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Improving balance control and self-reported lower extremity function in community-dwelling older adults: a randomized control trial [with consumer summary]
Melzer I, Oddsson LIE
Clinical Rehabilitation 2013 Mar;27(3):195-206
clinical trial
8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVES: To evaluate the effect of a group-based functional and specific balance training programme that included dual-task exercises on balance function in healthy older adults. DESIGN: A single-blind randomized controlled trial. SETTING: General community. PARTICIPANTS: Sixty-six community-dwelling older adults (age 77.0 +/- 6.5 years), without functional balance impairment were recruited and allocated at random to an intervention group (n = 33) or a reference group (n = 33). INTERVENTION: The intervention group received 24 training sessions over three months that included perturbation as well as dual-task exercises. The reference group received no intervention. OUTCOME MEASURES: The voluntary step execution times during single- and dual-task conditions, stabilogram-diffusion analysis in upright standing, and self-reported physical function; all were measured assessed at baseline and at the end of intervention. The intervention group was retested after six months. RESULTS: Compared with the reference group, participation in group-based functional and specific balance training led to faster voluntary step execution times under single-task (p = 0.02; effect size (ES) = 0.34) and dual-task (p = 0.036; ES 0.55) conditions; lower transition displacement and shorter transition time of the stabilogram-diffusion analysis under eyes-closed conditions (p = 0.007, ES 0.30 and p = 0.08, ES 0.44, respectively); and improved self-reported lower extremity function (p = 0.006, ES 0.37). Effects were lost at six-month follow-up. CONCLUSIONS: Functional and specific balance training can improve voluntary stepping and balance control in healthy older non-fallers, parameters previously found to be related to increased risk of falls and injury in older adults.

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