Taking it to the Water: Balance Training Programs in Aquatic Environments can Lower the Risk Factors for Falls in High-Risk Older Adults.

Abstract

Land-based exercise programs that target balance and mobility deficits constitute an effective strategy for lowering fall risk and fall incidence rates (Rubenstein et al, 2000; Lord et al. 2003) among older adults at different levels of fall risk. While aquatic exercise programs also afford multiple health benefits for groups of healthy, albeit sedentary older adults (Bravo et al., 1997; Douris et al, 2003), it remains to be determined whether tailored aquatic exercise programs can positively influence balance, gait, and other important risk factors associated with falls in "at-risk" older adult groups. PURPOSE: A single-blind randomized clinical controlled trial was conducted to examine the short-term efficacy of a multidimensional balance and mobility program delivered in an aquatic setting on multiple risk factors associated with falls. METHODS: A total of 61 community-residing older adults (M = 75 years, SD = 8.62) identified at moderate-to-high risk for falls were randomly assigned to an Aquatic Exercise (AE) or Usual Activity (UA) control group. The AE group attended 2 X 60 minute sessions per week for 12 weeks and performed progressive water-based activities designed to improve balance, gait, upper and lower-body strength, and balance-related self-confidence. RESULTS: The results of repeated measures analyses of variance revealed significant Group X Time interactions for upper (p < .005) and lower body strength (p < .01), balance (p < .01), and balance-related self-confidence (p < .03). No significant group differences were evident for gait velocity at preferred or maximum speed following the intervention although a positive trend was evident for gait velocity at the preferred speed in the AE group. CONCLUSIONS: The aquatic-based balance and mobility program was effective in significantly reducing known risk factors for falls (e.g., balance and lower body weakness) in a group of "at-risk" older adults. Between-group effect sizes further indicated that the improvements observed in three of the four measures were clinically significant. Balance-related self-confidence was also significantly enhanced as a function of the aquatic exercise program. The long-term effects of aquatic exercise on both the perceived and actual risk for falls require further investigation.