Balancing and strengthening of the everyday activities my help older people prevent falls and improve overall strength and balance. This has been suggested by a study published in the British Medical Journal online on August 7.
Lindy Clemson and colleagues conducted a 3-group randomized trial in which residents of Sydney older than 70 years who had 2 or more falls or 1 injurious fall within the previous year. The residents were recruited and randomly assigned to one of the following interventions
- Novel activity-integrated exercise program called Lifestyle integrated Functional Exercise (LiFE)
- A structured exercise program
- A gentle exercise control program.
Following patients were excluded from study
- With moderate to severe cognitive problems
- Who could not ambulate without help
- Neural diseases that affected gait and mobility
- Residents in a nursing home or hostel
- With unstable or terminal illness affecting ability to do exercises
In this approach movements specifically prescribed to improve balance or increase strength are embedded within everyday activities, so that the movements can be done multiple times during the day.
Rather than a prescribed set of exercises conducted several times a week, LiFE activities occur whenever the opportunity arises during the day.
The strategies to improve balance include
- Reduce base of support
- Move to limits of sway
- Shift weight from foot to foot
- Step over objects
- Turning and changing direction.
For example a prescribed activity incorporating the strategy of reducing base of support might involve a tandem stand while working at the kitchen bench, and over time could be upgraded to working while standing on one leg.
Strategies to increase strength include
- Bend your knees
- On your toes
- Up the stairs
- On your heels
- Sit to stand
- Walk sideways
- Tighten muscles”.
For example squatting instead of bending at the waist to close a drawer [Bend your knees].
The LiFE training focuses on instituting new habitual behaviours within selected situational contexts.
The structured Program
Seven exercises for balance and six for lower limb strength using ankle cuff weights and performed three times a week.
The Control Program
Two sessions comprised 12 gentle and flexibility exercises while seated, lying down, or standing.
The overall incidence of falls in the LiFE program was 1.66 per person years, compared with 1.90 in the structured program and 2.28 in the control group
At the 12-month follow-up
- Participants in the LiFE group experienced 172 falls
- Participants in the structured group experienced 193 falls
- Participants in the control group experienced 224 falls.
LiFE participants also showed improvements in balance, ankle strength, daily activity measures, and adherence rates.