Music-based exercise class cuts seniors' fall risk

NEW YORK (Reuters Health) - Exercises that combine music and rhythmic movement may help curb the rate of falls among older adults at increased risk, a study published Monday suggests.

Swiss researchers found that a form of music/movement education known as Dalcroze eurhythmics seemed to improve balance and walking ability among 134 older adults who were at increased risk of falls due to frailty, balance problems or a history of falls.

Moreover, those improvements translated into fewer falls by participants during the six-month series of classes.

The findings, reported in the Archives of Internal Medicine, suggest that the classes -- and possibly other music-based forms of movement as well -- could be helpful to seniors with balance and gait problems.

Dalcroze eurhythmics is not the latest fad in exercise; it was developed in the early part of the 20th century by the Swiss composer Emile Jaques-Dalcroze as a way to better understand music through movement. Classes in the method are now available worldwide.

A class typically involves improvised piano music, with participants adapting their movements to the music’s rhythmic changes. In the current study, the classes started off simply -- by having participants walk in time to the music -- then gradually became more challenging over time. Besides footwork, participants sometimes had to perform upper-body movements or work with some object, like a percussion instrument or a ball, while moving.

It’s that type of multi-tasking that may help explain why the classes were associated with improved balance and gait and a lower fall risk, according to lead researcher Dr. Andrea Trombetti of the University Hospitals and Faculty of Medicine of Geneva, in Switzerland.

In an e-mail to Reuters Health, he noted that the classes share some features with other “multi-component, attention-demanding” types of exercise like tai chi. Some studies, though not all, have found that tai chi -- an ancient Chinese art that involves slow, fluid movements combined with mental imagery and deep breathing -- may help reduce older adults’ fall risk.

For the study, Trombetti’s team recruited 134 adults age 65 and older, mostly women, who were at higher-than-average risk of falls because of physical frailty, poor performance on a standard test of balance or a history of falls.

The researchers randomly assigned the participants into two groups: one that took a one-hour weekly Dalcroze class for six months; and a “delayed-intervention” group that spent the first six months of the study maintaining their normal activities, and then took the Dalcroze class for the remaining six months.

After the first six months, the researchers found, the eurhythmics group showed greater improvements in tests of balance and walking compared with the delayed-intervention group. They were also half as likely as the control group to have suffered a fall.

Over the first six months of the study, there were 24 falls among the 66 women and men taking the eurhythmics class (translating to a rate of 0.7 falls per person per year), versus 54 falls among those in the delayed-intervention group (1.6 falls per person per year).

During the second half of the study, participants in the delayed-intervention group also showed similar reductions in their fall risk versus their own first six months.

As for the long-term effects, study participants who took the classes in the first half of the study were still showing improved balance and walking ability six months after the classes ended, according to Trombetti and his colleagues.

While this study looked at a specific form of music-based exercise, Trombetti said the findings raise the possibility that social dancing or other activities that challenge balance and require continuous adjustments to the environment -- like trying to stay in step with musical rhythm -- could have benefits for older adults.

“This remains to be fully explored in large randomized controlled trials,” Trombetti said.

It would be interesting for further studies to look into the effects of music-based activities on older adults’ movement, balance and fall risk, according to Dr. William Hall, director of the Center for Healthy Aging at the University of Rochester Medical Center/Highland Hospital in Rochester, New York.

Hall, who was not involved in the current study, speculated that there may be something particularly beneficial about music-based movement, which involves a “motor-cognitive connection.” That is, it simultaneously engages a person’s muscles and also the cognitive processes of the brain, with a potential reinforcing effect.

In an interview, Hall noted that he already recommends ballroom-dance classes as a good form of physical activity for older adults. Part of the reasoning for that is that ballroom dance combines movement, music and socialization.

“It’s very important for older adults to have some type of exercise program,” Hall said, “but it’s also tough for them to stick with it. One of the biggest inducements is if (the activity) involves some sort of socialization.”

The current findings, Hall said, are “very timely and important,” given the increasing focus on reining in healthcare costs. For older adults, falls frequently cause bone fractures, including hip fractures, which are a major contributor to hospitalizations and long-term disability among the elderly.

SOURCE: Archives of Internal Medicine, online November 22, 2010.