The Effect of an Exercise-Based Balance Intervention on Physical and Cognitive Performance for Older Adults

Background: Several exercise-based falls prevention interventions produced significant long-term reductions in fall rate, but few demonstrate long-term improvements in falls risk factors. A strong body of evidence supports a protective effect of aerobic or strength-training exercise on cognition. Individuals participating in an exercise-based balance improvement program may also experience this protective effect. This may contribute to the decreased rate of falls reported in the literature. Purpose: To determine if individuals participating in an evidence-based exercise program to reduce falls would demonstrate improvements in both physical and cognitive performance. Methods: In this nonexperimental, pretest, posttest design study, 76 adults (65-93 years) participated in a scripted 12-week, 24 session exercise-based balance improvement program. Each 60 minute class incorporated balance, strength, endurance, and flexibility exercises. Participants completed baseline assessments of physical and cognitive performance measures 1 week prior and 1 week following the intervention. Results: Fifty-two participants completed posttest measures. There were significant improvements in 3 physical performance measures (chair rise time, 360° turn, and 4 square step test). There also was similar improvement in the Symbol Digit Modality Test, a measure of processing speed and mental flexibility. When participants were dichotomized into 2 groups based on achieving/not achieving, a baseline walking speed of at least 1.0 meters/second, secondary analysis revealed greater improvements in cognitive performance measures of Trails A and Trails B tests by faster walkers compared to slower walkers. Conclusions: Participation in balance programs can have a positive impact on cognition and physical outcomes. This may provide insight about how exercise influences fall risk. Therapists can utilize this information clinically by educating patients about the potential positive effect of balance exercises on cognition.