Canan Outdoor Multisurface Terrain Enhance the Effects of Fall Prevention Exercise in Older Adults? A Randomized Controlled Trial

Abstract

Walking on complex surface conditions in outdoor environments is important for active aging. This study aimed at examining whether fall prevention exercise integrated with an outdoor multisurface terrain compared with indoor solid ground was more beneficial for older adults. Twenty-two older nursing home residents were randomly assigned to outdoor multisurface terrain (n = 11, 79.5 ± 2.1 years) or indoor solid ground (n = 11, 78.8 ± 5.2 years) groups. Training occurred five times per week (30 min) for 3 weeks. The following performance test outcomes were measured: 10 m walk test (10 mWT), multisurface terrain walk test (MTWT), 2 min walk test (2 MWT), timed up and go test (TUGT), single-leg standing test with eyes open (SLSTEO), single-leg standing test with eyes closed (SLSTEC), and closed cycles test (CCT). Compared with baseline, the outdoor multisurface terrain training significantly improved performance in all tests (p < 0.01). The improvements of the outdoor multisurface terrain group after intervention were significantly higher than those of the indoor solid group in the 10 mWT (p = 0.049), MTWT (p = 0.02), and 2 MWT (p = 0.000). Exercise combined with outdoor multisurface terrain training may be an efficacious approach and a feasible environmental intervention for fall prevention in older adults.

Predictors of Falls with Injuries in People with Parkinson's Disease

“…35 The complex relationship between fear of falling, balance confidence, and balance performance may also have influenced our results. 32 Because it has been shown that a fall prevention program integrated with an outdoor multisurface terrain has improved balance, gait, and mobility measures in older adults when compared with indoor solid ground 36 and those preliminary outcomes of a feasibility study have shown a reduction of outdoor falls among older adults, 37 future fall prevention trials including people with PD should investigate whether an outdoor multimodal training and the adoption of fall protective behavior 38 would reduce the number of injurious falls in this population.…”

The Effects of Outdoor versus Indoor Exercise on Psychological Health, Physical Health, and Physical Activity Behaviour: A Systematic Review of Longitudinal Trials

“…Characteristics of included studies are presented in Supplementary Table S3. Six of the ten included trials were parallel-group randomized controlled trials [18,20,[27][28][29][30][31][32], whereas three studies were parallel-group controlled trials with no reporting of randomization [19,33,34]. One study was a cluster-randomized, counterbalanced crossover trial [17].…”

“…All studies aimed to compare the effect of outdoor exercise versus indoor exercise on psychological, physical, and/or behavioural outcomes. Two of these studies focused on specific environmental variables: cold exposure (outdoors at −5 [19] and terrain (outdoor multisurface path versus indoor solid floor) [20]. Three of the studies also investigated additional independent variables (i.e., vitamin D supplementation [29] and exercise [18,32]) by including additional intervention groups or control groups [18,29,32] that were not relevant to this review and will not be further discussed.…”

“…Since 2019, the increase in green exercise studies has continued (Figure A1), including an increase in longitudinal green exercise studies, e.g., [17][18][19][20]. Additionally, while this growing body of research suggests that outdoor green exercise may have greater health benefits than exercise performed in built environments, previous green exercise reviews [15,16] have not explored (1) the potential moderating effect of the extent of natural versus built elements in the outdoor environment, and (2) the relative effects of outdoor versus indoor built environments.…”

Effects of Locomotion Training on the Physical Functions and Quality of Life in Patients with Rheumatoid Arthritis: A Pilot Clinical Trial

“…In previous studies, these exercises resulted in improved physical functions such as mobility, strength, balance, and gait. 14 , 15 , 16 , 17 , 18 ) Literature reports also indicated that the prevalence of LS was higher in patients with RA than in the general population. 19 , 20 , 21 ) We believe that the locomotion training recommended by the JOA (Locotre), unlike aerobic exercise and general resistance exercise, is low-intensity training that can be safely performed at home by RA patients.…”