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The performance of balance exercises during daily tooth brushing is not sufficient to improve balance and muscle strength in healthy older adults
Granacher U, Muehlbauer T, Gostemeyer G, Gruber S, Gruber M
BMC Geriatrics 2021 Apr 17;21(257):Epub
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; 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*

BACKGROUND: High prevalence rates have been reported for physical inactivity, mobility limitations, and falls in older adults. Home-based exercise might be an adequate means to increase physical activity by improving health- (ie, muscle strength) and skill-related components of physical fitness (ie, balance), particularly in times of restricted physical activity due to pandemics. OBJECTIVE: The objective of this study was to examine the effects of home-based balance exercises conducted during daily tooth brushing on measures of balance and muscle strength in healthy older adults. METHODS: Fifty-one older adults were randomly assigned to a balance exercise group (n = 27; age 65.1 +/- 1.1 years) or a passive control group (n = 24; age 66.2 +/- 3.3 years). The intervention group conducted balance exercises over a period of eight weeks twice daily for three minutes each during their daily tooth brushing routine. Pre- and post-intervention, tests were included for the assessment of static steady-state balance (ie, Romberg test), dynamic steady-state balance (ie, 10-m single and dual-task walk test using a cognitive and motor interference task), proactive balance (ie, Timed-Up-and-Go Test (TUG), Functional-Reach-Test (FRT)), and muscle strength (ie, Chair-Rise-Test (CRT)). RESULTS: Irrespective of group, the statistical analysis revealed significant main effects for time (pre versus post) for dual-task gait speed (p < 0.001, 1.12 <= d <= 2.65), TUG (p < 0.001, d = 1.17), FRT (p = 0.002, d = 0.92), and CRT (p = 0.002, d = 0.94) but not for single-task gait speed and for the Romberg-Test. No significant group x time interactions were found for any of the investigated variables. CONCLUSIONS: The applied lifestyle balance training program conducted twice daily during tooth brushing routines appears not to be sufficient in terms of exercise dosage and difficulty level to enhance balance and muscle strength in healthy adults aged 60 to 72 years. Consequently, structured balance training programs using higher exercise dosages and/or more difficult balance tasks are recommended for older adults to improve balance and muscle strength.

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