Balance and strength training in everyday tasks can prevent falls in older people
14 August 2012
Balance and strength training integrated into everyday routines could reduce falls in older people by almost a third, according to a new University of Sydney study.
The research, published online in the British Medical Journal by researchers in the University's Faculty of Health Sciences, found balance and strength tasks integrated into everyday activities were effective in reducing the rate of falls in older, high-risk people living at home.
"It's well known that improving balance and strength can prevent falls in older adults, but in spite of this less than 10 percent of older people routinely engage in strength training," says Professor Lindy Clemson, lead author of the study.
"The figure for older adults engaging in activities that challenge balance is likely to be much lower."
In response, Professor Clemson and her team developed the Lifestyle integrated Functional Exercise (LiFE) program, which involves embedding balance and lower limb strength training into daily routines such as climbing stairs, stepping over objects, and moving from sitting to standing.
The LiFE program is the first in the world to investigate whether integrating exercise into everyday activities could prevent falls in frail older people.
Rather than a prescribed set of exercises conducted several times a week, participants were encouraged to complete LiFE activities, such as walking sideways or bending knees, whenever the opportunity arose during their day.
"Participants might shift their weight from foot to foot while standing at the kitchen bench, or bend their knees to close a drawer instead of bending at the waist. They can then upgrade these everyday activities as they increase their strength and balance, for example once they've mastered closing drawers with bended knees, they could bend at the knees to pick something up from the floor," Professor Clemson says.
The study recruited 317 men and women over the age of 70 living in the community who had experienced two or more falls, or one injurious fall, in the past year.
Participants were split into the LiFE group and the control group and recorded any falls over 12 months using daily calendars. Other measures such as static and dynamic balance, ankle, knee and hip strength, daily living activities, and quality of life were also measured using recognised scales.
Researchers then compared results from LiFE with a control group, who performed a structured exercise program three times a week using ankle cuff weights.
"We found a significant 31 percent reduction in the rate of falls for participants in the LiFE program compared with the control group," says Professor Clemson.
Compared with control patients, LiFE participants showed improvements in both static and dynamic balance, ankle strength, and in function and participation in daily life, suggesting that this program improves both fall risk and frailty.
"The LiFE program provides an alternative for older people at risk of falls to traditional exercise programs, and it could work better for many people," says Professor Clemson.
"LiFE gives participants more energy to do tasks, improves function during activities and enhances participation in daily life.
"In a modern world that increasingly relies on automation and doing less, the LiFE program offers some much-needed challenge and complexity."
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