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Long-term effects of a progressive and specific balance-training programme with multi-task exercises for older adults with osteoporosis: a randomized controlled study [with consumer summary]
Halvarsson A, Oddsson L, Franzen E, Stahle A
Clinical Rehabilitation 2016 Nov;30(11):1049-1059
clinical trial
5/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; 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*

OBJECTIVE: To evaluate long-term effects of balance-training on concerns about falling, gait, balance performance, and physical function in older adults with osteoporosis and increased risk of falling. DESIGN: Randomized controlled trial, including three groups (training, training+physical activity, and control group), with follow-ups at three, nine, and 15 months. Short-term, three-month follow-up, benefits for those who fulfilled the first follow-up (n = 69) have previously been reported. SETTING: Stockholm, Sweden. PARTICIPANTS: A total of 96 elderly, age 66 to 87, with verified osteoporosis. INTERVENTIONS: Balance-training programme including dual- and multitasks, with or without supplementary physical activity, three times/week over 12 weeks. MEASUREMENTS: Concerns about falling Falls Efficacy Scale International (FES-I), walking at preferred speed with and without a cognitive dual-task and at fast speed, balance tests (one-leg stance and modified figure-of-eight), and physical function Late-Life Function and Disability Instrument (LLFDI). RESULTS: Participants in the training group maintained positive effects throughout the study period for concerns about falling (baseline versus 15 months, median 27.5 versus 23 points, p < 0.001) and walking performance (baseline versus 15 months, p <= 0.05 with an improvement of 0.9 to 1.4 m/s). The training+physical activity group declined to baseline values at the nine-month follow-up, and were even lower at the 15-month follow-up for concerns about falling (median 26 versus 26 points), walking performance (changes of -0.02 to 0.04 m/s), and physical function (mean 44.0 versus 42.9 points). The control group remained unchanged throughout the study period. CONCLUSIONS: This balance-training programme reduced concerns about falling, and also improved gait in older adults with osteoporosis and increased risk of falling in a long-term perspective -- important issues for fall prevention.

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