THE EFFECT OF MULTIDIMENSIONAL EXERCISES ON BALANCE, MOBILITY, AND FALL RISK IN COMMUNITY-DWELLING OLDER ADULTS

Background and Purpose. This prospective clinical investigation examin ed the effects of a multidimensional exercise program on balance, mobi lity, and risk for falls in community-dwelling older adults with a his tory of falling. Factors used to predict adherence and a successful re sponse to exercise were identified. Subjects. A total of 105 community -dwelling older adults (greater than or equal to 65 years of age) with a history of two or more falls in the previous 6 months (no neurologi c diagnosis) participated. They were classified into (1) a control gro up of fallers (n=21), (2) a fully adherent exercise group (n=52), and (3) a partially adherent exercise group (n=32). Methods. Following eva luation, each patient received an individualized exercise program addr essing the impairments and functional disabilities identified during t he assessment. The control group received no intervention. Changes in performance on five clinical tests of balance and mobility and fall ri sk were compared among groups. Results. Both exercise groups scored be tter than the control group on all measures of balance and mobility. A lthough both exercise groups showed a reduction in fall risk compared with the control group, the greatest reduction was found in the fully adherent exercise group. Factors associated with successful response t o exercise included degree of adherence to exercise program and pretes t score on the Tinetti Mobility Assessment. Conclusion and Discussion. Exercise can improve balance and mobility function and reduce the lik elihood for falls among community-dwelling older adults with a history of falling. The amount of exercise needed to achieve these results, h owever, could not be determined from this study.