The Effect Of Training Mode On Balance & Gait In The Elderly

Abstract

Habitual exercise or physical activity is an effective means for improving functional ability and decreasing risk for falling in the elderly. The optimal exercise prescription to enhance balance and gait ability, thereby reducing risk for falling, is unknown. PURPOSE The purpose of this study was to determine the comparitive effects of differing exercise modes on balance and gait ability in community-dwelling elderly. METHODS Thirty-seven elderly individuals (65 – 85 years old) completed an exercise program after being randomized into A) a cardiovascular training regimen using treadmills and stair-climbers (CVE; n = 18, 71.9±4.5 y) or B) balance, gait or stabilization training regimen (BAL; n = 19, 70.9±5.8 y) for 10 mo. Balance performance was assessed using the Berg balance scale, composite score on the EquiTest (EQT; a quantitative method of assessing upright balance function under a variety of tasks that simulate conditions encountered in daily life), and standing postural sway and limits of stability using a force platform. Gait performance was assessed using timed stair descent and ascent, timed 8-Foot Up and Go, and self-paced 7-meter walk with and without obstacle. Cardiovascular fitness was determined from a maximal oxygen uptake test (VO2max). RESULTS Program completion (1 and 2 drop-outs for CVE and BAL, respectively) and exercise session attendance (86.5% vs. 84.9% for CVE and BAL, respectively) was similar. Both groups exhibited similar improvements in their static balance ability as assessed by EQT (CVE = 11%; BAL = 13%, p < 0.05); however, no changes occurred in dynamic balance or gait function. Base of support increased significantly in both groups (16% vs. 19% for CVE and BAL, respectively, p < 0.05) with no apparent group effect. No relations existed between changes in VO2max and changes in balance and gait outcomes. CONCLUSION These results suggest that similar improvements in static balance and stance width can be obtained with cardiovascular or balance and gait training in the elderly. These results are potentially due to training on equipment, as opposed to flat-surface walking, the former challenging balance systems. High levels of independent function in these community-dwelling individuals may account for the minimal impact of the interventions on balance and gait function. Supported by NIH AG18861 (PI: Woods)