Background While ageing the frequency of osteoporosis increases. The most frequent risk factor is falling and consequently bone fractures which in this population is associated with high mortality. According to WHO data, 28–35% of elderly over 65 years falls at least once per year, which increases to 32–47% over 70 years.
Objectives The purpose of this randomized control study was to investigate the efficacy of a land-based and water-based exercise program specifically targeting balance to reduce fall risk in patients over 65 years with osteoporosis. We assumed that water-based training program would develop balance efficiently even at elderly people with severe degenerative diseases. Coordination in water is possible to be developed efficiently.
Methods The study was carried out in the National Institute of Rheumatology and Physiotherapy. 61 participants were randomized [n=20 sensorimotor training group, n=20 control group (CG)] in the land-based sensorimotor training program (SMT) and 21 people [n=7 Ai Chi group (AC), n=7 water adapted sensorimotor training group (WASM), n=7 control group] in the water-based training program (WBT). The control group did not participate in any training program. The exclusion criteria were neurological, cardiovascular and musculoskeletal diseases, which contraindicated the participation in the training program. Functional Reach Test (FRC), Timed Up and Go Test (TUG), Star Excursion Balance Test (SEBT) and coordination test by stabilometer were used to measure static and dynamic balance. The measurements were performed before and after the training period. The results of the SMT were analyzed with two-sample t-test, and the results of the WBT with non-parametrical methods. The results were defined with p<0,05 statistical margin by SPSS program.
Results After 18-weeks of the SMT program significant improvement was experienced in the SMT group compared to the CG with the following parameters: FRC (p<0.001), TUG (p=0.01). In the coordination test no significant difference was found between the SMT and the CG (p=0.09). After 8-weeks of the WBT programs significant improvement in the mediolateral direction of SEBT was detected in the WASM (p=0.028) and in the AC group (p=0.043) compared to the CG. FRC test was shown marginal significance (p=0.075) in the WASM group, while at the AC group remarkable improvement (p=0.043) was recognised compared to the CG. In the TUG test significant improvement was found in the CG and the WASM (p=0.028, p=0.043) compared to the CG.
Conclusions The findings from this study support the efficacy of the land- and water-based exercise programs in improving balance in this sample. Our results pointed out that balance improved efficiently even at degenerative joint diseases. Limitations of our research was the small number of the participants and the short duration of the program. In the light of the promising outcome we will continue our research that would result in an efficient fall prevention in this population with high risk of falling.
Sherrington C, Tiedemann A, Fairhall N, Close JC, Lord SR. (2011). Exercise to prevent falls in older adults: an updated meta-analysis and best practice recommendations. NSW Public Health Bulletin, Vol. 22(3–4): 78–83.
Disclosure of Interest None declared