Exercise intervention, falls, and older adults

http://www.ncbi.nlm.nih.gov/pubmed/22324753

J Am Geriatr Soc. 2012 Feb 10. doi: 10.1111/j.1532-5415.2011.03859.x. [Epub ahead of print]
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.
Freiberger E, Häberle L, Spirduso WW, Rixt Zijlstra GA.
Source
Institut für Sportwissenschaft und Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.

Abstract
OBJECTIVES:
To determine the long-term effects of three strength and balance exercise interventions on physical performance, fall-related psychological outcomes, and falls in older people.

DESIGN:
A single-blinded, four-group, randomized controlled trial.

SETTING:
Community, Germany.

PARTICIPANTS:
Community-dwelling adults aged 70 to 90 who had fallen in the past 6 months or reported fear of falling.

INTERVENTION:
After baseline assessment, 280 participants were randomly assigned to the control group (CG; no intervention; n = 80) or one of three strength and balance exercise interventions (the strength and balance group (SBG; strength and balance only; n = 63), the fitness group (FG; strength and balance plus endurance training; n = 64), or the multifaceted group (MG; strength and balance plus fall risk education; n = 73). The interventions consisted of 32 one-hour group sessions in 16 weeks.

MEASUREMENTS:
Data on physical performance, fall-related psychological outcomes, and falls were collected for 24 months.

RESULTS:
Mixed-effects regression analyses showed improved short- and long-term (12 and 24 months, respectively) physical performance for the SBG and FG, particularly regarding mobility, balance, and walking speed (P < .05). The improvements in physical performance outcomes were most prominent in the FG. Fall-related psychological outcomes, number of falls, and injurious falls were not significantly different from in the control group.

CONCLUSION:
Training focusing on strength, balance, and endurance can enhance physical performance for up to 24 months in community-dwelling older adults. These findings did not translate to improved fall-related psychological outcomes or reduced incidence of falls. This demonstrates the need for a different approach (e.g., regarding intervention dose and components) to gain intervention benefits in the multiple domains that contribute to independence and well-being in older adults.