Exercise training and fall-risk prevention for community-dwelling elders

Abstract

Purpose: To investigate how a group of community-dwelling Hong Kong Chinese elderly persons with a history of falling can benefit from an eight-week home-based program of exercise. Methods: From an initial group of 69 volunteers, 40 participants (mean age = 80 ± 4.5years) with a history of falling were selected and randomly assigned into Group 1—the exercise group (n = 20) and Group 2—the control group (n = 20). Following an introductory talk and exercise instruction session, Group 1 engaged in a daily 45-minute home-based exercise session, plus a 30-minute walk twice per week, for eight weeks. Measurements, taken at baseline and after eight weeks, included strength of hip flexors and knee extensors, mobility, dynamic balance, and functional reach. Participants were requested to complete a daily activity diary. Physiotherapists followed up by phone in the first, second, fourth, and sixth week, with regard to the exercise program, health status, motivation, and advice if necessary. Results: Twenty-seven participants successfully completed the eight-week program (Group 1 = 5; Group 2 = 12). There was no difference between the groups in any outcome measure at baseline. However, following the eight-week intervention, Group 1 demonstrated significant improvements in strength of hip flexors and knee extensors (p < 0.000). Performance in Functional Reach (p = 0.008), Time to Get-up and Go (p = 0.034), and Berg Balance Scale (p = 0.022) test scores improved markedly. There was no significant change in any outcome measures in Group 2. Conclusion: Participation in a home-based exercise program is an effective intervention to enhance strength, gait, and balance and to reduce the functional declines associated with aging in the elderly. Lower-limb strength, gait, and balance training exercises should be a major component within a fall-risk reduction program for the elderly.