The effect of strength and endurance training on gait, balance, fall risk, and health services use in community-living older adults.
BACKGROUND
The study tested the effect of strength and endurance training on gait, balance, physical health status, fall risk, and health services use in older adults.


METHODS
The study was a single-blinded, randomized controlled trial with intention-to-treat analysis. Adults (n = 105) age 68-85 with at least mild deficits in strength and balance were selected from a random sample of enrollees in a health maintenance organization. The intervention was supervised exercise (1-h sessions, three per week, for 24-26 weeks), followed by self-supervised exercise. Exercise groups included strength training using weight machines (n = 25), endurance training using bicycles (n = 25), and strength and endurance training (n = 25). Study outcomes included gait tests, balance tests, physical health status measures, self-reported falls (up to 25 months of follow-up), and inpatient and outpatient use and costs.


RESULTS
There were no effects of exercise on gait, balance, or physical health status. Exercise had a protective effect on risk of falling (relative hazard = .53, 95% CI = .30-.91). Between 7 and 18 months after randomization, control subjects had more outpatient clinic visits (p < .06) and were more likely to sustain hospital costs over $5000 (p < .05).


CONCLUSIONS
Exercise may have beneficial effects on fall rates and health care use in some subgroups of older adults. In community-living adults with mainly mild impairments in gait, balance, and physical health status, short-term exercise may not have a restorative effect on these impairments.
Buchner
D M
DM
Department of Health Services, University of Washington, Seattle, USA. buchner@u.washington.edu
Cress
M E
ME
de Lateur
B J
BJ
Esselman
P C
PC
Margherita
A J
AJ
Price
R
R
Wagner
E H
EH
D000058:Accidental Falls; D000332:Aerobiosis; D000368:Aged; D000375:Aging / Q000502:physiology; D003154:Community Medicine / Q000379:methods; D015444:Exercise; D005260:Female; D005684:Gait; D017048:Health Care Costs; D006296:Health Services / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D008297:Male; D010806:Physical Education and Training; D010807:Physical Endurance; D004856:Postural Balance; D012307:Risk Factors