title: Effectiveness of a targeted exercise intervention in reversing older people's mild balance dysfunction: a randomized controlled trial.
abstract: BACKGROUND
  Previous research has mainly targeted older people with high risk of falling. The effectiveness of exercise interventions in older people with mild levels of balance dysfunction remains unexplored.
  
  
  OBJECTIVE
  This study evaluated the effectiveness of a home balance and strength exercise intervention in older people systematically screened as having mild balance dysfunction.
  
  
  METHODS
  This was a community-based, randomized controlled trial with assessors blinded to group allocation.
  
  
  METHODS
  Study participants were older people who reported concerns about their balance but remained community ambulant (n=225). After a comprehensive balance assessment, those classified as having mild balance dysfunction (n=165) were randomized into the trial.
  
  
  METHODS
  Participants in the intervention group (n=83) received a 6-month physical therapist-prescribed balance and strength home exercise program, based on the Otago Exercise Program and the Visual Health Information Balance and Vestibular Exercise Kit. Participants in the control group (n=82) continued with their usual activities.
  
  
  METHODS
  Laboratory and clinical measures of balance, mobility, and strength were assessed at baseline and at a 6-month reassessment.
  
  
  RESULTS
  After 6 months, the intervention group (n=59) significantly improved relative to the control group (n=62) for: the Functional Reach Test (mean difference=2.95 cm, 95% confidence interval [CI]=1.75 to 4.15), the Step Test (2.10 steps/15 seconds, 95% CI=1.17 to 3.02), hip abductor strength (0.02, 95% CI=0.01 to 0.03), and gait step width (2.17 cm, 95% CI=1.23 to 3.11). There were nonsignificant trends for improvement on most other measures. Fourteen participants in the intervention group (23.7%) achieved balance performance within the normative range following the exercise program, compared with 3 participants (4.8%) in the control group.
  
  
  CONCLUSIONS
  Loss to follow-up (26.6%) was slightly higher than in some similar studies but was unlikely to have biased the results.
  
  
  CONCLUSIONS
  A physical therapist-prescribed home exercise program targeting balance and strength was effective in improving a number of balance and related outcomes in older people with mild balance impairment.
authors: MWomen'sHlth, MHlthSci, School of Population Health, University of Melbourne, Carlton, Victoria, Australia. jing@nari.unimelb.edu.au
authors: Xiao Jing
authors: XJ
authors: Yang
authors: Keith
authors: K
authors: Hill
authors: Kirsten
authors: K
authors: Moore
authors: Susan
authors: S
authors: Williams
authors: Leslie
authors: L
authors: Dowson
authors: Karen
authors: K
authors: Borschmann
authors: Julie Anne
authors: JA
authors: Simpson
authors: Shyamali C
authors: SC
authors: Dharmage
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000203:Activities of Daily Living; D000368:Aged; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D016014:Linear Models; D008297:Male; D053580:Muscle Strength / Q000502:physiology; D004856:Postural Balance / Q000502:physiology*; D016896:Treatment Outcome