Effects of a Supervised versus an Unsupervised Combined Balance and Strength Training Program on Balance and Muscle Power in Healthy Older Adults: A Randomized Controlled Trial

Abstract

Background: Losses in lower extremity muscle strength/power, muscle mass and deficits in static and particularly dynamic balance due to aging are associated with impaired functional performance and an increased fall risk. It has been shown that the combination of balance and strength training (BST) mitigates these age-related deficits. However, it is unresolved whether supervised versus unsupervised BST is equally effective in improving muscle power and balance in older adults. Objective: This study examined the impact of a 12-week BST program followed by 12 weeks of detraining on measures of balance and muscle power in healthy older adults enrolled in supervised (SUP) or unsupervised (UNSUP) training. Methods: Sixty-six older adults (men: 25, women: 41; age 73 ± 4 years) were randomly assigned to a SUP group (2/week supervised training, 1/week unsupervised training; n = 22), an UNSUP group (3/week unsupervised training; n = 22) or a passive control group (CON; n = 22). Static (i.e., Romberg Test) and dynamic (i.e., 10-meter walk test) steady-state, proactive (i.e., Timed Up and Go Test, Functional Reach Test), and reactive balance (e.g., Push and Release Test), as well as lower extremity muscle power (i.e., Chair Stand Test; Stair Ascent and Descent Test) were tested before and after the active training phase as well as after detraining. Results: Adherence rates to training were 92% for SUP and 97% for UNSUP. BST resulted in significant group × time interactions. Post hoc analyses showed, among others, significant training-related improvements for the Romberg Test, stride velocity, Timed Up and Go Test, and Chair Stand Test in favor of the SUP group. Following detraining, significantly enhanced performances (compared to baseline) were still present in 13 variables for the SUP group and in 10 variables for the UNSUP group. Conclusion: Twelve weeks of BST proved to be safe (no training-related injuries) and feasible (high attendance rates of >90%). Deficits of balance and lower extremity muscle power can be mitigated by BST in healthy older adults. Additionally, supervised as compared to unsupervised BST was more effective. Thus, it is recommended to counteract intrinsic fall risk factors by applying supervised BST programs for older adults.

Effects of power training on quality of life and postural stability in elderly

“…The positive association between functional mobility and power intervention has been reported in previous studies (5,13,18) . The possible biological mechanisms related to this improvement would be the increase in muscle strength and power, cross-sectional area, glucose tolerance, fast muscle fiber type and oxidative profile as described in the literature (27,13) .…”

“…Falls generally occur due to the physical, cognitive and affective losses of senescence associated with comorbidities and previously installed chronic conditions (3) . These decreases are called geriatric syndromes and involve a number of aspects, among them loss of muscle strength, commonly managed from physical interventions achieving favorable results (4,5) . Discussions on the mechanisms of falls in the elderly encompass several aspects and there is evidence of reductions in strength in falling elderly, (6,7) condition possibly related to sarcopenia and reduction of gait velocity performance.…”

Ginkgo biloba special extract LI 1370 improves dual-task walking in patients with MCI: a randomised, double-blind, placebo-controlled exploratory study

“…The significant increase of working memory dual-task-related gait cadence is of relevance, because in contrast to other targeted interventions (e.g. exercise) [29], this non-targeted GBE intervention improved dual-task walking. The small-to-moderate effect sizes ( d  = 0.01–0.71) were lower compared to an exercise intervention (i.e.…”

Beam Walking to Assess Dynamic Balance in Health and Disease: A Protocol for the “BEAM” Multicenter Observational Study

“…Static steady-state balance will be assessed by the modified Romberg test [32]. The outcomes are standing time (s) and the path velocity (mm/s) of the center of force.…”