Comparison of two doses of an exercise intervention on mobility and function in older adults

Dan M Ritchie, Purdue University

Abstract

Balance and Mobility are important functions for older adults to maintain in later life. Numerous exercise interventions have been proposed for improving and maintaining high levels of mobility and balance. The majority of the research to date has evaluated different types of exercise programming (strength, flexibility, endurance, power, tai chi) but has not evaluated the necessary dose or frequency needed to achieve positive outcomes. Limited recent research has reported that the FallProof™ program results in improved scores on the Berg Balance Scale and decreased times on the 8 foot Up and Go when offered 2 times per week over 8 weeks. Purpose. The purpose of the present study was to compare the effect of dose (frequency: one day per week vs. two days per week) of the FallProof™ intervention on improvements in function and mobility, as well as adherence and attrition, when implemented in a residential retirement community. A secondary purpose was to determine if two questionnaires could be utilized, instead of physical assessments, for quantifying baseline function and mobility. The use of questionnaires would permit more cost effective assessment, and thus remove a potential barrier to program implementation. Methods. Participants (n=23; mean age=79.1, one male) were recruited from a local residential retirement community and randomly assigned to one of two intervention groups, 1 day group (n=12), or 2 day group (n=11), utilizing the FallProof™ program. Participant eligibility criteria included age 65-95 years, ability to walk with or without a gait aid, and mild-moderate mobility impairment (based on the Motor Fitness Scale). The exercise program was conducted for 16 weeks, with baseline, 8 week and 16 week assessments of the Berg Balance Scale (BBS), 8 foot Up and Go (UG), 50 foot walk test and chair stands. Questionnaires evaluated were the Motor Fitness Scale (MFS) and Late Life Function and Disability Instrument (LLFDI). Results. Of the 23 participants that began the intervention, 19 completed 8 weeks (84.0% attendance 2 day group, 77.5% attendance 1 day group) and 14 completed all 16 weeks (80.4% attendance 2 day group, 78.6% attendance 1 day group). There was no difference in adherence to the protocols between groups for either those that completed 8 weeks (p=.45) or 16 weeks (p=.92). Significant improvements were observed on the Berg Balance Scale for the 1 day group (49.9 to 52.4, p<.05), and the 2 day group (45.1 to 48.7, p<.05) from baseline to 16 weeks. Significant improvements were observed on the 8 foot Up and Go from baseline to 16 weeks for both intervention groups as well: 1 day group (8.7 sec to 6.9 sec, p<.05), 2 day group (10.9 sec to 8.9 sec, p<.05). A significant difference was observed between the groups on the Motor Fitness Scale at 16 weeks (p<.01): the 1 day group M=9.7(2.1) and 2 day group M=6.0(2.4). Both the MFS and LLFDI questionnaires were positively correlated to the BBS (MFS r=.72 p<.001, LLFDI r=.73 p<.001) and negatively correlated to the UG (MFS r=-.84 p<.001, LLFDI r=-.71 p<.001). Conclusion. These results suggest that the FallProof™ exercise program, offered one day per week, can achieve improvements in the Berg Balance Scale and 8 foot Up and Go as have been reported previously when offered two days per week. In addition, questionnaires may prove a suitable alternative to numerous physical assessments for determining baseline function of older adults prior to beginning the FallProof™ program. However small sample sizes prevent broad generalization of the effectiveness of the FallProof™ program offered 1 day per week, so further research is needed, utilizing larger and more diverse samples, to more fully assess the value of reducing the dose of evidence based exercise interventions. Nevertheless, these results support the potential for cost effective adoption of the FallProof™ program, offered one time per week, among retirement communities and senior centers.

Degree

Ph.D.

Advisors

Lyle, Purdue University.

Subject Area

Gerontology|Physical education|Health education

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