The Effect of Proprioceptive Exercises on Balance and Physical Function in Institutionalized Older Adults: A Randomized Controlled Trial

Objectives: To evaluate the efficacy of a proprioceptive exercise program on functional mobility, musculoskeletal endurance, dynamic and static balance, gait, and risk of falls in institutionalized older adults. Design: Randomized, single-blind, controlled trial. Setting: A Spanish nursing home in the autonomous community of Extremadura, Spain. Participants: An initial sample was created by recruiting 148 older adult volunteers. The final sample (N=42) was randomly divided into 2 groups. Interventions: Both the control and experimental group received physical therapy treatment based on a combination of adapted exercises and other physical therapy techniques (physical therapy intervention program) for a period of 12 weeks. This program consisted of 45 minutes (group intervention) plus 100 minutes (individual intervention) a week, for a total of 36 sessions (29 hours). The experimental group received a proprioceptive training program during the same intervention period, which was conducted twice weekly (24 sessions), with each session lasting 55 minutes. Main Outcome Measures: Timed Up and Go (TUG), Cooper, Tinetti, 1-leg stance, and the Morse Fall Scale (MFS). Results: Analysis of variance showed a time x group interaction in TUG score (F = 10.41, P = .002), Cooper test (F =5.94, P = .019), Tinetti score (F= 6.41, P = .015), and MFS scores (F =5.24, P = .028). Differences between groups were achieved for TUG scores (d = 0.76), Tinetti scores (d= 1.12), 1-leg stance test scores (d = 0.77), and MFS scale scores (d= 0.85). In the experimental group, within-group analyses showed pre- to post-treatment differences for TUG scores (d= 0.72), Cooper test scores in meters (d= 0.18), Tinetti scores (d= 0.60), 1-leg stance scores (d = 0.55), and MFS scores (d = 0.42). Conclusions: A proprioceptive exercise program demonstrated significant improvements compared with the control group in areas such as functional mobility, musculoskeletal endurance, balance, gait, and risk of falls in institutionalized older adults. This study may help to enhance our understanding of the impact of a specific protocol for a proprioceptive rehabilitation program. (C) 2020 by the American Congress of Rehabilitation Medicine