falls in elderly

Trial of a lifestyle integrated approach to balance and strength training

Background

In elderly people, the rate of hospital admissions due to falls has not declined during the last decade. Reducing the frequency of falls would lead to a reduction in immobility and institutionalization as well as the easing of associated economic burdens. Although structured programmes of exercise and balance training exist as strategies to reduce the frequency of falls, relatively few elderly people participate in them. Particularly in the case of frail, older people, the integration of exercise programmes into daily activities may enhance participation and adherence. This paper reports the results of a randomized, parallel group trial comparing a conventional structured exercise programme with the Lifestyle integrated Functional Exercise (LiFE) programme.
The LiFE programme consists of movements designed to enhance balance and strength, integrated into daily activities.
The 317 elderly people (≥ 70 years of age) included in the trial had a recent history of falls.
Participants were randomized (1:1:1) to the LiFE programme, a conventional structured programme to improve balance and lower limb strength given three times a week, or a sham control of gentle exercise. They were assessed at baseline, and at 6 and 12 months.
At 12 months there was a significant 31% reduction in the rate of falls in the LiFE group compared with the control group. There was a 19% reduction in the rate of falls in the structured programme group which was not significantly different from the control group.
Adherence in the structured programme group was significantly lower than in either the LiFE group or the control group.

Take-home message

“The LiFE programme provides an additional choice to traditional exercise and another fall prevention programme that could work for some people. Functional based exercise should be a focus for protection from falling and for improving and maintaining functional capacity for older people at risk.”
Purchase full-text article at PubMed

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