Effectiveness of simple balancing training program in elderly patients with history of frequent falls

Vilai Kuptniratsaikul¹, Rungnirand Praditsuwan², Prasert Assantachai³, Teerada Ploypetch¹, Suthipol Udompunturak⁴, Julaporn Pooliam^4
1Department of Rehabilitation Medicine, ²Department of Medicine, ³Department of Preventive Medicine, ⁴Office for Research and Development, Siriraj Hospital, Mahidol University, Thailand

Objective: To study the effectiveness of simply-performed balancing exercises in fall prevention.
Design: Pre- and post-trial.
Setting: University hospital from January 2009 to May 2010.
Participants: Elderly with falls in the previous year.
Intervention: Simple balancing exercise was performed at home every day and was recorded in the booklet.
Measurements: New falling events and a battery of balancing abilities including the Timed Up and Go Test (TUGT), chair stand, functional reach, and Berg balance scale-short form were evaluated at baseline, 3-, 6-, 9-, and 12-month periods. Fear of falling and quality of life scores were assessed at baseline and 12-month periods.
Results: 146 subjects were recruited, 116 female (79.5%) with a mean age of 67.1 years. At the end of the study, 49% of participants had not fallen. All of the balancing abilities were compared between frequent and infrequent fallers and were significantly improved (P < 0.001) except for functional reach in the frequent fall group. Most subjects (72%–79%) complied well with the exercise program. However, compliance had no effect on balancing abilities. About 36.4% of participants had adverse events from exercise, of which knee pain was the top ranked. The quality of life and the fall efficacy scores increased significantly at the end of the study. Factors affecting falling were compliance with exercise (adjusted odds ratio [OR]: 2.55, 95% confidence intervals [CI]: 1.04, 6.30) and a history of falling ≥3 times in the previous year (adjusted OR: 3.76, 95% CI: 1.18, 11.98).
Conclusion: Performing simply-designed balancing exercises, at least 3 days per week, can increase balancing abilities, and decrease fall rates in the elderly with a history of previous falls. However, strategies to encourage elderly compliance may prevent falling.

Keywords: balancing training, exercise, fall prevention, frequent fall, elderly