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Aging Clinical and Experimental Research

, Volume 19, Issue 4, pp 300–309 | Cite as

Old women with a recent fall history show improved muscle strength and function sustained for six months after finishing training

  • Nina BeyerEmail author
  • Lene Simonsen
  • Jens Bülow
  • Tove Lorenzen
  • Dorte V. Jensen
  • Lone Larsen
  • Ulla Rasmussen
  • Michael Rennie
  • Michael Kjær
Original Articles

Abstract

Background and aims: Restricted physical activity as a consequence of chronic disease or injury is a predictor of functional decline. The aim of this study was to test the hypothesis that a 6-month multidimensional training program would have sustained beneficial effects upon the physiological, functional and psychological condition of old women with a recent history of falls. Methods: Participants were 65 home-dwelling women (70–90 years) identified from hospital records as having had an accidental fall. After assessment of muscle strength, balance performance, walking speed, balance confidence, and physical activity level, the participants were randomly assigned to a control group (n=33) or a training group (n=32), who performed a multidimensional training program including moderate resistance exercise and balance exercise twice weekly for 6 months. Measurements were repeated after 6 and 12 months. Results: Six months of multidimensional training resulted in significant improvements and between-group differences in isometric knee extension strength (p<0.05), trunk extension/flexion strength (p<0.001), habitual/maximal walking speed (p<0.001) and balance performance (p<0.001). At follow-up, 6 months after intervention, these improvements were preserved in the training group and there was also a significant between-group difference with regard to balance confidence. No between-group differences were found concerning number of falls or physical activity level during the one-year study period. Conclusions: A multi-dimensional training program produced significant improvements in physiological and functional risk factors for falls and disability in women aged 70–90 years with a recent history of falls.

Keywords

Accidental falls exercise female risk factors 

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References

  1. 1.
    Fried LP, Guralnik JM. Disability in older adults: evidence regarding significance, etiology, and risk. J Am Geriatr Soc 1997; 45: 92–100.PubMedGoogle Scholar
  2. 2.
    Fiatarone MA, O’Neill EF, Ryan ND, et al. Exercise training and nutritional supplementation for physical frailty in very elderly people. N Engl J Med 1994; 330: 1769–75.PubMedCrossRefGoogle Scholar
  3. 3.
    Hughes MA, Myers BS, Schenkman ML. The role of strength in rising from a chair in the functionally impaired elderly. J Biomech 1996; 29: 1509–13.PubMedGoogle Scholar
  4. 4.
    Rantanen T, Avlund K, Suominen H, Schroll M, Frandin K, Pertti E. Muscle strength as a predictor of onset of ADL dependence in people aged 75 years. Aging Clin Exp Res 2002; 14 (3 Suppl): 10–5.PubMedGoogle Scholar
  5. 5.
    Rantanen T, Guralnik JM, Ferrucci L, et al. Coimpairments as predictors of severe walking disability in older women. J Am Geriatr Soc 2001; 49: 21–7.PubMedCrossRefGoogle Scholar
  6. 6.
    Guralnik JM, Ferrucci L, Pieper CF, et al. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci 2000; 55: M221–31.PubMedCrossRefGoogle Scholar
  7. 7.
    Onder G, Penninx BW, Ferrucci L, Fried LP, Guralnik JM, Pahor M. Measures of physical performance and risk for progressive and catastrophic disability: results from the Women’s Health and Aging Study. J Gerontol A Biol Sci Med Sci 2005; 60: 74–9.PubMedCrossRefGoogle Scholar
  8. 8.
    Hirvensalo M, Rantanen T, Heikkinen E. Mobility difficulties and physical activity as predictors of mortality and loss of independence in the community-living older population. J Am Geriatr Soc 2000; 48: 493–8.PubMedGoogle Scholar
  9. 9.
    Dunn JE, Rudberg MA, Furner SE, Cassel CK. Mortality, disability, and falls in older persons: the role of underlying disease and disability. Am J Public Health 1992; 82: 395–400.PubMedCrossRefGoogle Scholar
  10. 10.
    Arfken CL, Lach HW, Birge SJ, Miller JP. The prevalence and correlates of fear of falling in elderly persons living in the community. Am J Public Health 1994; 84: 565–70.PubMedCrossRefGoogle Scholar
  11. 11.
    Tinetti ME, Mendes de Leon CF, Doucette JT, Baker DI. Fear of falling and fall-related efficacy in relationship to functioning among community-living elders. J Gerontol 1994; 49: M140–47.PubMedCrossRefGoogle Scholar
  12. 12.
    Bruce DG, Devine A, Prince RL. Recreational physical activity level in healthy older women: the importance of fear of falling. J Am Geriatr Soc 2002; 50: 84–9.PubMedCrossRefGoogle Scholar
  13. 13.
    Gill TM, Allore H, Guo Z. Restricted activity and functional decline among community-living older persons. Arch Intern Med 2003; 163: 1317–22.PubMedCrossRefGoogle Scholar
  14. 14.
    Close J, Ellis M, Hooper R, Glucksman E, Jackson S, Swift C. Prevention of falls in the elderly trial (PROFET): a randomised controlled trial. Lancet 1999; 353: 93–7.PubMedCrossRefGoogle Scholar
  15. 15.
    Gill TM, Baker DI, Gottschalk M, Peduzzi PN, Allore H, Byers A. A program to prevent functional decline in physically frail, elderly persons who live at home. N Engl J Med 2002; 347: 1068–74.PubMedCrossRefGoogle Scholar
  16. 16.
    Gillespie LD, Gillespie WJ, Robertson MC, Lamb SE, Cumming RG, Rowe BH. Interventions for preventing falls in elderly people. Cochrane Database Syst Rev 2003; 4: CD000340.PubMedGoogle Scholar
  17. 17.
    Kongsgaard M, Backer V, Jorgensen K, Kjaer M, Beyer N. Heavy resistance training increases muscle size, strength and physical function in elderly male COPD-patients—a pilot study. Respiratory Medicine 2004; 98: 1000–7.PubMedCrossRefGoogle Scholar
  18. 18.
    Ettinger WHJ, Burns R, Messier SP, et al. A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis. The Fitness Arthritis and Seniors Trial (FAST). JAMA 1997; 277: 25–31.PubMedGoogle Scholar
  19. 19.
    Skelton DA, Young A, Greig CA, Malbut KE. Effects of resistance training on strength, power, and selected functional abilities of women aged 75 and older. J Am Geriatr Soc 1995; 43: 1081–7.PubMedGoogle Scholar
  20. 20.
    Ferrucci L, Guralnik JM, Buchner D, et al. Departures from linearity in the relationship between measures of muscular strength and physical performance of the lower extremities: the Women’s Health and Aging Study. J Gerontol A Biol Sci Med Sci 1997; 52: M275–85.PubMedCrossRefGoogle Scholar
  21. 21.
    Barnett A, Smith B, Lord SR, Williams M, Baumand A. Community-based group exercise improves balance and reduces falls in at-risk older people: a randomised controlled trial. Age Ageing 2003; 32: 407–14.PubMedCrossRefGoogle Scholar
  22. 22.
    American College of Sports Medicine. Physical activity programs and behavior counseling in older adult populations. Med Sci Sports Exerc 2004; 36: 1997–2003.CrossRefGoogle Scholar
  23. 23.
    Jensen BR, Jorgensen K, Hargens AR, Nielsen PK, Nicolaisen T. Physiological response to submaximal isometric contractions of the paravertebral muscles. Spine 1999; 24: 2332–8.PubMedCrossRefGoogle Scholar
  24. 24.
    Berg KO, Wood-Dauphinee SL, Williams JI, Maki B. Measuring balance in the elderly: validation of an instrument. Can J Public Health 1992; 83(Suppl 2): S7–11.PubMedGoogle Scholar
  25. 25.
    Powell LE, Myers AM. The Activities-specific Balance Confidence (ABC) Scale. J Gerontol A Biol Sci Med Sci 1995; 50A: M28–34.PubMedCrossRefGoogle Scholar
  26. 26.
    Schnohr P, Scharling H, Jensen JS. Changes in leisure-time physical activity and risk of death: an observational study of 7,000 men and women. Am J Epidemiol 2003; 158: 639–44.PubMedCrossRefGoogle Scholar
  27. 27.
    Skelton DA, Greig CA, Davies JM, Young A. Strength, power and related functional ability of healthy people aged 65–89 years. Age Ageing 1994; 23: 371–7.PubMedCrossRefGoogle Scholar
  28. 28.
    Buchner DM, Hornbrook MC, Kutner NG, et al. Development of the common data base for the FICSIT trials. J Am Geriatr Soc 1993; 41: 297–308.PubMedGoogle Scholar
  29. 29.
    Jensen CV. A computer program for randomizing patients with near-even distribution of important parameters. Comput Biomed Res 1991; 24: 429–34.PubMedCrossRefGoogle Scholar
  30. 30.
    Fielding RA, LeBrasseur NK, Cuoco A, Bean J, Mizer K, Fiatarone Singh MA. High-velocity resistance training increases skeletal muscle peak power in older women. J Am Geriatr Soc 2002; 50: 655–62.PubMedCrossRefGoogle Scholar
  31. 31.
    Bath PA, Morgan K. Differential risk factor profiles for indoor and outdoor falls in older people living at home in Nottingham. UK. Eur J Epidemiol 1999; 15: 65–73.CrossRefGoogle Scholar
  32. 32.
    Rantanen T, Era P, Heikkinen E. Maximal isometric strength and mobility among 75-year-old men and women. Age Ageing 1994; 23: 132–7.PubMedCrossRefGoogle Scholar
  33. 33.
    Beimborn DS, Morrissey MC. A review of the literature related to trunk muscle performance. Spine 1988; 13: 655–60.PubMedGoogle Scholar
  34. 34.
    Rantanen T, Guralnik JM, Izmirlian G, et al. Association of muscle strength with maximum walking speed in disabled older women. Am J Phys Med Rehabil 1998; 77: 299–305.PubMedCrossRefGoogle Scholar
  35. 35.
    Schroll M, Avlund K, Davidsen M. Predictors of five-year functional ability in a longitudinal survey of men and women aged 75 to 80. The 1914-population in Glostrup. Denmark. Aging (Milano) 1997; 9: 143–52.Google Scholar
  36. 36.
    Giles B, Henke P, Edmonds J, McNeil D. Reproducibility of isokinetic muscle strength measurements in normal and arthritic individuals. Scand J Rehabil Med 1990; 22: 93–9.PubMedGoogle Scholar
  37. 37.
    Liddle J. Gilleard C. The emotional consequences of falls for older people and their families. Clin Rehabil 1995; 9: 110–4.Google Scholar
  38. 38.
    Rantanen T, Era P, Heikkinen E. Physical activity and the changes in maximal isometric strength in men and women from the age of 75 to 80 years. J Am Geriatr Soc 1997; 45: 1439–45.PubMedGoogle Scholar
  39. 39.
    Guideline for the prevention of falls in older persons. American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopaedic Surgeons Panel on Falls Prevention. J Am Geriatr Soc 2001; 49: 664–72.CrossRefGoogle Scholar
  40. 40.
    Luukinen H, Koski K, Hiltunen L, Kivela SL. Incidence rate of falls in an aged population in northern Finland. J Clin Epidemiol 1994; 47: 843–50.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Internal Publishing Switzerland 2007

Authors and Affiliations

  • Nina Beyer
    • 1
    • 2
    Email author
  • Lene Simonsen
    • 3
  • Jens Bülow
    • 3
  • Tove Lorenzen
    • 4
  • Dorte V. Jensen
    • 4
  • Lone Larsen
    • 1
  • Ulla Rasmussen
    • 1
  • Michael Rennie
    • 5
  • Michael Kjær
    • 2
  1. 1.Department of Physical Therapy, Institute of Sports Medicine CopenhagenCopenhagen University Hospital BispebjergCopenhagen NVDenmark
  2. 2.Institute of Sports Medicine CopenhagenDenmark
  3. 3.Department of Clinical PhysiologyDenmark
  4. 4.Department of RheumatologyCopenhagen University Hospital BispebjergCopenhagen Denmark
  5. 5.School of Life SciencesUniversity of Nottingham, Graduate Entry Medical SchoolDerbyUK

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