Case Report

Fall prevention among older adults: Case reports exemplifying the value of incorporating lumbar stabilization training during balance exercises

P. Van Der Merwe, M.A. Wilmarth
South African Journal of Physiotherapy | Vol 69, No 3 | a30 | DOI: | © 2013 P. Van Der Merwe, M.A. Wilmarth | This work is licensed under CC Attribution 4.0
Submitted: 12 December 2013 | Published: 12 December 2013

About the author(s)

P. Van Der Merwe, Northeastern University, Boston, Massachusetts, United States.
M.A. Wilmarth, Chief of Physical Therapy, Harvard University Assistant Professor Northeastern University, Boston, Massachusetts, United States.

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Background: Older adults are at risk of fallingeach year. Fall injuries results in many health care expenses anddisabilities, yet non-western countries lack the infra-structure andresources for prevention programs. Balance exercises have beenfound to be a cost effective evidence-based intervention in treatingand preventing falls among older adults in western countries.Purpose: The aim of this report was to show that lumbar stabilizationexercises are not only a beneficial addition to a balanceprogram for the prevention and treatment of falls in older adults,but to demonstrate that these exercise can more rapidly improve thefunctional status of older adults, limiting healthcare costs.Case description: Two high functional older adults with a historyof falls presented with poor balance and fear of falling. Both patientsreceived the same balance exercise regime however lumbar stabilization exercises were added to one of the patient’s exerciseprograms. Gait speed, lower extremity strength and balance were assessed with the Balance Evaluation systems test (BESTest),figure-of-eight, four-step-square (FSST), five-time-sit-to-stand tests (5TSTS) after two weeks and four weeks of treatment.Outcomes. All the outcome measures showed statistically significant improvements. Greater improvements in vertical stabilitylimits (14%), gait speed (9%), stability during gait (20%) and five-time-sit-to-stand test were seen with the addition of lumbarstabilization exercises.Discussion. The addition of lumbar stabilization exercises during balance training is of value to improve gait speed, balancetesting scores in stability in gait and vertical stability limits.


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