Meeting News

Mobility exercises can reduce fall risk for older adults

Dual-task functional power and mobility training was shown to improve muscle power, reaction time and mobility and limit multiple falls for older adults in a study presented at the 2018 ASBMR annual meeting.

“Exercise is widely promoted to reduce the risk of falls, but not all types of exercise are effective. The reason why many exercise programs are not that effective is that they are not specific to the needs of the elderly,” Robin Daly, PhD, chair in exercise and aging, Faculty of Health, School of Exercise and Nutrition Sciences at Deakin University in Australia, told Endocrine Today. “When designing programs to reduce falls risk one needs to consider the most frequent causes of falls, and there is evidence that slips and trips account for nearly two-thirds of all falls. Hence programs need to be designed that specifically target these risk factors.”

Daly and colleagues performed a 12-month cluster-randomized controlled trial with 300 residents (mean age, 77 years; 73% women) from 22 Australian retirement communities. Each community was randomly assigned to training or a control group. The intervention group participated in 45- to 60-minute high-velocity strength and mobility conditioning, together with cognitive or motor tasks, with a trainer twice a week for 6 months. There was then a 6-month maintenance period. Falls and other incidents were self-reported.

During the first 6 months of the trial, there were 89 falls among 65 participants, with those in the intervention group falling at a rate 30% lower than the control group (incidence rate ratio = 0.7; 95% CI, 0.42-1.17). The researchers noted that although this was not a statistically significant difference, a significantly lower RR for multiple falls was observed for those in the intervention group (RR = 0.3; 95% CI, 0.09-0.97).

There were 76 reported falls among 53 participants in the subsequent 6 months, but few differences were observed between the two groups. However, the researchers found that those in the intervention group, when compared with the control group, had improved muscle power (P < .05), mobility (P < .05) and reaction time (P < .05). The dual-task training also promoted better motor skills (P < .05) and cognitive speed (P < .05) in the intervention group.

Daly said results from the study did not present many surprises, but he noted a lack of adherence to the exercise programs as factor for future investigation. During the 12 months, those in the intervention group were asked to train twice per week, but only 50% did for the first 6 months and that number dropped to 40% in the next 6 months.

“We initially thought that conducting the study within retirement communities would be ideal as they represent a captive audience since they all live independently on-site at these communities (and hence don’t need to travel off-site to exercise),” Daly said. “Further research is needed to understand the key factors driving adherence and non-adherence to such exercise programs in the elderly, and how the findings from this (and other) successful studies can be successfully implemented and integrated into retirement villages or aged care facilities to ensure that the elderly maintain their functional capacity and independence. Perhaps we also need to avoid using the term ‘exercise’ and instead encourage just ‘movement’ for health and functional benefits.”– by Phil Neuffer

Reference:

Daly R, et al. Abstract 1060. Presented at: American Society for Bone and Mineral Research Annual Meeting; Sept. 28-Oct. 1, 2018; Montreal.

Disclosures: The authors report no relevant financial disclosures.

Dual-task functional power and mobility training was shown to improve muscle power, reaction time and mobility and limit multiple falls for older adults in a study presented at the 2018 ASBMR annual meeting.

“Exercise is widely promoted to reduce the risk of falls, but not all types of exercise are effective. The reason why many exercise programs are not that effective is that they are not specific to the needs of the elderly,” Robin Daly, PhD, chair in exercise and aging, Faculty of Health, School of Exercise and Nutrition Sciences at Deakin University in Australia, told Endocrine Today. “When designing programs to reduce falls risk one needs to consider the most frequent causes of falls, and there is evidence that slips and trips account for nearly two-thirds of all falls. Hence programs need to be designed that specifically target these risk factors.”

Daly and colleagues performed a 12-month cluster-randomized controlled trial with 300 residents (mean age, 77 years; 73% women) from 22 Australian retirement communities. Each community was randomly assigned to training or a control group. The intervention group participated in 45- to 60-minute high-velocity strength and mobility conditioning, together with cognitive or motor tasks, with a trainer twice a week for 6 months. There was then a 6-month maintenance period. Falls and other incidents were self-reported.

During the first 6 months of the trial, there were 89 falls among 65 participants, with those in the intervention group falling at a rate 30% lower than the control group (incidence rate ratio = 0.7; 95% CI, 0.42-1.17). The researchers noted that although this was not a statistically significant difference, a significantly lower RR for multiple falls was observed for those in the intervention group (RR = 0.3; 95% CI, 0.09-0.97).

There were 76 reported falls among 53 participants in the subsequent 6 months, but few differences were observed between the two groups. However, the researchers found that those in the intervention group, when compared with the control group, had improved muscle power (P < .05), mobility (P < .05) and reaction time (P < .05). The dual-task training also promoted better motor skills (P < .05) and cognitive speed (P < .05) in the intervention group.

Daly said results from the study did not present many surprises, but he noted a lack of adherence to the exercise programs as factor for future investigation. During the 12 months, those in the intervention group were asked to train twice per week, but only 50% did for the first 6 months and that number dropped to 40% in the next 6 months.

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“We initially thought that conducting the study within retirement communities would be ideal as they represent a captive audience since they all live independently on-site at these communities (and hence don’t need to travel off-site to exercise),” Daly said. “Further research is needed to understand the key factors driving adherence and non-adherence to such exercise programs in the elderly, and how the findings from this (and other) successful studies can be successfully implemented and integrated into retirement villages or aged care facilities to ensure that the elderly maintain their functional capacity and independence. Perhaps we also need to avoid using the term ‘exercise’ and instead encourage just ‘movement’ for health and functional benefits.”– by Phil Neuffer

Reference:

Daly R, et al. Abstract 1060. Presented at: American Society for Bone and Mineral Research Annual Meeting; Sept. 28-Oct. 1, 2018; Montreal.

Disclosures: The authors report no relevant financial disclosures.

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