The Effect of Multidimensional Exercises .....

....... on Balance, Mobility, and Fall Risk in Community-Dwelling Older Adults

1. Anne Shumway-Cook,
2. William Gruber,
3. Margaret Baldwin and
4. Shiquan Liao

Abstract

Background and Purpose. 

This prospective clinical investigation examined the effects of a multidimensional exercise program on balance, mobility, and risk for falls in community-dwelling older adults with a history of falling. Factors used to predict adherence and a successful response to exercise were identified. 

Subjects. A total of 105 community-dwelling older adults (≥65 years of age) with a history of two or more falls in the previous 6 months (no neurologic diagnosis) participated. They were classified into (1) a control group of fallers (n=21), (2) a fully adherent exercise group (n=52), and (3) a partially adherent exercise group (n=32). 

Methods. Following evaluation, each patient received an individualized exercise program addressing the impairments and functional disabilities identified during the assessment. The control group received no intervention. Changes in performance on five clinical tests of balance and mobility and fall risk were compared among groups.  

Results. Both exercise groups scored better than the control group on all measures of balance and mobility. Although both exercise groups showed a reduction in fall risk compared with the control group, the greatest reduction was found in the fully adherent exercise group. Factors associated with successful response to exercise included degree of adherence to exercise program and pretest score on the Tinetti Mobility Assessment.  

Conclusion and Discussion. Exercise can improve balance and mobility function and reduce the likelihood for falls among community-dwelling older adults with a history of falling. The amount of exercise needed to achieve these results, however, could not be determined from this study.

Quelle:  http://www.physicaltherapyjournal.com/content/77/1/46.short


Full Text / pdf - online im internet - Zugriff 01.10.2012 -  The Effect of Multidimensional Exercises on Balance, Mobility, and Fall Risk in Community-Dwelling Older Adults

http://www.physicaltherapyjournal.com/content/77/1/46.full.pdf+html

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The effect of strength and endurance training on gait, balance, fall risk,......

......., and health services use in community-living older adults.

Buchner DM, Cress ME, de Lateur BJ, Esselman PC, Margherita AJ, Price R, Wagner EH

Department of Health Services, University of Washington, Seattle, USA. buchner@u.washington.edu

 

The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences [1997, 52(4):M218-24]

 

Type:  Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, U.S. Gov't, Non-P.H.S., Research Support, U.S. Gov't, P.H.S.
 

Abstract

BACKGROUND: The study tested the effect of strength and endurance training on gait, balance, physical health status, fall risk, and health services use in older adults. METHODS: The study was a single-blinded, randomized controlled trial with intention-to-treat analysis. Adults (n = 105) age 68-85 with at least mild deficits in strength and balance were selected from a random sample of enrollees in a health maintenance organization. The intervention was supervised exercise (1-h sessions, three per week, for 24-26 weeks), followed by self-supervised exercise. Exercise groups included strength training using weight machines (n = 25), endurance training using bicycles (n = 25), and strength and endurance training (n = 25). Study outcomes included gait tests, balance tests, physical health status measures, self-reported falls (up to 25 months of follow-up), and inpatient and outpatient use and costs. RESULTS: There were no effects of exercise on gait, balance, or physical health status. Exercise had a protective effect on risk of falling (relative hazard =.53, 95% CI =.30-.91). Between 7 and 18 months after randomization, control subjects had more outpatient clinic visits (p <.06) and were more likely to sustain hospital costs over $5000 (p <.05). CONCLUSIONS: Exercise may have beneficial effects on fall rates and health care use in some subgroups of older adults. In community-living adults with mainly mild impairments in gait, balance, and physical health status, short-term exercise may not have a restorative effect on these impairments.

Quelle:   http://ukpmc.ac.uk/abstract/MED/9224433


Full Text / pdf:    http://www.cebp.nl/media/m785.pdf

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Relationship between Balance Ability and Lower Extremity Muscular Strength in the Elderly

Comparison by Gender, Age, and Tokyo Metropolitan Institute of Gerontology (TMIG) Index of Competence

Tatsuya HIRASE¹⁾, Shigeru INOKUCHI²⁾, Jun SHIOZUKA¹⁾, Kazumi NAKAHARA²⁾, Nobuou MATSUSAKA²⁾

 

1) Department of Rehabilitation Medicine, Nijigaoka Hospital 2) Department of Physical Therapy, Graduate School of Health Sciences, Nagasaki University 

Released 2008/11/21   

 

Keywords: the elderly, balance ability, lower extremity muscular strength

Abstract:

[Purpose] We studied the relationship between balance ability and lower extremity muscular strength in the elderly, and compared the data by gender, age, and the TMIG index of competence scores. 

[Subjects] The subjects of this study were 69 persons with an average age of 77.4 years. 

[Methods] Balance ability was assessed using center of gravity sway data for a static-standing posture and the Functional Reach Test (FRT) scores. Lower extremity muscular strength was assessed using measurements of knee extensor and ankle dorsiflexor strengths. For the age group analysis, subjects were divided into those above and below the median age(≤78 years and ≥79). For the activity level analysis, subjects were divided according to their TMIG index of competence score into those with scores of <11 and those with scores of ≥11. 

[Results] The study showed that lower extremity strength was negatively correlated with sway of center of gravity and positively correlated with FRT scores. Negative correlation between sway of the center of gravity and lower extremity strength was observed in women aged ≥79 whose TMIG index of competence score was <11. In contrast, lower extremity strength was positively correlated with FRT in women aged ≤78 whose TMIG index of competence score was ≥11. 

[Conclusion] In the elderly, there seem to be different characteristics that are dependent on physical ability in the relationship between balance ability and lower extremity muscular strength.

Quelle:   https://www.jstage.jst.go.jp/article/rika/23/5/23_5_641/_article

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Regular Heel-raise Training Focused on the Soleus for the Elderly

Evaluation of Muscle Thickness by Ultrasound

Katsuo Fujiwara¹⁾, Hiroshi Toyama¹⁾, Hitoshi Asai²⁾, Kaoru Maeda³⁾, Chie Yaguchi¹⁾

1) Department of Human Movement and Health, Graduate School of Medical Science, Kanazawa University 2) Department of Physical Therapy, Graduate School of Medical Science, Kanazawa University 3) Department of Physical Therapy, Faculty of Health Sciences, Morinomiya University of Health Sciences 

Released 2010/04/30   

 

Keywords: muscle training, soleus, gastrocnemius, plantar flexor strength, the elderly

ABSTRACT
 
 The soleus, one of the triceps surae muscles, greatly contributes to standing and walking. Strength training focused on the soleus could be important to prevent age-related deterioration in these functions.

We therefore investigated the effects of regular heel-raise training focused on the soleus for the elderly. Forty-nine healthy women aged 60 to 79 years trained for at least 40 days in a period of two months. Training consisted of a set of 100 repetitions per day of heel-raise with both legs in a standing position.

The training effect was evaluated by changes in each muscle thickness of the soleus and gastrocnemius medialis, which was measured using an ultrasound scanner, as well as plantar flexor strength.

The subjects' ability to perform the training and their subjective opinions of its effects were assessed by a questionnaire survey. Plantar flexor strength and thicknesses of the soleus and gastrocnemius medialis were increased significantly by the training.

The percentage increase in thickness was significantly greater for the soleus than for the gastrocnemius medialis (12.7% vs. 6.6%). These improvements did not significantly correlate with age.

The questionnaire results suggested that the elderly were able to safely and easily perform the heel-raise training at home. This study demonstrated that regular heel-raise training is an effective muscle training method for the elderly, focused on the soleus.

Quelle:  https://www.jstage.jst.go.jp/article/jpa2/29/1/29_1_23/_article

Full Text / pdf:

https://www.jstage.jst.go.jp/article/jpa2/29/1/29_1_23/_pdf


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  Grafik:  http://ikillfat.com/wp-content/uploads/2012/02/soleus.jpg?w=136

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Fall risk assessment and ......

.........knee extensor muscle activity in elderly people

Yukiko Oya¹⁾, Masumi Nakamura¹⁾, Emi Tabata¹⁾, Ryo Morizono¹⁾, Sachiko Mori¹⁾, Yukari Kimuro¹⁾, Etsuo Horikawa^{1) 2)}

 

1) Graduate School of Medicine, Saga University 2) Center for Comprehensive and Community Medicine, Faculty of Medicine, Saga University 

Released 2008/07/14   

 

Keywords: Community-dwelling elderly people, Falls, Knee extensor muscle, Peak latency, Hand-held dynamometer

ABSTRACT

Purpose: The purpose of this study was to analyze relationships between the history of falls, tripping, sway, and knee extensor muscle strengths as a tool for fall risk assessment in elderly people. We examined effective fall prevention measures.

Methods: We investigated 102 elderly volunteers in the community. The subjects were classified according to history of falls, tripping, sway and 5 performance tests conducted to assess fall risk including Timed up-and-go test (TUG), Functional Reach test (FR), Hand grip and Reaction time (RT). In addition, the time serial data of the knee extensor muscle strength were acquired using a hand-held dynamometer.

Results: In comparison to the non-faller group, the faller group showed a significantly higher incident rate of tripping and sway. A frequency analysis using the Maximum Entropy Method revealed that the fallers group showed lower peak frequency (p=0.025). Also, the slope of the logarithmical spectrum was less steep in the fallers group (p=0.035). Also results from analysis of the peak force latency from the beginning of measurement to 50%, 80%, and 100% muscle strength, also showed that the faller group took more time for maximal voluntary contraction.

Conclusions: The frequency analysis of the time series date of peak force latency of knee extensor muscle strength revealed that the muscle activity differs in faller compared to non-fallers. This study suggested that knee extensor muscle isometric performance could possibly be used as a new tool for fall risk assessment. We concluded that exercises to raise maximal muscle strength and muscle response speed are useful for the prevention of falls.




Quelle:   https://www.jstage.jst.go.jp/article/geriatrics/45/3/45_3_308/_article

Der Full Text / pdf  ist leider in japanischer Schrift.

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