Taking balance training for older adults one step further: the rationale for and a description of a proven balance training programme (original) (raw)
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Training of Balance Under Single and Dual-Task Conditions in Older Adults With Balance Impairment
2006
Background and Purpose. Traditionally, rehabilitation programs emphasize training balance under single-task conditions to improve balance and reduce risk for falls. The purpose of this case report is to describe 3 balance training approaches in older adults with impaired balance. Case Descriptions. Three patients were randomly assigned to 1 of 3 interventions: (1) single-task balance training, (2) dual-task training under a fixed-priority instructional set, and (3) dual-task training under a variable-priority instructional set. Outcomes. The patients who received balance training under dual-task conditions showed dual-task training benefits; these training benefits were maintained for 3 months. The patient who received variable-priority training showed improvement on novel dual tasks. Discussion. Older adults may be able to improve their balance under dual-task conditions only following specific types of balance training. This case report gives insight on how this intervention might be combined with more traditional physical therapy intervention. [Silsupadol P, Siu KC, Shumway-Cook A, Woollacott MH. Training of balance under singleand dual-task conditions in older adults with balance impairment. Phys Ther. 2006;86:269 -281.] 27 Shumway-Cook A, Woollacott M, Kerns KA, Baldwin M. The effects of two types of cognitive tasks on postural stability in older adults with and without a history of falls.
Physical therapy, 2021
Objective. The purpose of this study was to compare the effects of integrated and consecutive cognitive dual-task balance training in older adults on balance, fear of falling, and gait performance. Methods. Fifty-eight participants (age >65 years) were randomly assigned to an integrated dual-task training group (IDTT) (n = 29) and consecutive dual-task training group (CDTT) (n = 29). Balance exercises and cognitive tasks were performed simultaneously by the IDTT group and consecutively by the CDTT group for 8 weeks. Balance was assessed using the Berg Balance Scale as a primary outcome measure and the Timed "Up & Go" Test (TUG) (standard-cognitive), fear of falling was assessed using the Tinetti Falls Efficacy Scale, and gait speed was assessed using the 10-Meter Walk Test (10MWT) (under single-task and dual-task conditions). All tests were performed before and after the training. Results. There was no difference in group-time interaction in the Berg Balance Scale, TUG-standard, 10MWT-single task, and 10MWT-dual task tests. Group-time interaction was different in the TUG-cognitive and Tinetti Falls Efficacy Scale scores. Also, the effect of time was significantly different in all scales except for the 10MWT-single task in both groups. Conclusion. At the end of the 8-week training period, the impact of integrated and consecutive dual-task balance training on balance and gait performance in older adults was not statistically significantly different. This study suggests that consecutive dual-task balance training can be used as an alternative method to increase balance performance and gait speed in older adults who cannot perform integrated dual-task activities. Impact. There were no significant differences between the effects of the 2 dual-task training methods on balance and gait speed, suggesting that the consecutive dual-task balance training method can be used to improve the balance and gait of older adults. CDTT can be performed safely and considered as an alternative method for use in many rehabilitation training programs with older adults who cannot perform simultaneous activities.
International Journal of Scientific Research in Science and Technology, 2020
Background and Purpose: Balance is controlled through a complex process involving sensory, visual, vestibular and cerebral functioning which get affected by various neurological disorders such as fall. The purpose of the study was to compare the efficiency of three different balance training strategies in an effort to understand the mechanisms underlying training-related changes in dual task balance performance of older adults with balance impairment. Methods: 45 older adults with balance impairment were recruited and randomly assigned to three groups. Group one received single task balance training, group two received dual task training balance training under fixed priority, group three received dual task balance training under variable priority. Subjects received one-hour individualized training sessions, five times in a week for two weeks. Berg balance scale and time up and go test were the outcome measure and their scores for all groups were taken prior and after the training. Results: One-way analysis of variance was used to analyse the difference among the balance improvement in Group one, two and three. And the results revealed that post intervention scores were highly significant (p£ 0.05) in group two and group three performed better than group one. Conclusion: In conclusion, dual task training is effective in improving balance under dual task context in older adults with balance impairment, and single task training may not generalize to balance performance under dual task conditions.
Comparison of two balance training programs on balance in community dwelling older adults
Geriatric Care, 2016
Impaired balance has been associated with an increased risk for falls and a resulting increase in the mortality rate of elder people. Thus, balance-training interventions have an important place in fall prevention. This study was designed with the purpose of identifying the appropriate balance-training program for community dwelling elderly adults with an active lifestyle. A sample of 70 elderly adults were randomly allocated into two groups: group 1 (n=35) received general balance and mobility exercise; group 2 (n=35) received specific balance strategy training. The intervention consisted of 5 sessions/week for 4 weeks. The outcome measures were <em>Timed up and go test</em> (TUGT) and <em>Berg balance scale</em> (BBS). An inter-group (2-way mixed model analysis of co-variance) and intra-group (repeated measures) analysis was done to find the change in balance scores. After the intervention, the TUGT scores in group 1 were, mean=10.38 s, standard deviation (...
Effectiveness of multi-component balance speciic training on active community-dwelling elderly
2013
Introduction: Although impaired balance function is an important risk factor for unexpected falls in the elderly there is still no agreement regarding the type and intensity of training to decrease this impairment. Purpose: The purpose of our study was to determine the eficacy of a specially developed multi-component balance-speciic exercise programme with special emphasis on training on a compliant surface to improve the balance of active elderly living in an urban environment. Methods: The training group consisted of 26 elderly, aged 69.6 ± 6.6 years. They participated in training twice a week for 12 weeks. A force platform was used to determine the movement of the body’s centre of pressure during sensory organisation tests: quiet stance on a hard and compliant surface with eyes open and closed. To evaluate functional balance skills the four square step test and timed 10 m walk tests were assessed. Results: After the training period the centre of pressure movement while standing o...
Indian Journal of Physiotherapy and Occupational Therapy - An International Journal, 2021
Background: Aging is the decline in efficiency of various physiological processes which is continuesand irreversible. The age related changes affect maintenance of balance control in steady state balance,reactive balance and anticipatory balance. The purpose of the study was to find out the effectiveness ofsingle task and dual task balance training in improving the quality of life among elderly with impairedbalance.Objectives: To compare the effectiveness of single and dual task training in improving the quality oflife of elderly with balance impairment and to compare the single and dual task balance training inelderly with impaired balanceStudy Design: Pre-post experimental study designMethod Thirty-four elderly adults with impaired balance were assigned into two groups, one groupunderwent single task training and other dual task training of about 4 weeks. Baseline measurementwere taken pre and post training by using TUG, BBS and SF-36.Results: Dual task training was more effective...
Balance Retraining in Community-Dwelling Older Adults
Topics in Geriatric Rehabilitation, 2014
To review the literature that describes effective intervention strategies to improve balance in older community-dwelling adults. Data Sources: CINAHL, PubMed, Cochrane, and Cochrane Center Register for Controlled Trial Databases. Review Methods: A search of the terms "balance and exercise," "fall risk and exercise," "fall risk and physical therapy," and "balance and rehabilitation" in Community Index to Nursing and Allied Health Literature (CINAHL) and PubMed. Interventions must be able to be reproduced in standard rehabilitation practice or at home or easily in the community recreation center. Results: The literature is robust with reports that describe the benefi ts and limitations of balance retraining exercises programs, most in combination with other objectives such as strength training, mobility improvement, functional improvement, and fall prevention within the timeframe of 2000 to 2013. Randomized controlled trial studies are becoming more evident in the literature and assist with greater generalizability; however, much more study is warranted to understand priorities of intervention selection, dosing, duration, and sensitive outcome measures. Conclusion: Multicomponent exercise programs that specifi cally address the older adult's physical impairments based on a therapist evaluation is more effective in promoting increased strength, balance, and fall prevention than general, nonspecifi c approaches. This individualized approach, whether conducted in a health care facility or at home guided specifi cally by a rehabilitation clinician, will result in more immediate gains. This may also improve the long-term compliance that is needed for long-term balance improvement, fall prevention, and maximizing physical function in older adults. Rehabilitation professionals should consider expanding their role in prevention and ongoing primary care practices that monitor the physical function of older adults on a routine basis to assist in optimal aging.
Sports medicine (Auckland, N.Z.), 2015
The effects of balance training (BT) in older adults on proxies of postural control and mobility are well documented in the literature. However, evidence-based dose-response relationships in BT modalities (i.e., training period, training frequency, training volume) have not yet been established in healthy older adults. The objectives of this systematic literature review and meta-analysis are to quantify BT intervention effects and to additionally characterize dose-response relationships of BT modalities (e.g., training period, training frequency) through the analysis of randomized controlled trials (RCTs) that could maximize improvements in balance performance in healthy community-dwelling older adults. A computerized systematic literature search was performed in the electronic databases PubMed and Web of Science from January 1985 up to January 2015 to capture all articles related to BT in healthy old community-dwelling adults. A systematic approach was used to evaluate the 345 arti...
Clinical Rehabilitation, 2013
Objectives: To evaluate the effect of a group-based functional and specific balance training programme that included dual-task exercises on balance function in healthy older adults. Design: A single-blind randomized controlled trial. Setting: General community. Participants: Sixty-six community-dwelling older adults (age 77.0 ± 6.5 years), without functional balance impairment were recruited and allocated at random to an intervention group (n = 33) or a reference group (n = 33). Intervention: The intervention group received 24 training sessions over three months that included perturbation as well as dual-task exercises. The reference group received no intervention. Outcome measures: The voluntary step execution times during single-and dual-task conditions, stabilogram-diffusion analysis in upright standing, and self-reported physical function; all were measured assessed at baseline and at the end of intervention. The intervention group was retested after six months. Results: Compared with the reference group, participation in group-based functional and specific balance training led to faster voluntary step execution times under single-task (P = 0.02; effect size (ES) = 0.34) and dual-task (P = 0.036; ES = 0.55) conditions; lower transition displacement and shorter transition time of the stabilogram-diffusion analysis under eyes-closed conditions (P = 0.007, ES = 0.30 and P = 0.08, ES = 0.44, respectively); and improved self-reported lower extremity function (P = 0.006, ES = 0.37). Effects were lost at six-month follow-up. Conclusions: Functional and specific balance training can improve voluntary stepping and balance control in healthy older non-fallers, parameters previously found to be related to increased risk of falls and injury in older adults.
The dose-response relationship of balance training in physically active older adults
Journal of aging and physical activity, 2012
A 6-wk group balance-training program was conducted with physically active older adults (based on American College of Sports Medicine requirements) to investigate the effect of dose-related static and dynamic balance-specific training. All participants, age 60-87 yr, continued their regular exercise program while adding balance training in 1 of 3 doses: three 20-min sessions/wk (n = 20), one 20-min session/wk (n = 21), or no balance training (n = 19). Static balance (single-leg-stance, tandem), dynamic balance (alternate stepping, limits of stability), and balance confidence (ABC) were assessed pre- and posttraining. Significant interactions were observed for time in single-leg stance, excursion in limits of stability, and balance confidence, with the greatest increase observed in the group that completed 3 training sessions/wk. The results demonstrate a dose-response relationship indicating that those who are already physically active can improve balance performance with the additi...