The Effect of Multidimensional Exercises on Balance, Mobility, and Fall Risk in Community-Dwelling Older Adults

Shumway-Cook, Anne; Gruber, William C.; Baldwin, Margaret; Liao, Shiquan

doi:10.1093/ptj/77.1.46

Cited by 356 publications

(191 citation statements)

References 24 publications

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“…7 Researchers have shown that reducing the number of prescription medications reduces falls, 3,8 improving strength reduces falls, [10][11][12] and improving measures of gait and balance reduces falls. 13,14 In addition, group-based therapeutic exercise reduces falls in community-dwelling older adults 7,11,[15][16][17] Activities that incorporate complementary and alternative therapies are on the rise in the United States, 18,19 with nearly 40% of adults and 12% of children in the United States using some form of complementary or alternative therapy. 20,21 Complementary and alternative therapies are also recommended to Quinnipiac University, Hamden, Connecticut.…”

Section: Introductionmentioning

confidence: 99%

The Effects of a Therapeutic Yoga Program on Postural Control, Mobility, and Gait Speed in Community-Dwelling Older Adults

Kelley

Aaron

Hynds

et al. 2014

The Journal of Alternative and Complementary Medicine

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Objective: To examine the effects of a 12-week therapeutic yoga program on gait speed, postural control, and mobility in community-dwelling older adults. Design: Quasi-experimental study with a pretest/post-test design. Researchers evaluated changes over time (pretest to post-test) in all outcome measures. Paired t-tests were used to analyze normal and fast gait speed, Timed Up and Go test, and Timed Up and Go Dual Task. Wilcoxon signed-rank test was used to evaluate scores for the Mini-BESTest (MBT). Setting: Yoga classes were performed at a local senior center. Blind examiners who were previously trained in the outcome measures performed all pretests and post-tests at the site. Participants: Thirteen adults (12 women and 1 man, with a mean age -standard deviation of 72 -6.9 years) completed the study. Research participants had minimal to no yoga experience. Interventions: A 12-week, 60-minute, biweekly Kripalu yoga class designed specifically for communitydwelling older adults. Outcome measures: Postural control (MBT), mobility (Timed Up and Go test), and gait speed (normal and fast) were assessed. Results: All 13 participants attended at least 19 of the 24 classes (80% attendance). Statistically significant improvements were seen in the MBT ( p = 0.039), normal gait speed ( p = 0.015), fast gait speed ( p = 0.001), Timed Up and Go test ( p = 0.045), and Timed Up and Go Dual-Task ( p = 0.05). Conclusions: Improvements in postural control and mobility as measured by the MBT and Timed Up and Go gait as measured by fast gait speed indicate that research participants benefitted from the therapeutic yoga intervention. The yoga program designed for this study included activities in standing, sitting, and lying on the floor and may be effective in improving mobility, postural control, and gait speed in community-dwelling older adults.

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Section: Introductionmentioning

confidence: 99%

The Effects of a Therapeutic Yoga Program on Postural Control, Mobility, and Gait Speed in Community-Dwelling Older Adults

Kelley

Aaron

Hynds

et al. 2014

The Journal of Alternative and Complementary Medicine

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“…18 The ABC-scale, however, is by far Despite positive psychometric evidence supporting the use of the ABC-scale, further evaluation of the scale's measurement properties is necessary, 19,28 and for several reasons this is especially true among individuals aging with a lower-limb amputation. First, the properties of the ABC-scale have only been established in a sample of individuals with a lower-limb amputation who were 20 years of age and older.…”

Section: Introductionmentioning

confidence: 99%

“…18 The ABC-scale, however, is by far the most widely used measure to assess balance confidence. 19 This scale was developed to assess balance confidence in high functioning older adults.…”

mentioning

confidence: 99%

Rasch Analyses of the Activities-specific Balance Confidence Scale With Individuals 50 Years and Older With Lower-Limb Amputations

Sakakibara

Miller

Backman

2011

Archives of Physical Medicine and Rehabilitation

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Objective-To explore shortened response formats for use with the Activities-specific Balance Confidence scale and then: 1) evaluate the unidimensionality of the scale; 2) evaluate the item difficulty; 3) evaluate the scale for redundancy and content gaps; and 4) evaluate the item standard error of measurement (SEM) and internal consistency reliability among aging individuals (≥50 years) with a lower-limb amputation living in the community.Design-Secondary analysis of cross-sectional survey and chart review data.Setting-Out-patient amputee clinics, Ontario, Canada.Participants-Four hundred forty eight community living adults, at least 50 years old (mean = 68 years), who have used a prosthesis for at least 6 months for a major unilateral lower limb amputation. Three hundred twenty five (72.5%) were men. Intervention-N/aMain Outcome Measure(s)-Activities-specific Balance Confidence Scale.Results-A 5-option response format outperformed 4-and 6-option formats. Factor analyses confirmed a unidimensional scale. The distance between response options is not the same for all items on the scale, evident by the Partial Credit Model (PCM) having a better fit to the data than the Rating Scale Model. Two items, however, did not fit the PCM within statistical reason. Revising the wording of the two items may resolve the misfit, and improve the construct validity Corresponding author: Dr. William C Miller, Department of Occupational Science and Occupational Therapy, University of British Columbia, T325-2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Tel work: 604-714-4108, Fax: 604-714-4168, bcmiller@telus.net. We certify that no party having a direct interest in the results of the research supporting this article has or will confer a benefit on us or on any organization with which we are associated AND, if applicable, we certify that all financial and material support for this research (eg, NIH or NHS grants) and work are clearly identified in the title page of the manuscript.The manuscript submitted does not contain information about medical device(s). CIHR Author Manuscript CIHR Author Manuscript CIHR Author Manuscriptand lower the SEM. Overall, the difficulty of the scale's items is appropriate for use with aging individuals with lower-limb amputation, and is most reliable (Cronbach ∝ = 0.94) for use with individuals with moderately low balance confidence levels.Conclusions-The ABC-scale with a simplified 5-option response format is a valid and reliable measure of balance confidence for use with individuals aging with a lower limb amputation. KeywordsAging; amputation; self-efficacy; rehabilitation; psychometrics; postural balanceFalling and the consequences of falling are important health issues for older individuals with a lower limb amputation. In Canada, the prevalence of falling among community dwelling individuals with a lower-limb amputation is reported to be as high as 52%. 1 Further, the annual incidence of falling among older adults (≥65 years) living in the community is commonly reported to be around 30% to ...

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“…Daubney and Culham examined lower-extremity muscle force and balance and found that isometric hip extensor strength was significantly lower in individuals who reported more falls [14]. Hip abductor weakness is also a major contributor to falls in older adults [15], and the importance of hip abductor strength in maintaining balance during gait is well established [16][17][18]. Increased hip flexion moment is associated with increased total hip joint force during stair climbing [19].…”

Section: Introductionmentioning

confidence: 99%

Isometric performance following total hip arthroplasty and rehabilitation

Frost¹,

Bertocci²,

Wassinger³

et al. 2006

JRRD

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Abstract-We compared differences in isometric strength between older adults who have undergone elective unilateral total hip arthroplasty (THA) and completed rehabilitation with a population of community-dwelling older adults who have not had THA. The study was a cross-sectional design, and 22 unilateral THA subjects and 38 community-dwelling older adults participated. THA subjects received on average 13 outpatient or home-based physical therapy sessions before evaluation. THA subjects were evaluated 4 to 5 months postsurgery. We assessed isometric muscle strength by measuring peak hip torque per body weight with a robotic dynamometer during abduction, flexion, and extension. No significant performance differences were observed between operated and nonoperated hips of THA subjects. THA subject operated and nonoperated hips generated significantly less peak torque per body weight during flexion (p = 0.03) compared with community-dwelling older adult hips (THA subject operated hips = 6.96 ft-lb/lb, THA subject nonoperated hips = 8.26 ft-lb/lb, communitydwelling older adult hips = 11.56 ft-lb/lb). No significant differences were observed between THA subjects and community-dwelling older adults during hip extension (p = 0.55) or abduction (p = 0.17). At 4 to 5 months postsurgery, THA subjects were not at the same level of biomechanical performance as community-dwelling older adults. Significant strength deficits were found in THA subject operated versus nonoperated hips during isometric flexion. Additional or modified physical therapy that targets the hip flexors is recommended after THA.

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The Effect of Multidimensional Exercises on Balance, Mobility, and Fall Risk in Community-Dwelling Older Adults

Abstract: Exercise can improve balance and mobility function and reduce the likelihood for falls among community-dwelling older adults with a history of falling. The amount of exercise needed to achieve these results, however, could not be determined from this study.

Cited by 356 publications

References 24 publications

The Effects of a Therapeutic Yoga Program on Postural Control, Mobility, and Gait Speed in Community-Dwelling Older Adults

The Effects of a Therapeutic Yoga Program on Postural Control, Mobility, and Gait Speed in Community-Dwelling Older Adults

Rasch Analyses of the Activities-specific Balance Confidence Scale With Individuals 50 Years and Older With Lower-Limb Amputations

Isometric performance following total hip arthroplasty and rehabilitation

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