A comparison of the effectiveness of two different exercise interventions in reducing the risk of falling in older adults in Gauteng

• Main Author: Raath, Hannah Jade
• Format: Others
• Language: en
• Published: 2016
• Online Access: http://hdl.handle.net/10539/19487

Dissertation submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree of Msc (Med) in Sport and Exercise Science. Johannesburg, 2015 === Background: The development and implementation of effective strategies to prevent falls in older adults is an urgent global health issue. Various exercise interventions have successfully reduced fall risk, but many have used non–specific exercise programmes, making it difficult to assess which physical components are responsible for the favourable outcomes. In addition, little is known on exactly how long the exercise interventions need to continue. Therefore, the aim of this study was to assess the effectiveness of two fall prevention exercise programmes; a general exercise programme and a dynamic balance and stepping exercise programme on fall risk outcomes in older adults. In addition to this, comparisons between the two programmes were made and differences between 8 weeks and 12 weeks of the intervention were determined. Methods: Thirty two participants over the age of 65 years were randomly assigned to one of two exercise intervention groups. Participants attended one hour group classes twice a week. Fall risk outcomes were measured at baseline, and after 8 and 12 weeks of the exercise intervention. Outcomes included the five times sit to stand test, timed up and go test, fall efficacy scale- International, Berg balance scale, Biodex overall stability index and the Biodex modified clinical test of sensory integration and balance. Statistical analysis included multifactorial ANOVA on log transformed data and the Mann-Whitney test for non-parametric data. Results: Although both groups showed reduction in fall risk after the exercise interventions, results indicated the dynamic balance and stepping exercise programme had more of an effect on the functional strength (five times sit to stand test) and functional balance outcomes (Berg balance scale) than the general exercise programme. Within group statistical differences were noted between 8 and 12 weeks for the dynamic balance and stepping group for the five times sit to stand test (p= 0.02) and between group differences at 12 weeks for the Berg balance scale (p= 0.04), for the same group. The general exercise group however, did perform better in the mobility outcome variable; the timed up and go test, with significant differences occurring between 8 and 12 weeks (p= 0.04). Conclusions: Both exercise groups were effective in reducing the risk of falls in the older adults. However, incorporating dynamic balance and stepping into the exercise programme was more effective in improving specifically functional strength and balance. In addition, all differences were noted between 8 and 12 weeks, thus programmes that aim at improving fall risk outcomes should be at least 12 weeks in length. Future studies should compare long term outcomes and fall rates in response to these two exercise programmes.