Efficacy of a Student-Led, Community-Based, Multifactorial Fall Prevention Program: Stay in Balance

Abstract

BackgroundFalls are a major public health concern in older adults. Recent fall prevention guidelines recommend the use of multifactorial fall prevention programs (FPPs) that include exercise for community-dwelling older adults; however, the availability of sustainable, community-based FPPs is limited.MethodsWe conducted a 24-week quasi-experimental study to evaluate the efficacy of a community-based, multifactorial FPP [Stay in Balance (SIB)] on dynamic and functional balance and muscular strength. The SIB program was delivered by allied health students and included a health education program focused on fall risk factors and a progressive exercise program emphasizing lower-extremity strength and balance. All participants initially received the 12-week SIB program, and participants were non-randomly assigned at baseline to either continue the SIB exercise program at home or as a center-based program for an additional 12 weeks. Adults aged 60 and older (n = 69) who were at-risk of falling (fall history or 2+ fall risk factors) were recruited to participate. Mixed effects repeated measures using Statistical Application Software Proc Mixed were used to examine group, time, and group-by-time effects on dynamic balance (8-Foot Up and Go), functional balance (Berg Balance Scale), and muscular strength (30 s chair stands and 30 s arm curls). Non-normally distributed outcome variables were log-transformed.ResultsAfter adjusting for age, gender, and body mass index, 8-Foot Up and Go scores, improved significantly over time [F(2,173) = 8.92, p = 0.0; T0 − T2 diff = 1.2 (1.0)]. Berg Balance Scores [F(2,173) = 29.0, p < 0.0001; T0 − T2 diff = 4.96 (0.72)], chair stands [F(2,171) = 10.17, p < 0.0001; T0 − T2 diff = 3.1 (0.7)], and arm curls [F(2,171) = 12.7, p < 0.02; T0 − T2 diff = 2.7 (0.6)] also all improved significantly over time. There were no significant group-by-time effects observed for any of the outcomes.ConclusionThe SIB program improved dynamic and functional balance and muscular strength in older adults at-risk for falling. Our findings indicate continuing home-based strength and balance exercises at home after completion of a center-based FPP program may be an effective and feasible way to maintain improvements in balance and strength parameters.

Comparing Estimates of Fall-Related Mortality Incidence Among Older Adults in the United States

“…Results suggest that although risk for falls and fall mortality are closely linked, individuals who are more likely to fall are not necessarily more likely to die from fall-related injuries. Fall-related mortality prevention efforts should focus on combined strategies to reduce fall hazards (26)(27)(28)(29)(30) and to identify individuals who may be less resilient to falls (31)(32)(33). Further consideration of the methodological challenges of reporting and estimating fall-related mortality incidence is also warranted.…”

Trends of Nursing Research on Accidental Falls: A Topic Modeling Analysis

“…In 2011, the American Geriatrics Society emphasized the assessment of fall risk factors, multi-faceted interventions, and environment adjustments to prevent falls [ 67 ]. It was observed that multi-faceted programs consisting of exercise therapy and education on exercise, nutrition, and environmental adjustment were effective in preventing falls [ 68 ]. A systematic literature review study also suggested the necessity of studies on complex programs that consider physical factors such as balance improvement and psychological factors including depression and cognitive levels [ 69 ].…”

Comparison of attitudes toward the medical student-led community health education service to support chronic disease self-management among students, faculty and patients

“…Based on their vibrancy, acquired professional knowledge and skills, as well as their awareness of local cultural customs, medical students have been well-accepted as a force multiplier for the community-based health service [17][18][19][20]. For example, medical students were involved in a student-led community-based prevention program for falls, which has been demonstrated to potentially enhance the sustainability of the program and reduce program costs [17].…”

“…Based on their vibrancy, acquired professional knowledge and skills, as well as their awareness of local cultural customs, medical students have been well-accepted as a force multiplier for the community-based health service [17][18][19][20]. For example, medical students were involved in a student-led community-based prevention program for falls, which has been demonstrated to potentially enhance the sustainability of the program and reduce program costs [17]. Our team previously recruited undergraduate students from medical and other health professions to participate in household visits for community residents suffering from diabetes aiming to increase diabetes self-management education [18].…”