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The effect of 15 weeks of exercise on balance, leg strength, and reduction in falls in 40 women aged 65 to 89 years
Ballard JE, McFarland C, Wallace LS, Holiday DB, Roberson G
Journal of the American Medical Women's Association 2004;59(4):255-261
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: Risk of falling increases as people age, and decreased leg strength and poor balance have been implicated as contributors. Our aims were to: (1) assess the efficacy of a fall-prevention exercise program on balance and leg strength in women aged 65 to 89 years and (2) conduct a 1-year follow-up to determine the effect of exercise on fall rates. METHODS: Forty women were classified by falling history and fear of falling and assigned to exercise and control groups using stratified randomization. We used the Berg Balance Scale, Get-up and Go, Functional Reach, and Wall-Sit Tests to evaluate changes in balance and leg strength before and after a supervised 15-week exercise program (3 1-hr sessions/week). We conducted 1-year follow-up telephone interviews and compared the number of falls reported by exercise and control groups. The study used a 2x2 (exercise/control by pretest/post-test) factorial design with the testing times being a repeated factor, so we used analysis of variance (ANOVA) to evaluate differences between the 2 groups across testing times. Power analysis computed a priori with STPLAN software (Version 4.2) showed that a sample size of 40 was necessary to determine statistical differences in balance and leg strength. RESULTS: Exercise subjects showed significant improvement on 5 of 14 items (5.2%, p <= 0.05 to 34.4%, p <= 0.01) in the Berg Balance Scale and on the total score (6.8%, p <= 0.05). Leg strength increased significantly (p <= 0.05) on post-test as measured by the Wall-Sit Test. Control subjects reported 6 falls and exercise subjects no falls during the follow-up year, but this difference was not significant using Fischer's exact test (p = 0.106). CONCLUSION: The exercise program resulted in increased balance and leg strength, but did not result in a significant difference in falls during the follow-up eriod. Further research with a larger and possibly older sample is needed to more adequately investigate this question. Health care providers who work with older women should provide exercise programs in which balance and leg strength are emphasized.

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