Brotherton S1, Van Ravenstein K2
1Medical University of South Carolina, Health Professions, Charleston, United States, 2Medical University of South Carolina, Nursing, Charleston, United States
Background: According to the Centers for Disease Control and Prevention, three million people, age 65 and over, are treated in emergency departments annually for fall related injuries. Serious injuries, such as fractures and traumatic brain injuries, occur in one out of five falls. Even if not injured, many people develop a fear of falling, which leads to decreased activity and increased weakness and risk of future falls. Unfortunately, fall prevention programs are not usually reimbursed by insurance providers, and low-income individuals and those living in rural communities may lack access to these programs.
Purpose: To determine if there are differences in scores on performance-based and self-report outcome measures after participation in a small group fall prevention program delivered using telehealth compared to the same program led by an on-site instructor.
Methods: Twelve African American older adults, who lived in low-income senior apartments, participated in a modified Otago exercise program with six individuals in the telehealth group and six in the instructor led group. Exercise sessions were held twice a week for 12 weeks for both groups in a common area at the apartment building. The instructor for the telehealth group was visible to participants on a computer monitor during exercise sessions and was able to view participants using a second computer monitor off-site. The Otago program consists of balance and strengthening exercises and walking and has been shown to improve balance and reduce falls. Residents also walked three times per week and used wearable activity trackers to record steps. Performance-based data were collected using steps recorded by activity trackers, Berg Balance Scale score (BBS), Timed Up and Go (TUG), 2-minute walk test (2MWT), and 30 second Chair Stand Test (30sCST). Self-report measures included Self-Efficacy for Exercise Scale (SEES) and Social Network Scale.
Results: Due to the small sample size for this pilot study, descriptive statistics were determined for performance-based and self-report outcome measures. With regards to performance-based measures, participants in the on-site instructor led group had greater improvement in the BBS, TUG, 2-MWT, and average steps per day but worse performance on the 30sCST. Two participants in the on-site instructor led group had BBS score changes that exceeded the minimal detectable change (MDC) of 3.3 points. One participant in the telehealth group and 3 in the on-site instructor group had changes in the 2MWT that met the MDC of 40 steps. Average daily steps increased by 545 for the telehealth group and by 1765 for the on-site group. With regards to self-report measures, those in the telehealth group had higher SEES and social network scores.
Conclusion(s): While participants in the on-site instructor led group performed slightly better on performance-based measures, the difference in in pre and post test scores was small with the exception of average daily steps. However, the telehealth group scored higher on self-efficacy and social network indicating greater confidence in being able to exercise and greater social engagement, respectively.
Implications: Telehealth may provide an alternative means to deliver a fall prevention program to low income and rural older adults.
Keywords: telehealth, fall prevention, older adults
Funding acknowledgements: Duke Endowment Grant #6635-SP
Purpose: To determine if there are differences in scores on performance-based and self-report outcome measures after participation in a small group fall prevention program delivered using telehealth compared to the same program led by an on-site instructor.
Methods: Twelve African American older adults, who lived in low-income senior apartments, participated in a modified Otago exercise program with six individuals in the telehealth group and six in the instructor led group. Exercise sessions were held twice a week for 12 weeks for both groups in a common area at the apartment building. The instructor for the telehealth group was visible to participants on a computer monitor during exercise sessions and was able to view participants using a second computer monitor off-site. The Otago program consists of balance and strengthening exercises and walking and has been shown to improve balance and reduce falls. Residents also walked three times per week and used wearable activity trackers to record steps. Performance-based data were collected using steps recorded by activity trackers, Berg Balance Scale score (BBS), Timed Up and Go (TUG), 2-minute walk test (2MWT), and 30 second Chair Stand Test (30sCST). Self-report measures included Self-Efficacy for Exercise Scale (SEES) and Social Network Scale.
Results: Due to the small sample size for this pilot study, descriptive statistics were determined for performance-based and self-report outcome measures. With regards to performance-based measures, participants in the on-site instructor led group had greater improvement in the BBS, TUG, 2-MWT, and average steps per day but worse performance on the 30sCST. Two participants in the on-site instructor led group had BBS score changes that exceeded the minimal detectable change (MDC) of 3.3 points. One participant in the telehealth group and 3 in the on-site instructor group had changes in the 2MWT that met the MDC of 40 steps. Average daily steps increased by 545 for the telehealth group and by 1765 for the on-site group. With regards to self-report measures, those in the telehealth group had higher SEES and social network scores.
Conclusion(s): While participants in the on-site instructor led group performed slightly better on performance-based measures, the difference in in pre and post test scores was small with the exception of average daily steps. However, the telehealth group scored higher on self-efficacy and social network indicating greater confidence in being able to exercise and greater social engagement, respectively.
Implications: Telehealth may provide an alternative means to deliver a fall prevention program to low income and rural older adults.
Keywords: telehealth, fall prevention, older adults
Funding acknowledgements: Duke Endowment Grant #6635-SP
Topic: Information management, technology & big data
Ethics approval required: Yes
Institution: Medical University of South Carolina
Ethics committee: Institutional Review Board
Ethics number: Pro00058515
All authors, affiliations and abstracts have been published as submitted.
