Abstract
Vogler CM, Menant JC, Sherrington C, Ogle SJ, Lord SR. Evidence of detraining after
12-week home-based exercise programs designed to reduce fall-risk factors in older
people recently discharged from hospital.
Objective
To measure the extent to which improved sensorimotor function and balance resulting
from a 12-week exercise intervention were retained 12 weeks after exercise cessation
in older adults recently discharged from hospital.
Design
Randomized controlled trial with reassessment 12 weeks after exercise cessation.
Setting
Home-based exercises.
Participants
Adults (N=180) aged 65 years and older recently discharged from hospital (mean length
of stay, 12.3±10.6d).
Interventions
Weight-bearing (WB) exercises (n=60), seated resistance (SR) exercises (n=60), or
social visits (n=60).
Main Outcome Measures
Physiological Profile Assessment (PPA), a composite sensorimotor fall-risk score,
and 2 measures of controlled leaning balance assessed at baseline, immediately after
the intervention (12wk, 95% assessed), and again 12 weeks later (24wk, 92% assessed).
Results
After the initial improvements in outcomes found at 12 weeks, both the SR and WB exercise
groups showed detraining effects at 24 weeks. The PPA fall-risk scores for both SR
and WB groups returned to close to baseline values, and there was no significant difference
between groups at 24 weeks when controlling for baseline scores (P=.924). WB exercise participants lost up to half of the improvement in the maximal
balance range and coordinated stability tests. There was no difference between groups
for the maximal balance range test at 24 weeks when controlling for baseline scores
(P=.207), but between-group differences were maintained for the coordinated stability
test (P=.017).
Conclusions
Balance improvements and fall-risk reductions associated with a 12-week home-based
exercise program in older adults were partially to totally lost 12 weeks after the
cessation of the intervention. These significant detraining effects suggest that sustained
adherence to falls prevention exercise programs is required to reduce fall risk.
Key Words
List of Abbreviations:
PPA (Physiological Profile Assessment), SR (seated resistance), WB (weight-bearing)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 13, 2012
Footnotes
Supported by the National Health and Medical Research Council Prevention of Older People's Injuries Partnership in Injury (grant no. 209799); Good Age Trust; and the Geoff and Elaine Penney Research Trust at Royal North Shore Hospital.
Sponsors had no role in the study design, recruitment, data collection, analysis, or preparation of this article.
A commercial party having a direct financial interest in the results of the research supporting this article has conferred or will confer a financial benefit on the author or one or more of the authors. The Physiological Profile Assessment (PPA; marketed as NeuRA FallScreen) is commercially available through Neuroscience Research Australia (NeuRA); Lord declares that any profits from sales of the PPA are shared equally between the inventor (Lord), the falls and balance research group at NeuRA, and the NeuRA central fund.
Australian New Zealand Clinical Trials Registry No.: ACTRN12605000335695.
In-press corrected proof published online on May 16, 2012, at www.archives-pmr.org.
Identification
Copyright
© 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
