Effects of a falls exercise intervention on strength, power, functional ability and bone in older frequent fallers: FaME (Falls Management Exercise) RCT secondary analysis

Dawn A. Skelton, Olga M. Rutherford, Susie Dinan-Young, Marlene Sandlund

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Abstract

Objectives: Falls Management Exercise (FaME) has been shown to reduce falls in frequent fallers and in lower risk sedentary older people. The effects of FaME on the strength, power, physical function and bone health of frequently falling older women are yet to be established. Methods: This paper reports secondary analysis of data from the original randomised controlled trial of FaME in 100 community dwelling women aged =65 years with a history of =3 falls in the previous year. Intervention was group delivered, weekly one hour tailored dynamic balance and strength exercise classes and home exercise for nine months. Outcome measures included: strength (handgrip, quadriceps, hamstrings, hip abductors, ankles), lower limb explosive power and functional tests (timed up and go, functional reach, timed floor rise and balance), analysed using Linear Mixed Model analysis. Bone Mineral Density (BMD) at hip and spine was measured in a smaller sub-group and analysed using t-tests. Results: Significant time*group interactions in all measures of strength, except isometric ankle dorsiflexion, concentric hamstring and eccentric quadriceps strength. These improvements in strength equated to average improvements of 7-45%. There were also significant improvements in explosive power (W/kg) (18%, p=0.000), timed up and go (16%, p=0.000), functional reach (17%, p=0.000), floor rise (10%, p=0.002) and eyes closed static balance (56%, p=0.000). There was a significant loss of hip BMD in the control group (neck of femur p<0.05; ward’s triangle p<0.02). Conclusion: The FaME intervention improves lower limb strength, power and clinically relevant functional outcomes in frequently falling older women.
Original languageEnglish
Pages (from-to)11-19
Number of pages9
JournalJournal of Frailty, Sarcopenia and Falls
Volume4
Issue number1
DOIs
Publication statusPublished - 31 Mar 2019

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Exercise
Bone and Bones
Ankle
Bone Density
Lower Extremity
Accidental Falls
Pelvic Bones
Independent Living
Femur Neck
Hip
Linear Models
Spine
Randomized Controlled Trials
Outcome Assessment (Health Care)
Control Groups
Health

Keywords

  • exercise
  • intervention
  • falls prevention
  • strength
  • balance
  • RCT
  • functional ability
  • bone health
  • falls
  • power
  • physical function

Cite this

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title = "Effects of a falls exercise intervention on strength, power, functional ability and bone in older frequent fallers: FaME (Falls Management Exercise) RCT secondary analysis",
abstract = "Objectives: Falls Management Exercise (FaME) has been shown to reduce falls in frequent fallers and in lower risk sedentary older people. The effects of FaME on the strength, power, physical function and bone health of frequently falling older women are yet to be established. Methods: This paper reports secondary analysis of data from the original randomised controlled trial of FaME in 100 community dwelling women aged =65 years with a history of =3 falls in the previous year. Intervention was group delivered, weekly one hour tailored dynamic balance and strength exercise classes and home exercise for nine months. Outcome measures included: strength (handgrip, quadriceps, hamstrings, hip abductors, ankles), lower limb explosive power and functional tests (timed up and go, functional reach, timed floor rise and balance), analysed using Linear Mixed Model analysis. Bone Mineral Density (BMD) at hip and spine was measured in a smaller sub-group and analysed using t-tests. Results: Significant time*group interactions in all measures of strength, except isometric ankle dorsiflexion, concentric hamstring and eccentric quadriceps strength. These improvements in strength equated to average improvements of 7-45{\%}. There were also significant improvements in explosive power (W/kg) (18{\%}, p=0.000), timed up and go (16{\%}, p=0.000), functional reach (17{\%}, p=0.000), floor rise (10{\%}, p=0.002) and eyes closed static balance (56{\%}, p=0.000). There was a significant loss of hip BMD in the control group (neck of femur p<0.05; ward’s triangle p<0.02). Conclusion: The FaME intervention improves lower limb strength, power and clinically relevant functional outcomes in frequently falling older women.",
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author = "Skelton, {Dawn A.} and Rutherford, {Olga M.} and Susie Dinan-Young and Marlene Sandlund",
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Effects of a falls exercise intervention on strength, power, functional ability and bone in older frequent fallers: FaME (Falls Management Exercise) RCT secondary analysis. / Skelton, Dawn A.; Rutherford, Olga M.; Dinan-Young, Susie; Sandlund, Marlene.

In: Journal of Frailty, Sarcopenia and Falls, Vol. 4, No. 1, 31.03.2019, p. 11-19.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effects of a falls exercise intervention on strength, power, functional ability and bone in older frequent fallers: FaME (Falls Management Exercise) RCT secondary analysis

AU - Skelton, Dawn A.

AU - Rutherford, Olga M.

AU - Dinan-Young, Susie

AU - Sandlund, Marlene

N1 - Acceptance from webpage CC licence on webpage, not in VoR This journal is OA (all published work is licensed under Creative Commons Attribution NonCommercial - ShareAlike 4.0 International) Added last day of month as pub date (journal gives month and year)

PY - 2019/3/31

Y1 - 2019/3/31

N2 - Objectives: Falls Management Exercise (FaME) has been shown to reduce falls in frequent fallers and in lower risk sedentary older people. The effects of FaME on the strength, power, physical function and bone health of frequently falling older women are yet to be established. Methods: This paper reports secondary analysis of data from the original randomised controlled trial of FaME in 100 community dwelling women aged =65 years with a history of =3 falls in the previous year. Intervention was group delivered, weekly one hour tailored dynamic balance and strength exercise classes and home exercise for nine months. Outcome measures included: strength (handgrip, quadriceps, hamstrings, hip abductors, ankles), lower limb explosive power and functional tests (timed up and go, functional reach, timed floor rise and balance), analysed using Linear Mixed Model analysis. Bone Mineral Density (BMD) at hip and spine was measured in a smaller sub-group and analysed using t-tests. Results: Significant time*group interactions in all measures of strength, except isometric ankle dorsiflexion, concentric hamstring and eccentric quadriceps strength. These improvements in strength equated to average improvements of 7-45%. There were also significant improvements in explosive power (W/kg) (18%, p=0.000), timed up and go (16%, p=0.000), functional reach (17%, p=0.000), floor rise (10%, p=0.002) and eyes closed static balance (56%, p=0.000). There was a significant loss of hip BMD in the control group (neck of femur p<0.05; ward’s triangle p<0.02). Conclusion: The FaME intervention improves lower limb strength, power and clinically relevant functional outcomes in frequently falling older women.

AB - Objectives: Falls Management Exercise (FaME) has been shown to reduce falls in frequent fallers and in lower risk sedentary older people. The effects of FaME on the strength, power, physical function and bone health of frequently falling older women are yet to be established. Methods: This paper reports secondary analysis of data from the original randomised controlled trial of FaME in 100 community dwelling women aged =65 years with a history of =3 falls in the previous year. Intervention was group delivered, weekly one hour tailored dynamic balance and strength exercise classes and home exercise for nine months. Outcome measures included: strength (handgrip, quadriceps, hamstrings, hip abductors, ankles), lower limb explosive power and functional tests (timed up and go, functional reach, timed floor rise and balance), analysed using Linear Mixed Model analysis. Bone Mineral Density (BMD) at hip and spine was measured in a smaller sub-group and analysed using t-tests. Results: Significant time*group interactions in all measures of strength, except isometric ankle dorsiflexion, concentric hamstring and eccentric quadriceps strength. These improvements in strength equated to average improvements of 7-45%. There were also significant improvements in explosive power (W/kg) (18%, p=0.000), timed up and go (16%, p=0.000), functional reach (17%, p=0.000), floor rise (10%, p=0.002) and eyes closed static balance (56%, p=0.000). There was a significant loss of hip BMD in the control group (neck of femur p<0.05; ward’s triangle p<0.02). Conclusion: The FaME intervention improves lower limb strength, power and clinically relevant functional outcomes in frequently falling older women.

KW - exercise

KW - intervention

KW - falls prevention

KW - strength

KW - balance

KW - RCT

KW - functional ability

KW - bone health

KW - falls

KW - power

KW - physical function

U2 - 10.22540/JFSF-04-011

DO - 10.22540/JFSF-04-011

M3 - Article

VL - 4

SP - 11

EP - 19

JO - Journal of Frailty, Sarcopenia and Falls

JF - Journal of Frailty, Sarcopenia and Falls

SN - 2459-4148

IS - 1

ER -