1. THE DOSE RESPONSE OF AN INDIVIDUALIZED EXERCISE PROGRAM TO IMPROVE MOBILITY AND BALANCE IN COMMUNITY-DWELLING FALLERS
- Author
-
Wang, CY, Olson, SL, and Protas, EJ
- Subjects
Falls (Accidents) -- Prevention ,Aged -- Care and treatment ,Exercise therapy -- Research - Abstract
PURPOSE: The purpose of this study was to examine the dose response of an individualized exercise program to restore mobility and balance in community-dwelling elderly fallers. The exercises were directed at improving patient-specific deficits found by using the Elemental Resource Model (ERM), a human factors engineering model that targets resources below the threshold for high-level task performance. METHODS AND MATERIALS: Fifteen community dwellers, 8 females and 7 males with a mean age of 77 years, who fell at least once in the past year participated in the study. Subjects exercised with a physical therapist twice a week for 12 weeks. Subjects were tested three times, at baseline and after 6 and 12 weeks of exercise. Their high level tasks of mobility and balance were measured by functional reach (inches), 5-minute walking distance (feet), time to walk 50 feet (seconds), time to step-up 5 times (seconds), and floor transfer time (seconds). The resources measured were range of motion, strength, and balance. The exercises were directed toward improving the resources that were below previously established thresholds for high level task performance. ANALYSES AND RESULTS: Subjects who couldn't perform the floor transfer at any test session were assigned times as long as the slowest baseline time in the group. Log transformation was performed for the 50-foot walk to reduce skewness. Multivariate repeated measures ANOVA showed a significant difference among the 3 test sessions ([Alpha] [is less than] .05) for the combination of 5 variables. Repeated measures ANOVAs revealed significant differences ([Alpha] [is less than] .05) among tests for all variables except the 50-foot walk time, which might have been affected by one extreme score despite the transformation. Post hoc comparisons indicated that 5 step-ups and 5-minute walk were significantly improved after only 6 weeks of training ([Alpha] [is less than] .017). Both functional reach and floor transfer scores were significantly improved at 12 weeks ([Alpha] [is less than] .017). CONCLUSIONS: These results indicated that high level performance tasks emphasizing strength and endurance (step-ups and 5-minute walk) improved in less time than the balance measure of functional reach or the floor transfer task that requires a combination of flexibility, strength, and balance. For those subjects not able to perform a floor transfer even after the exercise program, we recommended they obtain a medical alert system if they lived alone. This study supports the use of the ERM to target specific limiting resources in a population of elderly persons at risk for falling., Wang CY, Olson SL, Protas EJ. School of Physical Therapy, Texas Woman's University, Houston. TX, [...]
- Published
- 2001