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The effects of a multicomponent intervention program on clinical outcomes associated with falls in healthy older adults

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Multicomponent intervention programs have been shown to be effective in reducing risk factors associated with falls, but the primary target population of these interventions is often low-functioning older adults.


The purpose of this study was to investigate the effectiveness of a multicomponent intervention program focusing on balance and muscle strength for independently functioning community-dwelling older adults.


Fifty-three independently functioning older adults, aged 80.09 ± 6.62 years, participated in a group exercise class (conducted 2 times/week for 8 weeks) emphasizing balance. Outcome measures were balance performance using the Fullerton Advanced Balance (FAB) scale and muscle strength using the Senior Fitness Test (SFT).


The intervention improved balance (P < 0.001), and older adults who were classified as having high fall risks based on the FAB scores at pre-testing improved more than older adults who were classified as having low fall risks (P = 0.017). As a result, 22 participants transitioned from a high fall risk group at pre-testing to a low fall risk group at post-testing (P < 0.001). The intervention also enhanced both upper and lower muscle extremity strength based on SFT results (P < 0.001) regardless of participants’ classification of fall risk status.

Conclusions and discussion

The multicomponent intervention conducted two times per week for 8 weeks was effective in improving balance and enhancing muscle strength of independently functioning older adults. The results underscore the importance of providing fall prevention interventions to healthy older adults, a population often not a target of balance interventions.

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This research was supported by a SCAN Health Plan grant. We are grateful to the Osher Lifelong Learning Institute at the California State University, Long Beach, and the Leisure World® Seal Beach, CA, for their assistance in the participants recruitment. We also thank many student assistants from the Department of Physical Therapy and the Department of Psychology at the California State University, Long Beach for their help in data collection and data analysis.


This study was partially funded by a Grant from SCAN Health Plan.

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Corresponding author

Correspondence to Young-Hee Cho.

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Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical standards

All procedures performed in this project involving human participants were in accordance with the ethical standards of our institutional review board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standard.

Informed consent

Informed consent was obtained from all individuals participants included in the study.

Appendix: Weekly progression of the exercise intervention

Appendix: Weekly progression of the exercise intervention


Week 1

Week 2 Additions

Week 3 Additions

Week 4 Additions

Week 5 Additions

Week 6 Additions

Week 7 Additions

Week 8 Additions

Warm up (7 min) with music


Proper posture awareness

Core muscle contraction

Arm and shoulder movement

Chest stretch


Sitting on a compliant surface (disc or ball)


Marching while sitting


Head turns with movement


Pass the potato


Balloon volleyball


Balloon volleyball


Balloon volleyball


With music, arm movement


High stepping walking


Fast and slow walking

Abrupt change of pace


Abrupt change of direction


Tossing a bean bag upward and catching it


Tossing a ball upward and catching it


Tossing a bean bag between two hands


Tossing balls between two hands

Balance and multisensory training (10 min)

Standing weight shifts (all directions, EO, EC)

Diagonal weight shift (forward and backward)

Tandem standing

Tandem weight shifts (forward and backward)

Toe and heel tapping(all directions)

Foot drawing (first name with the right foot, last name with the left foot)

Single limb stance

Marching in place with head turns

Four corner marching with head turns

Teach how to get on and off foam pad

Standing on foam weight shifts (all directions)

Standing on foam (EO, EC)

Standing on foam weight shifts (all directions, EO, EC)

Standing on foam on one foot (EO, EC)

Semi-tandem weight shifts (all directions, EO, EC)

Walking activities and games (10 min) with music

Walking on toes

Walking on heels

Walk in files (in line one behind the other)

Walk in files across the midline

Walk with abrupt stop and change of direction

Walking across tossing a bean bag then relay to opposite participant

Walk reading a script

Passing a ball (forward, behind and to the side in a circle)

Walk on dense foam

Standing volleyball

Wide step walking as if crossing a real water creek

Obstacle course (avoiding obstacles and stepping on & off different objects)

Obstacle course (stepping on different surfaces picking objects from floor)

Obstacle course (carrying objects while stepping on different surfaces)

Wall flexibility and strengthening (10 min)

Semi-tandem walk

Narrow step walking

Alternating narrow and wide step


Side walking

Walking with head turns

Tossing a ball while walking

Figure 8 walking

Wall squats (10 reps)

Heel raises (10 reps)

Toe raises (10 reps)

Wall push-up (10 reps)

Hamstring stretch (10 reps)

Calf stretch (10 reps)

Seated strengthening (10 min) using resistance bands (10 reps for each set)a

Biceps curls

Horizontal and diagonal pulls

Triceps curls

Leg press

Seated hip abduction

Point and flex

Eye/hand coordination (3 min)

Follow a moving target (popsicle stick) with slow eye movement (side to side, up/down and diagonal) with the head stable

Increase the speed of eye movement

Follow eye movement with head movement in the same direction

Cool down (5 min) breathing instructions with all movements

Arm movements

Neck bending

Trunk bending and rotation

Arm stretches

Hamstring and calf stretches

Ankle circles

  1. EO eyes open, EC eyes closed
  2. aSeated strengthening was increased to 2–3 sets at week 5

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Cho, YH., Mohamed, O., White, B. et al. The effects of a multicomponent intervention program on clinical outcomes associated with falls in healthy older adults. Aging Clin Exp Res 30, 1101–1110 (2018).

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