gms | German Medical Science

Decline in balance and lower extremity strength are associated with aging process. Several authors suggest that the participation of elderly subjects in strength training programs increases muscle mass, muscle strength and dynamic balance, reducing the risk of falls and consequently reducing the osteoporotic fractures.

To describe the effects of a low cost strength training program of the ankle plantar-flexor and dorsiflexors on muscle strength and balance, and to determine whether strength gain is associated with improvement in balance, in elderly institutionalized subjects.

18 healthy volunteers (72–87 years of age) were recruited and divided in 2 groups: the intervention (n=9) and the control group (n=9). Both groups were tested at baseline and outcome for lower extremity strength and balance, but only the intervention group received strengthening exercises while control subjects continued their normal activities. Balance measures were Functional Reach Test (FRT) and Timed Up & Go Test (TUG). Dynamometer (Globus Ergo Meter, Italia) was used to assess the maximal isometric voluntary contraction (MVC). The intervention group completed 6 weeks of elastic band resistance training of the dorsiflexor and plantar-flexor muscles, 3 times a week. After a 5-minute warm-up consisting of gentle stretching and marching in place, each participant was systematically positioned to perform exercises for each of the muscles groups identified. Participants were started at a Theraband color for each muscle that was consistent with their initial strength capacity. The starting level of Theraband was determined by finding the point at which the participant could perform 6 to 8 repetitions of the exercise with good quality before fatigue. The participant exercised progressing to three sets of 10 repetitions for each exercise. Once the participant could perform three sets of 10 easily at a given color of Theraband, the resistance was increased by replacing the Theraband with the next color. During the course intervention, physiotherapists used these guidelines (ACSM), coupled with their clinical knowledge, to determine the appropriate time for and amount of increased resistance for each participant.

No significant difference in mean age, mean weight and mean height was detected between groups. In the intervention group, muscle strength and balance improved significantly: dorsiflexors and plantar-flexors MVC increased 37,19±7,92% and 24,81±5,25%, while that balance increased 40,82±7,26% in FRT, and 21,61±5,45% in TUG (p<.02). Increases in dorsiflexors strength correlated significantly with balance measured by TUG (p<.05). In control group no significant differences were detected.

Low cost strength training program of the ankle plantar-flexor and dorsiflexors improves muscle strength and balance; and, dorsiflexors strength gain is associated to the improvement in balance (TUG), in elderly institutionalized subjects.