Examining the Effect of Exercise Interventions on Balance and Fall Prevention in the Elderly: A Systematic Review
Subject Areas : Exercise Physiology and Performance
zeynab amini valashani
1
,
Hasan Daneshmandi
2
*
,
Reza Khazaei
3
1 - 1. Department of corrective exercise and sport injuries, Faculty of Physical Education & Sport Sciences, University of Tehran, Tehran, Iran.
2 - 2. Department of sport injuries and corrective exercise, Faculty of Physical Education & Sport Sciences, University of Guilan, Rasht, Iran.
3 - 3. Department of corrective exercise and sport injuries, Faculty of Physical Education & Sport Sciences, Shahid Bahonar University of Kerman, Kerman, Iran.
Keywords: Balance, Falls Accidental, , Aged, Exercise Interventions, Prevention,
Abstract :
Background and purpose: With the growing elderly population worldwide, their associated problems are also increasing. Falls and their consequent outcomes are considered major health issues for the elderly, and imbalance is undoubtedly recognized as the primary cause of falls among the elderly.
Materials and methods: The aim of this study was to search for articles published in scientific and research journals from 2000 to 2020 and to review studies related to physical and exercise interventions aimed at improving balance and reducing the risk of falls in the elderly. Keywords such as elderly, older adults, aging, exercise, and falling were used to review the literature in electronic databases such as PubMed, Embase, Medline, SID, Scopus, and Google Scholar.
Results: A total of 190 articles were identified through the preliminary database search. One hundred studies were selected through title screening, and 90 of these records were excluded after abstract analysis. Of the remaining 50 articles, whose full texts were analyzed, 40 were excluded due to non-compliance with the inclusion criteria. Finally, 7 studies were identified as potentially relevant and met all the considered criteria.
Conclusion: It appears that the use of various exercise methods specifically designed for the elderly, such as home-based protocols like Otago, vestibular exercises such as Cawthorne and Cooksey, fall-proof exercises, and other similar exercises mentioned in the present study, which specifically challenge balance in the elderly, can enhance their abilities and consequently reduce the risk of falls.
1- Laessoe U, Hoeck HC, Simonsen O, Sinkjaer T, Voigt M. Fall risk in an active elderly population–can it be assessed?. Journal of negative results in biomedicine. 2007 Dec;6:1-1. doi:10.1186/1477-5751-6-2
2- Chodzko-Zajko W, Schwingel A, Hee C. Successful Aging: The Role of Physical Activity. American Journal of Lifestyle Medicine. 2009;3(1):20-28. doi:10.1177/1559827608325456
3- Chang JT, Morton SC, Rubenstein LZ, Mojica WA, Maglione M, Suttorp MJ, Roth EA, Shekelle PG. Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trials. Bmj. 2004 Mar 18;328(7441):680. doi:/10.1136/bmj.328.7441.680
4- Safavi Bayat Z, Zorriasatain F. Determining risk factors associated with falling among elderly at residential care facilities in Tehran. Journal of Inflammatory Diseases. 2008 Feb 10;11(4):66-70. ID: emr-143440.[in persian]
5- Kamrani AA, Azadi F, Foroughan M, Siadat S, Kaldi A. Characteristics of falls in elderly residents of nursing homes. Iranian Journal of Ageing. 2007;1(2):101-5. URL: http://salmandj.uswr.ac.ir/article-1-19-en.html.[in persian]
6- Nejc S, Loefler S, Cvecka J, Sedliak M, Kern H. Strength training in elderly people improves static balance: a randomized controlled trial. European Journal of Translational Myology. 2013 Jul 25;23(3):85-9. doi.org/10.4081/ejtm.2013.1777
7- Granata KP, Lockhart TE. Dynamic stability differences in fall-prone and healthy adults. Journal of Electromyography and Kinesiology. 2008 Apr 1;18(2):172-8. doi:/10.1016/j.jelekin.2007.06.008
8- Pizzigalli L, Filippini A, Ahmaidi S, Jullien H, Rainoldi A. Prevention of falling risk in elderly people: the relevance of muscular strength and symmetry of lower limbs in postural stability. The Journal of Strength & Conditioning Research. 2011 Feb 1;25(2):567-74. doi: 10.1519/JSC.0b013e3181d32213
9- Ungar A, Rafanelli M, Iacomelli I, Brunetti MA, Ceccofiglio A, Tesi F, Marchionni N. Fall prevention in the elderly. Clinical Cases in mineral and bone metabolism. 2013 May;10(2):91. PMID: 24133524
10- de Almeida ST, Soldera CL, de Carli GA, Gomes I, de Lima Resende T. Analysis of extrinsic and intrinsic factors that predispose elderly individuals to fall. Revista da Associação Médica Brasileira (English Edition). 2012 Jul 1;58(4):427-33. doi:10.1016/S2255-4823(12)70224-2
11- Marschollek M, Rehwald A, Wolf KH, Gietzelt M, Nemitz G, zu Schwabedissen HM, Schulze M. Sensors vs. experts-a performance comparison of sensor-based fall risk assessment vs. conventional assessment in a sample of geriatric patients. BMC medical informatics and decision making. 2011 Dec;11:1-7. doi:10.1186/1472-6947-11-48
12- Howcroft J, Kofman J, Lemaire ED. Review of fall risk assessment in geriatric populations using inertial sensors. Journal of neuroengineering and rehabilitation. 2013 Dec;10:1-2. doi:10.1186/1743-0003-10-91
13- Yoshida-Intern S. A global report on falls prevention epidemiology of falls. Geneva: WHO. 2007 Apr 21.
14- Campbell AJ, Robertson MC. Rethinking individual and community fall prevention strategies: a meta-regression comparing single and multifactorial interventions. Age and ageing. 2007 Nov 1;36(6):656-62. doi:10.1093/ageing/afm122
15- Hartholt KA, van Beeck EF, Polinder S, van der Velde N, van Lieshout EM, Panneman MJ, van der Cammen TJ, Patka P. Societal consequences of falls in the older population: injuries, healthcare costs, and long-term reduced quality of life. Journal of Trauma and Acute Care Surgery. 2011 Sep 1;71(3):748-53. doi: 10.1097/TA.0b013e3181f6f5e5
16- Lopes KT, Costa DF, Santos LF, Castro DP, Bastone AC. Prevalence of fear of falling among a population of older adults and its correlation with mobility, dynamic balance, risk and history of falls. Brazilian Journal of Physical Therapy. 2009;13:223-9. doi: 10.1590/S1413-35552009005000026
17- Resende SM, Rassi CM. Effects of hydrotherapy in balance and prevention of falls among elderly women. Brazilian Journal of Physical Therapy. 2008;12:57-63. doi:10.1590/S1413-35552008000100011
18- Guccione AA, Felson DT, Anderson JJ, Anthony JM, Zhang Y, Wilson PW, Kelly-Hayes M, Wolf PA, Kreger BE, Kannel WB. The effects of specific medical conditions on the functional limitations of elders in the Framingham Study. American journal of public health. 1994 Mar;84(3):351-8. doi:10.2105/AJPH.84.3.351
19- Hosseini L, Kargozar E, Sharifi F, Negarandeh R, Memari AH, Navab E. Tai Chi Chuan can improve balance and reduce fear of falling in community dwelling older adults: a randomized control trial. Journal of exercise rehabilitation. 2018 Dec;14(6):1024. doi: 10.12965/jer.1836488.244.[in persian]
20- Shahbazian M ,Daneshmandi H., the effect of 6 weeks of virtual reality exercises on posture control and motor performance of elderly women.2022. https://civilica.com/doc/1599443.[in persian]
21- Shimada H, Suzukawa M, Ishizaki T, Kobayashi K, Kim H, Suzuki T. Relationship between subjective fall risk assessment and falls and fall-related fractures in frail elderly people. BMC geriatrics. 2011 Dec;11:1-8. doi:10.1186/1471-2318-11-40
22- Carter ND, Kannus P, Khan K. Exercise in the prevention of falls in older people: a systematic literature review examining the rationale and the evidence. Sports medicine. 2001 May;31:427-38. doi:10.2165/00007256-200131060-00003
23- Arnold CM, Sran MM, Harrison EL. Exercise for fall risk reduction in community-dwelling older adults: a systematic review. Physiotherapy Canada. 2008 Oct;60(4):358-72. doi.org/10.3138/physio.60.4.358
24- Balzer K, Bremer M, Schramm S, Lühmann D, Raspe H. Falls prevention for the elderly. GMS health technology assessment. 2012;8. doi: 10.3205/hta000099
25- Daneshmandi H. The effect of virtual reality training program on the Functional Fitness of the elderly. Journal of Gerontology. 2021 Apr 10;6(1):32-41. URL: http://joge.ir/article-۱-۴۴۸-fa.html.[in persian]
26- Province MA, Hadley EC, Hornbrook MC, Lipsitz LA, Miller JP, Mulrow CD, Ory MG, Sattin RW, Tinetti ME, Wolf SL, Schechtman KB. The effects of exercise on falls in elderly patients: a preplanned meta-analysis of the FICSIT trials. Jama. 1995 May 3;273(17):1341-7. doi:10.1001/jama.1995.03520410035023
27- Gillespie LD, Gillespie WJ, Robertson MC, Lamb SE, Cumming RG, Rowe BH, Cochrane Bone, Joint and Muscle Trauma Group. Interventions for preventing falls in elderly people. Cochrane database of systematic reviews. 1996 Sep 1;2009(1). doi:10.1002/14651858.CD000340
28- Ansai JH, Aurichio TR, Gonçalves R, Rebelatto JR. Effects of two physical exercise protocols on physical performance related to falls in the oldest old: A randomized controlled trial. Geriatrics & gerontology international. 2016 Apr;16(4):492-9. doi:10.1111/ggi.12497
29- Daneshmandi H, hoseinpour M. The role of muscle weakness in balance and postural instability in the elderly with and without falls: A Systematic review. joge 2022; 6 (4) :89-104
URL: http://joge.ir/article-1-532-fa.html.[in persian]
30- Leiros-Rodríguez R, García-Soidan JL. Balance training in elderly women using public parks. Journal of women & aging. 2014 Jul 3;26(3):207-18. doi:10.1080/08952841.2014.888220
31- Zhao Y, Chung PK, Tong TK. Effectiveness of a balance-focused exercise program for enhancing functional fitness of older adults at risk of falling: A randomised controlled trial. Geriatric nursing. 2017 Nov 1;38(6):491-7. doi:10.1016/j.gerinurse.2017.02.011
32- Ambrose AF, Paul G, Hausdorff JM. Risk factors for falls among older adults: a review of the literature. Maturitas. 2013 May 1;75(1):51-61. doi:10.1016/j.maturitas.2013.02.009
33- Sousa N, Mendes R, Silva A, Oliveira J. Combined exercise is more effective than aerobic exercise in the improvement of fall risk factors: a randomized controlled trial in community-dwelling older men. Clinical rehabilitation. 2017 Apr;31(4):478-86. doi:10.1177/02692155166558
34- Keysor JJ. Does late-life physical activity or exercise prevent or minimize disablement?: a critical review of the scientific evidence. American journal of preventive medicine. 2003 Oct 1;25(3):129-36. doi:10.1016/S0749-3797(03)00176-4
35- Sui X, LaMonte MJ, Laditka JN, Hardin JW, Chase N, Hooker SP, Blair SN. Cardiorespiratory fitness and adiposity as mortality predictors in older adults. Jama. 2007 Dec 5;298(21):2507-16. doi:10.1001/jama.298.21.2507
36- Gaught AM, Carneiro KA. Evidence for determining the exercise prescription in patients with osteoarthritis. The Physician and sportsmedicine. 2013 Feb 1;41(1):58-65. doi:10.3810/psm.2013.02.2000
37- Gómez-Cabello A, Ara I, González-Agüero A, Casajús JA, Vicente-Rodriguez G. Effects of training on bone mass in older adults: a systematic review. Sports Medicine. 2012 Apr;42:301-25. doi: 10.2165/11597670-000000000-00000
38- Kouchaki E, Sedaghati P, Daneshmandi H. Comparing the fear of falling and quality of life outcomes following a functional movement protocol among the experimental and control idiopathic Parkinson cases. Feyz Medical Sciences Journal. 2016 Aug 10;20(3):252-9. URL: http://feyz.kaums.ac.ir/article-1-3084-en.html.[in persian]
39- Pate RR, Pratt M, Blair SN, Haskell WL, Macera CA, Bouchard C, Buchner D, Ettinger W, Heath GW, King AC, Kriska A. Physical activity and public health: a recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. Jama. 1995 Feb 1;273(5):402-7. doi:10.1001/jama.1995.03520290054029
40- Leavey VJ. The comparative effects of a six-week balance training program, gluteus medius strength training program, and combined balance training/gluteus medius strength training program on dynamic postural control. West Virginia University ProQuest Dissertations & Theses; 2006.
41- Jung H, Yamasaki M. Association of lower extremity range of motion and muscle strength with physical performance of community-dwelling older women. Journal of physiological anthropology. 2016 Dec;35:1-9. doi:10.1186/s40101-016-0120-8
42- Mittaz Hager AG, Mathieu N, Lenoble-Hoskovec C, Swanenburg J, de Bie R, Hilfiker R. Effects of three home-based exercise programmes regarding falls, quality of life and exercise-adherence in older adults at risk of falling: protocol for a randomized controlled trial. BMC geriatrics. 2019 Dec;19:1-1. doi:10.1186/s12877-018-1021-y
43- Ward K. Effectiveness of FallProof home-based DVD program in improving balance, select functional fitness parameters, and balance-related confidence among community-dwelling older adults who have been identified as moderate to high risk of falls. oai:alma.01CALS_USL:11232444480001671
44- Bjerk M, Brovold T, Skelton DA, Liu-Ambrose T, Bergland A. Effects of a falls prevention exercise programme on health-related quality of life in older home care recipients: a randomised controlled trial. Age and ageing. 2019 Mar 1;48(2):213-9. doi:10.1093/ageing/afy192
45- Wati DN, Sahar J, Rekawati E. Effectiveness of Lafiska exercise on risk of fall, balance, and health status in the elderly. Enfermeria clinica. 2018 Feb 1;28:337-42. doi:10.1016/S1130-8621(18)30181-5
46- Park JH. The effects of eyeball exercise on balance ability and falls efficacy of the elderly who have experienced a fall: A single-blind, randomized controlled trial. Archives of gerontology and geriatrics. 2017 Jan 1;68:181-5. doi:10.1016/j.archger.2016.10.006
47- Khazanin H, Daneshmandi H. Effect of selected fallproof exercise on static and dynamic balance in the elderly. The Scientific Journal of Rehabilitation Medicine. 2020 Sep 22;9(3):16-26. doi:10.22037/JRM.2019.112562.2218.[in persian]
48- Zambare PD, Soni N, Sharma P. Effect of Cawthorne and Cooksey exercise program on balance and likelihood of fall in older women. Ind J Physioth Occupat Therapy-An Inter J. 2015 Jul;9:55. doi: 10.14196/mjiri.32.74
49- Thomas S, Mackintosh S, Halbert J. Does the ‘Otago exercise programme’reduce mortality and falls in older adults?: a systematic review and meta-analysis. Age and ageing. 2010 Nov 1;39(6):681-7. doi:10.1093/ageing/afq102
50- Khazanin H, Daneshmandi H, Fakoor Rashid H. Effect of selected fall-proof exercises on fear of falling and quality of life in the elderly. Iranian Journal of Ageing. 2022 Feb 10;16(4):564-77. URL: http://salmandj.uswr.ac.ir/article--2174-1fa.html.[in persian]
51- Shubert TE, Smith ML, Ory MG, Clarke CB, Bomberger SA, Roberts E, Busby-Whitehead J. Translation of the Otago Exercise Program for adoption and implementation in the United States. Frontiers in public health. 2015 Apr 27;2:152. doi:10.3389/fpubh.2014.00152
52- Rose DJ. Reducing the risk of falls among older adults: the Fallproof Balance and Mobility Program. Current Sports Medicine Reports. 2011 May 1;10(3):151-6. doi: 10.1249/JSR.0b013e31821b1984
53- Macias JD, Massingale S, Gerkin RD. Efficacy of vestibular rehabilitation therapy in reducing falls. Otolaryngology—Head and Neck Surgery. 2005 Sep;133(3):323-5. doi:10.1016/j.otohns.2005.04.024
54- Zanardini FH, Zeigelboim BS, Jurkiewicz AL, Marques JM, Martins-Bassetto J. Vestibular rehabilitation in elderly patients with dizziness. Pró-Fono Revista de Atualização Científica. 2007;19:177-84. doi:10.1590/S0104-56872007000200006
55- Robinovitch SN, Feldman F, Yang Y, Schonnop R, Leung PM, Sarraf T, Sims-Gould J, Loughin M. Video capture of the circumstances of falls in elderly people residing in long-term care: an observational study. The lancet. 2013 Jan 5;381(9860):47-54. doi:10.1016/S0140-6736(12)61263-X
56- Dashti P, Shabani M, Moazami M. Comparison of the effects of two selected exercises of Theraband and Pilates on the balance and strength of lower limb in elderly women. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2015 Jun 22;18(153):1-9.doi: 10.22038/IJOGI.2015.4698.[in persian]
57- Yaali R, Naeimi Kia M, Gholami A. Effect of weight transfer training on static and dynamic balance of older women. Research in Sport Management and Motor Behavior. 2018 Dec 10;8(16):47-59.doi: 10.29252/JRSM.8.16.47.[in persian]
58- de Bruin ED, Murer K. Effect of additional functional exercises on balance in elderly people. Clinical rehabilitation. 2007 Feb;21(2):112-21. doi:10.1177/0269215506070144