Effect of additional functional exercises on balance in elderly people

Objective: To evaluate the additional effect of functional exercises on balance and lower extremity function among hostel-dwelling elderly people partaking in strength training. Design: A randomized two-group parallel controlled trial. Setting: A senior resident's hostel in Switzerland. Participants: Thirty-two individuals randomized to either strength or strength and functional exercise groups. Interventions: Both groups received machine-driven strength training for 45 min, twice weekly, for 12 weeks. The strength and functional exercises group received an additional 30 min of functional exercise training, once weekly. Main outcome measures: Tinetti test, balance tests and a physical performance test. Assessments were performed before and after the intervention. Results: Improvements for the balance test depended on the type of training (significant interaction effects [F(1,20) = 6.7; P= 0.018]). This test improved from 11.3 +/- 11.7 to 17 +/- 11.2 (P= 0.009) in the combined training group (n = 12) and remained from 7.3 +/- 9.5 to 6.9 +/- 9.2 unchanged (P=0.821) in the strength training group (n = 13). A significant difference between groups following training was observed (P= 0.031). The Tinetti balance score and the chair stand test of the physical performance assessment improved from 14.3 +/- 1.9 to 15.3 +/- 1.1 (P= 0.026) and 1.8 +/- 1.2 to 2.8 +/- 1.1 (P= 0.012) respectively in the combined training group only. Conclusions: Our findings suggest that twice-weekly lower extremity strength training of 12 weeks' duration in hostel-dwelling elderly people only improves task-specific balance performance and lower extremity physical function when additional functional exercises are added.