Two years later: a prospective long-term follow-up of a training intervention in geriatric patients with a history of severe falls.
OBJECTIVE
To study the long-term outcome of a physical training regimen of ambulant postward rehabilitation in community-dwelling geriatric patients with a history of injurious falls.


METHODS
Prospective 2-year follow-up of a randomized placebo-controlled intervention trial.


METHODS
Postward rehabilitation in a geriatric hospital in Germany.


METHODS
Fifty-seven geriatric patients (mean age, 84.3+/-4.4 y) with a history of severe falls.


METHODS
Ambulatory training of strength, functional performance, and balance 3 times a week for 3 months for 31 patients versus placebo activities for 26 patients.


METHODS
Strength, functional performance, fall-related psychologic parameters, and physical activity assessed by standardized protocols 2 years after the training intervention, compared with baseline results.


RESULTS
Motor performance decreased substantially in both groups. As patients in the intervention group declined from significantly improved motor performance levels achieved in the initial training intervention, differences between the groups were still significant in most functional performances 2 years later. Functional decline was greater in persons who were institutionalized or being cared for by family members. Physical activity, which increased during the exercise intervention, returned to low baseline levels.


CONCLUSIONS
Improved functional performance in the training group did not lead to an increased level of physical activity after training, which might have preserved the functional improvements. In mobility-restricted, frail, geriatric patients such as our study population, training programs should continue to keep patients active and to prevent the decline in strength and functional performance that precedes loss of autonomy.
Bethanien Krankenhaus, Geriatrisches Zentrum an der Universität Heidelberg, Germany. klhauer@web.de
Klaus
K
Hauer
Mathias
M
Pfisterer
Mattias
M
Schuler
Peter
P
Bärtsch
Peter
P
Oster
D000058:Accidental Falls / Q000517:prevention & control*; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D016330:Frail Elderly; D015577:Geriatric Assessment; D006299:Health Services for the Aged / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D005082:Physical Exertion; D004856:Postural Balance / Q000502:physiology; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome