Abstract

Objective: The role of exercise in the prevention of falls and fall-related injuries among elderly persons is unclear. The objective of this study was to assess the response to an exercise-based rehabilitation program intended to improve balance and mobility and reduce or prevent falls. Design: Pretest-posttest experimental design with repeated measures at baseline, immedately postintervention, and 6 months postintervention. To assess the effect of repeated exposure to our main outcome measure (the obstacle course), half of the participants (randomly selected) were allowed to practice on the obstacle course. Setting: A veterans affairs medical center. Participants: Elderly, ambulatory, community-dwelling volunteers recruited from among local outpatients at our medical center. Intervention: Sixty-five volunteers completed a 6-week supervised low to moderate intensity program of stretching, postural control, endurance walking, and coordination exercises designed to improve balance and mobility. Participants were divided into 2 groups: 34 participants who did not practice on the obstacle course during their exercise program and 31 participants who practiced on the obstacle course in addition to their otherwise identical exercise program. Main Outcome Measures: Performance on a functionally oriented obstacle course and self-reported falls and fall-related injuries. Results: No significant performance differences were found between the two groups. After intervention, mean qualitative obstacle course scores improved modestly (5%) and mean obstacle course completion time decreased by 15% from baseline. These postintervention pairwise performance differences were clinically important but not statistically significant. Relative to baseline levels, postintervention falls and injuries did not change significantly. Conclusions: Our exercise intervention may have the potential to improve functional performance. However, some modifications are necessary to enhance efficacy. The obstacle course may be a useful tool in the evaluation of elderly persons with balance and mobility impairment in the rehabilitation setting. Verf.-Referat