Effects of acute bouts of exercise on balance and the influence of aerobic capacity on fall risk in older adults: a scoping review

Abstract

Background: Falls are a major health concern among older adults causing around 684,000 deaths annually. By 2050, 16% of the world population is projected to be 65 years and older hence effective fall prevention strategies are crucial for the health systems. The World Falls Guidelines from 2022 classified cardiovascular disease as a potential risk factor while recommending multidomain fall-prevention intervention strategies in older community dwelling adults. Individual cardiorespiratory fitness was not further discussed leading to the aim of this scoping review which is to (1) assess the effects acute bouts of aerobic exercise on balance, fall risk or fall rate and to (2) assess the relationship between aerobic capacity, balance, fall risk and fall rate in older adults. Methods: A scoping review was conducted, including peer-reviewed articles written in in English language, dating from 1957 to February 2024 that are listed in the databases PubMed, Scopus, Web of Science, and Cochrane. Eligible for inclusion were articles using the following keywords and their synonyms: aerobic capacity, falls, balance, exercise, and older adults. The references were categorized in two topics: (1) effects of acute bouts of exercise on balance or gait performance as fall risk factors in older persons and (2) the direct relation between aerobic capacity, balance and fall rate in older adults. The findings were systematically summarized, using the PRISMA-ScR reporting guidelines. Results: Twelve articles with a total of 11,109 persons aged between 20 and 94 years old were included. Eight publications reported impaired balance after moderate to strenuous exercise in older adults. The direct relationship of aerobic capacity and fall risk was described in four publications, suggesting an inverse relationship. Conclusions: After acute bouts of aerobic exercise, an intensity-related impairment of balance in older persons was observed, a finding worth acknowledging when prescribing strenuous exercise with increased lactate levels to older adults. Since the effects lasted from 10 to 30 minutes, it is recommended to avoid balance challenging tasks after moderate to strenuous exercise in this demographic.