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The effect of proprioceptive exercises on balance and physical function in institutionalized older adults: a randomized controlled trial
Espejo-Antunez L, Perez-Marmol JM, de Los Angeles Cardero-Duran M, Toledo-Marhuenda JV, Albornoz-Cabello M
Archives of Physical Medicine and Rehabilitation 2020 Oct;101(10):1780-1788
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; 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: To evaluate the efficacy of a proprioceptive exercise program on functional mobility, musculoskeletal endurance, dynamic and static balance, gait, and risk of falls in institutionalized older adults. DESIGN: A randomized, single-blind, controlled trial. SETTING: A Spanish nursing home from the Autonomous Community of Extremadura, Spain. PARTICIPANTS: An initial sample was created by recruiting 148 older adult volunteers. The final sample (n = 42) was randomly divided into two groups. INTERVENTION: Both the control and experimental group received physical therapy treatment based on a combination of adapted exercises and other physical therapy techniques (physical therapy intervention program) for a period of 12 weeks. This program consisted of 45 minutes (group intervention) plus 100 minutes (individual intervention) a week, for a total of 36 sessions (29 hours). The experimental group also received a proprioceptive training program during the same intervention period, which was conducted twice weekly (24 sessions), each session lasting 55 minutes. MAIN OUTCOME MEASURES: The TUG, Cooper, Tinetti, One-Leg Stance and MORSE scales were used. RESULTS: ANOVA analysis showed a time x group interaction in TUG scores (F = 10.41, p = 0.002), Cooper test (F = 5.94, p = 0.019), Tinetti scores (F = 6.41, p = 0.015) and MORSE scores (F = 5.24, p = 0.028). Differences between groups were achieved for TUG scores (d = 0.76), Tinetti scores (d = 1.12), One-Leg Stance test scores (d = 0.77) and MORSE scale scores (d = 0.85). In the experimental group, within-group analyses showed pre-post-treatment differences for TUG scores (d = 0.72), Cooper test scores in meters (d = 0.18), Tinetti scores (d = 0.60), One-Leg Stance scores (d = 0.55), and MORSE scores (d = 0.42). CONCLUSIONS: A proprioceptive exercise program produced significant improvements compared to the control group in areas such as functional mobility, musculoskeletal endurance, balance, gait, and risk of falls in institutionalized older adults. This study may help to enhance our understanding of the impact of a specific protocol for a proprioceptive rehabilitation program.

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