Effects of Three Different Exercise Programs on Dynamic Balance in Community-Dwelling Older Adults

Fenerbahce University45 enrolled

Overview

This study aims to compare the effects of core stabilization exercises, an amplitude-based exercise program derived from LSVT BIG principles, and their combination on dynamic balance in community-dwelling healthy older adults aged 65 years and above. Secondary outcomes include functional mobility, fear of falling, reaction time, and quality of life. Age-related declines in neuromuscular and sensory functions impair postural control and increase fall risk. While both core stabilization and amplitude-based exercises have shown beneficial effects, their comparative and combined effects in healthy older adults remain unclear. This study will determine whether the combined intervention provides additional benefits over single interventions.

Aging is associated with progressive declines in muscle strength, proprioceptive function, vestibular efficiency, and reaction time, all of which contribute to impaired postural control and reduced dynamic balance. These changes significantly increase the risk of falls in older adults, representing a major public health concern due to their association with morbidity, mortality, and loss of independence. Exercise-based interventions are widely recommended to improve balance and reduce fall risk. Core stabilization exercises aim to enhance trunk muscle activation and improve postural control by increasing spinal stability. In contrast, amplitude-based exercise approaches derived from LSVT BIG principles focus on increasing movement amplitude, thereby improving motor performance and functional mobility. Although both approaches have demonstrated beneficial effects, evidence regarding their comparative effectiveness and the potential additive benefit of combining these interventions in healthy older adults remains limited. In this randomized controlled study, participants aged 65 years and older will be allocated to one of three intervention groups: core stabilization exercises, amplitude-based exercises based on LSVT BIG principles, or a combined core and amplitude-based exercise program. All interventions will be conducted over a structured training period under supervision. Dynamic balance will be assessed as the primary outcome. Secondary outcomes will include functional mobility, fear of falling, reaction time, and quality of life. Standardized and validated assessment tools will be used to ensure reliability of the measurements. The findings of this study are expected to provide evidence on the relative and combined effectiveness of these exercise approaches and may contribute to the development of more effective rehabilitation strategies aimed at improving balance and reducing fall risk in older adults.

Study Type

Interventions

Core Stabilization ExercisesBEHAVIORAL

A structured exercise program focusing on trunk muscle activation, spinal stability, and postural control.

Amplitude-Based Exercise (LSVT BIG)BEHAVIORAL

An exercise program derived from LSVT BIG principles, emphasizing increased movement amplitude and functional mobility.

Combined Core and Amplitude-Based ExerciseBEHAVIORAL

A combined program including core stabilization exercises and amplitude-based exercises based on LSVT BIG principles.

Eligibility

Sex: ALLMin age: 65 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Age 65 years and older * Ability to walk independently * Mini-Mental State Examination (MMSE) score \> 24, indicating sufficient cognitive ability to understand and follow instructions * Willingness to participate in the study and provide written informed consent Exclusion Criteria: * History of serious lower extremity injury, surgery, or acute musculoskeletal condition within the last 6 months * Severe visual or hearing impairment that would prevent safe and accurate completion of the assessments * Presence of acute vestibular disorders significantly affecting balance * Presence of neurological disease * Uncontrolled cardiac disease, uncontrolled hypertension, severe pulmonary disease, or any condition that makes exercise unsafe

Outcomes

Primary Outcomes

Dynamic Balance (Y Balance Test)

The Y Balance Test is a reliable and valid measure used to assess dynamic balance and neuromuscular control. It is a modified version of the Star Excursion Balance Test and evaluates an individual's ability to maintain single-leg stance while reaching in multiple directions. During the test, the participant stands on one leg at the center of a Y-shaped grid and uses the free limb to reach as far as possible in three directions: anterior, posteromedial, and posterolateral. Reach distances are measured in centimeters, and a composite score is calculated by normalizing reach distances to limb length. Higher reach distances and composite scores indicate better dynamic balance performance. The test has been widely used in clinical and research settings due to its sensitivity in detecting balance deficits and risk of injury or falls.