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

Steadman, J. Richard; Donaldson, Nora; Kalra, Lalit

doi:10.1046/j.1365-2389.2003.51268.x

Cited by 160 publications

(110 citation statements)

References 25 publications

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“…Moreover, several randomized controlled trials [17][18][19] confirmed that 45-60 minutes of standing balance training significantly improves the walking speed of community-dwelling elderly people. However, the present study demonstrated that even 5 minutes of standing balance training could be sufficient to improve walking speed of elderly patients with IHD.…”

Section: Discussionmentioning

confidence: 99%

Effect of Balance Training on Walking Speed and Cardiac Events in Elderly Patients With Ischemic Heart Disease

et al. 2014

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SummaryThe purpose of this study was to clarify the effect of standing balance training on walking speed (short-term outcome) and cardiac events (long-term outcome) in elderly ischemic heart disease (IHD) patients. This was a retrospective cohort study. Ninety-two elderly (≥ 65 years) IHD patients who underwent an inpatient cardiac rehabilitation program were assigned to two groups: a balance group that received standing balance training in addition to conventional (aerobic and resistance) training and a conventional group. Standing balance was assessed by one-leg standing time and a postural stability index reflecting dynamic balance, and normal walking speed was measured at baseline and hospital discharge. Patients were followed for up to 3 years or until a cardiac event occurred. There were no significant differences in clinical characteristics between the groups. Both groups showed a significant change in normal walking speed from baseline to hospital discharge (P < 0.001, respectively), and normal walking speed was significantly higher in the balance group compared to the conventional group (P = 0.001). The postural stability index improved significantly only in the balance group (P = 0.005). Multivariable analyses using Cox proportional hazards model confirmed that standing balance training (hazard ratio [HR]: 0.408; 95% confidence interval [CI]: 0.162-1.029; P = 0.058) and fast walking speed (HR: 0.362; 95% CI: 0.137-0.957; P = 0.041) were associated with cardiac events. These findings show that standing balance training improves walking speed and reduces cardiac events, and suggests that such training can be an effective intervention for elderly IHD patients. (Int Heart J 2014; 55: 397-403) Key words: Coronary artery disease, Standing balance, Aging, Secondary prevention, Cardiac rehabilitation D ecreased walking speed in elderly people is closely related to physical inactivity, difficulty performing physical activities of daily living, and health-related events.1-3) A 3-year prospective cohort study showed that wellfunctioning elderly people with a slow walking speed (≤ 90 m/ minute for men and ≤ 81 m/minute for women) have an almost 3-fold higher risk of cardiovascular mortality compared to those with a fast walking speed (> 111 m/minute for men and > 90 m/minute for women).3) Therefore, walking speed is considered a valuable parameter for assessing lower extremity functional status and prognoses such as disability, institutionalization, and/or mortality after adverse health-related events in community-dwelling elderly.In the clinical setting, walking speed tests at maximal or normal pace over 6 or 10 meters are also quick, safe, inexpensive, and reliable assessment tools. Ostir, et al 4) reported that cardiac patients have approximately a 5-to 8-fold greater degree of deterioration in lower extremity performance, including walking during hospitalization, compared to well-functioning elderly people. Moreover, clinical data 5) at hospital discharge reveal that walking speed in patients with acute m...

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Section: Discussionmentioning

confidence: 99%

Effect of Balance Training on Walking Speed and Cardiac Events in Elderly Patients With Ischemic Heart Disease

et al. 2014

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“…In the Environment domain, it was observed two Different studies have already presented some improvement to quality of life after physical training programs. It was observed, for example, significant improvement to quality of life after a balance training program among elderly people with risk of falls (23); after a home training program among elderly women with vertebral fractures (24); and, after a water-based resistance and balance training among women with fibromyalgia (25).…”

Section: Discussionmentioning

confidence: 99%

Effects of a physical therapy program on quality of life among community-dwelling elderly women: randomized-controlled trial

et al. 2013

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INTRODUCTION: Health promotion policies for encouraging elderly to remain active, independent and, effectively have a positive effect on their quality of life. OBJECTIVE: To verify the effects of a low-intensity group-based physical therapy program on quality of life among community-dwelling elderly women. MATERIALS AND METHODS: It was carried out a randomized controlled trial. Seventeen women (67.8 ± 4.9 years old) that completed 12-week training program and 10 women (68.9 ± 5.7 years old) that were included in control group answered the abbreviated version for World Health Organization Quality of life Questionnaire - WHOQOL-bref at baseline and after 12 weeks. Exercise group performed stretching, resistance and balance training. Intragroup and intergroup analysis was made using Wilcoxon and Mann-Whitney U tests, respectively. The level of significance used for all comparisons was 5%. Furthermore, it was determined the Reliable Change Index (RCI) as part of JT Method. RESULTS: Exercise group presented a significant improvement for Psychological domain (p = 0.047) after 12-week physical therapy program. Otherwise, control group presented a significant worsening for overall (p = 0.01), physical (p = 0.01) and psychological (p = 0.008) domains. Exercise group presented two participants with positive reliable change (PRC) for social domain, two participants with PRC for Environment domain. Overall and Physical domain presented three participants with PRC. Psychological domain presented four participants with PRC and one with negative reliable change. CONCLUSION: A low-intensity group-based physical therapy program may contribute in order to maintain quality of life and improve some psychological aspects among community-dwelling elderly women.

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“…Mortalität (van Haastregt, Diederiks, van Rossum, de Witte, Voorhoeve, & Crebolder, 2000;van Rossum, Frederiks, Philipsen, Portengen, Wiskerke, & Knipschild, 1993;Carpenter & Demopoulos, 1990), Muskelkraft (Woo, Hong, Lau, & Lynn, 2007;Lord, Ward, Williams, & Strudwick, 1995), Koordinationsfähigkeit (Woo et al, 2007;Lord et al, 1995), Reaktionszeit (Lord et al, 1995), Gehgeschwindigkeit (Steadman, Donaldson, & Kalra, 2003;Liu-Ambrose, Khan, Eng, Lord, & McKay, 2004;Woo et al, 2007), posturale Balance (Swanenburg, De Bruin, Stauffacher, Mulder, & Uebelhart, 2007), StandSitz-Performance (Lord et al, 2005), Knochendichte (Harwood, Sahota, Gaynor, Masud, & Hosking, 2004;Greenspan, Resnick, & Parker, 2003;Swanenburg et al, 2007) und allgemeiner Gesundheitsstatus (McMurdo, Mole, & Paterson, 1997;Carter et al, 2002;Barnett, Smith, Lord, Williams, & Baumand, 2003). Jedoch berücksichtigt die Begrenzung der Endpunkte auf klinische Parameter die Präferenzen der Zielgruppe nicht ausreichend (Langer et al, 2012;Nilsen, Myrhaug, Johansen, Oliver & Oxman, 2006;PCORI, 2012).…”

Section: Klientenzentrierte Endpunkteunclassified

Potential analysis for research on occupational therapy-led physical exercise programmes and home environment adaptation programmes to prevent falls for elderly people living at home / Potenzialanalyse zu ergotherapeutischen körperlichen Trainingsprogrammen und Wohnraumanpassungen zur Vermeidung von Stürzen bei zu Hause lebenden älteren Menschen

Müller

Lautenschläger

Voigt-Radloff

2016

International Journal of Health Professions

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Background:In Germany, four to five million community-dwelling people aged 65 years or older fall every year. The presented potential analysis evaluates the potential of occupational therapy-led physical exercise programs and home environment adaptations to reduce the frequency of falling and as well as intrinsic and extrinsic risk factors for falling of older people living at home. Methods: The potential analysis was compiled according to a method guideline (p.11-22) available as follows: http://www.cochrane. de/news/leitfaden-f%C3%BCr-gesundheitsfachberufe-mai-2013. The research question of fall prevention was considered as very relevant for health care and specified according to the PICOS-system. A Cochrane review was systematically searched and the body of evidence was assessed using the GRADE-system. In addition, studies after the search period of the Cochrane review were identified using the search strategy of this review. Both the studies within and after the review were assessed regarding their transferability to the German health care context. . However, direct implementation into the German healthcare context is not recommendable. Implication for research: It is recommended (1) to manualise identified home environment adaptation programmes for the German healthcare context and (2) to pilot-test the physical exercise programmes `LiFE` with regard to theoretical framework, acceptance, applicability and feasibility and to examine both interventions as part of a feasibility study. If this trial results in a feasible treatment programme well accepted by patients and their treating occupational therapists, a large-scaled randomized clinical trial in terms of comparative effectiveness research may follow. Abstract

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

Abstract: 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.

Cited by 160 publications

References 25 publications

Effect of Balance Training on Walking Speed and Cardiac Events in Elderly Patients With Ischemic Heart Disease

Effect of Balance Training on Walking Speed and Cardiac Events in Elderly Patients With Ischemic Heart Disease

Effects of a physical therapy program on quality of life among community-dwelling elderly women: randomized-controlled trial

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