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  1. Maritz, Carol A. PT, EdD, GCS
  2. Silbernagel, Karin Gravare PT, ATC, PhD


Background: Falls are the number 1 cause of injury, fractures, and death among the older population. In fact, one-third of adults older than 60 years will experience 1 or more falls annually. Factors including inactivity and decreased mobility are associated with overall declines in strength, balance, and functional mobility in older adults.


Purpose: The purpose of this study was to evaluate the effect of a balance training program, including calf muscle strengthening, in community-dwelling older adults and to evaluate how calf muscle strength correlates with risk factors for falls.


Methods: Community-dwelling older adults from a local senior center were invited to participate in a 5-week (10 sessions), 1-on-1, balance training program, which included calf muscle strengthening. All the participants were evaluated before and after the intervention. The outcome measures were static balance, unilateral heel-rise test, Timed Up and Go test (TUG), the 30-second Chair Stand Test (30-sCST), and the Activity Balance Confidence Scale.


Results: Twenty-eight participants (6 males and 22 females) mean (standard deviation) age of 78 years were included in the study and completed the baseline evaluation. Eight participants did not complete the study. Static balance with eyes closed, heel rise, TUG, 30-sCST, and the Activity Balance Confidence Scale improved significantly (P < .05) following treatment compared with the baseline evaluation. The heel-rise ability correlated significantly (P < .05) with TUG (r = -0.484 to -0.528) and 30-sCST (r = 0.501-0.595). Sixty-three percent of the participants performed 10 reps or less of the unilateral heel rise on the right side and 60% on the left side. None of the participants who performed 10 reps or more of the unilateral heel rise had a high risk of falls based on the TUG.


Conclusions: A balance training program that includes calf muscle strengthening performed twice a week for 5 weeks resulted in significant improvements in calf muscle strength, functional performance and balance, as well as a significant improvement in balance confidence. The results from this study identify the importance unilateral calf muscle strength has to falls risk among older adults.