THE EFFECT OF STRENGTH AND ENDURANCE TRAINING ON GAIT, BALANCE, FALL RISK, AND HEALTH-SERVICES USE IN COMMUNITY-LIVING OLDER ADULTS

Background. The study tested the effect of strength and endurance trai ning on gait, balance, physical health status, fall risk, and health s ervices use in older adults. Methods. The study was a single-blinded, randomized controlled trial with intention-to-treat analysis. Adults ( n = 105) age 68-85 with at least mild deficits in strength and balance were selected from a random sample of enrollees in a health maintenan ce organization. The intervention was supervised exercise (1-h session s, three per week for 24-26 weeks), followed by self-supervised exerci se. Exercise groups included strength training using weight machines ( n = 25). endurance training using bicycles (n = 25), and strength and endurance training (n = 25). Study outcomes included gait tests, balan ce tests, physical health status measures, self-reported falls (up to 25 months of follow-up). and inpatient and outpatient use and costs. R esults. There were no effects of exercise on gait, balance, or physica l health status. Exercise had a protective effect on risk of falling ( relative hazard = .53, 95% CI = .30-.91). Between 7 and 18 months afte r randomization. control subjects had more outpatient clinic visits (p < .06)and were more likely to sustain hospital costs over $5000 (p < .05). Conclusions. Exercise may have beneficial effects on fall rates and health care use in some subgroups of older adults. In community-li ving adults with mainly mild impairments in gait, balance, and physica l health status, shortterm exercise map not have a restorative effect on these impairments.