Physical activity programs for balance and fall prevention in elderly: A systematic review

Ewan Thomas, Giuseppe Battaglia, Antonino Patti, Jessica Brusa, Vincenza Leonardi, Antonio Palma, Marianna Bellafiore, Ewan Thomas, Giuseppe Battaglia, Antonino Patti, Jessica Brusa, Vincenza Leonardi, Antonio Palma, Marianna Bellafiore

Abstract

Background: Due to demographic changes the world's population is progressively ageing. The physiological decay of the elderly adult may lead to a reduction in the ability to balance and an increased risk of falls becoming an important issue among the elderly. In order to counteract the decay in the ability to balance, physical activity has been proven to be effective. The aim of this study is to systematically review the scientific literature in order to identify physical activity programs able to increase balance in the elderly.

Methods: This review is based on the data from Medline-NLM, Pubmed, ScienceDirect, and SPORTDiscuss and includes randomized control trials that have analyzed balance and physical activity in healthy elderly over 65 years of age during the last decade. A final number of 8 manuscripts were included in the qualitative synthesis, which comprised 200 elderly with a mean age of 75.1 ± 4.4 years. The sample size of the studies varied from 9 to 61 and the intervention periods from 8 to 32 weeks.

Results: Eight articles were considered eligible and included in the quantitative synthesis. The articles investigated the effects of resistance and aerobic exercise, balance training, T-bow© and wobble board training, aerobic step and stability ball training, adapted physical activity and Wii Fit training on balance outcomes. Balance measures of the studies showed improvements between 16% and 42% compared to baseline assessments.

Conclusions: Balance is a multifactorial quality that can be effectively increased by different exercise training means. It is fundamental to promote physical activity in the aging adult, being that a negative effect on balance performance has been seen in the no-intervention control groups.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Review and Meta-Analyses (PRISMA) flow diagram illustrating the different phases of study inclusion.

References

    1. Peters E, Pritzkuleit R, Beske F, et al. Demografischer Wandel und Krankheitshäufigkeiten. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 2010;53:417–26. 10.1007/s00103-010-1050-y.
    1. Fernandez-Arguelles EL, Rodriguez-Mansilla J, Antunez LE, et al. Effects of dancing on the risk of falling related factors of healthy older adults: a systematic review. Arch Gerontol Geriatr 2015;60:1–8. 10.1016/j.archger.2014.10.003.
    1. Owino V, Yang SY, Goldspink G. Age-related loss of skeletal muscle function and the inability to express the autocrine form of insulin-like growth factor-1 (MGF) in response to mechanical overload. FEBS Lett 2001;505:259–63.
    1. Daley MJ, Spinks WL. Exercise, mobility and aging. Sports medicine 2000;29:1–2.
    1. Zecevic AA, Salmoni AW, Speechley M, et al. Defining a fall and reasons for falling: comparisons among the views of seniors, health care providers, and the research literature. Gerontologist 2006;46:367–76. DOI 10.1093/geront/46.3.367.
    1. Kendrick D, Kumar A, Carpenter H, et al. Exercise for reducing fear of falling in older people living in the community. Cochrane Database Syst Rev 2014;11:CD00984810.1002/14651858.CD009848.pub2.
    1. Orimo H, Ito H, Suzuki T, et al. Reviewing the definition of “elderly”. Geriatr Gerontol Int 2006;6:149–58. 10.1111/j.1447-0594.2006.00341.x.
    1. Gillespie LD, Gillespie WJ, Robertson MC, et al. Interventions for preventing falls in elderly people. Cochrane Database Syst Rev 2003;4:CD00034010.1002/14651858.CD000340.
    1. Inouye SK, Studenski S, Tinetti ME, et al. Geriatric syndromes: clinical, research, and policy implications of a core geriatric concept. J Am Geriatr Soc 2007;55:780–91. 10.1111/j.1532-5415.2007.01156.x.
    1. Woollacott M, Shumway-Cook A. Attention and the control of posture and gait: a review of an emerging area of research. Gait Posture 2002;16:1–4.
    1. Thomas E, Martines F, Bianco A, et al. Decreased postural control in people with moderate hearing loss. Medicine 2018;97:e024410.1097/MD.0000000000010244.
    1. Sherrington C, Whitney JC, Lord SR, et al. Effective exercise for the prevention of falls: a systematic review and meta-analysis. J Am Geriatr Soc 2008;56:2234–43. 10.1111/j.1532-5415.2008.02014.x.
    1. Gine-Garriga M, Roque-Figuls M, Coll-Planas L, et al. Physical exercise interventions for improving performance-based measures of physical function in community-dwelling, frail older adults: a systematic review and meta-analysis. Arch Phys Med Rehabil 2014;95:753–69. e753.10.1016/j.apmr.2013.11.007.
    1. Gobbo S, Bergamin M, Sieverdes JC, et al. Effects of exercise on dual-task ability and balance in older adults: a systematic review. Arch Gerontol Geriatr 2014;58:177–87. 10.1016/j.archger.2013.10.001.
    1. Bembom O, van der Laan M, Haight T, et al. Leisure-time physical activity and all-cause mortality in an elderly cohort. Epidemiology 2009;20:424–30. 10.1097/EDE.0b013e31819e3f28.
    1. Gillespie LD, Robertson MC, Gillespie WJ, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev 2012;9:CD00714610.1002/14651858.CD007146.pub3.
    1. Bellafiore M, Battaglia G, Bianco A, et al. Improved postural control after dynamic balance training in older overweight women. Aging Clin Exp Res 2011;23:378–85. 10.3275/7354.
    1. Battaglia G, Bellafiore M, Bianco A, et al. Effects of a dynamic balance training protocol on podalic support in older women. Pilot Study. Aging Clin Exp Res 2010;22:406–11. 10.3275/6713.
    1. Melzer I, Benjuya N, Kaplanski J. Postural stability in the elderly: a comparison between fallers and non-fallers. Age Ageing 2004;33:602–7. 10.1093/ageing/afh218.
    1. Muir SW, Berg K, Chesworth BM, et al. Modifiable risk factors identify people who transition from non-fallers to fallers in community-dwelling older adults: a prospective study. Physiother Can 2010;62:358–67. 10.3138/physio.62.4.358.
    1. Rao SS. Prevention of falls in older patients. Am Fam Physician 2005;72:81–8.
    1. Bird ML, Fell J. Positive long-term effects of Pilates exercise on the aged-related decline in balance and strength in older, community-dwelling men and women. J Aging Phys Act 2014;22:342–7. 10.1123/japa.2013-0006.
    1. Donath L, Faude O, Roth R, et al. Effects of stair-climbing on balance, gait, strength, resting heart rate, and submaximal endurance in healthy seniors. Scand J Med Sci Sports 2014;24:e93–101. 10.1111/sms.12113.
    1. Granacher U, Muehlbauer T, Bridenbaugh SA, et al. Effects of a salsa dance training on balance and strength performance in older adults. Gerontology 2012;58:305–12. 10.1159/000334814.
    1. Yang F, King GA, Dillon L, et al. Controlled whole-body vibration training reduces risk of falls among community-dwelling older adults. J Biomech 2015;48:3206–12. 10.1016/j.jbiomech.2015.06.029.
    1. Bianco A, Patti A, Bellafiore M, et al. Group fitness activities for the elderly: an innovative approach to reduce falls and injuries. Aging Clin Exp Res 2014;26:147–52. 10.1007/s40520-013-0144-4.
    1. Patti A, Bianco A, Karsten B, et al. The effects of physical training without equipment on pain perception and balance in the elderly: a randomized controlled trial. Work 2017;57:23–30. 10.3233/WOR-172539.
    1. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009;6:e100009710.1371/journal.pmed.1000097.
    1. Ansai JH, Aurichio TR, Goncalves R, et al. Effects of two physical exercise protocols on physical performance related to falls in the oldest old: a randomized controlled trial. Geriatr Gerontol Int 2016;16:492–9. 10.1111/ggi.12497.
    1. Sousa N, Mendes R, Silva A, et al. Combined exercise is more effective than aerobic exercise in the improvement of fall risk factors: a randomized controlled trial in community-dwelling older men. Clin Rehabil 2017;31:478–86. 10.1177/0269215516655857.
    1. Leiros-Rodriguez R, Garcia-Soidan JL. Balance training in elderly women using public parks. J Women Aging 2014;26:207–18. 10.1080/08952841.2014.888220.
    1. Zhao Y, Chung PK, Tong TK. Effectiveness of a balance-focused exercise program for enhancing functional fitness of older adults at risk of falling: a randomised controlled trial. Geriatr Nurs 2017;38:491–7. 10.1016/j.gerinurse.2017.02.011.
    1. Chulvi-Medrano I, Colado JC, Pablos C, et al. A lower-limb training program to improve balance in healthy elderly women using the T-bow device. Phys Sportsmed 2009;37:127–35. 10.3810/psm.2009.06.1719.
    1. Ogaya S, Ikezoe T, Soda N, et al. Effects of balance training using wobble boards in the elderly. J Strength Cond Res 2011;25:2616–22. 10.1519/JSC.0b013e31820019cf.
    1. Dunsky A, Yahalom T, Arnon M, et al. The use of step aerobics and the stability ball to improve balance and quality of life in community-dwelling older adults - a randomized exploratory study. Arch Gerontol Geriatr 2017;71:66–74. 10.1016/j.archger.2017.03.003.
    1. Toulotte C, Toursel C, Olivier N. Wii Fit® training vs. Adapted physical activities: which one is the most appropriate to improve the balance of independent senior subjects? A randomized controlled study. Clin Rehabil 2012;26:827–35. 10.1177/0269215511434996.
    1. Marques EA, Figueiredo P, Harris TB, et al. Are resistance and aerobic exercise training equally effective at improving knee muscle strength and balance in older women? Arch Gerontol Geriatr 2017;68:106–12. 10.1016/j.archger.2016.10.002.
    1. Lacroix A, Kressig RW, Muehlbauer T, et al. Effects of a supervised versus an unsupervised combined balance and strength training program on balance and muscle power in healthy older adults: a randomized controlled trial. Gerontology 2016;62:275–88. 10.1159/000442087.
    1. Lee IH, Park SY. Balance improvement by strength training for the elderly. J Phys Ther Sci 2013;25:1591–3. 10.1589/jpts.25.1591.
    1. Rubenstein LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing 2006;35Suppl 2:ii37–41. 10.1093/ageing/afl084.
    1. Xu D, Hong Y, Li J, et al. Effect of tai chi exercise on proprioception of ankle and knee joints in old people. Br J Sports Med 2004;38:50–4.
    1. Barnett A, Smith B, Lord SR, et al. Community-based group exercise improves balance and reduces falls in at-risk older people: a randomised controlled trial. Age Ageing 2003;32:407–14.
    1. Liu H, Frank A. Tai chi as a balance improvement exercise for older adults: a systematic review. Arch Gerontol Geriatr 2010;33:103–9.
    1. Maciaszek J, Osinski W. The effects of Tai Chi on body balance in elderly people--a review of studies from the early 21st century. Am J Chin Med 2010;38:219–29. 10.1142/S0192415X10007798.
    1. Leung DP, Chan CK, Tsang HW, et al. Tai chi as an intervention to improve balance and reduce falls in older adults: a systematic and meta-analytical review. Altern Ther Health Med 2011;17:40–8.
    1. Herold F, Orlowski K, Bormel S, et al. Cortical activation during balancing on a balance board. Hum Mov Sci 2017;51:51–8. 10.1016/j.humov.2016.11.002.
    1. Bieryla KA. Xbox Kinect training to improve clinical measures of balance in older adults: a pilot study. Aging Clin Exp Res 2016;28:451–7. 10.1007/s40520-015-0452-y.
    1. Fisher JP, Steele J, Gentil P, et al. A minimal dose approach to resistance training for the older adult; the prophylactic for aging. Exp Gerontol 2017;99:80–6. 10.1016/j.exger.2017.09.012.
    1. Souza D, Barbalho M, Vieira CA, et al. Minimal dose resistance training with elastic tubes promotes functional and cardiovascular benefits to older women. Exp Gerontol 2019;115:132–8. 10.1016/j.exger.2018.12.001.
    1. Barbalho MSM, Gentil P, Izquierdo M, et al. There are no no-responders to low or high resistance training volumes among older women. Exp Gerontol 2017;99:18–26. 10.1016/j.exger.2017.09.003.
    1. Simonsick EM, Lafferty ME, Phillips CL, et al. Risk due to inactivity in physically capable older adults. Am J Public Health 1993;83:1443–50.
    1. Knight JA. Physical inactivity: associated diseases and disorders. Ann Clin Lab Sci 2012;42:320–37.
    1. Taylor D. Physical activity is medicine for older adults. Postgrad Med J 1059;90:26–32. 10.1136/postgradmedj-2012-131366.

Source: PubMed

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