A simple series of ankle and foot flexing exercises can improve strength and balance in older people, research from Portugal shows.

Among elderly individuals living in an institution, those who performed the exercises showed substantial increases in the strength of the muscles that flex and extend the ankle, as well as significantly better balance.

People lose mobility with aging in part due to weakening of the lower limbs, Fernando Ribeiro of the University of Porto and his colleagues note in their report in the journal Geriatrics and Gerontology International. Targeting muscle groups in the legs that play a key role in helping maintain balance may offer a low-cost way to increase mobility and prevent falls among elderly people, they add.

To investigate whether strengthening one set of key muscles might indeed build balance, Ribeiro and his team randomly assigned 48 institutionalized elderly individuals to an ankle exercise group or a "control" group.

The exercise group performed three 15-minute exercise sessions a week for six weeks. The sessions consisted of five minutes of warmup, five minutes of ankle extension and flexion exercises using elastic bands for resistance, and five minutes of cool down. Participants were given increasingly resistant bands as they got stronger.

There were no significant differences in ankle strength or mobility after six weeks in the control group, but the exercise group showed significant increases in strength in the ankle dorsiflexors, which flex the foot upward, and the plantar flexors, which extend it.

The individuals in the exercise group also improved in two tests designed to measure functional mobility and balance: one measuring how far a person can reach forward while keeping their feet in the same position, and the other timing how long it took them to get up from a chair, walk three meters, turn around, walk back, and sit back down.

The researchers conclude: "In our opinion, this low-technology, progressive resistive exercise program can be implemented in almost all elderly institutions under the supervision of a rehabilitation team."