Evaluation of the Stay in Balance wellness program: An interdisciplinary, multi-component falls prevention program

Fall-induced injuries are a common cause of restricted activity, disability and death among the elderly. Approximately 30 percent of community-dwelling adults over 65 years of age fall each year; whereas 50 percent of those over 75 years fall annually. Physical performance is a strong predictor of falls and disability onset in older adults. The evidence supporting multifactorial interventions in community-dwelling older adults with a history of falls is strong; however there is limited evidence demonstrating the effectiveness of sustainable, low cost community-based, multifactorial falls prevention programs (FPP). This 12 week quasi-experimental study examined the feasibility and efficacy of a multi-component exercise plus education FPP delivered by allied healthcare students. Adults age 60 and older (n=69) who had an increased risk of falling (fall history or 2+ risk factors) were recruited to participate. The present study's primary aim was to evaluate the effects of the FPP on physical performance [(Timed Up & Go (TUG)]. Secondary aims were: changes in functional balance [Berg Balance Scale (BBS)], muscular strength, mobility disability [(400 meter walk test (400MWT)], flexibility, physical activity (PA), and falls self-efficacy. Significant improvements (p < .05) were found in the following physical assessments: TUG [8.78 (2.87) versus 7.47 (2.60) seconds], BBS [50.0 (6.0) versus 54.0 (5.0)], leg strength (9.88+/-3.43 versus 11.95+/-4.31), arm strength (13.24+/-2.87 versus 14.90+/-3.26), 400MWT time [431.0 (213.0) versus 404.0 (208.0) seconds], 400MWT speed (0.87+/-0.33 versus 1.01+/-0.26 m/s), shoulder flexibility (-5.58+/-6.50 versus -3.46+/-5.76 inches), and PA (3.62+/-1.75 versus 4.91+/-1.91). Leg flexibility (-1.35+/-3.61 versus -0.98+/-3.99) and falls self efficacy [25.0 (13.0) versus [25.0 (11.0)] did not change. Physical assessment measures explained 50 percent of the variance in the balance scores (F=5.01, p=.0009). Post-hoc analysis revealed only those ≥80 years of age significantly improved 400MWT time and shoulder flexibility whereas those >80 years did not [400MWT: S(30)=130.5, p=.008 vs. S(18)=40, p=.0832; shoulder: t(35)=4.04, p=.0003 vs. t(21)=-.31, p=.7632]. This community-based multifactorial falls prevention program successfully improved modifiable fall risk factors including physical performance, functional balance, muscular strength, mobility disability, shoulder flexibility, and PA, but did not significantly affect leg flexibility or falls self-efficacy.