Thursday, 29 October 2015

Pilates exercise to improve balance and reduce falls in older people

SPHPM's Falls and Bone Health team have gleamed new insights into the potential benefits of Pilates for improving balance in older adults, which may reduce their risk of falling. Associate Professor Anna Barker along with colleagues Jason Talevski and Renata Morello recently published a series of papers that examined the effect of Pilates exercise on balance and falls risk in older people.

The team is part of the Health Services Research (HSR) Unit in the Department of Epidemiology and Preventive Medicine (DEPM) and lead a number of clinical research projects that generate new knowledge to improve the quality of clinical practices relating to falls prevention, bone health and healthy ageing.

The research involved a systematic review of the literature that aimed to evaluate the evidence for the effect of Pilates on balance and falls in older adults.

Following this review, a pilot randomised controlled trial was completed to assess the feasibility of a Pilates exercise program that incorporates best-practice recommendations for exercise to prevent falls, and to obtain a preliminary estimate of effect of the program on falls, fall injuries and fall risk factor outcomes.

The rate of falls resulting in an injury was reduced by 64 per cent in the Pilates group compared to the usual care group.

Although there was no difference in the rate of falls, participants in the Pilates group also showed significant improvements in balance, lower-limb strength and flexibility.

Dr Barker is cautiously excited by the results of the pilot study.

“As a pilot study, the results of this study are prone to random error and uncertainty, and therefore are more so to inform future research as opposed to provide definitive conclusions. Based on the findings of this study, a large scale trial is warranted to definitively test a Pilates exercise program in community-dwelling older people on falls, fall injuries and fall risk factor outcomes,” she said.

The link between exercise and decreased falls in older people is well established. However, research has shown that exercise programs that are known to effectively reduce falls in older people have poor participation and compliance rates.

“Poor patient participation in falls prevention activities appears to be an important factor limiting the effectiveness of prior exercise programs,” said Dr Barker.

The results of the study showed that participation in the Pilates exercise program was very good (over 90 per cent adherence rate) and all participants agreed that classes were enjoyable and would recommend them to their friends.

The majority of participants (94 per cent) also believed that the classes were beneficial to their health and could feel improvements in their balance and falls risk.

“Pilates may be a more acceptable form of intervention than traditional ‘falls prevention’ exercises. If future, larger trials were to show significant reductions in falls following Pilates exercise, Pilates may be promoted as a more acceptable form of falls prevention exercise,” said Dr Barker.

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