Balance Training For seniors

Research Shows that Balance Training Helps Seniors

Enhancing Functional Balance and Mobility Among Older People Living in
Long-Term Care Facilities



Jennifer C. Nitz, PhD, M Phty, B Phty
Diane
L. Josephson, Dip Physio
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This study of long-term care residents investigated whether a balance strategy training program (BSTP) developed for
older people living in the community is effective in improving functional mobility and reducing falls when adapted to resident functional abilities. Balance Training was delivered twice weekly over 12 weeks. Outcome measures compared pre-
and postintervention measured Timed Up and Go, Functional Reach, timed 5 sit-to-stand movements, and number of falls in 12 weeks before intervention with 12-week follow-up period. Forty-seven residents participated in the balance training, 26 of whom were cognitively impaired. There was a significant improvement in all functional balance and mobility measures.

Background on those Seniors Who Need Balance Training

Residents in long-term or aged care facilities have a higher risk of sustaining an injurious fall than community-dwelling older people. Hospital admissions result in between 10% and 25% of falls.[1] The risk of falling is compounded by residents’ low levels of physical activity and need for balance training. Frailty is a major contributor to inactivity and fall susceptibility, but the environment is also an important contributor.[2]



Individual frail residents commonly have multiple coexisting complex and chronic conditions. These commonly include diabetes, heart failure, arthritis, stroke, and dementia. All contribute to vulnerability to decreased activity and falls and need for balance training.[3] It is known that the medications prescribed for management of many conditions are proven risk factors for falling.[3] Vision deficits are commonly encountered in residents. When combined with strength, balance, and gait impairments, as well as environmental hazards, potential for fall risk is accentuated.[4] Acquisition of an acute illness is also a major risk factor for falling, and a history of a recent fall is a most significant indicator for future falls.

Effectiveness of Balance Training

There is evidence that exercise programs that include target-directed reaching, coordination, and balance training in addition to
strengthening with or without gait training have an impact on functional mobility. [9] , [10] , [11] , [12] Functional
mobility is determined by postural stability and dynamic balance. The concept that postural stability and balance relies on intact sensory and motor systems with efficient integration centrally underpins the balance strategy training program (BSTP)[13] as
previously reported. In frail older people, there are considerable constraints on sensory (somatosensation, vision, vestibular system) efficiency, integration, and anticipatory postural adjustments, as well as limits of stability due to age and pathology.[14]
Knowledge suggests that improvement in these, through balance training, contributors to postural stability and balance is
only achieved by challenging all these aspects with applicable task-based exercises. It is therefore important to determine whether exercise programs that are designed to challenge the sensory and motor components of functional balance and mobility and known to reduce falls in community-dwelling older people [13] , [15] can affect functional balance and mobility and reduce the
number of falls in frail older people living in residential long-term care.

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