Abstract
Objective
To investigate the associations of balance confidence with physical and cognitive
markers of well-being in older adults receiving government-funded aged care services
and whether progressive resistance plus balance training could positively influence
change.
Design
Intervention study.
Setting
Community-based older adult–specific exercise clinic.
Participants
Older adults (N=245) with complex care needs who were receiving government-funded
aged care support.
Interventions
Twenty-four weeks of twice weekly progressive resistance plus balance training carried
out under the supervision of accredited exercise physiologists.
Main Outcome Measures
The primary measure was the Activity-specific Balance Confidence Scale. Secondary
measures included the Short Physical Performance Battery; fall history gathered as
part of the health history questionnaire; hierarchical timed balance tests; Geriatric
Anxiety Index; Geriatric Depression Scale; Fatigue, Resistance, Ambulation, Illness,
Loss of Weight scale; and EuroQoL-5 dimension 3 level.
Results
At baseline, better physical performance (r=.54; P<.01) and quality of life (r=.52; P<.01) predicted better balance confidence. In contrast, at baseline, higher levels
of frailty predicted worse balance confidence (r=−.55; P<.01). Change in balance confidence after the exercise intervention was accompanied
by improved physical performance (+12%) and reduced frailty (−11%). Baseline balance
confidence was identified as the most consistent negative predictor of change scores
across the intervention.
Conclusions
This study shows that reduced physical performance and quality of life and increased
frailty are predictive of worse balance confidence in older adults with aged care
needs. However, when a targeted intervention of resistance and balance exercise is
implemented that reduces frailty and improves physical performance, balance confidence
will also improve. Given the influence of balance confidence on a raft of well-being
determinants, including the capacity for positive physical and cognitive change, this
study offers important insight to those looking to reduce falls in older adults.
Keywords
List of abbreviations:
ABC (Activity-specific Balance Confidence Scale), DNF (did not finish), DNS (did not start), FIN (finished), FRAIL (Fatigue, Resistance, Ambulation, Illness, Loss of Weight), PRBT (progressive resistance plus balance training), SPPB (Short Physical Performance Battery)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 05, 2018
Footnotes
Supported by the Commonwealth of Australia Department of Social Services Aged Care Service Improvement and Healthy Ageing Grant (grant no. 4-Z35FF5).
Clinical Trial Registration No.: ACTRN12615001153505.
Disclosures: none.
Identification
Copyright
© 2018 by the American Congress of Rehabilitation Medicine
