Fall prevention exercise programs

Physical therapist researchers at Cal State University Northridge performed a study to determine the effectiveness of a balance exercise training program on strength, balance, gait, and fall risk in 23 healthy community-dwelling older adults at risk for falls. Subjects were randomly assigned to an exercise group or non-exercising control group. The exercise group performed a small group-based balance program, “A Matter of Balance” for 12 weeks, three times a week in a class setting at the PT department.

According to the authors, the exercises included balance exercises standing on foam surfaces and balance boards, as well as squats with an exercise ball. Interestingly, there was no resistive strengthening component in their description of the exercise program, although the original “A Matter of Balance” program developed at Boston University  did use Thera-Band® resistive bands.

After the training program, the exercise group significantly improved lower extremity strength, improved their balance and functional mobility, and reduced their incidence of falls compared to the control group. The results of this program are promising, but more research is needed on larger sample sizes, as well as a cost-benefit analysis.

Simple balance training devices such as Thera-Band® Stability Trainers, balance boards, and exercise balls can be helpful at reducing falls and improving function in older adults.

Visit the Fall Prevention Center at Thera-Band Academy

 Beling J, Roller M. Multifactorial intervention with balance training as a core component among fall-prone older adults. J Geriatr Phys Ther. 2009;32(3):125-33.

Recent recommendations from the Centers for Disease Control (CDC) and American College of Sports Medicine include strengthening exercises for older adults at least twice a week. Strength training can improve muscular strength, power and endurance in older adults. In addition, strength training can increase bone mass or decrease bone mass loss which is particularly important in women with osteoporosis. Falls in osteoporotic women in particular often lead to fractures of the hip, back, and arm.

Researchers in Germany set out to determine if a well-rounded exercise program that included Thera-Band® resistance bands would be effective at increasing bone density, decreasing falls, and improving cardiovascular risk factors in older women. In the study, published in the Archives of Internal Medicine, 246 women over 65 years old were randomly assigned to either a high-intensity/low volume “well-rounded” exercise program, or a low-intensity “wellness” exercise control group. The 18 month exercise program included 2 group sessions per week and 2 home-based sessions per week.

The well-rounded exercise group protocol included cardiovascular warm-up exercises, upper body strengthening exercise using Thera-Band bands, unilateral lower extremity weight-bearing exercises, stretching, and balance exercises. The control group performed low-level cardiorespiratory exercises and a variety of activities designed not to cause physical adaptations.

At the end of the 1 ½ year exercise program, the strengthening group using Thera-Band bands significantly improved in bone density compared to the control group. They also experienced 50% fewer falls than the control group. Both groups improved their cardiovascular disease risk factors, but the well-rounded exercise group reduced their risk nearly twice as much as the control group. Interestingly, there was no significant difference in costs for either program, although the healthcare costs per participant was higher in the control group.

Reference: Kemmler W, et al. Exercise effects on bone mineral density, falls, coronary risk factors, and health care costs in older women: the randomized controlled senior fitness and prevention (SEFIP) study. Arch Intern Med. 2010 Jan 25;170(2):179-85.

Disclaimer: Thera-Band Academy supplied the bands for the study, but did not provide any financial support.

Thera-Band Ankle Plantarflexion

After 6 weeks, the researchers found significant increases in ankle strength (dorsiflexion and plantarflexion), as well as significant increases in functional mobility and balance. The gain in ankle strength was significantly associated with improvement in dynamic balance. There was no significant change in the control group. The researchers concluded, the low cost strength training program may provide a ”modest degree of protection from injurious falls among these institutionalized older adults.”

Riberio et al. Impact of low cost strength training of dorsi- and plantar flexors on balance and functional mobility in institutionalized elderly people.Geriatr Gerontol Int. 2009 Mar;9(1):75-80.