[Effect of physical training on postural control of elderly].

BACKGROUND: Preservation of balance in the elderly is fundamental to maintaining functional independence. Balance impairments have a tremendous impact on health care costs and quality of life. Fall prevention programs are an important health strategy, consequently there is a general need to develop effective and practical exercise programs that improve balance in the elderly.

OBJECTIVE: To explore whether stability can be improved through exercise in inactive old subjects and to determine whether specific balance training proves to be more beneficial to retaining balance than strength training.

METHODS: A randomized controlled study was conducted with 42 healthy elderly individuals. They were randomly allocated to three groups: Balance training (BT), Isometric training (IT) and Control (CG) received no intervention; each group consisted of 14 members. "Static" and "dynamic" postural stability were evaluated for seven postural conditions in upright standing before and immediately after 3 months of intervention using a force platform, and an isokinetic dynamometer used to determine whether the training improved muscle strength.

RESULTS: The BT group significantly improved their forward-backward stability limits (maximal body lean) post intervention compared with other groups. Plantar and dorsiflexion isometric strength remained the same in all groups. No significant improvement was found in COP based measures in upright standing in all study groups, apart from the BT group that significantly improved parameters in performance with eyes open and during standing on a foam. BT subjects improved their self-confidence post intervention in 64.2%, while IT subjects improved in only 35.7%.

CONCLUSIONS: Balance exercises appear to improve balance in the elderly, especially extending the boundaries of their stability a more dynamic component of balance. However it remains to be determined whether the lack of difference between groups in COP measures in upright standing ("static balance") was due to the short period of intervention, small sample size, unchallenged exercise regime or due to the inability of elderly individuals to improve their sway in upright standing.