Freiberger, et al.
This study examined 2 interventions to reduce falls: a psychomotor intervention that focused on body awareness, body experience, and coordination; and a fitness intervention that focused on functional skills, strength, endurance, and flexibility. Both interventions included group classes, home-based exercises, and physical activity recommendations.
Only the fitness intervention was effective in reducing falls. Compared to the control group, participants in the fitness group experienced 23 percent fewer falls.
The participants were community-dwelling, physically active people in very good health, aged 70 or older. Slightly more than half were male.
Improve functional skills, strength, endurance, and flexibility.
The group classes were conducted at the University of Erlangen-Nuremberg, Institute of Sport Science, and the home-based portion was carried out in participants’ homes.
This program consisted of group exercise classes, home-based exercises, and recommendations for increasing physical activity levels such as daily walking or biking. Each session lasted 1 hour. Approximately one-third of the time was spent on each of the components:
- Strength and flexibility training (including the use of dumbbells, ankle weights, weight-bearing exercises, and joint flexibility)
- Balance and motor coordination training (including standing balance, dynamic weight transfers, stepping strategies, motor control when performing activities of daily living, motor control under time pressure and sensory awareness)
- Endurance training (including normal walking and Nordic walking) Group discussions were conducted at the beginning and end of each session to outline the goals of the program and to review progress.
One-hour classes were held twice a week for 16 weeks. In addition, participants were instructed to perform selected exercises at home on a daily basis between sessions and after the program ended.
The program was supervised by 2 trainers, preferably a man and a woman, who had backgrounds in sports science. This training is similar to that received by physical education teachers. It included knowledge of physical education, kinesiology, motor control, and motor learning. Trainers also had experience working with older persons, which they generally gained during the course of their academic studies.
Trainers need to have a background in physical therapy, psychology, sports science, or as a personal trainer. Trainers also need to have experience working with older adults and attend a 2-day training session, or to attend a comprehensive 4-day training if they do not have experience working with older adults. Training should include age-related changes in physical, cognitive and social dimensions (e.g., changes in muscle mass, loss of strength and power); fear of falling and how to address it; how to perform the strength, balance, and gait training exercises; and an introduction to public health theories and models, such as the Health Belief Model.
- Strength, endurance, and functional skill exercises, including balance and gait training, should increase in intensity over the duration of the program.
- Trainers must attend the program training.
A course manual has been published in German (Freiberger E, Schöne D. Sturzprophylaxe im Alter. Deutscher Aerzteverlag: Köln). In addition, there is a German web site with information about fall prevention and trainers’ education at www.standfestimalter.de.
Freiberger E, Menz HB, Abu-Omar K, Rütten A. Preventing falls in physically active community-dwelling older people: A comparison of two intervention techniques. Gerontology. 2007 Aug;53(5):298-305.
Supplemental article Freiberger E, Menz HB. Characteristics of falls in physically active community-dwelling older people. Zeitschrift für Gerontologie und Geriatrie. 2006 Aug;39(4):261-7.
Practitioners interested in using this intervention may contact the principal investigator for more information:
Dr. Ellen Freiberger
Institut für Sportwissenschaft und Sport
Gebbertstrasse 123b, DE-91058, Erlangen, Germany
Tel: +49 9131 852 5464
Fax: +49 9131 852 5002
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