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Physical activity and successful aging
10th International EGREPA Conference

European Group for Research into Elderly and Physical Activity

14.09. - 16.09.2006 in Köln

Fall reduction 60% with the "In Balance" programme

Meeting Abstract

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  • corresponding author G. Kroes - The Netherlands Institute for Sport and Physical Activity, The Netherlands

Physical activity and successful aging. Xth International EGREPA Conference. Cologne, 14.-16.09.2006. Düsseldorf, Köln: German Medical Science; 2006. Doc06pasa021

The electronic version of this article is the complete one and can be found online at:

Published: December 18, 2006

© 2006 Kroes.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.




Falls in the aging population pose a major threat to indepence, and to quality of life in the elderly. Falls in the elderly are a major health concern due to the financial impact on the public health care system.

In the year 2000, the Netherlands Institute for Sports and Physical Activity did make a start of developing a fall prevention programme based on the therapeutic elements of T'ai Chi, that have been identified as most benificial for elderly persons.

The reason to start this project is that a lot of pre-frail and frail persons, who don't reach the Pate norm (30 minutes a day of moderately intensive physical activity for a minimum of five days a week) answer that there bodily complaints hinder them to be active and that there is a lack of self-conficence (a fear of falling). However these are important reasons that the risks of falls increase.


But how to locate this people and how to stimulate them to be more physical active? We designed a programme with a low psychological treshold. We built a three phases system; the elderly can choose or they will continue their participation after every phase:

  • Phase one: introduction meeting about the aim of the programme, information and questions (lasting 2 hours).
  • Phase two: awareness: one session lasted half a day per week during four weeks. Content: the causes of falls, a risk-screening, a balance-test and an exercise grouptraining.
  • Phase three: training: twice weekly sessions during 16 weeks with attention to: condition, balance, muscle-strength, Tai Chi elements.

After the programme: continuation in regular local exercise groups with permanent attention of balance-exercises.


The Free University in Amsterdam (Faber and others, 2005) did a 20-week,multi-center randomized controlled trial in 15 homes for the elderly with 278 participants with a mean age of 85 years. Positive effects of the programme became apparent after 11 weeks of exercise. The programme did not use exercises with a maximum reach of intensity. The power of the programme is to create a situation that can be incorporated into daily life. The "In Balance" moderate intensive group-excercise programme has positive effects on falling and physical performance in pre-frail elderly and can rise till over the 60%.


The conclusion is that the high score of fall reduction compared to the effects of other effective interventions is highly promising. 85% of the participant will continue the programme, 50% once a week and 35% twice.