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Balance training may help the elderly avoid falls

Public HealthDec 25, 06

Although the ancient art of Tai Chi has been shown to lower older adults’ risk of falls, exercises that specifically focus on improving balance and speed may be even better, a study suggests.

Researchers found that among more than 200 elderly adults with balance problems, those who went through an exercise program called “combined balance and step training” (CBST) made greater gains in balance and mobility than those who took Tai Chi classes.

The findings, reported in the Journal of the American Geriatrics Society, suggest that the CBST approach might be particularly effective at improving older adults’ ability to avoid falls.

Whether it actually cuts fall rates is currently being studied, said Dr. Neil B. Alexander, a professor of geriatric medicine at the University of Michigan Health System in Ann Arbor and the senior author on the current study.

Tai Chi is an ancient Chinese practice that focuses on building strength, balance and flexibility through slow, fluid movements combined with mental imagery and deep breathing. Studies have suggested that the elderly can reduce their risk of falls, lower their blood pressure and ease arthritis symptoms through the practice.

CBST is different in that it focuses on “dynamic” balance, or a person’s ability to respond quickly and safely to a sudden loss of balance. To avoid a fall, Alexander explained, people often have to quickly take a long step—two things that are difficult for many older people.

In this study, elderly adults who went through the training showed greater improvements in their stepping length and speed than those in the Tai Chi group. But what was more interesting, Alexander told Reuters Health, was that they also made greater strides in their balance and basic walking ability.

The findings are based on outcomes for 213 older adults with at least mild impairments in balance and mobility. Half were randomly assigned to go through balance and step training for 10 weeks, while the rest went through a Tai Chi program.

The CBST program included exercises such as changing direction to walk backward or sideways, changing speed, walking on a plank and stepping over small obstacles. The Tai Chi classes focused on weight shifting, stepping in different directions and balancing, but with slower, flowing motions.

The CBST program is still research-based and not yet available in the community. However, Alexander said a physical therapist might be able to design a similar program for an older adult who’s at risk of falls.

Falls are a major cause of hip fractures and other disabilities, hospitalizations and deaths among the elderly. A recent government study found that the rate of fatal falls among older Americans rose by 55 percent between 1993 and 2003, underscoring a growing need for prevention.

SOURCE: Journal of the American Geriatrics Society, December 2006.

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