File
Lam F.1, Chan P.2, Liao L.-R.3, Woo J.4, Hui E.4, Lai C.2, Kwok T.5, Pang M.Y.C.1
1Hong Kong Polytechnic University, Department of Rehabilitation Sciences, Hong Kong, Hong Kong, 2Shatin Hospital, Physiotherapy Department, Shatin, Hong Kong, 3Guangdong Provincial Work Injury Rehabilitation Hospital, Department of Physiotherapy, Guangzhou, China, 4Shatin Hospital, Medical and Geriatric Unit, Shatin, Hong Kong, 5Chinese University of Hong Kong, Department of Medicine and Therapeutics, Shatin, Hong Kong
Background: Whole-body vibration (WBV) has been advocated as a useful adjunct treatment to improve various bodily functions in older adults through increasing the exercise training intensity. However, current evidence regarding the use of WBV training alone to improve balance and mobility in older adults remains largely inconclusive. The combined effects of WBV and a structured exercise program in older adults have only been evaluated in few studies, with conflicting results reported.
Purpose: To investigate whether WBV had additional therapeutic effect in improving physical function among institutionalized older adults when implemented in conjunction with a comprehensive exercise program.
Methods: This was a single-blinded randomized controlled trial. Seventy-three institutionalized older adults
[40 women; mean age: 82.3 (SD: 7.3) years] were randomly allocated to one of the three training groups: comprehensive strength and balance training program combined with WBV; comprehensive strength and balance training program without WBV; and social and recreational activities consisting of upper limb exercises only. All participants completed 3 training sessions per week for 8 weeks. Measured outcomes included assessment of: mobility, balance, lower limb strength, walking endurance, balance and self-perceived balance confidence. Outcomes were measured pre- and post-intervention. Incidences of falls requiring medical attention were recorded for 1 year after the end of the training session. Two-way repeated measures analysis of variance was used to compare the change in outcome variables across groups.
Results: A significant time × group interaction was found for lower limb strength, as measured by the five-times-sit-to-stand test (p=0.048). Post-hoc analysis showed that the interaction effect was attributable to the improvement in lower limb strength for the exercise group without WBV, compared to a decline in strength among controls (p=0.030). The exercise with WBV group had significantly better outcome in balance confidence score than the exercise only group (p=0.033).
Conclusion(s): The comprehensive exercise program was effective in improving lower limb strength among institutionalized older adults, but adding WBV did not enhance its effect. WBV may induce a placebo effect on balance confidence.
Implications: Regular participation in exercise can improve functional leg muscle strength among institutionalized older adults. WBV does not provide additional benefit on lower limb muscle strength, balance and mobility, when added to a comprehensive exercise program. More challenging balance training with a more substantial dynamic balance exercise component may be needed to improve balance and mobility functions in institutionalized older adults.
Funding acknowledgements: The study was funded by the Hong Kong Polytechnic University (RTSF and G-YJ41).
Topic: Health promotion & wellbeing/healthy ageing
Ethics approval: Ethics approval was given by the Human Subjects Ethics Subcommittee of the Hong Kong Polytechnic University.
All authors, affiliations and abstracts have been published as submitted.
