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Effect of a high-intensity functional exercise program on functional balance: preplanned subgroup analyses of a
Håkan Littbrand1, Maine Carlsson, Lillemor Lundin-Olsson
1Division of Geriatric Medicine, Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden. hakan.littbrand@germed.umu.se
Objectives:
To evaluate whether age, sex, depression, dementia disorder, nutritional status, or level of functional balance capacity influences the effect of a high-intensity functional weight-bearing exercise program on functional balance.
Design:
Preplanned subgroup analyses of a randomized controlled trial.
Setting:
Nine residential care facilities.
Participants:
One hundred ninety-one people aged 65 to 100 dependent in activities of daily living and with Mini-Mental State Examination scores of 10 or greater.
Intervention:
A high-intensity functional weight-bearing exercise program or a control activity, each comprising 29 sessions over 3 months.
Measurements:
Functional balance capacity was assessed blindly using the Berg Balance Scale (BBS) at baseline, 3 months, and 6 months. The BBS consists of 14 tasks, common in everyday life, such as standing up from sitting and, while standing, reaching forward or turning 360°. Interactions between allocation to activity group and each subgroup were evaluated according to the intention-to-treat principle.
Results:
The subgroup analyses revealed no statistically significant interaction for age, sex, depression, dementia disorder, nutritional status, or level of functional balance capacity at 3 (P=.65, .65, .51, .78, .09, .67, respectively) or 6 (P=.69, .62, .20, .94, .48, .85, respectively) months. In addition, at 3 and 6 months there was no significant interaction for cognitive level (P=.28, .47, respectively) or number of depressive symptoms (P=.85, .49, respectively).
Conclusion:
Older age, female sex, depression, mild to moderate dementia syndrome, malnutrition, and severe physical impairment do not seem to have a negative effect on functional balance from a high-intensity functional weight-bearing exercise program. Consequently, people with these characteristics in residential care facilities should not be excluded from offers of rehabilitation including high-intensity exercises.