Original articleEffects of Exercise Programs on Falls and Mobility in Frail and Pre-Frail Older Adults: A Multicenter Randomized Controlled Trial
Section snippets
Design
The study was carried out in 15 long-term care centers in Amsterdam, the Netherlands, and its vicinity. In these centers, people live in self-care and in nursing care residences. In self-care residences, people live independently but have access to on-site nursing care, dining, and recreational facilities. In nursing care residences, people live less independently, with care up to full nursing care. We designed the study as a multicenter, randomized, single-blind, controlled trial, with 2
Participants
The mean age of the participants who entered the trial was 84.9 years (range, 63–98y); 188 (79.0%) were women. On average 64 minutes a day were spent on habitual physical activity, mainly in the form of light household work that accounted for 47 minutes of activity per day. The number of persons active in some form of sports-like activity was 150 (63.3%) and on average this accounted for 13 minutes of physical activity per day. Examples of frequently reported activities were walking,
Discussion
The FW and IB exercise programs were effective in reducing fall risk and improving the scores on the POMA and the physical performance score in the subgroup of pre-frail elderly. In this subgroup small, but significant, beneficial effects were found for the physical performance measures, whereas the effect on fall risk reduction was more pronounced. Fall risk was not reduced immediately after the start of the intervention, but positive effects became apparent after 11 weeks of exercise. In the
Conclusions
Elderly people can reduce their risk of falling by participating in moderate intensity group-exercise programs. However, this beneficial effect is limited to those who are not yet frail. For frail elderly, the currently evaluated exercise programs may even increase the risk of falling. We therefore recommend including group-exercise programs as part of a fall-preventive intervention for nonfrail and pre-frail elderly only. For frail elderly, safety-enhancing interventions such as the use of hip
Acknowledgments
We thank Anna Paauw and Lyda ter Hofstede for their efforts in collecting the data and Ton Duijvestijn and Aschwin Kolman for their contribution in developing the exercise programs. We also thank Klaas Faber for his critical reading of the manuscript.
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Supported by Vrije Universiteit, Amsterdam.
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