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Mohamed O.1, Cho Y.-H.2, White B.3, Singh-Carlson S.3, Krishnan V.1
1California State University, Long Beach, Physical Therapy, Long Beach, United States, 2California State University, Long Beach, Psychology, Long Beach, United States, 3California State University, Long Beach, Nursing, Long Beach, United States
Background: Aging is associated with sensory, motor and cognitive changes that affect balance and consequently increase the risk for falls in older adults.
Purpose: The purpose of this study was to determine if a multifactorial program consisting of exercise, education, medication review and consultation on home safety will improve balance and reduce the risk of falls in a group of community dwelling older adults.
Methods: Pre and post-test data were collected using the GAITRite system to record spatial and temporal gait parameters at normal and fast walking speeds , Fullerton Advance Balance (FAB) Scale, and 3 components of the Senior Fitness Test (SFT): Chair Stand Test, Arm Curl Test, and 2-Minute Step Test. Participants were also asked before and after the program about how much they worry about falling on a 0-7 scale (0 being none, and 7 being extremely). The intervention included a 75-minute group exercise class conducted two times per week for 8 weeks. The exercise program included postural awareness, trunk stabilization, balance exercises, upper and lower extremity exercises and gait variation training. Educational modules consisted of a 15-minute presentation given each week on a variety of topics pertaining to balance. Participants also responded to the psychological well-being questionnaire, a home safety check list and a medication list. The number of fall incidences for the prior year was also recorded before clinical testing and a monthly follow up call to each participant for a total of 12 months was conducted to gather data on new incidences of fall. Multivariate analysis of variance was used on all continuous variables and non-parametric measures were applied to all categorical data (α .05)
Results: Gait: self-selected gait velocity increased from 111.21 cm/s to 116.84 cm/s (p= 0.025), and fast velocity increased from 152.05 cm/s to 160.03 cm/s (p= 0.001). Stride length increased at both velocities, p=.017 and .012 respectively. Cadence significantly decreased at fast but not at normal velocity while step length variability decreased at both walking velocities.
SFT: Chair stands increased from 9.28 to 11.44 (p 0.0001), Arm Curls increased from 12.22 to 15.08 (p 0.0001), and the 2-Minute Steps increased from 71.16 to 90.24 (p 0.000). FAB: total score increased 24.3%, from 25.54 to 31.73 (p 0.000). Nine out of the 10 items showed statistically significant increase. The participants worry scores decreased from 2.9 to 2.3 (p 0.0001). The total number of falls within 6 months after the program was 15 while the group reported 38 falls in the prior year. Number of falls will be recorded for another 6 months. Participants view of their heath and perceived life expectancy showed a trend toward improvement (p=0.05 for both measures).
Conclusion(s): A multi-factorial intervention program significantly improved balance, gait and confidence in this group of community dwelling older adults.
Implications: Multi-factorial intervention programs should be promoted in community dwelling older adults to increase overall balance and reduce the risk of falls. The program also has the potential of improving perceived health and increasing will-to-live.
Funding acknowledgements: Partially funded through SCAN Health Plan
Topic: Health promotion & wellbeing/healthy ageing
Ethics approval: California State University, Internal Review Board
All authors, affiliations and abstracts have been published as submitted.
