OBJECTIVES: To investigate the effects of a twice-weekly multitarget stepping (MTS) task combined with a multicomponent exercise program on stepping accuracy, gaze behavior, fall risk factors, and fall rates. DESIGN: Randomized controlled trial. SETTING: Community. PARTICIPANTS: Community-dwelling adults aged 65 and older in Japan (N = 264) were randomized into an MTS group (n = 132) and a control group (n = 132). INTERVENTION: Twenty-four weeks of a twice-weekly community-based MTS program in combination with a standardized multicomponent exercise program. MEASUREMENTS: Number of falls and fall-related fractures during a 12-month follow-up period after completion of the intervention, stepping accuracy, gaze behavior while performing the MTS test, and results of four clinical tests relevant to assessment of risk of falls (Timed Up and Go (TUG), functional reach (FR), 10-m walking, and Five Chair Stand (5CS)) were measured. RESULTS: Thirteen participants (11.6%) in the MTS group and 39 (33.0%) in the control group fell during the 12-month follow-up period (incidence rate ratio = 0.35, 95% confidence interval (CI) = 0.19-0.66). Three participants in the MTS group and 13 in the control group experienced fall-related fractures during the 12-month follow-up period (relative risk = 0.22, 95% CI = 0.06-0.80). After the intervention, a subset of participants in the MTS group had significantly greater improvement in stepping accuracy and gaze behavior during the MTS test, and all participants in the MTS group had significantly greater improvement in performing the TUG and 10-m walking (P < .001). CONCLUSION: Participants who performed MTS tests combined with a multicomponent exercise program showed greater improvements in stepping accuracy, gaze behavior, and physical performance in a virtually complex environment. Considering the less-frequent fall rate in the follow-up assessment, these improvements could contribute to preventing falls in community-dwelling older adults.
RCT Entities:
OBJECTIVES: To investigate the effects of a twice-weekly multitarget stepping (MTS) task combined with a multicomponent exercise program on stepping accuracy, gaze behavior, fall risk factors, and fall rates. DESIGN: Randomized controlled trial. SETTING: Community. PARTICIPANTS: Community-dwelling adults aged 65 and older in Japan (N = 264) were randomized into an MTS group (n = 132) and a control group (n = 132). INTERVENTION: Twenty-four weeks of a twice-weekly community-based MTS program in combination with a standardized multicomponent exercise program. MEASUREMENTS: Number of falls and fall-related fractures during a 12-month follow-up period after completion of the intervention, stepping accuracy, gaze behavior while performing the MTS test, and results of four clinical tests relevant to assessment of risk of falls (Timed Up and Go (TUG), functional reach (FR), 10-m walking, and Five Chair Stand (5CS)) were measured. RESULTS: Thirteen participants (11.6%) in the MTS group and 39 (33.0%) in the control group fell during the 12-month follow-up period (incidence rate ratio = 0.35, 95% confidence interval (CI) = 0.19-0.66). Three participants in the MTS group and 13 in the control group experienced fall-related fractures during the 12-month follow-up period (relative risk = 0.22, 95% CI = 0.06-0.80). After the intervention, a subset of participants in the MTS group had significantly greater improvement in stepping accuracy and gaze behavior during the MTS test, and all participants in the MTS group had significantly greater improvement in performing the TUG and 10-m walking (P < .001). CONCLUSION:Participants who performed MTS tests combined with a multicomponent exercise program showed greater improvements in stepping accuracy, gaze behavior, and physical performance in a virtually complex environment. Considering the less-frequent fall rate in the follow-up assessment, these improvements could contribute to preventing falls in community-dwelling older adults.
Authors: Asunción Mayoral-Moreno; Carlos Alexis Chimpén-López; Laura Rodríguez-Santos; María Isabel Ramos-Fuentes; Francisco José Vaz-Leal; Manuel Alfredo Moral; Jorge Pérez-Gómez; José Carmelo Adsuar Journal: J Pers Med Date: 2021-04-30
Authors: Keith D Hill; Plaiwan Suttanon; Sang-I Lin; William W N Tsang; Asmidawati Ashari; Tengku Aizan Abd Hamid; Kaela Farrier; Elissa Burton Journal: BMC Geriatr Date: 2018-01-05 Impact factor: 3.921
Authors: Fuzhong Li; Elizabeth Eckstrom; Peter Harmer; Kathleen Fitzgerald; Jan Voit; Kathleen A Cameron Journal: J Am Geriatr Soc Date: 2016-01-30 Impact factor: 5.562
Authors: Christopher A C M Ng; Nicola Fairhall; Geraldine Wallbank; Anne Tiedemann; Zoe A Michaleff; Catherine Sherrington Journal: BMJ Open Sport Exerc Med Date: 2019-12-16