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a Geriatric Research Education and Clinical Center, VA Greater Los Angeles Healthcare System, Sepulveda, California
b Department of Physical Therapy, California State University, Fresno
c Department of Kinesiology, California State University, Northridge
d Ralph H. Johnson VA Medical Center, Charleston, South Carolina
Laurence Z. Rubenstein, Geriatric Research Education and Clinical Center (11E), VA Greater Los Angeles Healthcare System, 16111 Plummer St., Sepulveda, CA 91343 E-mail: lzrubens{at}ucla.edu.
Decision Editor: John E. Morley, MB, BCh
Objectives. This randomized controlled trial studied the effects of a low- to moderate-intensity group exercise program on strength, endurance, mobility, and fall rates in fall-prone elderly men with chronic impairments.
Methods. Fifty-nine community-living men 
with specific fall risk factors (i.e., leg weakness, impaired gait or balance, previous falls) were randomly assigned to a control group 
or to a 12-week group exercise program 
. Exercise sessions (90 minutes, three times per week) focused on increasing strength and endurance and improving mobility and balance. Outcome measures included isokinetic strength and endurance, five physical performance measures, and self-reported physical functioning, health perception, activity level, and falls.
Results. Exercisers showed significant improvement in measures of endurance and gait. Isokinetic endurance increased 21% for right knee flexion and 26% for extension. Exercisers had a 10% increase ( p < .05) in distance walked in six minutes, and improved ( p < .05) scores on an observational gait scale. Isokinetic strength improved only for right knee flexion. Exercise achieved no significant effect on hip or ankle strength, balance, self-reported physical functioning, or number of falls. Activity level increased within the exercise group. When fall rates were adjusted for activity level, the exercisers had a lower 3-month fall rate than controls (6 falls/1000 hours of activity vs 16.2 falls/1000 hours, p < .05).
Discussion. These findings suggest that exercise can improve endurance, strength, gait, and function in chronically impaired, fall-prone elderly persons. In addition, increased physical activity was associated with reduced fall rates when adjusted for level of activity.
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