4.6 Drop Outs
Total of 12 people, six from each group, dropped out from our study during the first week of exercise. Their characteristics were shown in Table9.
At the end of exercise, there was no statistically significant difference in any outcomes. The mean BBS score increased from 45.54 +- 8.67 at pre- to 48.620 +- 8.89 at post-exercise. The average change in the BBS scores was 3.08 points.
บทที่5
Discussion and Conclusion
The objective of this study was to compare the effects of two exercise programs on postural control in Thai elderly with fall risks. Our results did not indicate that adding eye-head coordination exercise significantly enhance function balance and other outcomes.
5.1 Functional Balance
5.1.1 Berg Balance Scale (BBS)
The results of this study showed that the mean BBS scores of both groups increased after the exercise. The mean BBC score increased 6.3 points in the control group and 5.3 point in the experimental group. These results suggested that both exercise programs could improve functional balance in elderly with fall risks. These changes in the average BBS score were clinically significant. These results agreed with previous study by Stevenson .He suggested that minimal change of 5 points on the total BBS score reflects the genuine change in function balance.
The mean BBC scores were not significantly different between groups at the end of the program. This could imply that adding eye-head coordination exercise did not significantly enhance the postural control in elderly with fall risks more than the general exercise and balance training did. The improvement in balance of elderly could be mainly attributed to the general exercise and balance training.
Our general exercise and balance training program emphasized on self-perturbation on balance found in daily activities such as sit to stand, standing and walking. Eight training tasks were similar to BBS test. It was possible that elderly would score better on the BBS and gain more confidence in performing those tasks as the effect of practice. From our observation, subjects were able to properly adjust their base of support or shift weight for each activity better than before exercise. This implied that our subjects had increased their awareness of limits of stability. This reason agreed with Province and colleagues. They suggested that through balance training elderly may increase the awareness of limits of stability and, moreover, learn to voluntarily compensate for deficits though motor and sensory systems.
Another reason could be that our inclusion was not sensitive enough to detect fall-prone elderly who had balance deficits. We recruited subjects that has more than 3 fall risk factors and/or scored less than 45 on task completion score of FEMBAF. The average task completion score was 44 and average risk factor was 9.1.Eight subject had scored over 45 on task completion but had over 3 fall risk factors. As four fall risk factors in FEMBAF did not directly relate to postural control some elder may not have balance problem. This explained why some subjects scored quite high on the BBS. The BBS score itself has the ceiling effect as well. Thais led to small room of improvement. Therefore, for future study it will be better to recruit participants who have the total BBS score less than 45.