Programme frequency, type, time and duration do not explain the effects of balance exercise in older adults: a systematic review with a meta-regression analysis

Farlie, Melanie; Robins, Lauren; Haas, Romi; Keating, Jennifer Lyn; Molloy, Elizabeth; Haines, Terry

doi:10.1136/bjsports-2016-096874

Cited by 22 publications

(21 citation statements)

References 17 publications

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“…That study was conducted in outpatient facilities, and most participants were community-dwelling older people with dementia who had higher levels of cognitive and physical function and fewer comorbidities than did our population (44). In addition, comparison of our results with those of systematic reviews of the effects of balance interventions that included older participants, nearly all of whom were community dwelling and without dementia, yielded inconclusive findings (3,14,45). The authors of one review concluded, in line with our results, that exercise program modalities inadequately explained the balance effect (45).…”

Section: Discussionmentioning

confidence: 74%

“…In addition, comparison of our results with those of systematic reviews of the effects of balance interventions that included older participants, nearly all of whom were community dwelling and without dementia, yielded inconclusive findings (3,14,45). The authors of one review concluded, in line with our results, that exercise program modalities inadequately explained the balance effect (45). In contrast, a review of balance exercise in healthy older adults identified effective balance training protocol comprising exercise modalities (duration, frequency) (14).…”

Section: Discussionmentioning

confidence: 76%

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Is the Effect of a High-Intensity Functional Exercise Program on Functional Balance Influenced by Applicability and Motivation among Older People with Dementia in Nursing Homes?

Sondell

Littbrand

Holmberg

et al. 2019

The Journal of nutrition, health and aging

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Background and Objectives: Exercise can be an important way of maintaining balance function in people with dementia, but further investigation is needed to determine the optimal way of exercising. The objective was to evaluate whether exercise applicability (i.e., attendance, exercise intensity, and adverse events) and motivation were associated with the effect on functional balance of a high-intensity functional exercise program for older people with dementia in nursing homes. Design, Setting and Participants: Exercise intervention participants (n = 81; 60 women, 21 men) from a randomized controlled trial (UMDEX) were included. Their mean age was 84 and mean Mini-Mental State Examination score was 15. Intervention: Groups of 3-8 participants participated in the High-Intensity Functional Exercise (HIFE) Program, with 5 sessions per 2-week period, for 4 months (total, 40 sessions). Measurements: Outcome was the Berg Balance Scale (BBS), assessed at baseline and follow up, and the score difference, dichotomized to classify participants into two groups: responders (≥5-point increase) and non-responders (<5-point increase). Target variables were measures of applicability and motivation. Associations between each target variable and the outcome were analyzed using multivariable logistic regression. Baseline characteristics and new medical conditions developing during the intervention period were compared between responders and non-responders and included in the analyses when p < 0.10. Results: The BBS score was 28.6 ± 14.3 at baseline and 31.2 ± 15.3 at follow up, with the difference between follow-up and baseline scores ranging from -35 to 24. Twenty-nine (35.8%) participants were responders. The multivariable models showed no significant association between responders vs. non-responders and any target variable. Conclusion: Participation in a 4-month high-intensity functional exercise program can improve balance in many individuals with dementia in nursing homes, despite the progressiveness of dementia disorders and several co-existing medical conditions. Predicting balance exercise response based on applicability and motivation seem not to be possible, which lends no support for excluding this group from functional exercise, even when exercise intensity or motivation is not high.

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 76%

Is the Effect of a High-Intensity Functional Exercise Program on Functional Balance Influenced by Applicability and Motivation among Older People with Dementia in Nursing Homes?

Sondell

Littbrand

Holmberg

et al. 2019

The Journal of nutrition, health and aging

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“…A direct assessment of dynamic balance in gerontology is lacking, as it is indirectly inferred from walking speed [27] and qualitative self-reports [30]. The search and need for a valid and reliable measure of dynamic balance, i.e., an actual loss of balance, is highlighted by the use of an extraordinary array of 133 balance outcomes in 80 studies [35]. The difficulty in identifying a dynamic balance test may be related to the paradox that the number of falls increases despite reductions in walking speed.…”

Section: Discussionmentioning

confidence: 99%

Beam Walking to Assess Dynamic Balance in Health and Disease: A Protocol for the “BEAM” Multicenter Observational Study

et al. 2018

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Background: Dynamic balance keeps the vertical projection of the center of mass within the base of support while walking. Dynamic balance tests are used to predict the risks of falls and eventual falls. The psychometric properties of most dynamic balance tests are unsatisfactory and do not comprise an actual loss of balance while walking. Objectives: Using beam walking distance as a measure of dynamic balance, the BEAM consortium will determine the psychometric properties, lifespan and patient reference values, the relationship with selected “dynamic balance tests,” and the accuracy of beam walking distance to predict falls. Methods: This cross-sectional observational study will examine healthy adults in 7 decades (n = 432) at 4 centers. Center 5 will examine patients (n = 100) diagnosed with Parkinson’s disease, multiple sclerosis, stroke, and balance disorders. In test 1, all participants will be measured for demographics, medical history, muscle strength, gait, static balance, dynamic balance using beam walking under single (beam walking only) and dual task conditions (beam walking while concurrently performing an arithmetic task), and several cognitive functions. Patients and healthy participants age 50 years or older will be additionally measured for fear of falling, history of falls, miniBESTest, functional reach on a force platform, timed up and go, and reactive balance. All participants age 50 years or older will be recalled to report fear of falling and fall history 6 and 12 months after test 1. In test 2, seven to ten days after test 1, healthy young adults and age 50 years or older (n = 40) will be retested for reliability of beam walking performance. Conclusion: We expect to find that beam walking performance vis-à-vis the traditionally used balance outcomes predicts more accurately fall risks and falls. Clinical Trial Registration Number: NCT03532984.

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“…Para equilibrar dosis de ejercicio, las recomendaciones dependen de la prescripción de frecuencia de ejercicio, tipo y tiempo. En ausencia de una medida de intensidad, el ejercicio generalmente se prescribe 2-3 veces/ semana durante 45-60 min, con las tareas más difíciles practicadas 2-3 veces/sesión [75], apuntando tanto a la comunidad en general como individual, realizado en un entorno grupal o en el hogar; se aconseja que las personas con alto riesgo (como caídas) no deben estar sin supervisión [76].…”

Section: Ejercicio Para Promover El Envejecimiento Neural Saludableunclassified

Envejecimiento neural, plasticidad cerebral y Ejercicio: Avances desde la óptica de Fisioterapia

Ríos

Collazos

2019

archmed

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El ejercicio ha demostrado efectividad para promover la plasticidad cerebral en los procesos de envejecimiento neural. Esta revisión narrativa de literatura tiene como objetivo analizar el efecto neural del ejercicio para promover la plasticidad cerebral en el envejecimiento. Los resultados incluyeron publicaciones que mencionan los efectos de la plasticidad cerebral mediada por el ejercicio, mediante protocolos de ejercicio con duración, intensidad y frecuencia clínicamente significativa. Mediante la revisión documental se determinaron tres apartados: Envejecimiento Neural: Procesos fisiológicos interrelacionados; Plasticidad cerebral mediada por el Ejercicio; Ejercicio para promover el envejecimiento neural saludable. Se pudo concluir que el fisioterapeuta, aplicando protocolos de ejercicio, puede promover cambios positivos en la función cerebral lo cual se traducen en la mejoría del desempeño físico y funcional de los adultos mayores.

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Programme frequency, type, time and duration do not explain the effects of balance exercise in older adults: a systematic review with a meta-regression analysis

Abstract: Limitations to this study included the variability in design of balance interventions, incomplete reporting of data and statistical heterogeneity. The design of balance exercise programmes provides inadequate explanation of the observed benefits of these interventions.

Cited by 22 publications

References 17 publications

Is the Effect of a High-Intensity Functional Exercise Program on Functional Balance Influenced by Applicability and Motivation among Older People with Dementia in Nursing Homes?

Is the Effect of a High-Intensity Functional Exercise Program on Functional Balance Influenced by Applicability and Motivation among Older People with Dementia in Nursing Homes?

Beam Walking to Assess Dynamic Balance in Health and Disease: A Protocol for the “BEAM” Multicenter Observational Study

Envejecimiento neural, plasticidad cerebral y Ejercicio: Avances desde la óptica de Fisioterapia

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