The efficacy of a specific balance-strategy training programme for preventing falls among older people: a pilot randomised controlled trial

BACKGROUND: older people participate in exercise programmes to reduce the risk of falls but no study has investigated a specific balance strategy training intervention presented in a workstation format for small groups. OBJECTIVE: to determine whether a specific balance strategy training programmeme delivered in a workstation format was superior to a community based exercise class programme for reducing falls. DESIGN: a randomised controlled trial model. SETTING: Neurological Disorders, Ageing and Balance Clinic, Department of Physiotherapy, The University of Queensland. SUBJECTS: 73 males and females over 60 years, living independently in the community and who had fallen in the previous year were recruited. METHODS: all subjects received a falls risk education booklet and completed an incident calendar for the duration of the study. Treatment sessions were once a week for 10 weeks. Subject assessment before and after intervention and at 3 months follow-up included number of falls, co-morbidities, medications, community services and activity level, functional motor ability, clinical and laboratory balance measures and fear of falling. RESULTS: all participants significantly reduced the number of falls (P < 0.000). The specific balance strategy intervention group showed significantly more improvement in functional measures than the control group (P = 0.034). Separate group analyses indicated significantly improved performance in functional motor ability and most clinical balance measures for the balance group (P < 0.04). The control group only improved in TUG and TUGcog. CONCLUSIONS: the results provide evidence that all participants achieved a significant reduction in falls. Specific balance strategy training using workstations is superior to traditional exercise classes for improving function and balance.