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Icon: Exercise-based interventionsExercise-based Interventions: Veterans Affairs Group Exercise Program

Rubenstein, et al.

This study evaluated a structured group exercise program for fall-prone older men. During the 3-month program, participants were two-thirds less likely to fall compared with those who did not take part in the program.

Note: This study calculated the fall rate as the number of falls per hour of physical activity.


All participants were aged 70 or older and lived in the community. All were males who had at least 1 of these fall risk factors: leg weakness; impaired gait, mobility, and/or balance; and had fallen 2 or more times in the previous 6 months.

Geographic Locale

Los Angeles, California, United States


Increase strength and endurance and improve mobility and balance using a low- to moderate-intensity group exercise program.

Program Setting

Increase strength and endurance and improve mobility and balance using a low- to moderate-intensity group exercise program.


  • Strength training included hip flexion, extension, abduction, and adduction; knee flexion and extension; squats, dorsiflexion, and plantar flexion. Over the first 4 weeks, participants increased each exercise from 1 to 3 sets of 12 repetitions. Resistance levels also were increased progressively. The rate of progression was modified for subjects with physical limitations.
  • Endurance training used bicycles, treadmills, and indoor walking sessions. Endurance training alternated between cycling (once a week), using a treadmill (twice a week), and indoor walking that included a walking loop as well as 2 flights of stairs (twice a week). Heart rates were monitored to ensure that participants did not exceed 70 percent of their heart rate reserve.
  • Balance training used a rocking balance board, balance beam, obstacle course, and group activities such as balloon volleyball and horseshoes. Balance training sessions were held twice a week and increased in difficulty over the 12-week program.


Three 1½-hour sessions a week for 12 weeks.

Delivered by

Exercise physiology graduate students with training from experienced exercise physiologists or physical therapists.

Minimum Level of Training Needed

Facilitators should have approximately 2 weeks of on-the-job training by an experienced exercise physiologist or physical therapist.

Key Elements

  • Using a group format and providing a wide variety of exercise activities
  • Focusing on strength, balance, and endurance
  • Providing personal encouragement and reinforcement

Available Materials

No materials were available at time of publication.

Study Citation

Rubenstein LZ, Josephson KR, Trueblood PR, Loy S, Harker JO, Pietruszka FM, Robbins, AS. Effects of a group exercise program on strength, mobility, and falls among fall-prone elderly men. Journal of Gerontology: Medical Sciences. 2000 Jun;55A(6):M317-21.


Practitioners interested in using this intervention may contact the principal investigator for more information:

Laurence Z. Rubenstein, MD, MPH
VA Medical Center, GRECC (11e)
16111 Plummer St.
Sepulveda, CA 91343, United States
Tel: 818-895-9311
Fax: 818-891-8181

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