The effects of a home-based exercise program on balance confidence, balance performance, and gait in debilitated, ambulatory community-dwelling older adults: A pilot study

Purpose: The purpose of this pilot study was to evaluate the effects of a home-based standing exercise and balance training program on balance confidence, balance performance, and gait in debilitated, ambulatory community-dwelling older adults. Methods: A quasi-experimental single group pre- to posttest design was utilized in 14 subjects, 9 male and 5 female, aged 71 to 85 years receiving home care. Measurements included the Falls Efficacy Scale (FES), Performance Oriented Mobility Assessment (POMA), and the One-Leg Stance Test (OLST) administered prior to and following 4 weeks of exercise and balance training. Participants trained twice per day, 5 days per week for 4 weeks, and maintained exercise logs. Results: Pre- to posttest differences on the FES, POMA, and OLST were analyzed with the Wilcoxon signed rank test and the 2-tailed paired t test, respectively, with statistical significance set at .05. Analysis demonstrated significant improvements on the FES, POMA, and OLST following 4-weeks of standing exercise and balance training. Based on entrance and exit interviews, 6 of the 14 participants had a history of falls in the 6 months prior to the study, while only 2 participants reported having a single, minor fall by discharge. Conclusions: The results of the present pilot study demonstrated significant improvement in balance confidence, balance performance, and gait in debilitated, ambulatory community-dwelling older adults following participation in a home-based exercise and balance training program. However, definitive conclusions need to await validation from more rigorously designed studies before the present training program can be confidently recommended to physical therapists engaged in home care practice.