Benefits of a multicomponent Falls Unit-based exercise program in older adults with falls in real life

Background/objectives: Multicomponent exercise programs are the cornerstone in preventing gait and balance impairments and falls in older adults. However, the effects of these programs in usual clinical practice have been poorly analyzed. Design: 4-Month, twice-a-week multicomponent exercise program...

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Detalles Bibliográficos
Autores: García Molina, Rafael, Ruiz Grao, Marta Carolina, Noguerón García, Alicia, Martínez Reig, Marta, Esbrí Víctor, Mariano, Izquierdo Redín, Mikel, Abizanda Soler, Pedro
Tipo de recurso: artículo
Fecha de publicación:2018
País:España
Institución:Universidad de Castilla-La Mancha
Repositorio:RUIdeRA. Repositorio Institucional de la UCLM
OAI Identifier:oai:ruidera.uclm.es:10578/43299
Acceso en línea:https://www.sciencedirect.com/science/article/pii/S0531556518301062?via%3Dihub
https://hdl.handle.net/10578/43299
Access Level:acceso abierto
Palabra clave:Falls
Multicomponent exercise program
Older adults
Physical function
Usual care
Descripción
Sumario:Background/objectives: Multicomponent exercise programs are the cornerstone in preventing gait and balance impairments and falls in older adults. However, the effects of these programs in usual clinical practice have been poorly analyzed. Design: 4-Month, twice-a-week multicomponent exercise program cohort study in real-life. Setting: Falls Unit, Complejo Hospitalario Universitario of Albacete, Spain. Participants: Sixty-seven participants who had experienced a fall in the previous year were included. Measurements: Pre- and post-intervention measurements were collected for leg press, gait speed, the Short Physical Performance Battery (SPPB), the Falls Efficiency Scale International, fat mass percentage, body mass index, the Geriatric Depression Scale by Yesavage (GDS), the Mini Mental State Examination, and the number of falls. Results: Fifty participants completed the program (adherence rate 75%, attendance 80%). Their mean age was 77.2 (SD 5.8) years; 39 were women. The participants reduced the mean number of frailty criteria from 2.1 to 1.3 (95%CI 0.4–1.1) and increased mean gait speed from 0.65 m/s to 0.82 m/s (95%CI 0.11–0.22), increasing their median SPPB scores from 8.5 to 10.0 points (p < 0.001), leg press strength from 62.5 kg to 80.0 kg (p < 0.001), and leg press power at 60% load from 76 W to 119 W (p < 0.001). There was also an improvement in GDS scores from 5.3 to 4.4 (95%CI 0.1–1.7). Body mass index did not change, but fat-free mass increased from 43.7 kg to 44.2 kg (95%CI 0.1–1.0), and fat mass percentage declined from 36.7% to 36.0% (95% CI 0.1–1.4). Seventeen patients (34%) had a fall during the six-month follow-up, and there was a reduction in the median number of falls from 3.0/year to 0.0/six months. Conclusions: A multicomponent Falls Unit-based exercise program as part of usual clinical practice in real life, improved physical function, reduced depressive symptoms, improved body composition and decreased the number of falls in older adults with previous falls.