | Walk on dense foam Standing volleyball | Wide step walking as if crossing a real water creek Obstacle course (avoiding obstacles and stepping on & off different objects) | Obstacle course (stepping on different surfaces picking objects from floor) | Obstacle course (carrying objects while stepping on different surfaces) |
Wall flexibility and strengthening (10 min) | Semi-tandem walk Narrow step walking Alternating narrow and wide step walking | Side walking Walking with head turns Tossing a ball while walking | ||||||
Figure 8 walking Wall squats (10 reps) Heel raises (10 reps) Toe raises (10 reps) | Wall push-up (10 reps) Hamstring stretch (10 reps) Calf stretch (10 reps) | |||||||
Seated strengthening (10 min) using resistance bands (10 reps for each set)a | Biceps curls Horizontal and diagonal pulls Triceps curls | Leg press Seated hip abduction Point and flex | ||||||
Eye/hand coordination (3 min) | Follow a moving target (popsicle stick) with slow eye movement (side to side, up/down and diagonal) with the head stable | Increase the speed of eye movement | Follow eye movement with head movement in the same direction | |||||
Cool down (5 min) breathing instructions with all movements | Arm movements Neck bending Trunk bending and rotation Arm stretches Hamstring and calf stretches Ankle circles |
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Cho, YH., Mohamed, O., White, B. et al. The effects of a multicomponent intervention program on clinical outcomes associated with falls in healthy older adults. Aging Clin Exp Res 30, 1101–1110 (2018). https://doi.org/10.1007/s40520-018-0895-z
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DOI: https://doi.org/10.1007/s40520-018-0895-z