Multi-System Physical Exercise Intervention for Fall Prevention and Quality of Life in Pre-Frail Older Adults: A Randomized Controlled Trial

Abstract

Effective interventions for indicated fall prevention are necessary for older adults with frailty. We aimed to determine the effectiveness of a Multi-system Physical Exercise (MPE) for fall prevention and Health-Related Quality of Life (HRQOL) in pre-frail older adults. This randomized control trial with allocation concealment included 72 adults aged 65 and above, identified as pre-frailty and with mild and moderate fall risk scores measured by the Physiological Profile Assessment (PPA). Randomly, using block randomization, participants were divided into two groups: an MPE group (n = 36) and a control group (n = 36). The intervention consisted mainly of proprioception, muscle strengthening, reaction time, and balance training and was carried out three days per week for 12 weeks. The primary outcome was fall risk assessed using PPA at 12 weeks post-baseline and at a 24 week follow-up. Significant differences were found in the improvement in fall risk, proprioception, muscle strength, reaction time and postural sway, and fear of fall scores in the MPE group compared with controls at week 12 and 24. In addition, HRQOL had increased significantly in the MPE group in comparison to controls. The MPE program significantly increased muscle strength and improved proprioception, reaction time, and postural sway leading to fall risk reduction in older adults with pre-frailty. Therefore, the MPE program is recommended for used in day-to-day primary care practice in the pre-frail population.

The Comparisons of Physical Functional Performances between Older Adults with and without Regular Physical Activity in Two Different Living Settings

“…Moderate to vigorous intensity aerobic exercise could be advocated to the physically independent aged population, and muscle-strengthening for major muscle groups should be done more than twice a week to promote their physical fitness. Furthermore, PA on the basis of multiple components is a viable solution for fall prevention among community-dwelling older adults with prefrailty [ 49 ]. To avoid getting frail in old age, healthy older adults should engage in vigorous and moderate PA while they are non-frail [ 50 ].…”

Relationship between Postural Balance Training and Fall Risks for Elderly: a Systematic Review of Randomized Controlled Trials

“…The 22 selected RCTs provided 10 RCTs for multi-modal exercises [9][10][11][12][13]16,18,21,22,24], 2 RCTs for bi-modal exercises [27,30], 8 RCTs for uni-modal exercises [17,19,20,23,25,26,2829], and 2 RCTs for home exercise program [14,15] to improve the risk of falls. The postural balance training of the selected RCT studies involved multimodal exercises which consisted of the stretching, dynamic and static balancing, resistance exercise, dual task exercise, gait training, proprioception exercises, aerobic exercise, reaction time, and flexibility, stepping, step-up exercises [9][10][11][12][13]16,18,21,22,24]. Bi-modal exercises in the selected RCTs involved aerobic exercise, resistance exercise, balance and strengthening exercise [27,30].…”

“…Comparison Outcomes Supplementary therapy study was stretching exercise [22], and one another study was walking program for control group [28]. Flexibility exercise was provided for control group in only one study [11]. Four studies provided the additional therapy for all participants [9,13,14,28].…”

“…The additional therapy involved home exercise program, strengthening and balance training, physical therapy, and physical exercises. Nineteen records of the selected RCT studies reported that experimental group showed more improvement compared to control group [9][10][11][13][14][15][16][17][18][19][21][22][23][25][26][27][28][29][30], although thrive records showed more improvement on only one or two outcomes compared to control group [9,10,19]. Only three records of the selected RCT studies reported no statistically differential effects (Table 1).…”

The Relationship of Self-Presentation, Psychological Needs, and Exercise Dependence in College Students With Overweight

“…Numerous studies have shown that the regular physical activities or fitness exercise are not only beneficial in reducing symptoms such as obesity, cardiovascular disease, cancer, and diabetes (Wang and Zhou, 2013;George and Kristi, 2017;Tang, 2017) but also in reducing anxiety, depression, and negative emotions, as well as enhancing self-esteem and cognitive function (Anthonieta et al, 2016;Chittrakul et al, 2020). However, although regular exercise can bring many benefits to people, excessive sports and physical activity will also induce psychological and physiological problems (Astrid et al, 2014;Badau and Badau, 2018).…”