Main Article Content
Balance training, Berg Balance score, Elderly, Fall risk, Mobility
Background: In terms of morbidity and mortality fall is a major concern in older population. Decrease mobility and impaired balance are the main factors that increase prevalence of fall. Balance training along with strength and cognition training has good results in improvement of balance and mobility.
Objective: The purpose of the study was to determine and compare the effects of Supervised-BRACE (Balance, Resistance, Aerobic, Cognition Exercises) versus conventional therapy on functional balance, mobility and fall risk reduction in elderly individuals with moderate fall risk.
Methodology: The study design was Randomized Control Trial and conducted at District Head Quarter Hospital Chakwal from July-Dec 2018. 40 participants were recruited through purposive sampling with inclusion criteria of either gender of age (60-80) years with Berg Balance Score (20-40). Individuals having any neurological impairment, history of fall or fracture were excluded. Participants were divided into two groups through randomization. 12 weeks of supervised training were given to S-BRACE group, 3 days/week for 8 weeks & 2 days/week from 9 to 12 weeks. Unsupervised home plan included balance and resistance exercise was guided to conventional group. The tools used in this study were Berg Balance Scale (BBS), Montreal Cognitive Assessment (MoCA), Timed Up and Go test (TUG), Activities-specific Balance Confidence (ABC), Elderly Mobility Scale (EMS) and Fullerton Advanced Balance (FAB). The data was collected at baseline after 3, 6, 9 and 12 weeks.
Results: The mean age of participants in S-BRACE and control group was 67.17±5.98 and 66.63±5.30 years respectively and 68% (n=23) were male whereas 32% (n=11) were female. The within group analysis showed that there was significant difference from baseline to 12 weeks in both groups (p< 0.01). Between group analysis showed that there was significant improvement on BBS, TUG, ABC, EMS and FAB after 12weeks (p<0.01) in S-BRACE group as compared to conventional group. Both groups showed similar improvement on MoCA (P<0.05).
Conclusion: It is concluded that supervised balance training has better outcome in mobility and reduction in fall risk as compared to home based training. Cognitive improvement was observed in both groups.
2. Flatt TJFig. A new definition of aging? 2012;3:148.
3. Harraan D. Aging: a theory based on free radical and radiation chemistry. 1955.
4. Pathy MJ, Sinclair AJ, Morley JE. Principles and practice of geriatric medicine: John Wiley & Sons; 2006.
5. Rowe JW, Kahn RLJTg. Successful aging. 1997;37(4):433-40.
6. Chelluri LJJoICM. Critical illness in the elderly: review of pathophysiology of aging and outcome of intensive care. 2001;16(3):114-27.
7. Holbrook NJ, Martin GR, Lockshin RA. Cellular aging and cell death: John Wiley & Sons; 1996.
8. Kowal P, Dowd JE. Definition of an older person. Proposed working definition of an older person in Africa for the MDS Project. World Health Organization, Geneva, doi. 2001;10(2.1):5188.9286.
9. Rubenstein LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age and ageing. 2006;35(suppl_2):ii37-ii41.
10. Ungar A, Rafanelli M, Iacomelli I, Brunetti MA, Ceccofiglio A, Tesi F, et al. Fall prevention in the elderly. Clinical Cases in mineral and bone metabolism. 2013;10(2):91.
11. Pu-Lin Y, Zhao-Hui Q, Jing S, Zhang J, Mei-Zhe X, Zheng-Lai W, et al. Prevalence and related factors of falls among the elderly in an urban community of Beijing. Biomedical and environmental sciences. 2009;22(3):179-87.
12. Zhuang J, Huang L, Wu Y, Zhang Y. The effectiveness of a combined exercise intervention on physical fitness factors related to falls in community-dwelling older adults. Clinical interventions in aging. 2014;9:131.
13. Lacroix A, Hortobagyi T, Beurskens R, Granacher U. Effects of Supervised vs. Unsupervised Training Programs on Balance and Muscle Strength in Older Adults: A Systematic Review and Meta-Analysis. Sports medicine (Auckland, NZ). 2017;47(11):2341-61.
14. Bieryla KA, Dold NM. Feasibility of Wii Fit training to improve clinical measures of balance in older adults. Clinical interventions in aging. 2013;8:775.
15. Ogaya S, Ikezoe T, Soda N, Ichihashi N. Effects of balance training using wobble boards in the elderly. The Journal of Strength & Conditioning Research. 2011;25(9):2616-22.
16. Hatch J, Gill-Body KM, Portney LG. Determinants of balance confidence in community-dwelling elderly people. Physical therapy. 2003;83(12):1072-9.
17. Dustman RE, Ruhling RO, Russell EM, Shearer DE, Bonekat HW, Shigeoka JW, et al. Aerobic exercise training and improved neuropsychological function of older individuals. Neurobiology of aging. 1984;5(1):35-42.