Balance Ability and Fear of Falling in Elderly with Various Exercise Participation Levels. (Research Application)

By Wong, Allison Ka-yee; Cheung, Siu-yin | Palaestra, Fall 2002 | Go to article overview

Balance Ability and Fear of Falling in Elderly with Various Exercise Participation Levels. (Research Application)


Wong, Allison Ka-yee, Cheung, Siu-yin, Palaestra


Aging is a popular issue for the 21st century. The U.S. Bureau of the Census, International Data Base (1998) reported the aging population of individuals over sixty years of age in Hong Kong was 952,000 in 1998, and it is expected to increase to 1,282,000 in 2010. With this projected increase in the elderly population, maintaining good quality of life after the age of sixty has become an important goal in society.

Among numerous issues associated with aging, balance ability and fear of falling were prominent factors in determining quality of life in elderly people. According to Berg et al. (1992), balance ability was required for maintaining a position, remaining stable while moving from one position to another, performing acts of daily living, and moving freely in the community. The ability to balance could be compromised by disease, medications, and the processes of aging. Balance impairment, which is common in the elderly, was one of the most important risk factors for injuries.

Other studies have reported fear of falling had limited daily activities of 20% of the elderly. This also contributed to a major source of disability. Fear of falling among elderly people might compromise the quality of life by diminishing a sense of well being, limiting mobility, and reducing social interactions. By constraining movement, fear of falling might be a risk factor for falls as a result of reduced physical conditioning (Black et al., 1989).

Several studies pointed out that regular exercise participation could influence body composition energy, metabolism, and physical fitness in beneficial ways (Ades et al., 1992, Boon et al., 1997). However, geriatric studies focusing on' the roles of exercise participation in balance ability and fear of falling were limited. Therefore, the purpose of this study was to investigate the relationship among balance ability, fear of falling, and exercise participation levels of the elderly.

Method

A total of 52 men and 189 women (n = 241) participated in this study. They were divided into two groups according to their levels of exercise participation across three age levels. The first group was the exercise group (n = 155). Participants took part in physical exercises at least twice a week for six months prior to assessment. The non-exercise group (n = 86) did not engage in physical exercise regularly. Also, participants were divided into three age groups--the 60s group (aged 60-69), n = 73; the 70s group (aged 70-79), n = 136; and the 80s group (aged 80 or above), n = 32.

The Berg Scale was utilized to measure balance ability of participants. The Berg Balance Scale was a performance-oriented assessment of mobility consisting of a 14-item instrument designed to assess subjects' ability to successfully complete tasks such as standing from a sitting position, turning to look behind, standing with eyes closed, and standing on one foot. Each item was scored on a 0-4 metric scale, with possible total scores ranging from 0 to 56. The higher the score, the better the balance ability.

In addition, their fear of falling was determined by means of the Falls Efficacy Scale. Ten activities were included in the Falls Efficacy Scale. Subjects were asked to identify how confident they felt performing each of these activities without falling, using a 10-point scale. Activities included taking a bath or shower, reaching into cabinets or closets, preparing simple meals, walking around the house, getting in and out of a bed or chair, answering the door or telephone, getting dressed, performing light housekeeping, and doing simple shopping. The total efficacy score was the sum of scores on individual activity items. The higher the score, the higher the degree of fear of falling.

The study was conducted at five elderly centers in Hong Kong. Investigators interviewed participants, and their exercise participation levels were recorded. Moreover, the Falls Efficacy Scale and the Berg Balance Scale were administered to measure fears of falling and balance abilities, respectively. …

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