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Physical Performance Effects of Low-Intensity Exercise among Clinically Defined High-Risk EldersDeVito C.A.a · Morgan R.O.b · Duque M.c,d · Abdel-Moty E.e · Virnig B.A.c,f
aMiami Department of Veterans Affairs Medical Center (VAMC), Health Services Research and Development Center, Geriatric Research, Education, and Clinical Center (GRECC), and Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Miami, Fla.; bHouston Center for Quality of Care and Utilization Studies, Houston VAMC and Baylor College of Medicine, Houston, Tex.; cMiami Department of VAMC Health Services Research and Development Center, Miami, Fla.; Departments of dExercise and Sport Sciences, School of Education, and eIndustrial Engineering, College of Engineering, University of Miami, Coral Gables, Fla., Neurological Surgery, School of Medicine, University of Miami, and Comprehensive Pain and Rehabilitation Center, University of Miami, at South Shore Hospital and Medical Center, Miami Beach, Fla., and fDivision of Health Services Research and Policy, School of Public Health, University of Minnesota, Minneapolis, Minn., USA
Background: Falls are among the leading causes of injuries and deaths. Results from a number of studies have suggested that a community-based exercise program may be effective in improving lower body strength, although some have shown only limited improvements. However, the impact of these programs on gait and balance are equivocal. Further, studies that have specifically targeted deconditioned elderly individuals, rather than individuals drawn from the general community, either showed limited or no improvements in gait and balance. Objective: This study examined the effectiveness of a community-based, short-term, low-intensity exercise intervention strategy on measures of mobility skills, gait and balance, and muscle strength for a clinically targeted group of elderly individuals at high risk of falls. Methods: 245 men and women aged 60 years or older were randomized into either an intervention or control group and received a baseline (T1) assessment. Subjects in the intervention group received up to 24 sessions (45 min long) of low-intensity standard exercise modalities tailored to the individual patient over an 8- to 10-week period. At the conclusion of the program, the participants in the intervention group were instructed to continue performing the exercises at home until 1 year after T1. Measures of physical function and performance were collected for all subjects at three different points of study enrollment. Results: Of the subjects assessed at baseline, 138 (56%) also had a postintervention assessment (T2), 128 (52%) had a 6-month follow-up assessment (T3), and 105 subjects had assessments at all time points. Primary analyses were based on the 105 subjects who had assessments at all time points. Intervention and control subjects did not differ in any of the physical function or performance measures at baseline. Between T1 and T2, the intervention subjects showed significantly greater improvement than the control subjects on all outcomes, with improvements plateauing for most measures between T2 and T3. Gait and balance scores continued to improve throughout the study period for both groups of subjects. Conclusions: This easily implemented, low-intensity exercise program may lead to improvements in physical functioning that are retained over the long term and effectively targets a clinically defined population of deconditioned elders at high risk of falling and sustaining serious injury.
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