Short- and Long-Term Effects of Balance Training on Physical Activity in Older Adults With Osteoporosis: A Randomized Controlled Trial Balance training with multi-task exercises improves fall-related self-efficacy, gait, balance performance and physical function in older adults with osteoporosis: a randomized controlled trial Long-term effects of a progressive and specific balance-training programme with multi-task exercises for older adults with osteoporosis: a randomized controlled study Progressive load training for the quadriceps muscle associated with proprioception exercises for the prevention of falls in postmenopausal women with osteoporosis: a randomized controlled trial Effect of Tai Chi on body balance: randomized controlled trial in men with osteopenia or osteoporosis. Effectiveness of balance training programme in reducing the frequency of falling in established osteoporotic women: a randomized controlled trial Effectiveness of exercise interventions on physical function in community-dwelling frail older people: an umbrella review of systematic reviews Results of a 10 week community based strength and balance training programme to reduce fall risk factors: a randomised controlled trial in 65–75 year old women with osteoporosis Efficacy of a short multidisciplinary falls prevention program for elderly persons with osteoporosis and a fall history: a randomized controlled trial. Balance training program is highly effective in improving functional status and reducing the risk of falls in elderly women with osteoporosis: a randomized controlled trial A 12-month randomized controlled trial of balance training in elderly women with osteoporosis: improvement of quality of life. Vibration or balance training on neuromuscular performance in osteopenic women. The effect of 4-week aerobic exercise program on postural balance in postmenopausal women with osteoporosis The relationship of intrinsic fall risk factors to a recent history of falling in older women with osteoporosis.
Background and Purpose : We have developed a 12-week balance training program for older adults shown to improve fall-related concerns , gait speed , balance performance , and physical function . We hypothesized that this balance training would also contribute to higher habitual physical activity ( PA ) levels and improved health-related quality of life ( HRQoL ) . The primary aim was to evaluate short- and long-term effects of the balance training program on objective ly measured habitual PA in older adults with osteoporosis . Secondary aims were to assess the effects of the balance training on HRQoL , and to study whether any effects on PA were associated with changes in HRQoL , gait speed , balance performance , fall-related concerns , and physical function . Methods : A r and omized controlled trial with follow-up at 3 , 9 , and 15 months , including 91 participants with osteoporosis ( 75.6 ± 5.4 years ) , compared a balance training group  ( n = 61 ) with a control group ( n = 30 ) . The primary outcome was effect on habitual PA measured as steps/day , dichotomized into less than 5000 or 5000 or more steps/day . Physical activity was assessed with pedometers ( Yamax ) and accelerometers ( Actigraph ) , HRQoL with the Short Form-36 ( SF-36 ) , gait with a GAITRite walkway , balance performance with Modified-Figure-Eight test and one-leg stance , fall-related concerns with Falls Efficacy Scale International , and physical function with the advanced lower extremity subscale of the question naire Late Life Function and Disability Instrument . Statistical methods used were multivariate logistic regression and logistic generalized estimating equation . Results : Sixty-eight participants completed the short-term follow-up at 3 months , and 53 participants completed the long-term follow-up at 15 months . Per- protocol analysis ( n = 68 ) showed that the odds ratio for having a daily step count of 5000 or more at 3 months was 6.17 ( 95 % confidence interval , 1.23 - 30.91 ) , P = .027 , for the intervention group compared with the control group . The longitudinal analysis ( n = 91 ) showed that the odds ratio for having a daily step count of 5000 or more at 15 months was 2.02 ( 95 % confidence interval , 0.88 - 4.64 ) , P = .096 , for the intervention group compared with the control group . The mental component sum of the SF-36 improved significantly from baseline to 3 months in the intervention group , and the physical component sum improved in both groups , but no statistically significant differences were found between groups . No associations were found between PA and changes in covariates . Discussion and Conclusions : The short-term evaluation showed that balance training increased habitual PA in community-dwelling older adults with osteoporosis . A significantly higher proportion of participants in the intervention group reached a level of 5000 or more steps/day , which is important for overall health . This effect was not associated with improvements in HRQoL , gait speed , balance performance , or fall-related concerns , and did not persist through the long-term follow-up . To accomplish a sustained PA change , a prolonged intervention or more support regarding habitual PA may be required , such as reinforcement with personalized behavior change counseling or PA on prescription Objective : To evaluate the effects of a balance training program including dual- and multi-task exercises on fall-related self-efficacy , fear of falling , gait and balance performance , and physical function in older adults with osteoporosis with an increased risk of falling and to evaluate whether additional physical activity would further improve the effects . Design : R and omized controlled trial , including three groups : two intervention groups ( Training , or Training+Physical activity ) and one Control group , with a 12-week follow-up . Setting : Stockholm County , Sweden . Participants : Ninety-six older adults , aged 66 - 87 , with verified osteoporosis . Interventions : A specific and progressive balance training program including dual- and multi-task three times/week for 12 weeks , and physical activity for 30 minutes , three times/week . Main measures : Fall-related self-efficacy ( Falls Efficacy Scale-International ) , fear of falling ( single-item question – ‘ In general , are you afraid of falling ? ’ ) , gait speed with and without a cognitive dual-task at preferred pace and fast walking ( GAITRite ® ) , balance performance tests ( one-leg stance , and modified figure of eight ) , and physical function ( Late-Life Function and Disability Instrument ) . Results : Both intervention groups significantly improved their fall-related self-efficacy as compared to the controls ( p ≤ 0.034 , 4 points ) and improved their balance performance . Significant differences over time and between groups in favour of the intervention groups were found for walking speed with a dual-task ( p=0.003 ) , at fast walking speed ( p=0.008 ) , and for advanced lower extremity physical function ( p=0.034 ) . Conclusions : This balance training program , including dual- and multi-task , improves fall-related self-efficacy , gait speed , balance performance , and physical function in older adults with osteoporosis Objective : To evaluate long-term effects of balance-training on concerns about falling , gait , balance performance , and physical function in older adults with osteoporosis and increased risk of falling . Design : R and omized controlled trial , including three groups ( training , training+physical activity , and control group ) , with follow-ups at three , nine , and 15 months . Short-term , three-month follow-up , benefits for those who fulfilled the first follow-up ( n = 69 ) have previously been reported . Setting : Stockholm , Sweden . Participants : A total of 96 elderly , age 66–87 , with verified osteoporosis . Interventions : Balance-training programme including dual- and multitasks , with or without supplementary physical activity , three times/week over 12 weeks . Measurements : Concerns about falling Falls Efficacy Scale -International ( FES-I ) , walking at preferred speed with and without a cognitive dual-task and at fast speed , balance tests ( one-leg stance and modified figure-of-eight ) , and physical function Late-Life Function and Disability Instrument ( LLFDI ) . Results : Participants in the training group maintained positive effects throughout the study period for concerns about falling ( baseline vs. 15 months , median 27.5 vs. 23 points , p < 0.001 ) and walking performance ( baseline vs. 15 months , p ⩽ 0.05 with an improvement of 0.9–1.4 m/s ) . The Training+physical activity group declined to baseline values at the nine-month follow-up , and were even lower at the 15-month follow-up for concerns about falling ( median 26 vs. 26 points ) , walking performance ( changes of −0.02 to 0.04 m/s ) , and physical function ( mean 44.0 vs. 42.9 points ) . The control group remained unchanged throughout the study period . Conclusions : This balance-training programme reduced concerns about falling , and also improved gait in older adults with osteoporosis and increased risk of falling in a long-term perspective – important issues for fall prevention Summary This study aims to evaluate the effect of 18-week progressive muscular strength and proprioception training program on the muscle strength of the quadriceps , in prevention of falls in postmenopausal women with osteoporosis . The incidence of falls in the intervention group was significantly lower than in the control group ( incidence rate ratio ( IRR ) = 0.263 , 95 % CI 0.10–0.68 ) . Introduction This study aims to evaluate the effect of a progressive muscular strength and proprioception training program on the muscle strength of the quadriceps , balance , quality of life , and reduction in the risk of falls in postmenopausal women with osteoporosis . Methods One hundred sedentary postmenopausal women with osteoporosis , ages ranging from 55 to 75 , were selected and r and omized into two groups : the intervention group comprised of 50 patients who underwent a 18-week of progressive load training for the quadriceps muscle ( 50 % up to 80 % of 1-RM — one maximum repetition ) and proprioception training associated to a drug treatment of osteoporosis and the  control group that included 50 patients who only underwent a drug treatment of osteoporosis .  The muscular strength , balance , functional mobility , and quality of life were evaluated in the beginning and end of the research . The number of falls was evaluated 24 weeks post-treatment . Results Eighty-five patients concluded the research . The program promoted a significant difference among the groups for SF-36 in the eight sub-scales ( p ≤ 0.0018 ) , Timed Up & Go Test ( p < 0.0001 ) , 1-RM test ( p < 0.0001 ) , Berg Balance Scale ( p < 0.0001 ) and also a decrease in the number of falls in the intervention group compared to control ( IRR = 0.263 , 95 % CI 0.10–0.68 , p = 0.0064 ) . Conclusion The association of progressive strength training for the quadriceps and the proprioceptive training is effective for the prevention of falls , increasing the muscle power , the static and dynamic balance and increasing the speed of the motor responses , therefore improving the performance of daily activities The purpose of this study was to assess the effect of 18-week Tai Chi training on body balance in dynamic trial among elderly men . The study covered 49 subjects from age 60 to 82.1 years , who had osteopenia or osteoporosis . The subjects were recruited from the community by direct mailings and community efforts to participate in studies . The participants were r and omly assigned to either the exercise intervention ( n = 25 ) or control groups ( n = 24 ) . The Tai Chi group participated in an 18-week exercise class held for 45 min , twice a week . Body balance was assessed using a Computer Posturographic System PE 90 produced by the Military Institute of Aviation Medicine in Warsaw with modified software made in Pro-Med . During the measurement of body balance , the capacity to perform specific tasks was analyzed ( deflections in the set scope and direction ) . In the Tai Chi group , an increase ( p < or = 0.01 ) in effectiveness of balance task performance was noted from 80.95 % to 84.45 % after the training . In the control group , no statistically significant improvement in the level of body balance was found in the same period . Thus , an 18-week period of Tai Chi exercises twice a week for 45 min is beneficial for dynamic balance . It can be important for reducing fall risk factors Objective : To investigate the effect of a 12-month sensomotor balance exercise programme on postural control and the frequency of falling in women with established osteoporosis . Design : R and omized controlled trial where the intervention group was assigned the 12-month Balance Training Programme and the control group did not undertake any intervention beyond regular osteoporosis treatment . Subjects : A total of 100 osteoporotic women – at least with one osteoporotic fracture – aged 65 years old and above . Main measures : Balance was assessed in static and dynamic posture both with performance-based measures of balance , such as the Berg Balance Scale and the Timed Up and Go Test , and with a stabilometric computerized platform . Interventions : Patients in the intervention group completed the 12-month sensomotor Balance Training Programme in an outpatient setting , guided by physical therapists , three times a week , for 30 minutes . Results : The Berg Balance Scale and the Timed Up and Go Test showed a statistically significant improvement of balance in the intervention group ( p = 0.001 and p = 0.005 , respectively ) . Balance tests using the stabilometer also showed a statistically significant improvement in static and dynamic postural balance for osteoporotic women after the completion of the Balance Training Programme . As a consequence , the one-year exercise programme significantly decreased the number of falls in the exercise group compared with the control group . Conclusion : The Balance Training Programme significantly improved the balance parameters and reduced the number of falls in postmenopausal women who have already had at least one fracture in the past Objectives : This umbrella review aim ed to determine the effectiveness of exercise interventions , alone or in combination with other interventions , in improving physical function in community-dwelling older people identified as pre-frail or frail . Introduction : Exercise is said to have a positive impact on muscle mass and strength which improves physical function and hence is beneficial for the treatment of frailty . Several systematic review s discuss the effects of exercise interventions on physical function parameters , such as strength , mobility , gait , balance and physical performance , and indicate that multi-component exercise , including resistance , aerobic , balance and flexibility training , appears to be the best way in which to improve physical function parameters in frail older people . However , there is still uncertainty as to which exercise characteristics ( type , frequency , intensity , duration and combinations ) are the most effective and sustainable over the long-term . Inclusion criteria : Participants were adults , 60 years or over , living in the community and identified as pre-frail or frail . Quantitative systematic review s , with or without meta- analysis that examined the effectiveness of exercise interventions of any form , duration , frequency and intensity , alone or in combination with other interventions design ed to alter physical function parameters in frail older people , were considered . The quantitative outcome measures were physical function , including muscular strength , gait , balance , mobility and physical performance . Methods : An iterative search strategy for ten bibliometric data bases and gray literature was developed . Critical appraisal of seven systematic review s was conducted independently by two review ers using a st and ard Joanna Briggs Institute tool . Data was extracted independently by two review ers using a st and ard Joanna Briggs Institute data extraction tool and summarized using a narrative synthesis approach . Results : Seven systematic review s were included in this umbrella review , with a total of 58 relevant r and omized controlled trials and 6927 participants . Five systematic review s examined the effects of exercise only , while two systematic review s reported on exercise in combination with a nutritional approach , including protein supplementations , as well as fruit and dairy products . The average  exercise frequency was 2–3 times per week ( mean 3.0 ± 1.5 times per week ; range 1–7 weekly ) for 10–90 minutes per session ( mean of 52.0 ± 16.5 mins ) and a total duration of 5–72 weeks with the majority lasting a minimum of 2.5 months ( mean 22.7 ± 17.7 weeks ) . Multi-component exercise interventions can currently be recommended for pre-frail and frail older adults to improve muscular strength , gait speed , balance and physical performance , including resistance , aerobic , balance and flexibility tasks . Resistance training alone also appeared to be beneficial , in particular for improving muscular strength , gait speed and physical performance . Other types of exercise were not sufficiently studied and their effectiveness is yet to be established . Conclusions : Interventions for pre-frail and frail older adults should include multi-component exercises , including in particular resistance training , as well as aerobic , balance and flexibility tasks . Future research should adopt a consistent definition of frailty and investigate the effects of other types of exercise alone or in combination with nutritional interventions so that more specific recommendations can be made Objective —To test the efficacy of a community based 10 week exercise intervention to reduce fall risk factors in women with osteoporosis . Methods —Static balance was measured by computerised dynamic posturography ( Equitest ) , dynamic balance by timed figure of eight run , and knee extension strength by dynamometry . Subjects were r and omised to exercise intervention ( twice weekly Osteofit classes for 10 weeks ) or control groups . Results —The outcome in 79 participants ( 39 exercise , 40 control ) who were available for measurement 10 weeks after baseline measurement is reported . After confounding factors had been controlled for , the exercise group did not make significant gains compared with their control counterparts , although there were consistent trends toward greater improvement in all three primary outcome measures . Relative to the change in control subjects , the exercise group improved by 2.3 % in static balance , 1.9 % in dynamic balance , and 13.9 % in knee extension strength . Conclusions —A 10 week community based physical activity intervention did not significantly reduce fall risk factors in women with osteoporosis . However , trends toward improvement in key independent risk factors for falling suggest that a study with greater power may show that these variables can be improved to a level that reaches statistical significance OBJECTIVE To evaluate the efficacy of the Nijmegen Falls Prevention Program ( NFPP ) for persons with osteoporosis and a fall history in a r and omized controlled trial . Persons with osteoporosis are at risk for fall-related fractures because of decreased bone strength . A decrease in the number of falls therefore is expected to be particularly beneficial for these persons . DESIGN R and omized controlled trial . SETTING Hospital . PARTICIPANTS Persons with osteoporosis and a fall history ( N=96 ; mean ± SD age , 71.0±4.7y ; 90 women ) . INTERVENTION After baseline assessment , participants were r and omly assigned to the exercise ( n=50 ; participated in the NFPP for persons with osteoporosis [ 5.5wk ] ) or control group ( n=46 ; usual care ) . MAIN OUTCOME MEASURES Primary outcome measure was fall rate , measured by using monthly fall calendars for 1 year . Secondary outcomes were balance confidence ( Activity-specific Balance Confidence Scale ) , quality of life ( QOL ; Quality of Life Question naire of the European Foundation for Osteoporosis ) , and activity level ( LASA Physical Activity Question naire , pedometer ) , assessed posttreatment subsequent to the program and after 1 year of follow-up . RESULTS The fall rate in the exercise group was 39 % lower than for the control group ( .72 vs 1.18 falls/person-year ; risk ratio , .61 ; 95 % confidence interval , .40-.94 ) . Balance confidence in the exercise group increased by 13.9 % ( P=.001 ) . No group differences were observed in QOL and activity levels . CONCLUSION The NFPP for persons with osteoporosis was effective in decreasing the number of falls and improving balance confidence . Therefore , it is a valuable new tool to improve mobility and independence of persons with osteoporosis Introduction The purpose of this study was to investigate the effect of a 12-month Balance Training Program on balance , mobility and falling frequency in women with osteoporosis . Methods Sixty-six consecutive elderly women were selected from the Osteometabolic Disease Outpatient Clinic and r and omized into 2 groups : the ‘ Intervention ’ , su bmi tted for balance training ; and the ‘ Control ’ , without intervention .  Balance , mobility and falling frequency were evaluated before and at the end of the trial , using the Berg Balance Scale ( BBS ) , the Clinical Test Sensory Interaction Balance ( CTSIB ) and the Timed “ Up & Go ” Test ( TUGT ) . Intervention used techniques to improve balance consisting of a 1-hour session each week and a home-based exercise program . Results Sixty women completed the study and were analyzed . The BBS difference was significant higher in the Intervention group compared to Control ( 5.5 ± 5.67 vs −0.5 ± 4.88 score , p < 0.001 ) . Similarly , the number of patients in the Intervention group presented improvement in two conditions of CTSIB compared to Control ( eyes closed and unstable surface condition : 13 vs one patient , p < 0.001 and eyes open , visual conflict and unstable surface condition : 12 vs one patient , p < 0.001 ) . Additionally , the differences between the TUGT were reduced in the Intervention group compared to Control ( −3.65 ± 3.61 vs 2.27 ± 7.18 seconds , p < 0.001 ) . Notably , this improvement was paralleled by a reduction in the number of falls/patient in the Intervention group compared to Control ( −0.77 ± 1.76 vs 0.33 ± 0.96 , p = 0.018 ) . Conclusion This longitudinal prospect i ve study demonstrated that an intervention using balance training is effective in improving functional and static balance , mobility and falling frequency in elderly women with osteoporosis OBJECTIVE Physical and psychological incapacity , including fear of falling is related to decreased satisfaction with life in osteoporosis ( OP ) . The impact of a balance exercise program on improving the quality of life is not well established . We have , therefore , investigated the effect of 12-month Balance Training Program in quality of life , functional balance and falls in elderly OP women . METHODS Sixty consecutive women with senile OP were r and omized into a Balance Training Group ( BT ) of 30 patients and no intervention control group ( CG ) of 30 patients . The BT program included techniques to improve balance over a period of 12 months ( 1h exercise session/week and home-based exercises ) . The quality of life was evaluated before and at the end of the trial using the Osteoporosis Assessment Question naire ( OPAQ ) , functional balance was evaluated by Berg Balance Scale ( BBS ) . Falls in the preceding year were noted and compared to the period of study . RESULTS The comparison of OPAQ variations ( INITIAL-FINAL ) revealed a significant improvement in quality of life in all parameters for BT compared to CG : well-being ( 1.61+/-1.44 vs. -1.46+/-1.32 , p<0001 ) , physical function ( 1.30+/-1.33 vs. -0.36+/-0.82 , p<0.001 ) , psychological status ( 1.58+/-1.36 vs. -1.02+/-0.83 , p<0.001 ) , symptoms ( 2.76+/-1.96 vs. -0.63+/-0.87 , p<0.001 ) , social interaction ( 1.01+/-1.51 vs. 0.35+/-1.08 , p<0.001 ) . Of note , this overall benefit was paralleled by an improvement of BBS ( -5.5+/-5.67 vs. + 0.5+/-4.88 p<0.001 ) and a reduction of falls in 50 % in BT group vs. 26.6 % for the CG ( RR : 1.88 , p<0.025 ) . CONCLUSION The long-term Balance Training Program of OP women provides a striking overall health quality of life improvement in parallel with improving functional balance and reduced falls Maintaining neuromuscular function in older age is an important topic for aging societies , especially for older women with low bone density who may be at risk of falls and bone fracture . This r and omized controlled trial investigated the effect of resistive exercise with either whole-body vibration training ( VIB ) or coordination/balance training ( BAL ) on neuromuscular function ( countermovement jump , multiple 1-leg hopping , sit-to-st and test ) . 68 postmenopausal women with osteopenia or osteoporosis were recruited for the study . 57 subjects completed the 9-month , twice weekly , intervention period . All subjects conducted 30 min of resistance exercise each training day . The VIB-group performed additional training on the Galileo vibration exercise device . The BAL-group performed  balance training .  An " intent-to-treat " analysis showed greater improvement in the VIB-group for peak countermovement power ( p=0.004 ) . The mean [ 95 % confidence interval ] effect size for this parameter was a + 0.9[0.3 to 1.5 ] W/kg greater change in VIB than BAL after 9 months . In multiple 1-leg hopping , a significantly better performance in the VIB-group after the intervention period was seen on a " per- protocol " analysis only . Both groups improved in the sit-to-st and test . The current study provides evidence that short- duration whole-body vibration exercise can have a greater impact on some aspects of neuromuscular function in post-menopausal women with low bone density than proprioceptive training The aim of this study is to evaluate the effect of submaximal aerobic exercise program on postural balance in postmenopausal women with osteoporosis . Twenty-five postmenopausal women without osteoporosis and 28 postmenopausal women with osteoporosis enrolled in this study .  Balance ability of all subjects was measured by timed up and go test ( TUG ) , four square step test ( FSS ) , Berg balance scale ( BBS ) and Kinesthetic ability trainer 3000 . After completion of initial measurements of balance , postmenopausal women with osteoporosis attended the submaximal aerobic exercise program on treadmill . At the end of the exercise program , balance tests were repeated . Balance tests of postmenopausal women without osteoporosis were repeated approximately 4-weeks after the initial measurement . There was statistically significant improvement in all balance scores in the postmenopausal women with osteoporosis after exercise training whereas there were no statistically significant differences in the scores of postmenopausal women without osteoporosis who did not exercise . This study showed that a 4-week submaximal aerobic exercise program provided significant improvements in static and dynamic balances in postmenopausal osteoporotic women STUDY DESIGN Cross-sectional descriptive analysis investigating intrinsic fall risk factors in postmenopausal women with osteoporosis . OBJECTIVE To examine the relationships between history of recent falls and balance , pain , quality of life , function , posture , strength , and mobility . BACKGROUND Women with osteoporosis who fall are at a high risk of fracture due to decreased bone strength . Identifying fall risk factors for older women with osteoporosis is a crucial step in decreasing the incidence of falls and fracture . METHOD AND MEASURES : Seventy-three women over 60 years of age with established osteoporosis participated in comprehensive testing of fall history , physical function , and quality of life . RESULTS Significant correlations were found between a recent history of falls and degree of kyphosis ( r = 0.29 ) , fear of falls/emotional status ( r = -0.27 ) , and balance ( r = -0.27 ) . Degree of kyphosis and fear of falls/emotional status explained 20 % of the variance of recent fall history using binary logistic regression . Women with an increased kyphosis were more likely to have had a recent fall ( odds ratio [ OR ] , 1.17 ; 95 % CI , 1.03 - 1.34 ) and those with better emotional status and less fear of falling were less likely to have had a recent fall ( OR , 0.61 ; 95 % CI , 0.38 - 0.97 ) . CONCLUSION Increased thoracic kyphosis and fear of falling are 2 intrinsic factors associated with recent falls in women with osteoporosis . To design more effective interventions to decrease fall risk in this population , future prospect i ve , longitudinal studies should monitor kyphosis , fear of falling , balance reactions , and other potential risk factors not identified in this study
Balance training may significantly reduce the frequency of falls in patients with osteoporosis
BACKGROUND Balance training may be beneficial for patients with osteoporosis , although current results are inconclusive .
The aim of this systematic review and meta- analysis was to explore the effect of balance training on falls in patients with osteoporosis .