Falls are significant health issues among the elderly people. Most falls in elderly are caused by abnormal balance control mechanisms. Balance and muscle force generation are directly related, and are associated with age related muscular changes. Studies addressing fall prevention have focused on various group and individualised strength training. However, there is not much evidence on strengthening of key muscles necessary for maintaining balance and postural control. This study aimed to evaluate the effectiveness of individualised progressive resistance strength training (PRT) programme in improving balance for forward limits of stability in elderly with balance impairment, compared to traditional balance exercise (TBE), and combination of both (COMBI).
This randomised controlled trial included three groups; 18 subjects in each aged ≥ 65 years, from the elderly care centres of Mangalore city in Southern India (between June 2008 and December 2012). Block randomisation technique was used and allocation concealment was done using sequentially arranged sealed opaque envelopes. The TBE group received 8 component traditional balance exercise; 4 times a week for 6 months. The PRT group was administered resistance training for the key muscles of lower extremities, using DeLormes and Watkins protocol. The COMBI group received PRT and TBE alternately (2 days of PRT and 2 days of TBE per week). Functional reach test (FRT) was used for measurement of forward limits of stability. The data was analyzed using Statistical Package for Social Sciences (SPSS) version 15. Regarding functional reach, PRT group had steady progression from baseline to 6 months (p<0.001). The TBE and COMBI groups exhibited considerable initial improvement; beyond 3 months, moderate improvement was observed. The changes in scores of FRT were significantly better for PRT than TBE.
Individualised PRT intervention targeting the key muscles of lower limbs is more effective than TBE in improving forward limits of stability among elderly people, aged ≥65 years who are not frail.