Does physical exercises make a difference for risk of falling and independence of the elderly?

Introduction. Human life expectancy has been increasing at a rapid rate [1]. Generally, increased life expectancy has further increased the risk of disease, falls and fall-related injuries [2,3]. Novel interventions such as differential learning method should therefore be tested looking at its potential to improve quality of life among elderly. Current evidence indicates that differential learning allow participant to find individual performance repertoire in order to perform and adapt its complex motor skills in everyday life [4]. Primary aim of current study was twofold - to evaluate physical exercises adjusted on classical and differential learning methods for risk of falls and compare intervention impact on independence of the elderly. Research methods and organization. Ethical approval was obtained by the local bioethics center (No. BEC-SR(M) – 176). Study was performed during the period from 03/07/2021 to 28/08/2021. The study included 24 participants (age 68.83 ± 3.37 years). All participants that were involved in the study signed an informed consent. The main reason for meeting the inclusion criteria was being 60 – 75- year-old, Morse’s fall risk scale over 25 points and, Mini mental state test up to 18 points. Participants were randomly divided into two groups – Regular exercises group ((RG), included 11 participants aged 68.36 ± 3.17 years) and differential learning group ((DG), included 13 participants aged 69.23 ± 3.61 years). RG group had individual regular physical exercises program, and DG group, had physical exercise program based on differential learning. Both groups, in total had 20 sessions (each being 25 – 35 minutes long), 5 times per week (excluding weekends), for 4 weeks. Before and after both programs risk of falling was evaluated through Berg balance, Fukuda stepping, stand-and-go, tandem tests while dynamics of independence were measured with functional independence test and instrumental daily activity questionnaire. The data were analysed using IBM SPSS Statistics (Armonk, NY: IBM Corp, USA), version 27. A non-parametric Wilcoxon test was used to compare the two dependent samples. The Mann-Whitney U test was run to compare the test scores of two independent samples. Data were presented as the median (me), the minimal value (min), maximal value (max) and the mean – me (min; max; mean). The significance level was set at p < 0.05. Results. Results of Berg balance test. Before physical exercise program RG group results were 34 (32; 40; 34.27) points, after the regular program they were 42 (40; 45; 42.55) points. Therefore, there were a statistically significant difference before and after the program in RG group (Z=-2.969; p=0.003). Initial DG groups results were 34 (31; 40; 34) points, and after the program it reached 47 (44; 50; 46.61) points. Thus, DG groups results also showed a statistically significant difference (Z=-3.192; p=0.001). We found no statistically significant difference between the RG and DG groups results before the exercise programs (U=64.50; p=0.691). Although after the exercise programs there was a statistically significant difference between both groups (U=5.00; p=0.001). Fukuda stepping test results. Baseline results of RG group results were 46 (43; 49; 45.91) degrees. After intervention test results dropped till 34 (30; 36; 33.27) degrees and revealed statistically significant difference (Z=- 2.937; p=0.003). DG test results at baseline were 44 (36; 51; 43.85) degrees and after the physical exercises program based on differential learning results decreased to 30 (26; 38; 30.62) degrees. DG results revealed statistically significant difference (Z=-3.186; p=0.001). Hence, there was no statistically significant difference among the RG and DG groups before the applied programs (U=50; p=0.228), but after the exercised programs among the RG and DG groups we found a statistically significant difference (U=30.50; p=0.010). Conclusions: This study showed the differences between physical exercises adjusted on classical and differential learning methods proved to improve results for elderly people’s risk of falling prevention. Among the groups, better results were seen in DG.