Effectiveness of simple balancing training program in elderly patients with history of frequent falls

Figures & data

Table 1 Demographic data of 146 participants

Demographic data	n = 146
Age (years)	67.1 ± 8.4
Body mass index (kg/m^2)	25.2 ± 4.4
Sex: female	116 (79.5%)
Marital status: married	70 (47.9%)
Underlying diseases
Dyslipidemia	70 (47.9%)
Hypertension	69 (47.3%)
Diabetes mellitus	23 (15.8%)
Ischemic heart disease	9 (6.2%)
History of previous fracture	18 (12.8%)
Walking independently	125 (86.8%)
Able to go outside by themselves	132 (90.4%)
Medication use ≥4	44 (34.1%)
Fear of falling	110 (75.3%)
Swaying on turning	87 (59.6%)
Difficulty on turning	49 (33.6%)

Table 2 The number (%) and 95% confidence interval of subjects who fell at baseline and 12-month after recruitment (cumulative frequency), analyzed by per protocol (PP) and intention-to-treat (ITT) methods

Fall frequency	Per protocol		P-value	Intention-to-treat^b		P-value
	Baseline (n = 146)	12-month (n = 104)^a		Baseline (n = 146)	12-month (n = 146)
Did not fall	–	51 (49.0%) (39.6%, 58.5%)	<0.001*	–	51 (34.9%) (27.7%, 43.0%)	<0.001*
Fell one time	69 (47.3%) (39.3%, 55.3%)	24 (23.1%) (16.0%, 32.0%)		69 (47.3%) (39.3%, 55.3%)	28 (19.2%) (13.6%, 26.3%)
Fell ≥ two times	77 (52.7%) (44.7%, 60.7%)	29 (27.9%) (20.2%, 37.2%)		77 (52.7%) (44.7%, 60.7%)	67 (45.9%) (38.0%, 54.0%)

Notes:

a Only 104 subjects could be completely followed up every visit;

b ITT was hypothesized that the lost-to-follow-up patients fell at least one time;

* Statistical significance at a level of 0.05.

Table 3 Mean (SD) of the balancing abilities at baseline and 12-month follow up period compared between infrequent fall and frequent fall groups (N = 118)

Balancing abilities	Infrequent falls^a (n = 54)		P-value	Frequent falls^b (n = 64)		P-value	Mean difference^c (95% CI)	P-value
	Baseline	12-month		Baseline	12-month
TUGT (s)	11.6 (4.1)	8.3 (2.0)	<0.001*	11.6 (4.2)	9.2 (5.9)	<0.001*	−0.88 (−2.24, 0.49)	0.21
Chair stand(s)	14.5 (4.5)	9.5 (1.8)	<0.001*	15.2 (5.0)	10.1 (2.7)	<0.001*	−0.45 (−1.17, 0.27)	0.22
Functional reach (cm)	25.9 (5.5)	27.8 (6.5)	0.015*	26.5 (5.2)	27.9 (6.3)	0.055	0.35 (−1.59, 2.28)	0.72
Berg balance score	24.6 (2.7)	25.5 (3.1)	0.031*	24.5 (3.8)	25.5 (3.8)	0.004*	−0.04 (−0.98, 0.90)	0.93

Notes:

a Infrequent fall means fall 0–1 time;

b Frequent falls means fall ≥ two times;

c Mean difference between infrequent and frequent falls at 12-month adjusted for baseline values using regression analysis;

* Statistical significance at a level of 0.05.

Abbreviation: TUGT, timed up and go test.

Table 4 Compliance with exercise during 3-month, 6-month, 9-month and 12-month follow up period

Compliance^a	3-month (n = 132)	6-month (n = 121)	9-month (n = 111)	12-month (n = 118)	Completely F/U (n = 104)^b
Good	95 (72.0%)	94 (77.7%)	86 (77.5%)	93 (78.8%)	60 (57.7%)
Poor	37 (28.0%)	27 (22.3%)	25 (22.5%)	25 (21.2%)	44 (42.3%)

Notes:

a Compliance: good means exercise at least three days per week, poor means exercise less than three days per week;

b Patients who could be completely followed up every visit.

Abbreviation: F/U, followed up.

Figure 1 Balancing abilities including timed up and go test, chair stand, functional reach, and Berg balance scale based on compliance with exercise.

Figure 2 Quality of life score (SF-36) of 104 participants compared between baseline and 1-year after.

Table 5 Crude odds and adjusted odds of the factors relating to fall frequency (N = 104)

Factors	Infrequent falls (n = 75)	Frequent falls (n = 29)	Crude odds ratio^a (95% CI)	Adjusted odds^b (95% CI)
Age
<75	66 (88.0%)	23 (79.3%)	1.0	–
≥75	9 (12.0%)	6 (20.7%)	1.91 (0.61, 5.96)
Sex
Male	16 (21.3%)	8 (27.6%)	1.0	–
Female	59 (78.7%)	21 (72.4%)	0.71 (0.27, 1.90)
Underlying diseases
0–1	41 (54.7%)	14 (48.3%)	1.0	–
≥2	34 (45.3%)	15 (51.7%)	1.29 (0.55, 3.05)
Fear of fall
No	15 (20.0%)	10 (34.5%)	1.0	–
Yes	60 (80.0%)	19 (65.5%)	0.48 (0.18, 1.23)
Previous fall
<3 times	68 (90.7%)	21 (72.4%)	1.0	1.00
≥3 times	7 (9.3%)	8 (27.6%)	3.70 (1.20, 11.41)*	3.76 (1.18, 11.98)**
Compliance with exercise
Good	48 (64.0%)	12 (41.4%)	1.0	1.00
Poor	27 (36.0%)	17 (58.6%)	2.52 (1.05, 6.05)*	2.55 (1.04, 6.30)***
Medication use
0–3	50 (66.7%)	23 (79.3%)	1.0	–
≥4	25 (33.3%)	6 (20.7%)	0.52 (0.19, 1.45)
Difficulty on turning
No	47 (62.7%)	21 (72.4%)	1.0	–
Yes	28 (37.3%)	8 (27.6%)	0.64 (0.25, 1.64)
Swaying on turning
No	28 (37.3%)	15 (51.7%)	1.0	–
Yes	47 (62.7%)	14 (48.3%)	0.56 (0.23, 1.32)
Walking ability
Independent	67 (89.3%)	27 (93.1%)	1.0	–
With aids	8 (10.7%)	2 (6.9%)	0.60 (0.12, 3.11)
Going outside
Independent	68 (90.7%)	28 (96.6%)	1.0	–
Need assistance	7 (9.3%)	1 (3.4%)	0.35 (0.04, 2.95)

Notes:

a Chi-square test, Fisher’s exact test for qualitative data;

b Multiple logistic regression analysis;

* Statistical significance at a level of 0.05;

** P-value = 0.03;

*** P-value = 0.04.

Abbreviation: CI, confidence interval.