Objective: To investigate the efficacy of a guided and graded home-based exercise program for improving a range of physical outcomes in older people.
Design: Controlled clinical trial of 16 weeks.
Setting: Two geographical areas in Gent, Belgium.
Participants: 66 independent-living older people (age: 71-98) with a history of falls and moderate physical impairment.
Intervention: Twenty-four 30-minute training sessions were given by a trained physiotherapist over a period of 16 weeks in the participant's home. Different types of exercises on balance, aerobic performance, flexibility, and muscle strength were provided.
Main outcome measures: Muscle strength, static and dynamic balance, aerobic performance, activities in daily living, fear of falling and avoidance of daily activities were assessed at baseline and after 16 weeks intervention.
Results: At baseline, there were no significant differences in the measured variables between exercise and control groups. After 16 weeks, the exercise group showed significantly improved ankle muscle strength, balance performance and aerobic capacity, and decreased fear of falling, dependency in daily activities and avoidance of daily activities compared to the control group. The improvements in knee muscle strength, timed chair stands, and functional reach were not significant.
Conclusion: The home-based, individualized exercise program was effective in reducing several physical factors associated with falls in community-dwelling older people with moderate physical impairment. The decrease in fear of falling and other behavioural variables needs to be considered with care and needs further investigation.