The effect of aquatic exercise and education on lowering fall risk in older adults with hip osteoarthritis. A best practice fall prevention exercise program to improve balance, strength / power, and psychosocial health in older adults: study protocol for a randomized controlled trial Randomised controlled trial of a general practice programme of home based exercise to prevent falls in elderly women An exercise program to prevent falls in institutionalized elderly with cognitive deficits: a crossover pilot study. A water-based training program that include perturbation exercises to improve stepping responses in older adults: study protocol for a randomized controlled cross-over trial Training to Reduce Postural Sway and Increase Functional Reach in the Elderly A HOME-BASED MULTIDIMENSIONAL EXERCISE PROGRAM REDUCED PHYSICAL IMPAIRMENT AND FEAR OF FALLING Low-intensity exercise and reduction of the risk for falls among at-risk elders. Preventative effect of exercise against falls in the elderly: a randomized controlled trial Jumping combined exercise programs reduce fall risk and improve balance and life quality of elderly people who live in a long-term care facility. Exercise training for rehabilitation and secondary prevention of falls in geriatric patients with a history of injurious falls. LiFE Pilot Study: A randomised trial of balance and strength training embedded in daily life activity to reduce falls in older adults. A Randomized Controlled Trial of Fall Prevention Strategies in Old Peoples’ Homes Fall Incidence in Frail Older Women after Individualized Visual Feedback-Based Balance Training Risk factors for falls among elderly persons living in the community. A multifactorial approach to understanding fall risk in older people. Comparison of the effects of water- and land-based exercises on the physical function and quality of life in community-dwelling elderly people with history of falling: a single-blind, randomized controlled trial.
OBJECTIVE To evaluate the effect of aquatic exercise and education on fall risk factors in older adults with hip osteoarthritis ( OA ) . METHOD Seventy-nine adults , 65 years of age or older with hip OA and at least 1 fall risk factor , were r and omly assigned to 1 of 3 groups : aquatics and education ( AE ; aquatic exercise twice a wk with once-a-wk group education ) , aquatics only ( A ; 2 wk aquatic exercise ) and control ( C ; usual activity ) . Balance , falls efficacy , dual-task function , functional performance ( chair st and s ) , and walking performance were measured pre- and postintervention or control period . RESULTS There was a significant improvement in fall risk factors ( full-factorial MANCOVA , baseline values as covariates ; p = .038 ) ; AE improved in falls efficacy compared with C and in functional performance compared with A and C. CONCLUSION The combination of aquatic exercise and education was effective in improving fall risk factors in older adults with arthritis Background With increasing age neuromuscular deficits ( e.g. , sarcopenia ) may result in impaired physical performance and an increased risk for falls . Prominent intrinsic fall-risk factors are age-related decreases in balance and strength / power performance as well as cognitive decline . Additional studies are needed to develop specifically tailored exercise programs for older adults that can easily be implemented into clinical practice . Thus , the objective of the present trial is to assess the effects of a  fall prevention program that was developed by an interdisciplinary expert panel on measures of balance , strength / power , body composition , cognition , psychosocial well-being , and falls self-efficacy in healthy older adults . Additionally , the time-related effects of detraining are tested . Methods / Design Healthy old people ( n = 54 ) between the age of 65 to 80 years will participate in this trial . The testing protocol comprises tests for the assessment of static / dynamic steady-state balance ( i.e. , Sharpened Romberg Test , instrumented gait analysis ) , proactive balance ( i.e. , Functional Reach Test ; Timed Up and Go Test ) , reactive balance ( i.e. , perturbation test during bipedal stance ; Push and Release Test ) , strength ( i.e. , h and grip strength test ; Chair St and Test ) , and power ( i.e. , Stair Climb Power Test ; countermovement jump ) . Further , body composition will be analysed using a bioelectrical impedance analysis system . In addition , question naires for the assessment of psychosocial ( i.e. , World Health Organisation Quality of Life Assessment -Bref ) , cognitive ( i.e. , Mini Mental State Examination ) , and fall risk determinants ( i.e. , Fall Efficacy Scale – International ) will be included in the study protocol . Participants will be r and omized into two intervention groups or the control / waiting group . After baseline measures , participants in the intervention groups will conduct a 12-week balance and strength / power exercise intervention 3 times per week , with each training session lasting 30 min . ( actual training time ) . One intervention group will complete an extensive supervised training program , while the other intervention group will complete a short version ( ' 3 times 3 ’ ) that is home-based and controlled by weekly phone calls . Post-tests will be conducted right after the intervention period . Additionally , detraining effects will be measured 12 weeks after program cessation . The control group / waiting group will not participate in any specific intervention during the experimental period , but will receive the extensive supervised program after the experimental period . Discussion It is expected that particularly the supervised combination of balance and strength / power training will improve performance in variables of balance , strength / power , body composition , cognitive function , psychosocial well-being , and falls self-efficacy of older adults . In addition , information regarding fall risk assessment , dose – response-relations , detraining effects , and supervision of training will be provided . Further , training-induced health-relevant changes , such as improved performance in activities of daily living , cognitive function , and quality of life , as well as a reduced risk for falls may help to lower costs in the health care system . Finally , practitioners , therapists , and instructors will be provided with a scientifically evaluated feasible , safe , and easy-to-administer exercise program for fall prevention . Trial registration Clinical Trials.gov Identifier : Abstract Objective : To assess the effectiveness of a home exercise programme of strength and balance retraining exercises in reducing  falls and injuries in elderly women . Design : R and omised controlled trial of an individually tailored programme of physical therapy in the home ( exercise group , n=116 ) compared with the usual care and an equal number of social visits ( control group , n=117 ) . Setting : 17 general practice s in Dunedin , New Zeal and . Subjects : Women aged 80 years and older living in the community and registered with a general practice in Dunedin . Main outcome measures : Number of falls and injuries related to falls and time between falls during one year of follow up ; changes in muscle strength and balance measures after six months . Results : After one year there were 152 falls in the control group and 88 falls in the exercise group . The mean ( SD ) rate of falls was lower in the exercise than the control group ( 0.87 ( 1.29 ) v 1.34 ( 1.93 ) falls per year respectively ; difference 0.47 ; 95 % confidence interval 0.04 to 0.90 ) . The relative hazard for the first four falls in the exercise group compared with the control group was 0.68 ( 0.52 to 0.90 ) . The relative hazard for a first fall with injury in the exercise group compared with the control group was 0.61 ( 0.39 to 0.97 ) . After six months , balance had improved in the exercise group ( difference between groups in change in balance score 0.43 ( 0.21 to 0.65 ) . Conclusions : An individual programme of strength and balance retraining exercises improved physical function and was effective in reducing  falls and injuries in women 80 years and older . Key messages Modifiable risk factors for falls in elderly people have been well defined ; they include loss of muscle strength and impaired balance A programme to improve strength and balance in women aged 80 years and older can be set up safely with four home visits from a physiotherapist This programme reduced falls and moderate injuries appreciably over the subsequent year in Dunedin , New Zeal and The benefit was most noticeable in elderly people who fell Falls are the leading cause of injury among older adults in the United States , with the institutionalized elderly at elevated risk for injury and death . Physical weakness and mental frailty , prevalent in institutionalized elderly , are major risk factors for falls . The purpose of this study was to evaluate a program that addresses both the physical and mental aspects of exercise to reduce falls in institutionalized elderly . Twenty-seven volunteer subjects residing in an assisted living facility participated in the 24 week r and omized crossover study . After demographic , fall history , and mental status examinations , subjects were r and omly assigned first to ten weeks of either an exercise class or a control group , followed by a four week " washout period " of no activity , then cross assigned to ten weeks as either a control group or exercise class , respectively . Falls as well as mental status changes were monitored during the study . After adjusting for differences in baseline risk between the control and treatment groups , and for potential residual effects of the treatment during the crossover phase , a statistically significant ( P = .025 ) reduction in falls was found during treatment compared to the control periods . No change in mental status was seen . This small , pilot study shows that exercise programs , which emphasize mental strengthening as well as physical fitness , have the potential to reduce falls among mentally impaired , institutionalized seniors Background Gait and balance impairments may increase the risk of falls , the leading cause of accidental death in the elderly population . Fall-related injuries constitute a serious public health problem associated with high costs for society as well as human suffering . A rapid step is the most important protective postural strategy , acting to recover equilibrium and prevent a fall from initiating . It can arise from large perturbations , but also frequently as a consequence of volitional movements . We propose to use a novel water-based training program which includes specific perturbation exercises that will target the stepping responses that could potentially have a profound effect in reducing risk of falling . We describe the water-based balance training program and a study protocol to evaluate its efficacy ( Trial registration number # NCT00708136 ) . Methods / Design The proposed water-based training program involves use of unpredictable , multi-directional perturbations in a group setting to evoke compensatory and volitional stepping responses . Perturbations are made by pushing slightly the subjects and by water turbulence , in 24 training sessions conducted over 12 weeks . Concurrent cognitive tasks during movement tasks are included . Principles of physical training and exercise including awareness , continuity , motivation , overload , periodicity , progression and specificity were used in the development of this novel program . Specific goals are to increase the speed of stepping responses and improve the postural control mechanism and physical functioning . A prospect i ve , r and omized , cross-over trial with concealed allocation , assessor blinding and intention-to-treat analysis will be performed to evaluate the efficacy of the water-based training program . A total of 36 community-dwelling adults ( age 65–88 ) with no recent history of instability or falling will be assigned to either the perturbation-based training or a control group ( no training ) . Voluntary step reaction times and postural stability using stabiliogram diffusion analysis will be tested before and after the 12 weeks of training . Discussion This study will determine whether a water-based balance training program that includes perturbation exercises , in a group setting , can improve speed of voluntary stepping responses and improve balance control . Results will help guide the development of more cost-effective interventions that can prevent the occurrence of falls in the elderly Poor balance is one of the most common risk factors for falling , a common cause of work-related injury and death . To evaluate the effects of a 10-week intervention program on balance in older adults , 12 participants aged 61–77 years ( age = 70.4 ± 5.4 years ; mean ± SD ) completed an exercise program ( 60 min , 2 days · week−1 for 10 weeks ) performed while laying/sitting on large air-filled exercise balls ( Thera-B and ® ) . Several postural sway composite scores ( determined while st and ing with feet apart and semit and em , eyes open and closed ) improved ( p ≤ 0.05 ) including medial – lateral amplitude and speed of sway ( reduced by ∼9 % ) , and instantaneous speed ( reduced by ∼13 % ) . Reductions in XY area approached ( p = 0.06 ) statistical significance and anterior – posterior amplitude and speed of sway did not change . Functional reach also improved ( 20.3 % ) . These results suggest that challenging the physiological systems involved in balance control while on the nonstable support surface of the exercise balls improves both static and dynamic balance in older adults and may reduce the risk for falling Abstract Objective . To investigate the efficacy of a guided and grade d home-based exercise program for improving a range of physical outcomes in older people . Design . Controlled clinical trial of 16 weeks Setting . Two geographical areas in Gent , Belgium Participants . 66 independent-living older people ( age : 71 - 98 ) with a history of falls and moderate physical impairment Intervention . Twenty-four 30-minute training sessions were given by a trained physiotherapist over a period of 16 weeks in the participant ’s home . Different types of exercises on balance , aerobic performance , flexibility , and muscle strength were provided . Main outcome measures . Muscle strength , static and dynamic balance , aerobic performance , activities in daily living , fear of falling and avoidance of daily activities were assessed at baseline and after 16 weeks intervention . Results : At baseline , there were no significant differences in the measured variables between exercise and control groups . After 16 weeks , the exercise group showed significantly improved ankle muscle strength , balance performance and aerobic capacity , and decreased fear of falling , dependency in daily activities and avoidance of daily activities compared to the control group . The improvements in knee muscle strength , timed chair st and s , and functional reach were not significant . Conclusion : The home-based , individualized exercise program was effective in reducing several physical factors associated with falls in community-dwelling older people with moderate physical impairment . The decrease in fear of falling and other behavioural variables needs to be considered with care and needs further investigation BACKGROUND Among elderly persons , falls account for 87 % of all fractures and are contributing factors in many nursing home admissions . This study evaluated the effect of an easily implemented , low-intensity exercise program on the incidence of falls  and the time to first fall among a clinical ly defined population of elderly men and women . METHODS This community-based , r and omized trial compared the exercise intervention with a no-intervention control .  The participants were 294 men and women , aged 60 years or older , who had either a hospital admission or bed rest for 2 days or more within the previous month .  Exercise participants were scheduled to attend exercise sessions lasting 45 minutes , including warm-up and cool-down , 3 times a week for 8 weeks ( 24 sessions ) . Assessment s included gait and balance measures , self-reported physical function , the number of medications being taking at baseline , participant age , sex , and history of falling . Falls were tracked for 1 year after each participant 's baseline assessment . RESULTS 29 % of the study participants reported a fall during the study period . The effect of  exercise  in preventing falls varied significantly by baseline physical function level ( p < or = .002 ) . The risk for falls decreased for exercise participants with low baseline physical functioning ( hazard ratio,.51 ) but increased for exercise participants with high baseline physical functioning ( hazard ratio , 3.51 ) . CONCLUSIONS This easily implemented , low-intensity exercise program appears to reduce the risk for falls among elderly men and women recovering from recent hospitalizations , bed rest , or both who have low levels of physical functioning Summary The present study was conducted to determine the effect of 5-month exercise program on the prevention of falls in the elderly . The exercise training , which consisted of calisthenics , body balance training , muscle power training , and walking ability training 3 days/week improved the indices of the flexibility , body balance , muscle power , and walking ability and reduced the incidence of falls compared with non-exercise controls . The present study showed the beneficial effect of the exercise program aim ed at improving flexibility , body balance , muscle power , and walking ability in preventing falls in the elderly . Introduction The present study was conducted to determine the effect of exercise on the prevention of falls in the elderly . Methods Sixty-eight elderly ambulatory volunteers were r and omly divided into two groups : the exercise and control groups . The daily exercise , which consisted of calisthenics , body balance training ( t and em st and ing , t and em gait , and unipedal st and ing ) , muscle power training ( chair-rising training ) , and walking ability training ( stepping ) , were performed 3 days/week only in the exercise group . No exercise was performed in the control group . Results After the 5-month exercise program , the indices of the flexibility , body balance , muscle power , and walking ability significantly improved in the exercise group compared with the control group . The incidence of falls was significantly lower in the exercise group than in the control group ( 0.0 % vs. 12.1 % , P = 0.0363 ) . The exercise program was safe and well tolerated in the elderly . Conclusions The present study showed the beneficial effect of the exercise program aim ed at improving flexibility , body balance , muscle power , and walking ability in preventing falls in the elderly AIM The objective of this study was to determine whether regular combined exercise program , which consists strength , stretching and aerobic exercises and additional jumping training , improve balance , fall risk , quality of life and depression status of older people living in a residential care . METHODS A total of 168 residents who live in a long term care facility were screened . The trial began with 78 eligible participants and they were r and omly grouped as combined exercises program ( COM ) group that includes stretching , strength and aerobic exercises , and COM plus jumping ( COMpJ ) group . 66 of the participants finished the trial . The groups were convened three times a week for six weeks . Each group had a warm-up , effective training and a cooling down periods . The total exercising time was no longer than 45 minutes in each group . Berg balance test and Biodex Balance System for the assessment of the dynamic balance and fall risk , short form 36 ( SF 36 ) for the health related quality of life and Geriatric Depression Scale ( GDS ) for evaluation of the depression status were used . RESULTS The balance improvement and fall risk reduction were observed in both of the groups at the end of the trial ; however , the improvements were statistically better in jumping combined group . Also health related quality of life improved in both groups . CONCLUSION Regular group exercise in a long term care facility have several beneficial effects on the elderly residents in regard to balance improvement , fall risk reduction and quality of life . The addition of jumping to strength , stretching and aerobic exercises provides important contributions to balance improvement and fall risk reduction OBJECTIVE To determine the safety and efficacy of an exercise protocol design ed to improve strength , mobility , and balance and to reduce subsequent falls in geriatric patients with a history of injurious falls . DESIGN A r and omized controlled 3-month intervention trial , with an additional 3-month follow-up . SETTING Out-patient geriatric rehabilitation unit . PARTICIPANTS Fifty-seven female geriatric patients ( mean age 82 + /- 4.8 years ; range 75 - 90 ) admitted to acute care or inpatient rehabilitation with a history of recurrent or injurious falls including patients with acute fall-related fracture . INTERVENTION Ambulatory training of strength , functional performance , and balance 3 times per week for 3 months . Patients of the control group attended a placebo group 3 times a week for 3 months . Both groups received an identical physiotherapeutic treatment 2 times a week , in which strengthening and balance training were excluded . MEASUREMENTS Strength , functional ability , motor function , psychological parameters , and fall rates were assessed by st and ardized protocol s at the beginning ( T1 ) and the end ( T2 ) of intervention . Patients were followed up for 3 months after the intervention ( T3 ) . RESULTS No training-related medical problems occurred in the study group . Forty-five patients ( 79 % ) completed all assessment s after the intervention and follow-up period . Adherence was excellent in both groups ( intervention 85.4 + /- 27.8 % vs control 84.2 + /- 29.3 % ) . The patients in the intervention group increased strength , functional motor performance , and balance significantly . Fall-related behavioral and emotional restrictions were reduced significantly . Improvements persisted during the 3-month follow-up with only moderate losses . For patients of the control group , no change in strength , functional performance , or emotional status could be documented during intervention and follow-up . Fall incidence was reduced nonsignificantly by 25 % in the intervention group compared with the control group ( RR:0.753 CI:0.455 - 1.245 ) . CONCLUSIONS Progressive resistance training and progressive functional training are safe and effective methods of increasing strength and functional performance and reducing fall-related behavioral and emotional restrictions during ambulant rehabilitation in frail , high-risk geriatric patients with a history of injurious falls BACKGROUND Exercise as a falls prevention strategy is more complex with people at risk than with the general population . The Lifestyle approach to reducing Falls through Exercise ( LiFE ) involves embedding balance and lower limb strength training in habitual daily routines . METHODS A total of 34 community-residing people aged ≥70 years were r and omised either into the  LiFE programme  or into a no-intervention control group and followed up for six months . Inclusion criteria were two or more falls or an injurious fall in the past year . RESULTS There were 12 falls in the intervention group and 35 in the control group . Therelative risk ( RR ) analysis demonstrated a significant reduction in falls ( RR = 0.23 ; 0.07 - 0.83 ) . There were indications that dynamic balance ( P = 0.04 at three months ) and efficacy beliefs ( P = 0.04 at six months ) improved for the LiFE programme participants . In general , secondary physical and health status outcomes , which were hypothesised as potential mediators of fall risk , improved minimally and inconsistently . CONCLUSIONS LiFE was effective in reducing recurrent falls in this at-risk sample . However , there were minimal changes in secondary measures . The study was feasible in terms of recruitment , r and omisation , blinding and data collection . A larger r and omised trial is needed to investigate long-term efficacy , mechanisms of benefit and clinical significance of this new intervention Background : Falls are a major cause of morbidity in old age . A small number of fall prevention trials in cognitively intact community-dwelling older people have been effective . This study set out to examine the preventability of falls in older people living in institutional care . Objective : To evaluate the effectiveness of falls risk factor assessment /modification and seated balance exercise training in reducing falls among elderly people living in residential care . Methods : 133 residents with a mean age of 84± ( SD ) 6.8 years were allocated at r and om by home to receive either a 6-month falls risk factor assessment /modification and seated balance exercise training programme ( n = 77 ) or 6 months of reminiscence therapy ( n = 56 ) . The risk factors targeted were postural hypotension , polypharmacy , visual acuity , and ambient lighting levels . Falls risk factor assessment s and recommendation for modifications were performed at baseline in the intervention group and assessment s repeated at 6 months . Functional reach , reaction time , timed up- and - go , grip strength , spinal flexibility , and Philadelphia Geriatric Centre Morale Scale and Mini-Mental State Examination scores were determined at baseline and at 6 months by a ‘ blind ’ observer . Falls and fractures were then monitored in both groups during a 7- to 12-month falls-monitoring follow-up period . Results : Only 90 of 133 ( 67.7 % ) residents completed the 6-month intervention period , and 84 ( 63.2 % ) completed the 7- to 12-month falls-monitoring follow-up period . Both prevalence of postural hypotension ( p = 0.0005 ) and poor visual acuity ( p = 0.04 ) were reduced in the intervention group . There was no difference between the groups in the number of falls sustained , the risk of falling [ odds ratio 0.45 ( 95 % CI 0.19–1.14 ) ] , or in the risk of recurrent falling [ odds ratio 1.07 ( 95 % CI 0.40–2.97 ) ] . No significant differences were found between the groups with regard to change in other outcome measures . Conclusions : The high drop-out rate reduced the power of this study to detect any effect of the interventions used . It is possible that either the exercises were not sufficiently vigorous or that to improve balance exercises must be performed st and ing . Further research is required to identify effective fall prevention strategies for elderly people in residential setting Background : The knowledge concerning balance training actually lowering fall rates among frail older persons is limited . Objective : The aim of this study was to examine the effects of a 4-week individualized visual feedback-based balance training on the fall incidence during 1-year follow-up among frail older women living in residential care . Methods : Twenty-seven older women from 2 residential care homes were r and omized into  exercise ( n = 20 ) and  control ( n = 7 ) groups . Balance measurements were carried out before and after a 4-week training period and falls were monitored by monthly diaries for 1 year . An interview about fear of falling and physical activity was completed before and after the intervention and after the 1-year follow-up . Results : A positive effect of  balance training on fall incidence was found . A dynamic Poisson regression model showed that during the follow-up the monthly risk of falling was decreased in the exercise group compared to controls ( risk ratio 0.398 , 95 % CI 0.174–0.911 , p = 0.029 ) . In addition , the exercise group reported a reduced fear of falling and increased physical activity after a training period but these changes declined during the follow-up period . Conclusion : Individualized visual feedback-based balance training was shown to be a promising method for fall prevention among frail older women . High compliance ( 97.5 % ) with the training program showed that carefully targeted training programs can be carried out among older people with health limitations To study risk factors for falling , we conducted a one-year prospect i ve investigation , using a sample of 336 persons at least 75 years of age who were living in the community . All subjects underwent detailed clinical evaluation , including st and ardized measures of mental status , strength , reflexes , balance , and gait ; in addition , we inspected their homes for environmental hazards . Falls and their circumstances were identified during bimonthly telephone calls . During one year of follow-up , 108 subjects ( 32 percent ) fell at least once ; 24 percent of those who fell had serious injuries and 6 percent had fractures . Predisposing factors for falls were identified in linear-logistic models . The adjusted odds ratio for  sedative use was 28.3 ; for cognitive impairment , 5.0 ; for disability of the lower extremities , 3.8 ; for palmomental reflex , 3.0 ; for abnormalities of balance and gait , 1.9 ; and for foot problems , 1.8 ; the lower bounds of the 95 percent confidence intervals were 1 or more for all variables . The risk of falling increased linearly with the number of risk factors , from 8 percent with none to 78 percent with four or more risk factors ( P less than 0.0001 ) . About 10 percent of the falls occurred during acute illness , 5 percent during hazardous activity , and 44 percent in the presence of environmental hazards . We conclude that falls among older persons living in the community are common and that a simple clinical assessment can identify the elderly persons who are at the greatest risk of falling OBJECTIVE To identify the interrelationships and discriminatory value of a broad range of objective ly measured explanatory risk factors for falls . DESIGN Prospect i ve cohort study with 12-month follow-up period . SETTING Community sample . PARTICIPANTS Five hundred community-dwelling people aged 70 to 90 . MEASUREMENTS All participants underwent assessment s on medical , disability , physical , cognitive , and psychological measures .  Fallers were defined as people who had at least one injurious fall or at least two noninjurious falls during a 12-month follow-up period . RESULTS Univariate regression analyses identified the following fall risk factors : disability , poor performance on physical tests , depressive symptoms , poor executive function , concern about falling , and previous falls . Classification and regression tree analysis revealed that balance-related impairments were critical predictors of falls . In those with good balance , disability and exercise levels influenced future fall risk-people in the lowest and the highest exercise tertiles were at greater risk . In those with impaired balance , different risk factors predicted greater fall risk-poor executive function , poor dynamic balance , and low exercise levels . Absolute risks for falls ranged from 11 % in those with no risk factors to 54 % in the highest-risk group . CONCLUSIONS A classification and regression tree approach highlighted interrelationships and discriminatory value of important explanatory fall risk factors . The information may prove useful in clinical setting s to assist in tailoring interventions to maximize the potential benefit of falls prevention strategies PURPOSE The purpose of this study was to identify the effects of water-based exercises on the physical functions and quality of life ( QOL ) in community-dwelling elderly people with history of falling . MATERIAL S AND METHODS Participants were r and omly assigned to the water-based exercise group ( n=34 ) or l and -based exercise groups ( n=32 ) . To identify the effects on physical functions , muscle strength , flexibility , and mobility were measured . QOL and fear of falling were evaluated using the Short Form 36-item question naire and the modified falls efficacy scale ( M-FES ) . The measurements were performed before and after the 10-week training period . RESULTS Within-group analysis indicated that hip abduction and adduction strength improved significantly in both groups ( p=0.005 ; p=0.007 ) . However , no statistically significant within-group differences were found in the back scratch test ( p=0.766 ) and chair sit- and -reach test ( p=0.870 ) . QOL was significantly different in both groups ( health transition : p=0.014 , physical functioning : p<0.001 , role physical : p<0.001 , role emotional : p=0.002 , bodily pain : p<0.001 , vitality : p<0.001 , and mental health : p<0.001 ) . There was a significant difference in the M-FES in both groups ( p=0.040 ) . CONCLUSIONS These results indicate that water-based exercises are beneficial to improve the QOL , as well as physical activities , of community-dwelling elderly compared with l and -based exercise . Water-based exercises would be useful to improve physical and psychological health in the elderly people with history of falling
However , aquatic exercise improved key predisposing physical fitness components that are modifiable and internal risk factors for falling .
Conclusions There is limited , low- quality evidence to support the use of aquatic exercise for improving physiological components that are risk factors for falling .
Background According to the World Health Organization , the elderly are at the highest risk of injury or death from a fall .
Age-related changes in strength , balance and flexibility are degenerative factors that may increase the risk of falling , and an aquatic training may offer a favourable environment to improve these modifiable risk factors .
Methods A systematic review was conducted to assess the potential preventative role of aquatic exercise for reducing the risk of falls in the elderly by improving predisposing risk factors .