260544 Effects of a multifaceted fall prevention program on falls and physical functioning in community-dwelling elderly at fall risk

Monday, October 29, 2012

Hsuei-Chen Lee, PhD , Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, Taiwan
Ku-Chou Chang, MD , Division of Cerebrovascular Diseases, Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
Jau-Yih Tsauo, PhD , School and Graduate Institute of Physical Therapy, National Taiwan University, Taipei, Taiwan
Sang-I Lin, PhD , Department of Physical Therapy, National Cheng Kung University, Tainan, Taiwan
Background and Objective: This study aimed to evaluate the effects of a multifaceted fall prevention program on falls and physical functioning in community-dwelling elderly at fall risk.

Methods: This multi-center randomized controlled fall-prevention trial was conducted in Taipei, Tainan, and Kaohsiung of Taiwan from Jan. 2008 to June 2010. Eligible older subjects were randomly allocated into intervention group (IG) and control group (CG) stratified by Physiological Profile Assessment (PPA) risk level. IG received a 8-week multifaceted intervention program including exercise, education, recommendations for home hazards modification, along with referrals for medication review or vision check-up. CG got recommendation and referrals without direct exercise intervention. Primary outcome was fall incidence within 1-year follow-up. Secondary outcomes were PPA battery (vision, muscular strength, reaction time, postural sway and proprioception), timed up-and-go (TUG), Taiwanese- International Physical Activity Questionnaire (IPAQ), EuroQoL-5D, and Fall Efficacy Scale (FES).

Results: There were 594 older participants with mean age of 767 years. The cumulative 1-year fall incidence did not vary with both groups (28%:29%). The fall incidence significantly decreased from 41.6% (previous year) to 27.6% (1-year follow-up) in IG (P<.001), while no significant change in CG (30.4%→29.0%, P=.769). Both groups improved significantly in most secondary outcomes. IG improved more favorably than CG in knee extensor strength, reaction time, postural sway, TUG, PPA fall-risk and physical activity level, especially for those with marked fall risk.

Conclusions: A multifaceted fall prevention program showed beneficial effects on decreasing fall incidence and improving physical functions for the community-dwelling elderly at fall risk.

Learning Areas:
Administer health education strategies, interventions and programs
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs

Learning Objectives:
Evaluate the effects of a multifaceted fall prevention program on falls and physical functioning in community-dwelling elderly at fall risk.

Keywords: Elderly, Health Promotion

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the co-principal investigator of the multi-center randomized controlled fall-prevention trial (DOH97-HP-1301, DOH98-HP-1303) granted by the Bureau of Health Promotion, Department of Health, Executive Yuan, Taiwan. Among my scientific interests has been the development of strategies for health promotion of the elderly.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.