Specific effects of balance and gait exercises on physical function among the frail elderly

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Abstract
Objective: To evaluate the specific effects of balance and gait exercises among frail elderly individuals. Design: A randomized three-group parallel controlled study. Setting: Geriatric health services facility in Japan. Subjects: Thirty-four frail elderly subjects attending the care facility were randomized into a control group, an exercise group with emphasis on balance or an exercise group with emphasis on gait re-education. Interventions: The two exercise groups received balance or gait exercise for 40 minutes, 2–3 times weekly, for 12 weeks. Main outcome measures: One Leg Standing Test, Functional Reach Test, Manual Perturbation Test, Functional Balance Scale, Performance-Oriented Mobility Assessment, Timed ‘Up and Go’ Test and Stair Climbing/Descending Test. These assessments were performed before and after 12-week intervention. Results: Comparison of the performance before and after intervention demonstrated significant improvement in One Leg Standing Test, Functional Reach Test and Functional Balance Scale in the balance exercise group, and Functional Balance Scale, Timed ‘Up and Go’ Test and Stair Descending Test showed improvement in the gait exercise group. All test items showed no significant differences in the control groups. Among the three groups, the balance exercise group showed more significant improvement in Functional Balance Scale, and the gait exercise group showed more significant improvement in Performance-Oriented Mobility Assessment than the control group. The balance exercise group showed greater improvement in performance in Functional Reach Test than the gait exercise group. Conclusions: Balance exercises led to improvements in static balance function, and gait exercises resulted in improvements to dynamic balance and gait functions in the very frail elderly.