DEVELOPMENT OF A COMMUNITY-BASED BALANCE AND FALL PREVENTION PROGRAM: IMPLEMENTATION DURING THE COVID-19 PANDEMIC

R. Lazaro¹, M. Mckeough¹, S. Helbock¹, J. Bradford¹, J. DeAmaral¹, M.W. Lee¹, A. Oakes¹, M.D. Canlas¹, A.E. Andre¹, A. Leitner-Keiser¹, K. Xie¹, A. Hormozdyari¹, R. Maves¹, R. Escamilla¹

¹California State University Sacramento, Physical Therapy, Sacramento, United States

Background: Majority of the face-to-face programs with initiatives to improve balance and mobility in community-dwelling older adults have been halted during the COVID-19 pandemic. The lack of such services could have potentially resulted in a decline in the functional performance of these individuals. As restrictions continue to be gradually eased, there is an acute need to restart these vital programs that will benefit the community. Major considerations included safe program implementation and service delivery that followed current guidelines while providing evidence-based care. Providing these balance and fall prevention programs within an institution that provided professional health professions education also required adjustments to fit the prevailing safety protocols during the time of program implementation.

Purpose: To describe the development and implementation of a community-based balance and falls prevention program considering the limitations imposed upon by the COVID-19 pandemic.

Methods: The Otago Exercise Program (OEP) was modified to fit the hybrid education model of the service providers, who were 32 Doctor of Physical Therapy students their second of a three-year program. All student clinicians underwent training to become Certified Otago Practitioners. Sixteen older adult volunteers from the community who had self-reported balance dysfunctions and positive fall histories were included in the program. Student clinicians provided face to face Otago training during weeks 1, 3, 5, 7 and 9, while weeks 2, 4 and 6 were delivered remotely via telephone follow-ups or Zoom meetings. Outcome measures which included the 30 second chair stand test, the Timed Up and Go and the Four State Balance Test were administered during Sessions 1 and 9.

Results: The sixteen participants had varying degrees of balance impairments and fall risk. There were no adverse effects to the implementation of the OEP. The program provided much needed interventions that improved lower extremity strength, balance and mobility.

Conclusions: The Otago Exercise program is effectively delivered within the restrictions imposed by the COVID-19 pandemic. The program was appropriate and provided individualized instruction to selected participants in improving their balance and decreasing their fall risk.Participants demonstrated positive response on major outcomes related to the program. Program was delivered safely and efficiently. No incidences of COVID-19 infection noted. Minimal issues with technology during online/ phone sessions.

Implications: Similar programs could be delivered in a hybrid format, thereby allowing for the benefits of both face to face and remotely administered interventions. The remote interventions proved to be safe and effective methods of transferring knowledge and instruction on balance and fall prevention interventions.

Funding acknowledgements: None to disclose.

Keywords:
Community-based interventions
COVID-19
Balance and fall prevention

Topics:
Health promotion & wellbeing/healthy ageing/physical activity
COVID-19
Older people

Did this work require ethics approval? No

Reason: This was a retrospective review of de-indentified patient charts. No experimentation or manipulation of intervention was administered.