Clinical Rehabilitation

 

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Clinical Rehabilitation, Vol. 21, No. 3, 273-283 (2007)
DOI: 10.1177/0269215506069486

Comparison of the effectiveness of two programmes on older adults at risk of falling: unsupervised home exercise and supervised group exercise

Hülya Donat

Republic of Turkey Emekli Sandigi Narlidere Nursing Home, Izmir, Turkey

Ayse Özcan

School of Physical Therapy and Rehabilitation, Izmir, Turkey

Objective: To compare the effectiveness of unsupervised home and supervised group exercise on parameters related to risk of falling among older adults.

Design: Prospective, single-blind, randomized and controlled trial.

Setting: Nursing home.

Subjects: The subjects were selected from 535 independent individuals who resided in a nursing home. Forty-two older adults, aged > 65 years, with risk of falling were recruited, and 32 of them completed the study.

Intervention: The 42 subjects were divided into two groups (unsupervised home exercise and supervised exercise group) randomly. Exercise sessions were performed three times a week for a period of eight weeks.

Main measures: Measurements were taken at baseline and after the completion of the exercise programme. The fear of falling was evaluated using a visual analogue scale, quadriceps muscle strength was measured with a dynamometer, flexibility was assessed with the sit and reach test, functional mobility was determined using the Timed Up and Go Test, balance was evaluated using one-leg and tandem standing, and Berg Balance Scale and proprioception was assessed with knee position sense.

Results: Thirty-two subjects (unsupervised home exercise n = 15, supervised group exercise n = 17) completed the exercise programme and all of the measurements. The unsupervised home exercise group showed significant improvement in balance, functional mobility and flexibility (P > 0.05). In addition to balance, functional mobility and flexibility, the supervised exercise group also showed significant improvements in both strength and proprioception (P > 0.05).

Conclusions: Supervised group exercise is more effective at reducing the risk factors related to falling among older adults living in a nursing home than is unsupervised home exercise.


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