@article{ref1,
title="Engineering improved balance confidence among older adults with complex health care needs: learning from the Muscling Up Against Disability study",
journal="Archives of physical medicine and rehabilitation",
year="2018",
author="Hetherington, Sharon and Henwood, Tim and Swinton, Paul and Keogh, Justin and Gardiner, Paul and Tuckett, Anthony",
volume="99",
number="8",
pages="1525-1532",
abstract="OBJECTIVE: To investigate the associations of balance confidence with physical and cognitive markers of wellbeing among older adults receiving government-funded aged care services, and whether progressive resistance plus balance training could positively influence change. <br><br>DESIGN: Intervention study. SETTING: Community-based older-adult-specific exercise clinic. PARTICIPANTS: Older adults (N=245) with complex care needs who were receiving government aged care support. INTERVENTION: 24 weeks of twice-weekly progressive resistance plus balance training carried out under the supervision of accredited exercise physiologists. MAIN OUTCOME MEASURES: The primary measure was the Activity-specific Balance Confidence score. Secondary measures included the Short Physical Performance Battery, fall history, hierarchical timed balance tests, Geriatric Anxiety Index, Geriatric Depression Score, FRAIL scale and EuroQol 5D 3L. <br><br>RESULTS: At baseline, higher physical performance (r = 0.54, p <.01) and quality of life (r = 0.52, p <.01) predicted better balance confidence. In contrast, at baseline, higher levels of frailty predicted worse balance confidence (r = -0.55, p <.01). Change in balance confidence following the exercise intervention was accompanied by improved physical performance (+12%) and decreased frailty (-11%). Baseline balance confidence was identified as the most consistent negative predictor of change scores across the intervention. <br><br>CONCLUSIONS: This study shows that reduced physical performance and quality of life, and increasing frailty, are predictive of poor balance confidence among older adults with aged care needs. However, when a targeted intervention of resistance and balance exercise is implemented, that reduces frailty and increases physical performance, balance confidence will also improve. Given the influence of balance confidence on a raft of wellbeing determinants, including the capacity for positive physical and cognitive change, this study offers important insight to those looking to reduce falls among older adults.<br><br>Copyright © 2018. Published by Elsevier Inc.<p /> <p>Language: en</p>",
language="en",
issn="0003-9993",
doi="10.1016/j.apmr.2018.03.004",
url="http://dx.doi.org/10.1016/j.apmr.2018.03.004"
}