Exercise-Based Fall Prevention in the Elderly: What About Agility?
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CURRENT OPINION
Exercise-Based Fall Prevention in the Elderly: What About Agility? Lars Donath1 • Jaap van Diee¨n2 • Oliver Faude1
Ó Springer International Publishing Switzerland 2015
Abstract Annually, one in three seniors aged over 65 years fall. Balance and strength training can reduce neuromuscular fall risk factors and fall rates. Besides conventional balance and strength training, explosive or high-velocity strength training, eccentric exercises, perturbation-based balance training, trunk strength, and trunk control have also been emphasized. In contrast, aerobic exercise has to date not been included in fall-prevention studies. However, well-developed endurance capacity might attenuate fatigue-induced declines in postural control in sports-related or general activities of daily living. Physical performance indices, such as balance, strength, and endurance, are generally addressed independently in exercise guidelines. This approach seems time consuming and may impede integrative training of sensorimotor, neuromuscular, and cardiocirculatory functions required to deal with balance-threatening situations in the elderly. An agility-based conceptual training framework comprising perception and decision making (e.g., visual scanning, pattern recognition, anticipation) and changes of direction (e.g., sudden starts, stops and turns; reactive control; concentric and eccentric contractions) might enable an integrative neuromuscular, cardiocirculatory, and cognitive training. The present paper aims to provide a scientific sketch of how to build such an integrated modular training approach, allowing adaptation of intensity, complexity, and
& Lars Donath [email protected] 1
Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320 B, 4052 Basel, Switzerland
2
MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands
cognitive challenge of the agility tasks to the participant’s capacity. Subsequent research should address the (1) link between agility and fall risk factors as well as fall rates, (2) benefit–risk ratios of the proposed approach, (3) psychosocial aspects of agility training (e.g., motivation), and (4) logistical requirements (e.g., equipment needed).
Key Points Agility-based training may integratively improve cardiovascular, neuromuscular, and cognitive function. This framework considers complex functional tasks, including perception, decision making, reaction, and changes of direction. Future research should investigate this framework in terms of fall prevention in seniors.
1 Background Seniors aged [65 years will account for approximately 30 % of the population in Western societies at the end of the twenty-first century [1]. Each year, one-third of those seniors fall and half of those fallers will fall again within the subsequent year [2]. Falls are defined as ‘‘unexpected events in which the participant unintentionally comes to rest on the ground, floor, or lower level’’ [3]. Fall-related injuries are the l
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