The Effect of Exercise (Stability and Coordination) Training Programs on Risk of Falls in Older Adults with Cardiovascular Disease

Background: Cardiovascular diseases (CVD) are considered to be a main reason for mortality, commonly because of cardiovascular complications and secondary morbidity. Falls are one of the possible causes for additional ailment alongside with cardiovascular complications, as older adults with CVD are at higher risk of fall in comparison to age matched healthy population.

Aim: To investigate the effect of stability and coordination exercise within a cardiac rehabilitation program on measures of fall risk in elderly with CVD enrolled in cardiac rehabilitation.

Methods: Twenty-eight patients with CVD participated in the study and were randomly assigned to an experiment or control group. The intervention continued 12 weeks, twice a week, within 75 minutes of the cardiac rehabilitation program. The experiment group received 20 minutes of stability and coordination exercise within the 75 minutes, while the control group performed the routine cardiac rehabilitation program (mainly based on aerobic and resistance exercises). Clinical balance measures included the Time Up and Go Test (TUG), the Functional Reach Test (FR) and Balance Error Scale System (BESS). The Five Time Sit to Stand Test (FTSST) was used as a measure for lower extremity muscle strength. The Fall Risk Assessment Tool (FRAT) was used to measure fall risk.

Results: The experiment group showed significant improvement post-intervention in the following parameters TUG (p0.01), BESS (p0.02) and FTSST (p0.01). In addition, a significant group X time interaction was found for the TUG and the BESS (F_2,48=13.5, p.01; F_2,48=4.29, p.05, respectively) implying a significant advantage for the experiment group post-intervention. No significant group X time interaction were found on the FR (p=0.2) and FTSST (p=0.12).

Discussion: The results of the current study confirm that stability and coordination training alongside cardiac rehabilitation improve static and dynamic balance, and muscle strength, parameters that are considered major components in postural control. Improved postural control may reduce the risk of falls among people with CVD who are subjected to higher risk of fall.

Conclusion: Trainers who work in cardiac rehabilitation centers should consider including stability and coordination training alongside the routine cardiac rehabilitation program.