Can a three week balance training programme in a rehabilitation centre improve balance in elderly people? A randomised controlled clinical trial

Purpose: To observe effects of extra balance training for home-dwelling older people attending a three weeks rehabilitation stay, on balance, falls and falls related injuries. Methods: Randomised, controlled trial involving 174 people, aged 65 and older (mean: 73.2; SD: 6.4). Two groups of participants followed a three week rehabilitation programme in Lillehammer, Norway: Intervention Group (IG, n= 57), Control Group (CG, n= 56); A third group (non-randomised) did not follow the program (RG, n = 61). Both IG and CG had similar rehabilitation programmes (treatments, training sessions). IG additionally followed a balance-training programme (OTAGO) with a physiotherapist, in a group-setting plus self training. The Falls Efficacy Scale-International (FES-I) was used as primary outcome and was assessed at baseline (T1), after three weeks rehabilitation (T2), and after 3 (T3) and 6 months (T4). Timed Up and Go (TUG) and Sharpened Romberg were assessed at T1 and T2 for IG and CG. Results: No significant group differences in change were found (p=0.47), but FES-I and TUG improved in both IG (p<0.001) and CG (p=0.029). No significant group differences were found in number of falls, or falls injuries during follow-up, but a significant increase in weekly exercise for IG (p=0.027) and CG (p=0.002) was found compared to RG. Conclusion: Extra balance training did not improve balance compared with standard rehabilitation. However three weeks of rehabilitation did lead to improvements in certain aspects of balance and weekly exercise. Balance improvement in the elderly is a long term project and we suggest that balance training initiated in a rehabilitation centre should be followed up after discharge.