Effect of 24‐week strength training on unstable surfaces on mobility, balance, and concern about falling in older adults

Abstract

Objective: To evaluate the effects of 24 weeks of strength training on stable (ST) and unstable surfaces (UST) on the functional mobility, balance, and concern about falling in healthy older adults, younger than 70. Design: A single-center randomized clinical trial.Participants: Sixty-four older adults (58 females and 6 males; 68 years) were randomized into control, ST, or UST groups. Interventions: Both ST and UST intervention groups received a core muscle, upper, and lower limb moderate-intensity strength exercises using stable and unstable surfaces. The classes were performed three times per week over a 24-week period. The control group did not receive any type of active intervention. Measurements: The primary outcome measures were the dynamic balance (Berg Balance Scale (BBS)) and functional mobility (timed up and go (TUG) test). The secondary outcomes included the sitting and rising test (SRT) and Falls Efficacy Scale-International (FESI) scores. Results: There was a significant improvement in balance performance (BBS = +4 points) after 24 weeks of both ST (+1.22; 95% CI, −0.19 to 2.63) and UST (+2.26; 95% CI, 0.83-3.70) compared with the control group. Additionally, compared with the control, only UST experienced functional mobility gains (TUG = −2.44; 95% CI, −4.41 to −0.48; SRT = +1.12; 95% CI, 0.08-2.17) and decreased concern about falling (FESI = −4.41; 95% CI, −9.30 to −0.27). Conclusion: Long-term ST with and without unstable devices was effective to improve dynamic balance in older adults. Furthermore, the effects of UST were extended to functional mobility gains and reduced concern about falling. K E Y W O R D Sexercise, instability, resistance training

Effectiveness of Training Programs in Reducing Falls in Older Adults: Systematic Review

“…Regular exercise influenced total daily physical activity and possibly induced chronic physiological adaptations. We observed that all studies that combined strength training programs with balance exercises reduced the risk of falling [4,[16][17][18][19]21,22,24,26,29]. The same was seen in isolated strength training programs [15,20,24,25,27,30,33].…”

“…The analyzed studies were published between 2008 and 2019, including a total of 2229 people. The studies were conducted in Australia [15], Brazil [4,10,[16][17][18], Canada [19], China [20], Finland [21], Germany [22], Hungary [23], India [24], Iran [25], Japan [11], Portugal [7,26], Republic of Korea [27], Spain [12,28], Switzerland [29], and the United States [9,[30][31][32][33]. Eight studies were identified as using a combination of balance and strength exercises [4,16,17,19,21,22,24,29]; three studies using a combination of aerobic exercises, balance, and strength [7,9,28]; six studies using strength exercises [15,20,25,27,30,33]; one study using a combination of aerobic and strength exercises [10];…”

“…one study using aerobic exercises [12]; four studies using balance exercises [11,23,31,32]; and two studies using balance and strength exercises separately [18,26]. A reduction in the risk of falling was observed in 21 studies [4,7,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33]. In four studies, training programs did not show a reduction in the risk of falling [9][10][11][12].…”

“…To evaluate the risk of falling in the older population, 16 studies used the Timed Up and Go Test [4,7,9,11,12,[15][16][17][18][19][20][21][22]25,26,29]. Some studies opted for other tests to assess the risk of falling, such as the Balance Evaluation System Test [28], Six Minute Walk Test [30,33], Sit-to-Stand [10], Falls Efficacy Scale-Internacional [31], Posturografia estática BioRescue [27], Functional Reach Test [24], and Berg Balance Scale [23,32].…”

“…The studies evaluated by the PEDro scale presented an average score of 8.6 points. One study scored 6 points [12], seven studies scored 7 points [4,11,16,27,28,31,32], eight studies scored 8 points [9,10,19,21,23,24,29,30], one study scored 9 points [25], and eight studies scored 10 points [7,15,17,18,20,22,26,33] (Table 2).…”