Effect of Lower Limb Strengthening Exercises and Motor Dual Task Training in Elderly People with Impaired Balance: An Experimental Study

Introduction: Ageing progressively declines movements and functions, thereby impacting muscle strength, endurance, and power. Impaired mobility and muscle strength gradually lead to loss of balance, instability, and an increased risk of falls. The declines in these physical components must be identified early to prevent and control activity loss. Aim: To compare the efficacy of Progressive Resistance Exercises (PRE) and Motor Dual Task (MDT) on balance, gait, functional performance, self-confidence, and Health Related Quality of Life (HRQOL) in elderly people with impaired balance. Materials and Methods: This experimental study was conducted at selected elderly care homes at Bangalore, from November 2016 to May 2020. A total of 69 elderly individuals aged between 60 and 75 years were recruited according to the inclusion criteria from three residential homes in East Bangalore (Sarjapur), Karnataka. Participants included in the study were cognitively intact with a minimum Performance Oriented Mobility Assessment score (POMA) score of 24 and an Activity Specific Balance Confidence (ABC) scale score of 70% or less. Baseline data on age, sex, Body Mass Index (BMI), number of falls, and presence of physical discomfort were recorded and preserved for data analysis. Pre and post-test measures of balance and lower limb mobility, functional independence, balance confidence, and HRQOL were measured using the POMA, Short Physical Performance Battery (SPPB), ABC scale, and Euro Quality of Life (EQOL), respectively. Participants in all groups underwent eight weeks of supervised exercise training, with each exercise group performing three sessions per week for a total of 24 sessions. Each session consisted of 10 minutes of warm-up exercises, followed by main exercises (MDT training/ PRE/conventional exercises) specific to their assigned groups for approximately 40 minutes, and concluded with 10 minutes of cool down exercises similar to the warm-up session. The data were analysed using Systat SigmaPlot software. A probability of 0.05 or less was considered statistically significant. Results: The between-group analysis of the POMA and SPPB was analysed using Kruskal-Wallis one-way analysis of variance, while within-group analysis used the Wilcoxon signed rank test, revealing significance in the conventional, PRE, and MDT groups (p<0.001). ABC and EQOL scores were analysed using 2-way RM ANOVA. The results showed statistically significant differences in the post-test scores of all three groups. Among the three groups, the improvement in balance (50%), functional performance (42.8%), balance confidence (24.8%), and QOL (28%) was highest in the MDT group (n=2). Conclusion: MDT training is more effective than PRE and conventional balance exercises, leading to improvements in balance, walking ability, functional performance, balancerelated self-confidence, and HRQOL in elderly participants with impaired balance.