Effect of Community-Based Group Exercise Interventions on Standing Balance and Strength in Independent Living Older Adults

Abstract

Background and Purpose: Many interventions to improve mobility in older adults often include exercises to address underlying impairments such as strength deficits. Task-oriented exercise interventions that focus more on walking and stepping tasks that may be encountered in the community have been considered for improving mobility in older adults. The main purpose was to examine the effect of task-oriented and impairment-based group exercise interventions on standing balance and lower extremity muscle strength. Methods: This is an ancillary study to a cluster-randomized clinical trial. Participants included 107 older adults. Participants were randomized by facility to 1 of 2 different interventions, or a waitlist control group. The On the Move (OTM) task-oriented intervention consisted of warm-up, timing and coordination (stepping and walking patterns), strengthening, and stretching exercises. The standard of care impairment-based exercise intervention (STD) consisted of warm-up, strength, endurance, and stretching exercises. Postural sway and balance measures were recorded before and after the 12-week interventions. An accelerometer was used to collect postural sway for 6 different standing balance conditions. A portable load cell was used to assess lower extremity muscle strength for 3 muscle groups. Results and Discussion: The OTM group had a significant reduction in sway acceleration during most of the balance conditions over the 12-week period, whereas the STD had smaller, nonsignificant reductions. Both exercise interventions had a significant reduction in sway compared with the waitlist control group in at least 1 balance condition. The OTM and STD groups had significant increases in hip abduction strength during the intervention and the STD group also had an increase in knee extension strength. The waitlist group had a significant reduction in strength in all muscle groups during the 12-week period. Strength changes in both exercise groups were significantly different from the waitlist group but not from each other. Conclusion: Both exercise intervention groups had an improvement in standing balance and lower extremity strength when compared with a waitlist group that did not receive exercise. Although the exercise groups did not significantly differ from each other, the OTM exercise group showed a trend toward improvement in static standing balance conditions.

Psychometric properties of instrumented postural sway measures recorded in community settings in independent living older adults

“…This study has been approved by the Institutional Review Board of the University of Pittsburgh. Inclusion and exclusion criteria followed that of the parent study [13,14].…”

Effects of Exercise Interventions on Physical Performance and Activities of Daily Living in Oldest-Old and Frail Older Adults

“…Two studies compared single component intervention with multicomponent intervention. 36,49 Other exercise interventions included Tai Chi (TC), 65,66,82,94,103,110 dance, 102 and rocking-chair exercise. 68…”

“…Most interventions lasted 12 wks [36][37][38][39][40]46,[58][59][60]62,63,65,67,73,74,80,86,96,102,103,107,109 or longer, up to 2 yrs. 43,44,[47][48][49][50][51][52]54,56,64,66,69,[77][78][79]82,84,[87][88][89][90][91][92][93][94]100,101,104 Nine other studies involved interventions ranging from 8 wks 42,…”

“…The most common frequency of exercise is twice 36,43,48,49,51,52,58,59,67,78,82,86,93,99,105,107 to thrice per week. [37][38][39]41,42,46,56,60,[62][63][64]69,70,73,74,77,80,83,[89][90][91]96,98,101,104,109 Fourteen studies required the adults to exercise four to six times per week.…”

Efeitos do treinamento cognitivo-motor no controle postural de idosos: ensaio clínico randomizado

“…Uma intervenção com forte combinação entre treinamento motor e cognitivo que apresenta alta relevância ecológica 36 parece prevenir e tratar o declínio cognitivo dos idosos saudáveis 28,33 . As intervenções que propõem exercícios orientados para tarefas, como por exemplo, caminhar e pisar de acordo com padrões estabelecidos também tem se destacado na melhora da mobilidade em adultos mais velhos 37 . A sinergia positiva promovida pela associação dos benefícios desses tipos de intervenções combinadas 37 em ambiente enriquecido 38 são necessárias para promover plasticidade sináptica, a sobrevivência e integração funcional dos neurônios recém-formados em redes neurais 39 , melhorar a reserva cognitiva 40,41 a resiliência contra os processos degenerativos do cérebro 38,42,43 e a cognição dos idosos 28 Um treinamento multicomponente apresenta demandas mais compatíveis com aquelas que vivenciamos no dia a dia, quando comparado com um treino cognitivo-motor com duplatarefa 28,33 .…”