Long-Term Effects of Exercise on Balance and Fear of Falling in Elderly

The Maria Meiwati Widagdo(1), Claudia Bella Laurentia(2), Bagus Anggawaisna Anggawaisna Suryadiningrat(3), Teguh Kristian Perdamaian(4),


(1) Faculty of Medicine Duta Wacana Christian University
(2) Faculty or Medicine Duta Wacana Christian University
(3) Faculty or Medicine Duta Wacana Christian University
(4) Department of Public Health Faculty of Medicine Duta Wacana Christian University

Abstract

Falls is the main cause of injuries in elderly. Studies on the long-term effects of balance training are still limited. This study aimed to assess the long-term impact of a physical exercise on the balance and fear of falling in community dwelling elderly. This was a quasi-experimental study with pre-post design. The participants were older people ≥60 years with balance problems. They received a one-month physical exercise. The instruments included Functional Reach Test (FRT) to assess balance and Falls Efficacy Scale-International (FES-I) to assess fear for falling. Assessment was conducted at pre- and post-intervention and two years later. Data were analysed using Wilcoxon Signed-Rank Test and linear mixed model regression. Data of 23 participants were analysed. There were significant differences inn FRT and FES-I between pre-and post-intervention, pre-intervention and two years later. There was no significant difference in FRT and FES-I between post-intervention and two years after. There was significant improvement in the balance and fear of falling one month and two years after the program. The balance program had long-term effect that lasted at least for two years. Inclusion of the balance program in community-based health program for elderly can improve balance and prevent falls.

Keywords

elderly; exercise; falls; fear of falling; functional reach test

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References

Balasubramanian, C. K., Boyette, A. and Wludyka, P. (2015) ‘How well do functional assessments of mobility and balance discriminate fallers and recurrent fallers from non-fallers among ambulatory older adults in the community?’, Physiotherapy Canada, 67(2), pp. 184–193. doi: 10.3138/ptc.2014-19.

Bohannon, R. W., Wolfson, L. I. and White, W. B. (2017) ‘Functional Reach of Older Adults: Normative Reference Values Based on New and Published Data’, 103(4), pp. 387–391. doi: 10.1016/j.physio.2017.03.006.Functional.

Canever, J. B. et al. (2022) ‘Gender differentiated score on the Falls Efficacy Scale International (FES-I Brazil) to assess self-efficacy in falls in community-dwelling older adults’, Aging clinical and experimental research, 34, pp. 1341–1347. Available at: https://link.springer.com/article/10.1007/s40520-021-02058-9.

Chen, H. et al. (2019) ‘The effects of a home-based exercise intervention on elderly patients with knee osteoarthritis: A quasi-experimental study’, BMC Musculoskeletal Disorders. BMC Musculoskeletal Disorders, 20(1), pp. 1–11. doi: 10.1186/s12891-019-2521-4.

Duncan, P. W. et al. (1990) ‘Functional reach: A new clinical measure of balance’, Journals of Gerontology, 45(6), pp. 1–2. doi: 10.1093/geronj/45.6.M192.

El-Khoury, F. et al. (2015) ‘Effectiveness of two year balance training programme on prevention of fall induced injuries in at risk women aged 75-85 living in community: Ossébo randomised controlled trial’, BMJ (Online), 351(July). doi: 10.1136/bmj.h3830.

Falossi, F. et al. (2022) ‘Adherence to a home physical exercise program in patients with osteoporotic vertebral fractures: A retrospective observational study’, Journal of Back and Musculoskeletal Rehabilitation, 35(4), pp. 777–782. Available at: https://content.iospress.com/articles/journal-of-back-and-musculoskeletal-rehabilitation/bmr191826.

Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975) ‘“Mini-Mental State” A Practical Method for Grading the Cognitive State of Patients for the Clinician’, Journal of Psychiatric Research, 12, pp. 189–198. doi: 10.3744/snak.2003.40.2.021.

Freiberger, E. et al. (2012) ‘Long-term effects of three multicomponent exercise interventions on physical performance and fall-related psychological outcomes in community-dwelling older adults: A randomized controlled trial’, Journal of the American Geriatrics Society, 60(3), pp. 437–446. doi: 10.1111/j.1532-5415.2011.03859.x.

Fujimoto, A. et al. (2015) ‘Relationships between estimation errors and falls in healthy aged dwellers’, Gerontology, 61(2), pp. 109–115. doi: 10.1159/000363571.

Gadelha, A. B. et al. (2018) ‘Severity of sarcopenia is associated with postural balance and risk of falls in community-dwelling older women’, Experimental Aging Research. Routledge, 44(3), pp. 258–269. doi: 10.1080/0361073X.2018.1449591.

Gale, C. R., Cooper, C. and Sayer, A. A. (2016) ‘Prevalence and risk factors for falls in older men and women: The English longitudinal study of ageing’, Age and Ageing, 45(6), pp. 789–794. doi: 10.1093/ageing/afw129.

Hars, M. et al. (2014) ‘Long-Term Exercise in Older Adults: 4-Year Outcomes of Music-Based Multitask Training’, Calcified Tissue International, 95(5), pp. 393–404. doi: 10.1007/s00223-014-9907-y.

Hogervorst, E. et al. (2011) ‘Validation of two short dementia screening tests in Indonesia’, in Jacobsen, S. R. (ed.) Vascular Dementia: Risk Factors, Diagnosis and Treatment. New York: Nova Science, pp. 235–256. Available at: https://repository.lboro.ac.uk/articles/chapter/Validation_of_two_short_dementia_screening_tests_in_Indonesia/9616769.

Im, J. Y., Bang, H. S. and Seo, D. Y. (2019) ‘The effects of 12 weeks of a combined exercise program on physical function and hormonal status in elderly Korean women’, International Journal of Environmental Research and Public Health, 16(21). doi: 10.3390/ijerph16214196.

Jeon, M. Y., Gu, M. O. and Yim, J. E. (2017) ‘Comparison of Walking, Muscle Strength, Balance, and Fear of Falling Between Repeated Fall Group, One-time Fall Group, and Nonfall Group of the Elderly Receiving Home Care Service’, Asian Nursing Research. Elsevier, 11(4), pp. 290–296. doi: 10.1016/j.anr.2017.11.003.

Kim, T., Choi, S. D. and Xiong, S. (2020) ‘Epidemiology of fall and its socioeconomic risk factors in community-dwelling Korean elderly’, PLoS ONE, 15(6), pp. 6–10. doi: 10.1371/journal.pone.0234787.

Matla, J. et al. (2021) ‘The influence of the physiotherapeutic program on selected static and dynamic foot indicators and the balance of elderly women depending on the ground stability’, International Journal of Environmental Research and Public Health, 18(9). doi: 10.3390/ijerph18094660.

Meimandi, M. et al. (2021) ‘Falls Efficacy Scale and Single Item Question: Screening Accuracy for Older Adults Residing in Nursing Homes’, Clinical Gerontologist. Routledge, 44(5), pp. 544–551. doi: 10.1080/07317115.2020.1858467.

Merchant, R. A. et al. (2020) ‘Relationship Between Fear of Falling, Fear-Related Activity Restriction, Frailty, and Sarcopenia’, Journal of the American Geriatrics Society, 68(11), pp. 2602–2608. doi: 10.1111/jgs.16719.

Mohammed, R., Basha, A. S. K. and Jungade, S. (2020) ‘Influence of Age, Gender, and Body Mass Index on Balance and Mobility Performance in Indian Community-Dwelling Older People’, Physical and Occupational Therapy in Geriatrics. Taylor & Francis, 39(2), pp. 144–156. doi: 10.1080/02703181.2020.1818909.

Montero-odasso, M. and Speechley, M. (2018) ‘Falls in Cognitively Impaired Older Adults: Implications for Risk Assessment And Prevention’, Journal of the American Geriatrics Society, 66(2), pp. 367–375. Available at: https://www.researchgate.net/publication/322371527_Falls_in_Cognitively_Impaired_Older_Adults_Implications_for_Risk_Assessment_And_Prevention.

Moreland, B., Kakara, R. and Henry, A. (2020) ‘Trends in Nonfatal Falls and Fall-Related Injuries Among Adults Aged ≥65 Years — United States, 2012–2018’, MMWR. Morbidity and Mortality Weekly Report, 69(27), pp. 875–881. doi: 10.15585/mmwr.mm6927a5.

Park, J. H. et al. (2014) ‘Relationship among fear of falling, physical performance, and physical characteristics of the rural elderly’, American Journal of Physical Medicine and Rehabilitation, 93(5), pp. 379–386. doi: 10.1097/PHM.0000000000000009.

Patil, R. et al. (2015) ‘Effects of a multimodal exercise program on physical function, falls, and injuries in older women: A 2-year community-based, randomized controlled trial’, Journal of the American Geriatrics Society, 63(7), pp. 1306–1313. doi: 10.1111/jgs.13489.

Pirrie, M. et al. (2020) ‘Risk of falls and fear of falling in older adults residing in public housing in Ontario, Canada: Findings from a multisite observational study’, BMC Geriatrics. BMC Geriatrics, 20(1), pp. 1–8. doi: 10.1186/s12877-019-1399-1.

Saftari, L. N. and Kwon, O. S. (2018) ‘Ageing vision and falls: A review’, Journal of Physiological Anthropology. Journal of Physiological Anthropology, 37(1), pp. 1–14. doi: 10.1186/s40101-018-0170-1.

Sherrington, C. et al. (2011) ‘Exercise to prevent falls in older adults: an updated meta-analysis and best practice recommendations’, NSW Public Health Bulletin, 22(3–4), pp. 78–83. Available at: https://pubmed.ncbi.nlm.nih.gov/21632004/.

Suzuki, Y. et al. (2019) ‘Home exercise therapy to improve muscle strength and joint flexibility effectively treats pre-radiographic knee OA in community-dwelling elderly: a randomized controlled trial’, Clinical Rheumatology. Clinical Rheumatology, 38(1), pp. 133–141. doi: 10.1007/s10067-018-4263-3.

Thomas, E. (2020) Functional Reach Test (FRT). Available at: https://www.physio-pedia.com/Functional_Reach_Test_(FRT).

Tinetti, M. E., Richman, D. and Powell, L. (1990) ‘Falls efficacy as a measure of fear of falling’, Journals of Gerontology, 45(6), pp. 239–243. doi: 10.1093/geronj/45.6.P239.

Toronjo-Hornillo, L. et al. (2018) ‘Effects of the application of a program of adapted utilitarian judo (Jua) on the fear of falling syndrome (fof) for the health sustainability of the elderly population’, International Journal of Environmental Research and Public Health, 15(11). doi: 10.3390/ijerph15112526.

Wang, J., Liu, N. and Zhao, X. (2022) ‘Assessing the relationship between hearing impairment and falls in older adults’, Geriatric Nursing, 47, pp. 145–150. Available at: https://www.sciencedirect.com/science/article/abs/pii/S0197457222001719.

de Waroquier-Leroy, L. et al. (2014) ‘The Functional Reach Test: Strategies, performance and the influence of age’, Annals of Physical and Rehabilitation Medicine. Elsevier Masson SAS, 57(6), pp. 452–464. doi: 10.1016/j.rehab.2014.03.003.

Whipple, M. O., Hamel, A. V and Talley, K. M. C. (2019) ‘Fear of Falling Among Community-Dwelling Older Adults: A Scoping Review to Identify Effective Evidence-Based Interventions’, 39(2), pp. 612–626. doi: 10.1016/j.gerinurse.2017.08.005.Fear.

WHO (2021) Falls. Available at: https://www.who.int/news-room/fact-sheets/detail/falls.

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