domingo, 11 de marzo de 2012

Exercise may not make older people fall less: MedlinePlus

Exercise may not make older people fall less: MedlinePlus


Exercise may not make older people fall less

Thursday, March 8, 2012
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By Andrew M. Seaman
NEW YORK (Reuters Health) - Joining a regular exercise program may make older people move faster, but it doesn't mean they're more steady on their feet, suggests a new study.
Improving physical performance also doesn't mean an older person's fear of falling goes away.
We can't take it for granted that if we improve on the physical performance that it will translate over to the psychological dimension," said Ellen Freiberger, the study's lead author and a sports medicine and gerontology researcher at Friedrich-Alexander-Universitat Erlangen-Nurnberg in Germany.
Freiberger and her colleagues set out to compare different types of exercise and what impact -- if any -- they had on physical performance, falls and the fear of falling among older people.
For the study, which was reported in the Journal of the American Geriatrics Society, the researchers recruited 280 people over age 70 who were still living independently in Erlangen, Germany. Between 2003 and 2006 they were randomly assigned to one of four groups and followed for the next two years.
Of the four groups, one did not exercise and served as a comparison group. The other three used strength and balance exercises, but two also included either endurance exercises, which researchers used to gauge the participants' fitness, or an education program to measure their fear of falling.
The so-called multifaceted group included elements of an educational program designed to reduce the fear of falling, and also did mental exercises to target traits such as concentration and short-term memory.
Everyone in the study's exercise groups attended two one-hour sessions per week for 16 weeks. Each session had less than 15 people in it.
After two years, the people in the group whose program included endurance exercises were the only ones to maintain a meaningful improvement in the time it took to walk six meters, but even that was only a slight improvement.
For the comparison group, it took 51 seconds to walk six meters at a fast pace two years after the start of the study. It took the group that only did strength and balance exercises 48 seconds and the same amount of time for the fitness group. The multifaceted group's time was the worst at 56 seconds.
There was no difference in the scores that tracked fear of falling or falls.
But some researchers have seen positive outcomes from similar exercise programs and one says that the new study's limitations can help to explain its disappointing results.
One analysis of previous research, which was published after the data for the new study was collected, suggested the minimum amount of time needed to help prevent falls was 50 hours of exercise in a structured environment, according to Debbie Rose, the co-director of the Fall Prevention Center of Excellence and a researcher on aging at the California State University, Fullerton in Fullerton, Calif.
Rose said the participants in the new study only completed 32 hours, but that's not counting the time lost to discussions, warm ups and cool down activities.
She added that the researchers only included elements of the program that addressed the fear of falling, and that it may be harder to see improvements if the participants were high functioning to begin with.
The one thing that we know is that there is no quick fix in the reduction of falls," she added.
According to Rose, the most successful programs that address falling in older people focuses on behavioral changes. But she said that people need to be realistic about their goals.
Freiberger said current groups using their exercise program have introduced goal setting into their system, and that it's become a popular program.
She said it can cost between five to seven euros -- about seven to nine dollars -- for each session.
For people looking for similar programs, Rose said there are some in use in the U.S. She said a person should start by asking their primary doctor or another trusted health care provider about their options.
There are also really good evidence-based home exercise programs," she said.
SOURCE: Journal of the American Geriatrics Society, February 10, 2012.
Reuters Health
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