Effect of a Supervised Multicomponent Balance, Resistance, Aerobic, and Cognitive Exercise Program on Mobility in Older Adults with Risk of fall

Abstract

Background: Falls are a major cause of morbidity, disability, and loss of independence among older adults. Multicomponent exercise interventions have shown promise in improving balance and mobility while reducing fall risk. Objective: To compare the effects of a supervised Balance, Resistance, Aerobic, and Cognitive Exercise (BRACE) program with conventional home-based therapy on balance, mobility, cognitive function, and fall risk in older adults at moderate risk of falls. Methods: A randomized controlled trial was conducted at District Headquarter Hospital, Chakwal, Pakistan, from July to December 2018. Forty participants aged 60–80 years with Berg Balance Scale scores of 20–40 were randomly allocated to either a supervised BRACE group (n=20) or a conventional therapy group (n=20). The supervised group received structured multicomponent exercise for 12 weeks, whereas the control group performed home-based balance and resistance exercises. Outcomes were assessed at baseline and at 3, 6, 9, and 12 weeks using the Berg Balance Scale, Timed Up and Go test, Montreal Cognitive Assessment, Activities-specific Balance Confidence Scale, Elderly Mobility Scale, and Fullerton Advanced Balance Scale. Results: Thirty-four participants completed the study (18 supervised BRACE; 16 conventional therapy). After 12 weeks, the supervised BRACE group demonstrated significantly better outcomes than the conventional therapy group for Berg Balance Scale (51.70±1.74 vs. 40.06±4.42), Timed Up and Go (10.92±2.49 vs. 15.22±1.94 seconds), Activities-specific Balance Confidence Scale (82.70±7.22 vs. 67.69±11.92), Elderly Mobility Scale (19.39±1.03 vs. 16.19±1.79), and Fullerton Advanced Balance Scale (34.28±2.16 vs. 23.25±5.87) (all p<0.001). Conclusion: Supervised multicomponent BRACE training was more effective than conventional home-based therapy in improving balance, mobility, and reducing fall risk among older adults.

Keywords: Activities of Daily Living, Aged, Balance, Cognitive Training, Exercise Therapy, Falls, Mobility Limitation, Postural Balance, Resistance Training.