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 The analysis of seven previous studies, with a combined total of 660
older adults, found that interventions to improve stepping skills
cut the rate of falls roughly in half.
For fall prevention, elderly people may benefit from exercises
designed to help maintain balance during everyday activities like
getting out of a chair or avoiding obstacles on a sidewalk, said
senior study author Stephen Lord of the University of New South
Wales in Sydney. Workouts that improve the ability to recover when
balance is lost so that trips or slips don't turn into falls may
also be beneficial, Lord added.
"Strength and balance are both important for physical functioning,"
Lord said by email. "In terms of fall prevention, the best evidence
is for balance and step training."
In addition to cutting the rate of falls, step training also helped
cut the proportion of fallers across the studies roughly in half,
Lord and colleagues report in the British Journal of Sports
Medicine. This is important with the elderly because after one
tumble people are more likely to have repeat accidents.
A pooled analysis of data from five studies found stepping
interventions significantly improved decision-making and stepping
reaction time, single leg stance and the time it took people to rise
up from seated position and start moving.
Limitations of the results include the wide variation among the step
programs and in the outcomes measured across the studies analyzed,
many of which were fairly small, the authors note.
Even so, the findings suggest that step training should be a major
component of exercise interventions to prevent falls, the authors
conclude.
So-called functional training, or workouts tailored to skills needed
for a very specific activity or sport, is becoming much more common
in all age groups, not just the elderly, noted Dr. Elizabeth Joy,
medical director for community health at Intermountain Healthcare in
Salt Lake City.
"We are seeing training programs migrate into this 'functional'
space, not only for older adults, but for others as well," Joy, who
wasn't involved in the study, said by email.
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"For an older adult trying to maintain independent living, they need
function-specific training," Joy added. "Walking, getting up out of
a chair, getting up off the floor, those are the activities they
need to do."
While a wide variety of balance exercises is also important,
exercises focused on walking are particularly crucial for fall
prevention among the elderly, noted Saija Karinkanta, a scientist at
the UKK Institute for Health Promotion Research in Tampere, Finland,
who wasn't involved in the study.
"If you want to improve your walking ability, most of the exercises
need to be done while walking – standing on one foot, reaching,
shifting weight from one foot to the other, squatting, tandem
walking, stair walking, walking on different surfaces and stepping,"
Karinkanta said by email.
"In addition, if you want to improve your reaction time, the
exercises need to challenge your reactions," Karinkanta added.
"Volitional stepping using a dance mat or other target where you
need to hit quickly is a good way to improve reaction time."
SOURCE: http://bit.ly/1ROkx7s British Journal of Sports Medicine,
online January 8, 2016.
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