Does resistance training improve falls self-efficacy in older adults?

 

Introduction

Fear of falling in the elderly may compromise physical activity, resulting in a pattern of disuse that may negatively impact on quality of life and independence.  Resistance exercise is a training mode that is now recommended for older adults to enhance muscle function and physical performance. However, it is unclear if resistance exercise may also improve falls self-efficacy and thereby help prevent activity restriction due to a loss in balance confidence. The present study examined the effect of a 20-week resistance exercise intervention on falls self-confidence in community-dwelling older adults. 

Methods

Thirty-two healthy men and women aged 65-78 years underwent resistance training for 7 upper and lower body exercises 2 days per week for 20 weeks. Participants were randomly assigned to perform either a single set or 3 sets at 8 repetitions maximum (8-RM). Falls self-efficacy was assessed using the Activities-specific Balance Confidence (ABC) Scale.  The 16-item scale assesses confidence in performing daily tasks without falling, with a rating from 1 (not at all confident) to 10 (completely confident). Muscle strength was evaluated by the 1-RM.

Results

Twenty-eight participants completed the study. For groups combined, falls-self efficacy improved following training (pre 136 ± 16, post 143 ± 16, mean ± SD; P = 0.027).  After adjusting for baseline values (ANCOVA), there was no difference between the single- and 3-set groups (P = 0.321). In addition, there was no difference by sex. However, when groups were dichotomised into low and high self-confidence at baseline, there was a significant difference with improvement in the low but not the high group (P  = 0.003). Although muscle strength was associated with falls self-efficacy at baseline, there was no association between change in strength and self-efficacy following training.   

Discussion/ Conclusions

These results suggest that a 20-week program of high-intensity resistance exercise improves falls self-efficacy in older adults, although these results are driven by those with relatively low initial values at baseline.  Given the well-functioning nature of our cohort, we would expect the beneficial effect of resistance training on falls confidence to be enhanced in those with significant limitations.