Sanna Sihvonen

Background: The knowledge concerning balance training actually lowering fall rates among frail older persons is limited. Objective: The aim of this study was to examine the effects of a 4-week individualized visual feedback-based balance training on the fall incidence during 1-year follow-up among frail older women living in residential care. Methods: Twenty-seven older women from 2 residential care homes were randomized into exercise (n = 20) and control (n = 7) groups. Balance measurements were carried out before and after a 4-week training period and falls were monitored by monthly diaries for 1 year. An interview about fear of falling and physical activity was completed before and after the intervention and after the 1-year follow-up. Results: A positive effect of balance training on fall incidence was found. A dynamic Poisson regression model showed that during the follow-up the monthly risk of falling was decreased in the exercise group compared to controls (risk ratio 0.398, 95% CI 0.174–0.911, p = 0.029). In addition, the exercise group reported a reduced fear of falling and increased physical activity after a training period but these changes declined during the follow-up period. Conclusion: Individualized visual feedback-based balance training was shown to be a promising method for fall prevention among frail older women. High compliance (97.5%) with the training program showed that carefully targeted training programs can be carried out among older people with health limitations.

Background and aims: Older jailers aged over 70 years have shown impaired balance abilities, but it is unclear if impairment in balance control can be detected among jallers who are in their 50’s and 60’s. The aim oj this study was to analyze possible differences in balance control and other health-related factors between female fallers and nonfallers aged 50–68 years. Methods: Women 50–68 years of age (N=40) who had fallen outside and needed medical attention were recruited through a larger fall accident study. Non-fallers (N=97) were women representing the same age group who had not fallen during the preceding 12 months. A battery of standing force platform balance tests were administered together with an interview on health status, use of medication, dizziness, vision, hearing, and physical activity. Results: Significant differences were not found between women with injurious falls and non-fall-ers in the various balance tests. In the younger age group (50–58 years), chronic illnesses, use of medication, dizziness, and self-reported problems with vision and hearing were more common in fallers than in non-fallers. Conclusions: Our results suggest that, in active and independent women aged 50–68 years, it is not possible to use standing force platform balance tests to detect differences between fallers and non-fallers. However, younger women (50–58 years) with injurious falls reported more health-related problems than other groups, a fact which should be taken into consideration to prevent further development of fall-related problems.

Background: Balance training programs have not shown consistent results among older adults, and it remains unclear how different training methods can be adapted to frail elderly people. Objective: The purpose of this study was to investigate the effects of a 4-week visual feedback-based balance training on the postural control of frail elderly women living in residential care homes. Methods: Elderly women of two residential care facilities were randomized to an exercise group (EG, n = 20) and to a control group (CG, n = 7). The EG participated in training sessions three times/week for 4 weeks. The exercises were carried out with a computerized force platform with visual feedback screen. The dimensions of balance function studied were standing body sway, dynamic weight shifting, and Berg Balance Scale performance. Results: The EG showed significant improvement in balance functions. The performance time in dynamic balance tests improved on average by 35.9% compared with a 0.6% increase in the CG (p = 0.025–0.193). The performance distance in these tests decreased on average by 28.2% in the EG as compared with a 9.8% decrease seen in the CG. The Berg Balance Scale performance improved by 6.9% compared with a 0.7% increase in the CG (p = 0.003). The standing balance tests in the more demanding standing positions showed improvements in the EG, whereas similar changes in the CG were not found. Conclusions: Our findings suggest that balance training based on visual feedback improves the balance control in frail elderly women living in residential care, also enhancing the performance of functional balancing tasks relevant to daily living. The subjects were motivated to participate in the training, as indicated by the high compliance (97.5%) with the program.