title: Benefits of a novel concept of home-based exercise with the aim of preventing aspiration pneumonia and falls in frail older women: a pragmatic controlled trial.
abstract: OBJECTIVE
  To investigate whether home-based exercise with the aim of preventing aspiration pneumonia and accidental falls improves swallowing-related and physical functions in community-dwelling frail older women.
  
  
  METHODS
  Participants were 266 community-dwelling frail older women in a long-term care prevention class (mean (SD): age 75 (5) years). Participants were allocated to either an intervention group or a control group. In the intervention group, participants were asked to perform, at least three times a week for 6 months, a home-based exercise programme that was specifically developed to prevent aspiration pneumonia and accidental falls. Control group participants were instructed to perform general stretching exercises only. Voluntary peak cough flow and lip closure force were measured as swallowing-related functions. Static and dynamic balance function, lower limb strength and flexibility were measured as secondary outcomes. Intervention effects were determined using t tests; effect sizes were calculated using Cohen's d.
  
  
  RESULTS
  Voluntary peak cough flow in the intervention group was significantly greater than in the control group (p<0.01, d=0.5). However, lip closure force did not differ between groups. Regarding physical function, results of the Timed Up and Go Test (p<0.05, d=0.4), Chair Stand Test (p<0.01, d=0.4), maximal knee extension strength (p<0.05, d=0.4), and Sit and Reach Test (p<0.05, d=0.3) showed greater improvement in the intervention group.
  
  
  CONCLUSIONS
  Specifically developed home-based exercise as described in this study is simple and can be performed briefly. Improvements in voluntary peak cough flow and physical function indicate the possible usefulness of such exercise in preventing falls and aspiration pneumonia in community-dwelling frail older adults.
  
  
  BACKGROUND
  UMIN Clinical Trials Registry (UMIN-CTR): UMIN000014880.
authors.affiliation: Department of Physical Therapy, Faculty of Health Sciences , Kio University , Nara , Japan.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Takatori
authors.affiliation: Department of Physical Therapy, Faculty of Health Sciences , Kio University , Nara , Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Matsumoto
authors.affiliation: Department of Rehabilitation , Akitsu-Kounoike Hospital , Nara , Japan.
authors.forename: Munenori
authors.initials: M
authors.lastname: Nishida
authors.affiliation: Department of Rehabilitation , Nara Prefecture General Rehabilitation Center , Nara , Japan.
authors.forename: Shinnichiro
authors.initials: S
authors.lastname: Matsushita
authors.affiliation: Nara Medical University Department of Public Heath , Health Management and Policy , Kashihara , Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Noda
authors.affiliation: Nara Medical University Department of Public Heath , Health Management and Policy , Kashihara , Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Imamura
keywords: Exercise rehabilitation; Fall; Health promotion; Prevention; Respiratory