Journals of Gerontology Series A: Biological Sciences and Medical Sciences Large Type Edition
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The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 59:M154-M160 (2004)
© 2004 The Gerontological Society of America

The Effects of Multidimensional Home-Based Exercise on Functional Performance in Elderly People

Miriam E. Nelson1,2, Jennifer E. Layne2, Melissa J. Bernstein2, Andrea Nuernberger2, Carmen Castaneda2, David Kaliton2, Jeffrey Hausdorff3, James O. Judge4, David M. Buchner5, Ronenn Roubenoff2 and Maria A. Fiatarone Singh2,6,7

1 John Hancock Center for Physical Activity and Nutrition, Friedman School of Nutrition Science and Policy, Tufts University, Medford, Massachusetts.
2 The Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts.
3 Gerontology Division, Beth Israel Deaconess Medical Center and Division on Aging, Harvard Medical School, Boston, Massachusetts.
4 Masonicare, Wallingford, Connecticut.
5 Department of Health Services, University of Washington, Seattle.
6 University of Sydney, School of Exercise Science, Lidcombe, New South Wales, Australia.
7 Hebrew Rehabilitation Center for the Aged, Roslindale, Massachusetts.

Background. This study tested the hypothesis that a home-based exercise program would improve functional performance in elderly people.

Methods. We conducted a 6-month, single-blinded, randomized controlled trial. 72 community dwelling men and women (aged >=70 years) with self-reported and laboratory-based functional impairment were recruited for the study. Participants were randomly assigned to either a home-based progressive strength, balance, and general physical activity intervention or an attention-control group that received home-based nutrition education. Functional performance was measured in the laboratory using the Physical Performance Test (PPT) and the Established Populations for Epidemiologic Studies of the Elderly (EPESE) short physical performance battery. Physiologic capacity was measured by strength (one repetition maximum), dynamic balance (tandem walk), gait speed (2-meter walk), and cardiovascular endurance (6-minute walk).

Results. 70 participants (97%) completed the 6-month trial. Compliance with study interventions within each group ranged from 75% in controls to 82% in exercisers. PPT increased by 6.1 ± 13.4% in exercisers and decreased by 2.8 ± 13.6% in controls (p =.02). EPESE improved by 26.2 ± 37.5% in exercisers and decreased by 1.2 ± 22.1% in controls (p =.001). Dynamic balance improved by 33.8 ± 14.4% in exercisers versus 11.5 ± 23.7% in controls (p =.0002). There were no differences between groups in the change in strength, gait speed, or cardiovascular endurance.

Conclusions. Minimally supervised exercise is safe and can improve functional performance in elderly individuals. The improvements in functional performance occurred along with improvements in balance but without a significant change in muscle strength or endurance.






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