Effects of home exercises and group training on functional abilities in home-dwelling older persons with mobility and balance problems. A randomized study.
OBJECTIVE
Exercise in older people may reduce falls and improve functional abilities. Less is known about the optimal amount of training. The aim of this study was to determine the effectiveness of home training, and whether group training in addition to home training enhances the effect.


METHODS
This randomized trial included 77 persons aged 75 years and older (mean 81, SD 4.5), living at home. Home training (HT) comprised twice-daily functional balance and strength exercises and 3 group meetings. Combined training (CT) included group training twice weekly and the same home exercises. The trial lasted 12 weeks. Physical therapists ran both programs. Exercises and falls were recorded daily. We assessed function at baseline, 3 and 9 months, and falls at one year.


RESULTS
Mean participation for group meetings was 2.5 out of 3 (HT group) and, for group training sessions, 21 out of 24 (CT group). The mean numbers of daily home sessions were 1.29 and 1.35 in the HT and CT groups. Overall improvement, but no group differences, were found at 3 months for walking speed, Figure of Eight, Timed Up & Go, Maximum Step Length, Timed Pick-up and Sit-to-stand (p<0.02). Posturography (p=0.85) and isometric quadriceps strength (p=0.26) showed no improvement. Function at 9 months was equivalent to baseline level. There were no group differences in fall rate (p=0.78) or time to first fall (p=0.84).


CONCLUSIONS
Daily home training supervised by physical therapists improved functional abilities. Supplementary individualized group training gave no additional effect. The effect on function was not present 6 months after the end of the intervention.
Helbostad
Jorunn L
JL
Section of Physiotherapy Science, Institute of Public Health and Primary Health Care, University of Bergen, Bergen, Norway. jorunn.helbostad@medisin.ntnu.no
Sletvold
Olav
O
Moe-Nilssen
Rolf
R
D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015444:Exercise / Q000502:physiology*; D026241:Exercise Movement Techniques / Q000379:methods; D005260:Female; D006801:Humans; D007537:Isometric Contraction / Q000502:physiology; D007866:Leg / Q000502:physiology; D008137:Longitudinal Studies; D008297:Male; D008609:Mental Status Schedule; D009068:Movement / Q000502:physiology*; D009664:Norway; D010349:Patient Compliance / Q000706:statistics & numerical data; D004856:Postural Balance / Q000502:physiology*; D011187:Posture / Q000502:physiology; D014853:Walkers; D016138:Walking / Q000502:physiology