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Abstract
Purpose: To evaluate effects of combined mechano- and proprioceptive, vestibular and fall-prevention training on postural control, functional ability, confidence in activities of daily living (ADL) and frequency of falls among unsteady elderly people. Method: Subjects were 37 elderly outpatients attending physiotherapy because of instability. Treatment consisted of 18 multisensory balance training sessions. Results from Sensory Organization Test, Five-Times-Sit-to-Stand Test, 30-m normal and fast walk with a turn, Ascending–Descending 11 steps and Activities-specific Balance Confidence Scale were compared before and after training. Information was gathered about number of falls 1 year prior to training, during training period and for 6 months after completion of training. Results: Significant improvement was observed in all measured parameters (p < 0.001). The subjects aged between 70 and 92 years (mean age 80.8 years), had considerable medical history. Thirty four of them reported 159 falls in the year prior to the study. Six subjects reported seven falls during the training period and seven subjects reported 17 falls in the 6 months follow-up period. Conclusions: Combined vestibular, proprioceptive and fall-prevention training improve postural control, functional ability, confidence in ADL and might even decrease the risk of falling among elderly people.
Decreased proprioception in the lower limbs and vestibular dysfunction is common among elderly people.
Stimulation of the sensory systems and training of fall-prevention movements is essential when improving postural control among elderly people.
Multisensory training increases functional abilities, confidence in activities of daily living and possibly reduces rate of falls among elderly individuals.
Implications for Rehabilitation
Acknowledgements
We gratefully acknowledge funding for this study by the Landspitali National University Hospital, Reykjavik, Iceland and the Icelandic Physiotherapy Association research fund.