Effectiveness of a walking-focused physical exercise program for fall risk indicators in institutionalized older adults with and without intellectual disability: a pre-post quasi-experimental study.

Introduction: Exercise programs implemented among older adults have been extensively demonstrated to yield significant benefits; however, there is a limited body of research addressing the application of such interventions in older adults with severe or profound intellectual disabilities. This study aims to explore the effects of a structured physical exercise program on fall-risk indicators and balance-related outcomes in institutionalized older adults, both with and without intellectual disabilities. Methods: This pre-post quasi-experimental study included 56 institutionalized older adults, of whom 32 had an intellectual disability. Participants completed a 12-week structured physical exercise program targeting balance, lower-limb strength, gait pattern, and coordination. The primary hypothesis was that the program would be associated with improvements in validated fall-risk indicators within both groups. Results: Among participants with intellectual disabilities, significant improvements were observed in lower-limb strength (p < 0.001) and aerobic capacity, with a 12% increase in performance on the 6-Minute Walk Test (p < 0.001). In participants without intellectual disabilities, significant improvements were observed in balance and handgrip strength. Between-group differences were limited after adjustment for baseline values and age. Conclusion: The intervention was associated with improvements in validated fall-risk functional indicators in institutionalized older adults with and without intellectual disabilities. However, due to baseline heterogeneity and the quasi-experimental design, the findings should be interpreted as preliminary and hypothesis-generating rather than confirmatory of equivalent effectiveness.