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Regular exercise in the elderly is effective to preserve the speed of voluntary stepping under single-task condition
Itshak Melzer1, Roni Marx, Ilan Kurz
1Schwartz Movement Analysis and Rehabilitation Laboratory, Physical Therapy Department, The Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva, Israel. itzikm@bgu.ac.il
Background:
Stepping response may be considered the most important postural reaction to prevent a fall because it is the inability to respond effectively to a loss of balance that ultimately determines whether a fall occurs. However, very little has been studied on the effect of exercising on step execution behavior in the elderly.
Objectives:
To explore whether older persons who exercise regularly have faster voluntary stepping times than sedentary elderly persons. Additionally, we investigated the association between step execution behavior, self-reported physical function, and balance performance.
Methods:
Case-control study of 48 elderly adults aged 65-91 years who live independently in retirement homes. Participants were classified as 24 exercisers (reporting >2 exercise training activities/week) and 24 age- and gender-matched inactive elderly individuals (who do not exercise regularly). The Voluntary Step Execution Test was performed as a reaction time task while standing on a force platform under single-task and dual-task conditions. Step initiation phase, foot off time, foot contact time, preparatory, and swing phases were extracted from center of pressure and ground reaction force data. Self-reported function was examined using Late-Life Function and Disability Instrument; Berg Balance Test was also performed.
Results:
Exercisers had significantly faster voluntary step times in single-task condition (959 vs. 1,158 ms) but not during dual-task condition (1,170 vs. 1,303 ms). Exercisers had a significantly higher Berg Balance Test (53.7 +/-3.6 vs. 49.8 +/-5.3), consumed less medication (3.3 +/-2.3 vs. 5.6 +/-2.9), and their lower extremity function scores were higher (88.61 +/-2.3 vs. 73.1 +/-2.7) than those of inactive subjects.
Conclusion:
Exercising regularly protects from physical functioning loss in older persons and against a decrease in voluntary step execution times during single-task but not during dual-task conditions. Lack of specificity (dual-task exercises) during the training may be the cause of insignificant differences in dual-task stepping performance. Thus, adding dual-task training may improve dual-task performance in the elderly.
