title: The effect of strength and endurance training on gait, balance, fall risk, and health services use in community-living older adults.
abstract: 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.
authors.affiliation: Department of Health Services, University of Washington, Seattle, USA. buchner@u.washington.edu
authors.forename: D M
authors.initials: DM
authors.lastname: Buchner
authors.forename: M E
authors.initials: ME
authors.lastname: Cress
authors.forename: B J
authors.initials: BJ
authors.lastname: de Lateur
authors.forename: P C
authors.initials: PC
authors.lastname: Esselman
authors.forename: A J
authors.initials: AJ
authors.lastname: Margherita
authors.forename: R
authors.initials: R
authors.lastname: Price
authors.forename: E H
authors.initials: EH
authors.lastname: Wagner
mesh_terms: 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