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Effect of a High‐Intensity Functional Exercise Program on Functional Balance: Preplanned Subgroup Analyses of a Randomized Controlled Trial in Residential Care Facilities
Author(s) -
Littbrand Håkan,
Carlsson Maine,
LundinOlsson Lillemor,
Lindelöf Nina,
Håglin Lena,
Gustafson Yngve,
Rosendahl Erik
Publication year - 2011
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2011.03484.x
Subject(s) - medicine , randomized controlled trial , dementia , balance (ability) , physical therapy , subgroup analysis , activities of daily living , depression (economics) , berg balance scale , gerontology , meta analysis , disease , economics , macroeconomics
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.