Tsekoura M1,2, Billis E1, Tsepis E1, Dimitriadis Z3, Tyllianakis M2, Panagiotopoulos E2,4, Gliatis J2
1Technological Educational Institute (TEI) of Western Greece, Physiotherapy, Aigio, Greece, 2University of Patras, School of Medicine, Orthopaedics, Patra, Greece, 3General University Hospital Attikon, Athens, Greece, 4University of Patras, Rehabilitation Clinic, Patra, Greece

Background: Sarcopenia, an age-related decline in muscle mass and function leads to serious adverse health consequences, such as falls, disability, fear of falling and mortality. Exercise, either individualized or group-based, is supported to prevent falls and fear of falling; however, it is unclear which exercise type is best for improving balance and fear of falling in sarcopenic elderly.

Purpose: To compare the impact of a group-based and a home-based therapeutic exercise programme on balance and fear of falling across Greek sarcopenic subjects.

Methods: Sarcopenic volunteers over 60 years-old were recruited from a live-in community center of Achaia - southwestern Greece. Sarcopenia was identified via a combination of muscle mass, gait speed, and grip strength, according to the official criteria from the European Working Group on Sarcopenia in Older People. Participants were randomly assigned to one of three intervention groups: supervised group-based exercise (n=18), individualized home-based exercise (n=18) and health education (control) group (n=18). Both exercise programmes involved 60 minute sessions, 2 times per week for 12 weeks, including aerobic (30%), resistance (40%) and balance (30%) exercises. Balance was assessed with Berg Balance Scale, and fear of falling with the Falls-Efficacy Scale - International. All participants were tested at baseline, immediately post-intervention (week 12), and at 3 months post-intervention (week 24). Time-group interactions for each dependent variable were examined with two-way mixed ANOVAs. The effectiveness of each intervention was additionally explored with repeated measures ANOVAs. Post-hoc was performed with Bonferroni tests. This randomized controlled trial (RCT) has been registered at (Identification number: ISRCTN92538100).

Results: Fifty four sarcopenic participants (7 males, 47 females) with mean age 72.87±7.02 years-old and body mass index 22.72±2.45 completed the study. Twenty-five (45.5%) of them had experienced at least one fall during the last year. There were significant group x time interactions in balance (p 0.001) and fear of falling (p= 0.017). In the group-based program there was a significant improvement in balance after 12 and 24 weeks (p 0.001), while for fear of falling there was statistically significant improvement only after 12 weeks (p=0.006). The home-based programme showed significant differences in fear of falling only after 12 weeks (p=0.028). No differences were found in the control group.

Conclusion(s): The study's findings provide encouraging data regarding the effects of exercise in sarcopenic patients. While either supervised or home based exercise interventions can be effective for elderly sarcopenic patients, supervised group-based exercise was more effective for improving balance and fear of falling. Further studies examining larger samples and longer follow-ups are required to confirm these results.

Implications: The present RCT contributes to the growing field of exercise across sarcopenic patients. Poor balance is both an indicator of decreased vitality and a predictor of functional decline with subsequent disability amongst sarcopenic patients. Exercise preferentially delivered in a supervised group-based manner seem to be effective for improving balance and eliminating fear of falling.

Keywords: exercise, balance, sarcopenia

Funding acknowledgements: None

Topic: Older people; Health promotion & wellbeing/healthy ageing; Disability & rehabilitation

Ethics approval required: Yes
Institution: Technological Educational Institute of Western Greece
Ethics committee: Ethical Committee of the School of Health and Caring Professions
Ethics number: 4052

All authors, affiliations and abstracts have been published as submitted.

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