Effect of High-Intensity Strength-Training on Functional Measures of Balance Ability in Balance-Impaired Older Adults

doi:10.1016/j.jmpt.2005.08.013

Journal of Manipulative and Physiological Therapeutics

Volume 28, Issue 8, October 2005, Pages 582-590

https://doi.org/10.1016/j.jmpt.2005.08.013 Get rights and content

Abstract

Objective

The aim of this study was to evaluate the effect of a 10-week, high-intensity strength-training program targeting key lower extremity muscles for the purpose of improving postural control in balance-impaired older adults.

Methods

A quasi-experimental, delayed entry controlled design was used to evaluate balance ability in balance-impaired older adults after participation in 10 weeks of high-intensity strength training focused on the quadriceps, hamstrings, tibialis anterior, and gastrocnemius muscles. Participants were evaluated using validated clinical measures of functional balance ability: the Berg Balance Scale, the Timed Up and Go, and the Activities-Specific Balance Confidence Scale.

Results

After strength training, the exercisers were significantly stronger than the control subjects. They improved significantly on the Berg Balance Scale (P = .030) from a mean score of 48.8 ± 2.4 of 56 before training to 51.2 ± 4.3 of 56 after training. The Timed Up and Go (P = .045) and the Activities-Specific Balance Confidence Scale (P = .038) also improved significantly in the experimental group. These changes are associated with a decrease in fall risk.

Conclusions

High-intensity strength training can safely and effectively strengthen lower extremity muscles in balance-impaired older adults, resulting in significant improvements in functional balance ability and decreased fall risk.

Section snippets

Subjects

Participants were community-dwelling balance-impaired men and women, 74 to 96 years of age, recruited from the general older adult population in Eugene, Ore, by television, radio, and newspaper stories, and through talks at senior centers and health fairs. Participants were initially screened over the telephone to obtain pertinent medical history and obvious inclusion/exclusion information. A letter of approval to participate was sent to the primary care physician of all potential candidates

Strength-Training Protocol

Experimental group subjects participated in a 10-week, high-intensity strength-training program that consisted of specific exercises using professional equipment: (1) the Hammerstrength tibia dorsiflexion machine (Hammerstrength, Schiller Park, Ill), (2) Maxicam machine (Muscle Dynamics, Torrance, Calif) for strengthening plantar flexors (GA), and (3) Maxicam variable-resistance machines for performing knee extension to strengthen QDs and knee flexion to strengthen HMs. Each experimental

Results

This study population consisted of 13 experimental subjects and 14 control subjects. Seven individuals served in both the control and experimental groups, whereas an additional 6 experimental and 7 control subjects were separate individuals. Compliance in completing the study was generally good, although 4 people dropped out after being control subjects, two for health reasons and two for personal reasons. Ninety-three percent of each group, experimental and control, finished the study. In the

Strength

Strength declines approximately 15% per decade between the ages of 50 and 70 years, and approximately 1.5% per year after the age of 70 years,⁴⁶ and decreases in strength are associated with falling in elderly people.5, 7, 11 Örlander and Aniansson⁴⁷ concluded that muscle remains trainable regardless of age, although some studies have failed to find gains in strength with training. This study evaluated the effect of a 10-week, high-intensity strength-training program designed to enhance

Conclusion

Thirteen balance-impaired older adults safely completed a high-intensity strength-training program and significantly enhanced their lower extremity strength. These strength gains resulted in significant improvements on 3 clinical measures of functional balance ability. High-intensity strength training may provide clinicians with a viable option for improving functional balance control that will help their patients remain independent, active, and healthy.

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: Source of support: This research was supported by a Northwest Health Foundation, Poland, Ore, student grant; the University of Oregon Center for Study of Women in Society, Eugene, Ore, Stanton scholarship; and a Foundation for Chiropractic Education and Research fellowship.

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Original ArticleEffect of High-Intensity Strength-Training on Functional Measures of Balance Ability in Balance-Impaired Older Adults

Abstract

Objective

Methods

Results

Conclusions

Section snippets

Subjects

Strength-Training Protocol

Results

Strength

Conclusion

Am J Med

Arch Gerontol Geriatr

Web-based injury statistics query and reporting system (WISQARS)

Deaths: final data for 1998

Geriatric falls: injury severity is high and disproportionate to mechanism

J Trauma Inj Infect Crit Care

The incidence of fall injury events among the elderly in a defined population

Am J Epidemiol

The prognosis of falls in elderly people living at home

Age Ageing

Posture control in the elderly

Int J Technol Aging

Risk factors for recurrent nonsyncopal falls

JAMA

Falls in the elderly: part I, gait

Arch Phys Med Rehabil

Physiological factors associated with falls in older community-dwelling women

J Am Geriatr Soc

Influence of lower extremity strength of healthy older adults on the outcome of an induced trip

J Am Geriatr Soc

The relationship of knee and ankle weakness to falls in nursing home residents

J Am Geriatr Soc

Strength is a major factor in balance, gait and the occurrence of falls

J Gerontol

Long-term exercise and its effect on balance in older, osteoarthritic adults: results from the Fitness, Arthritis, and Seniors Trial (FAST)

J Am Geriatr Soc

Balance and strength-training in older adults: intervention gains and Tai Chi maintenance

J Am Geriatr Soc

The effect of strength and endurance training on gait, balance, fall risk, and health services use in community-living older adults

J Gerontol A Biol Sci Med Sci

The effect of Tai Chi Quan and computerized balance training on postural stability in older subjects. Atlanta FICSIT Group. Balance-impaired and injuries: cooperative studies on intervention techniques

Phys Ther

Effects of a group exercise program on strength, mobility, and falls among fall-prone elderly men

J Gerontol A Biol Sci Med Sci

Effect of exercise on postural sway in the elderly

Gerontology

Preventing falls among community-dwelling older persons: results from a randomized trial

Gerontology

The effects of exercise on falls in elderly patients: a preplanned meta-analysis of the FICSIT trials

JAMA

The etiology and reversibility of muscle dysfunction in the aged

J Gerontol

Multisensory training of standing balance in older adults: II. Kinematic and electromyographic postural responses

J Gerontol

Falls in the elderly: part II, balance, strength, and flexibility

Arch Phys Med Rehabil

Biomechanical walking pattern changes in the fit and healthy elderly

Phys Ther

Postural control in young and elderly adults when stance is perturbed: kinematics

J Gerontol Med Sci

Aging and posture control: changes in sensory organization and muscular coordination

Int J Aging Hum Dev

Visual, vestibular and somatosensory contributions to balance control in older adult

J Gerontol

Original Article
Effect of High-Intensity Strength-Training on Functional Measures of Balance Ability in Balance-Impaired Older Adults