Article

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. DESIGN: This
was a community-based, randomized controlled trial with assessors blinded to
group allocation. PARTICIPANTS: 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. INTERVENTION: 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.
OUTCOME MEASURES: 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.
LIMITATIONS: 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.

Langue : ANGLAIS