The effect of multidimensional exercises on balance, mobility, and fall risk in community-dwelling older adults.
OBJECTIVE
This prospective clinical investigation examined the effects of a multidimensional exercise program on balance, mobility, and risk for falls in community-dwelling older adults with a history of falling. Factors used to predict adherence and a successful response to exercise were identified.


METHODS
A total of 105 community-dwelling older adults (> or = 65 years of age) with a history of two or more falls in the previous 6 months (no neurologic diagnosis) participated. They were classified into (1) a control group of fallers (n = 21), (2) a fully adherent exercise group (n = 52), and (3) a partially adherent exercise group (n = 32).


METHODS
Following evaluation, each patient received an individualized exercise program addressing the impairments and functional disabilities identified during the assessment. The control group received no intervention. Changes in performance on five clinical tests of balance and mobility and fall risk were compared among groups.


RESULTS
Both exercise groups scored better than the control group on all measures of balance and mobility. Although both exercise groups showed a reduction in fall risk compared with the control group, the greatest reduction was found in the fully adherent exercise group. Factors associated with successful response to exercise included degree of adherence to exercise program and pretest score on the Tinetti Mobility Assessment.


CONCLUSIONS
Exercise can improve balance and mobility function and reduce the likelihood for falls among community-dwelling older adults with a history of falling. The amount of exercise needed to achieve these results, however, could not be determined from this study.
Shumway-Cook
A
A
Department of Physical Therapy, Northwest Hospital, Seattle, WA 96133, USA. ashumway@nwhsea.org
Gruber
W
W
Baldwin
M
M
Liao
S
S
D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D015444:Exercise / Q000502:physiology*; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D010349:Patient Compliance; D004856:Postural Balance; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012306:Risk