2014 年 3 巻 5 号 p. 515-524
This study aimed to examine the effects of walking, a common activity that has previously been reported not to be effective for fall prevention, on fall-related factors among a general population of community-dwelling older adults. A total of 90 men and women, ranging from 65-79 years of age, were randomly allocated into either the walking group (brisk walking) or the balance group (tai chi, balance and strength training) to participate in 12-week supervised and home-based exercise programs. Physical factors (11 items on gait, static/dynamic balance, and strength of the lower extremities), psychological factors (Japanese Falls Efficacy Scale or FES), and daily step counts were assessed. Falls and trips were recorded during the 12-week intervention period. In both groups, significant improvements (P < 0.05) over the 12-week intervention were observed in usual/maximum gait speed, timed up and go, 10-m walk over obstacles, 6-minute walk, functional reach, 30-s chair stand test, and isometric knee extension force. Only the walking group showed significant increases in fall self-efficacy (+3.1 ± 8.0 points) and daily step counts (+3366.4 ± 3212.5 steps/day) (P < 0.05). No significant differences between groups were observed in falls or trips. Our findings suggest that walking among general, community-dwelling older adults was specifically effective in improving fall-related psychological factors and physical activity levels, as well as in improving some fall-related physical factors such as gait, dynamic balance and dynamic strength of the lower extremities, which were also improved by the strength and balance program.