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Resistance and Agility Training Reduce Fall Risk in Women Aged 75 to 85 with Low Bone Mass: A 6-Month Randomized, Controlled Trial

Authors

  • Teresa Liu-Ambrose PhD, PT,

    1. From the Bone Health Research Group, British Columbia Women's Hospital and Health Center Osteoporosis Program and Faculty of Medicine
    2. School of Human Kinetics
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  • Karim M. Khan MD, PhD,

    1. From the Bone Health Research Group, British Columbia Women's Hospital and Health Center Osteoporosis Program and Faculty of Medicine
    2. School of Human Kinetics
    3. Rehabilitation Research Laboratory, GF Strong Rehabilitation Center, Vancouver, British Columbia, Canada
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  • Janice J. Eng PhD, PT/OT,

    1. School of Rehabilitation Sciences,
    2. Rehabilitation Research Laboratory, GF Strong Rehabilitation Center, Vancouver, British Columbia, Canada
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  • Patti A. Janssen PhD,

    1. From the Bone Health Research Group, British Columbia Women's Hospital and Health Center Osteoporosis Program and Faculty of Medicine
    2. Department of Health Care and Epidemiology, and
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  • Stephen R. Lord PhD,

    1. Department of Health Care and Epidemiology, and
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  • Heather A. Mckay PhD

    1. From the Bone Health Research Group, British Columbia Women's Hospital and Health Center Osteoporosis Program and Faculty of Medicine
    2. Department of Family Practice
    3. Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada
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  • Funding provided by the Vancouver Foundation (BCMSF), the Canadian Institutes of Health Research, and the Michael Smith Foundation for Health Research. The Peter Wall Institute for Advanced Studies at the University of British Columbia funded the Exploratory Workshop related to this study. The Canada Foundation for Innovation funded essential infrastructure used in this study (New Opportunities Fund).
    Drs. Khan, Eng, and Janssen are Canadian Institutes of Health Research New Investigators. Drs. McKay, Eng, and Janssen are Michael Smith Foundation for Health Research (MSFHR) Career Scholars. Ms. Liu-Ambrose is a MSFHR Doctoral Trainee, a Killam Pre-Doctoral Fellow, and a MSFHR Post-doctoral Trainee.
    Parts of this paper were presented at the International Society for Postural and Gait Research, 16th Biannual Conference 2003, Australia.

Address correspondence to Dr. Karim M. Khan, PhD, MD, Department of Family Practice, Faculty of Medicine, University of British Columbia, Suite 211–2150 Western Parkway, Vancouver, BC, Canada, V6T 1V6. E-mail: kkhan@interchange.ubc.ca

Abstract

Objectives: To compare the effectiveness of group resistance and agility-training programs in reducing fall risk in community-dwelling older women with low bone mass.

Design: A randomized, controlled, single-blind 25-week prospective study with assessments at baseline, midpoint, and trial completion.

Setting: Community center.

Participants: Community-dwelling women aged 75 to 85 with low bone mass.

Intervention: Participants were randomly assigned to one of three groups: resistance training (n=32), agility training (n=34), and stretching (sham) exercises (n=32). The exercise classes for each study arm were held twice weekly.

Measurements: The primary outcome measure was fall risk (derived from weighted scores from tests of postural sway, reaction time, strength, proprioception, and vision), as measured using a Physiological Profile Assessment (PPA). Secondary outcome measures were ankle dorsiflexion strength, foot reaction time, and Community Balance and Mobility Scale score.

Results: Attendance at the exercise sessions for all three groups was excellent: resistance training (85.4%), agility training (87.3%), and stretching program (78.8%). At the end of the trial, PPA fall-risk scores were reduced by 57.3% and 47.5% in the resistance and agility-training groups, respectively, but by only 20.2% in the stretching group. In the resistance and agility groups, the reduction in fall risk was mediated primarily by improved postural stability, where sway was reduced by 30.6% and 29.2%, respectively. There were no significant differences between the groups for the secondary outcomes measures. Within the resistance-training group, reductions in sway were significantly associated with improved strength, as assessed using increased squat load used in the exercise sessions.

Conclusion: These findings support the implementation of community-based resistance and agility-training programs to reduce fall risk in older women with low bone mass. Such programs may have particular public health benefits because it has been shown that this group is at increased risk of falling and sustaining fall-related fractures.

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