Functional-based exercise, such as such as ironing while standing on 1 leg, should be a focus for interventions to protect older, high-risk people from falling and to improve and maintain functional capacity, say authors of an article published August 7 in BMJ.
Researchers in Australia conducted a 3-arm randomized trial in which 317 residents of Sydney older than 70 years who had 2 or more falls or 1 injurious fall within the previous year were recruited and randomly assigned to 1 of the following interventions—a novel activity-integrated exercise program called Lifestyle integrated Functional Exercise (LiFE), a structured exercise program, or a gentle exercise control program.
"In the LiFE approach, movements specifically prescribed to improve balance or increase strength are embedded within everyday activities, so that the movements can be done multiple times during the day… whenever the opportunity arises," write the authors. For example, a prescribed activity incorporating the balance strategy of "reducing base of support" might involve a tandem stand while working at a countertop, and over time could be upgraded to working while standing on 1 leg. A prescribed activity incorporating the strategy to increase strength by bending knees might involve squatting instead of bending at the waist to close a drawer, and could be upgraded to picking things up from the floor.
The researchers performed follow-up at 6 months and 12 months after study participants started their programs. After 12 months of follow-up, the authors recorded 172 falls in the LiFE group, 193 in the structured exercise group, and 224 falls in the control group. The LiFE, structure exercise, and control groups had 21, 24, and 26 people who fell once, and 39, 41, and 45 who fell at least twice, respectively.
"The LiFE program provides an alternative to traditional exercise to consider for fall prevention," say the authors.
Don't forget to sign up for the National Council on Aging's (NOCA) free webinar on August 28 and learn how you can participate in Falls Prevention Awareness Day, recognized September 22. Find patient care, consumer education, and NOCA resources, in addition to continuing education courses on balance and falls at www.apta.org/BalanceFalls/.
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