NASHVILLE, TENN. – Practicing postural and strength exercises twice a week leads to significant increases in balance and overall activity among the frail elderly, Sue Scott said in a poster presented at the annual meeting of the American College of Sports Medicine.
The fear of a disabling fall causes many older people to severely restrict their activity levels, said Ms. Scott, an exercise specialist in Portland, Ore. The fear is especially intense in those who have already experienced a fall.
“Reductions in activity levels are common, causing greater declines in physical and social activities and activities of daily living,” she told this newspaper.
However, published research– including her own 40-week randomized study–indicates that balance can improve with even a modest amount of gentle exercise. “About halfway through our study, we were already seeing changes in balance, without a commensurate increase in strength,” she said.
Ms. Scott enrolled 84 participants aged 70 years and older, who were all living in retirement or assisted living communities. The oldest participant was aged 100 years; the mean age was 83 years. About 80% of the participants were female.
The 45-participant intervention group attended twice-weekly sessions for 16 weeks; one session included a 45-minute class of flexibility, balance, and strength training, and the other was a 30-minute practice session. From weeks 17 to 40, the intervention group was asked (but not required) to practice the exercises they had learned.
The control group (30 participants) had no contact with the class leaders and was given no instruction to exercise.
Participants of both groups were evaluated at baseline and at weeks 16, 33, and 42.
Ms. Scott began each class with a set of stretching exercises to promote flexibility, followed by simple strength-building moves involving legs, back, and posture. She devoted the rest of the session to balance training. “A lot of what we did was try to get them to use their other senses to promote balance,” Ms. Scott said.
“Most of these people rely heavily on visual clues, but they can't see what's going on under their feet,” Ms. Scott said. To promote balance perception with the inner ear, for example, she dimmed the room and asked participants to walk slowly on a treadmill, or bend over and pick up a lit flashlight.
At the study's end, the intervention group scored significantly better than the control group on all measures: chair stand (lower body strength), functional reach (balance), gait speed, and 8-foot up and go (mobility, agility, and strength).
Additionally, Ms. Scott said, the intervention group showed significantly increased daily activity, as measured by 1-week activity recall questionnaires. “I think they felt better about their balance and more like doing things because the activities were not as anxiety producing. Also, since we encouraged them to be more active, they might have had increased motivation to go out and do things,” she said.
Information about the exercises are available on Ms. Scott's Web site, www.ablebodies.org
In addition to improved balance, participants might have felt less anxiety about doing things after the intervention. Courtesy Sue Scott