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Updated: May 25, 2026

A Training Program Using an Agility Ladder for Community-Dwelling Older Adults
Published on: March 7, 2020
Long-term effects of three multicomponent exercise interventions on physical performance and fall-related
Ellen Freiberger1, Lothar Häberle, Waneen W Spirduso
1Institut für Sportwissenschaft und Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany. ellen.freiberger@sport.uni-erlangen.de
Objectives:
To determine the long-term effects of three strength and balance exercise interventions on physical performance, fall-related psychological outcomes, and falls in older people.
Design:
A single-blinded, four-group, randomized controlled trial.
Setting:
Community, Germany.
Participants:
Community-dwelling adults aged 70 to 90 who had fallen in the past 6 months or reported fear of falling.
Intervention:
After baseline assessment, 280 participants were randomly assigned to the control group (CG; no intervention; n = 80) or one of three strength and balance exercise interventions (the strength and balance group (SBG; strength and balance only; n = 63), the fitness group (FG; strength and balance plus endurance training; n = 64), or the multifaceted group (MG; strength and balance plus fall risk education; n = 73). The interventions consisted of 32 one-hour group sessions in 16 weeks.
Measurements:
Data on physical performance, fall-related psychological outcomes, and falls were collected for 24 months.
Results:
Mixed-effects regression analyses showed improved short- and long-term (12 and 24 months, respectively) physical performance for the SBG and FG, particularly regarding mobility, balance, and walking speed (P < .05). The improvements in physical performance outcomes were most prominent in the FG. Fall-related psychological outcomes, number of falls, and injurious falls were not significantly different from in the control group.
Conclusion:
Training focusing on strength, balance, and endurance can enhance physical performance for up to 24 months in community-dwelling older adults. These findings did not translate to improved fall-related psychological outcomes or reduced incidence of falls. This demonstrates the need for a different approach (e.g., regarding intervention dose and components) to gain intervention benefits in the multiple domains that contribute to independence and well-being in older adults.
