Improved Functional Independence, Balance, And Force Production With Low-volume, Alternative Training In Older Adults

Abstract

Reduced strength, balance, and functional independence are common with aging; this diminishes quality of life and increases individual and societal health care costs. Efficacious, safe and lifestyle-accommodating interventions that minimize or reverse these changes are needed. PURPOSE: Measure and compare effects of three interventions on strength (force production), balance, and functional independence in community-dwelling older adults. METHODS: 12-wk trial. Participants were randomized to a control group or one of three intervention groups: 1) bioDensity (bD); 2) Power Plate whole-body vibration (PP); or 3) bD+PP. bD training involved one 5-sec voluntary, maximal contraction of four major muscle groups (chest press, core pull, leg press, and vertical lift) done once a week. PP training involved alternating 1 min of marching in place and rest for 5 min twice a week. Primary outcomes were: force production (bD); static and dynamic balance (KOREBALANCE); and Functional Independence Measure (FIM). The FIM looks at physical and cognitive attributes using a 7-point scale, where 7 = fully independent. RESULTS: 24 men (83 ± 4 yr; BMI = 27 ± 4 kg/m2) and 36 women (81 ± 6 yr; BM I = 25 ± 4 kg/m2) completed the study (control, N=14; bD, N=16; PP, N=13; bD+PP, N=17). At baseline, no groups differed in force production capacity, balance, or FIM. Force production increased for chest press, leg press, and vertical lift in the bD and bD+PP groups (range: 21 to 49%; P<0.001). Dynamic balance improved in the bD+PP group. Between-group differences were isolated to the physical attribute FIM scores of self-care and mobility. bD+PP improved self-care (6.8 to 6.9; P=0.002). Mobility improved in bD and bD+PP (6.6 to 6.8; P<0.001; and 6.7 to 6.9; P<0.001, respectively). The scores for cognitive attributes (social cognition and communication) were 7 at baseline and did not change. CONCLUSION: The improved force production from a single weekly 5-min session of bD shows that this intervention not only has important health and clinical value but also overcomes the often-cited lack of time as an exercise barrier. The improved dynamic balance in the bD+PP group may reduce their risk of falls. The improved physical FIM scores in bD and bD+PP groups are clinically significant and justify larger RCTs investigating the efficacy of bD and bD+PP.