Effect of long-term, community-based daily exercise on the ability to control the dynamic standing balance of Japanese elderly persons in relation to falls

Impact of a public open-access community-based physical activity and fall prevention program on physical performance in older adults

BACKGROUND

In older adults, physical activity (PA) is important in maintaining physical performance. Data on the effectiveness of public open-access community-based programs on physical performance and fall prevention are scarce.

METHODS

Prospective observational controlled study in community centers providing an open-access public prevention program. Retirees aged ≥60 years who chose to participate in weekly PA workshops for 3 months were compared to those who chose the cognitive stimulation (CS) workshops. Collected data: handgrip strength, five times sit-to-stand, single-leg stance, Timed Up and Go tests, gait speed, short physical performance battery (SPPB) and frailty status at baseline (M0) and at 3 months (M3). The proportion of participants reporting a history of falls was assessed at baseline and using follow-up telephone interviews (F-Up).

RESULTS

Two hundred eighty-eight participants (age 73.8 years, 87% women) were included. The sit-to-stand test, single-leg stance and SPPB scores improved significantly between M0 and M3 in both groups. A greater SPPB increase was observed in the PA than in the CS group (+0.39 vs. +0.32 points, P = 0.02) after adjustment for age, sex, number of sessions attended, fall history and SPPB at baseline. During F-Up (median 22 months), the proportion of participants reporting at least one fall decreased from 55% to 31% (P = 0.01) in the PA group and from 27% to 19% (P = 0.12) in the CS group.

CONCLUSION

In a public open-access community-based program participants improved physical performance and reduced fall incidence when participating in the PA or the CS workshops. Older adults may benefit most from multifaceted prevention programs.

Decline of Hip Joint Movement Relates to Overestimation of Maximum Forward Reach in Elderly Persons

The authors aimed to characterize age-related changes in the performance of maximum reach and identify kinematic parameters that explain the age-related discrepancy between perceived and actual maximum reach distance. Maximum reach was evaluated in 22 younger women (21.3 years old) and 20 older women (81.2 years old). Both the perceived and actual maximum forward reach and forward excursion of the center of pressure was shorter in older women. Older women also overestimated their maximum reach distance to a greater extent. Decline of movement at the hip joint specifically correlated with both the maximum distance and the overestimation. Based on these results, decline of hip control may be a primary factor for the age-related retardation of perceived and actual maximum reach.

A four-week walking exercise programme in patients with knee osteoarthritis improves the ability of dual-task performance: a randomized controlled trial

Objective: To investigate whether a four-week walking exercise programme in patients with knee osteoarthritis improves the ability of dual-task performance in older adults with knee osteoarthritis.

Design: A randomized controlled trial with two groups: a walking group and a control group.

Subjects: Forty older adults with knee osteoarthritis, 20 participants in each group.

Intervention: The walking intervention was designed to increase the number of steps walked daily. The walking group was instructed to increase their number of steps to 3000 steps more than before the intervention.

Main outcome measures: Dual-task performance was computed by an automaticity index: the walking velocity under single-task condition/under dual-task conditions × 100 (%), defined as automaticity. The nearer to 100% automaticity, the better the dual-task performance. Decrease of the Trail Making Test (TMT) performance was defined as ΔTMT. ΔTMT was calculated as the difference between times (part B–part A) as a measure of executive function. In addition, functional ability was measured by the Japanese Knee Osteoarthritis Measure.

Results: The walking group improved significantly in automaticity ( P < 0.001, from 75.2 (7.6) to 86.9 (10.4), ΔTMT ( P < 0.001, from 63.4 (43.1) to 48.3 (29.6)) and Japanese Knee Osteoarthritis Measure score ( P < 0.001, from 54.4 to 51.9) compared with before the intervention, while the control group displayed no significant differences.

Conclusions: We found that walking exercise improves executive function and dual-task performance.