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Table of Contents
Vol. 52, No. 3, 2006
Issue release date: April 2006
Section title: Experimental Section
Gerontology 2006;52:131–141
(DOI:10.1159/000091822)

A Five-Week Exercise Program Can Reduce Falls and Improve Obstacle Avoidance in the Elderly

Weerdesteyn V. · Rijken H. · Geurts A.C.H. · Smits-Engelsman B.C.M. · Mulder T. · Duysens J.
aSint-Maartenskliniek Research, Development and Education, Nijmegen; bInstitute for Fundamental and Clinical Human Movement Sciences, Faculty of Human Movement Sciences, Vrije Universiteit, Amsterdam; cDepartment of Rehabilitation Medicine, University Medical Centre St. Radboud, Nijmegen, The Netherlands; dMotor Control Laboratory, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Leuven, Belgium; eCenter for Movement Sciences, University of Groningen, Groningen, The Netherlands

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Article / Publication Details

First-Page Preview
Abstract of Experimental Section

Received: 8/8/2005
Accepted: 11/27/2005
Published online: 4/27/2006

Number of Print Pages: 11
Number of Figures: 2
Number of Tables: 3

ISSN: 0304-324X (Print)
eISSN: 1423-0003 (Online)

For additional information: http://www.karger.com/GER

Abstract

Background: Falls in the elderly are a major health problem. Although exercise programs have been shown to reduce the risk of falls, the optimal exercise components, as well as the working mechanisms that underlie the effectiveness of these programs, have not yet been established. Objective: To test whether the Nijmegen Falls Prevention Program was effective in reducing falls and improving standing balance, balance confidence, and obstacle avoidance performance in community-dwelling elderly people. Methods: A total of 113 elderly with a history of falls participated in this study (exercise group, n = 79; control group, n = 28; dropouts before randomization, n = 6). Exercise sessions were held twice weekly for 5 weeks. Pre- and post-intervention fall monitoring and quantitative motor control assessments were performed. The outcome measures were the number of falls, standing balance and obstacle avoidance performance, and balance confidence scores. Results: The number of falls in the exercise group decreased by 46% (incidence rate ratio (IRR) 0.54, 95% confidence interval (CI) 0.36–0.79) compared to the number of falls during the baseline period and by 46% (IRR 0.54, 95% CI 0.34–0.86) compared to the control group. Obstacle avoidance success rates improved significantly more in the exercise group (on average 12%) compared to the control group (on average 6%). Quiet stance and weight-shifting measures did not show significant effects of exercise. The exercise group also had a 6% increase of balance confidence scores. Conclusion: The Nijmegen Falls Prevention Program was effective in reducing the incidence of falls in otherwise healthy elderly. There was no evidence of improved control of posture as a mechanism underlying this result. In contrast, an obstacle avoidance task indicated that subjects improved their performance. Laboratory obstacle avoidance tests may therefore be better instruments to evaluate future fall prevention studies than posturographic balance assessments.


Article / Publication Details

First-Page Preview
Abstract of Experimental Section

Received: 8/8/2005
Accepted: 11/27/2005
Published online: 4/27/2006

Number of Print Pages: 11
Number of Figures: 2
Number of Tables: 3

ISSN: 0304-324X (Print)
eISSN: 1423-0003 (Online)

For additional information: http://www.karger.com/GER


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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