Effects Of Life-based Physical Function Exercises On The Risk Of Falls And Balance Function In Older Adults

BackgroundFalls are the leading cause of injury and death in the elderly among the older adults over 65 years old in China.22%-60% of the older adults were injured by falling.Studies have reported that some life-based physical function exercise programs with high compliance can convert daily activities to exercise opportunities,which can be identified and exercised by participants.This exercise can significantly reduce the risk of falls and improve balance function in older adults.However,there are few studies on life-based physical function exercise in China,and the effectiveness of this intervention on older adults is not clear.ObjectiveTo construct a personalized daily physical function exercise program suitable for the older people in China,and to explore its effects on the risk of falls,balance function,lower limb strength,fall efficacy,activity balance confidence,physical activity level,and quality of life.MethodsThe quasi-experimental study was conducted at two nursing homes in Changchun City from April 2021 to October 2021.A total of 52 older adults who met the inclusion criteria were recruited.Participants were divided into intervention group and control group,with 26 older adults in each group.The intervention group implemented a threemonth life-based physical function exercise program.The first four weeks were for personalized goal setting and daily physical activities teaching,and the last eight weeks were for follow-up guidance.The daily physical activity part includes three modules of strength,balance,and physical activity,involving 18 kinds of daily activities.The participants of the control group continued to maintain their original living conditions without any intervention.The main measuring tools included a general information questionnaire,fall monitoring,Timed Up and Go test（TUGT）,Tandem Stance test（TST）,Functional reach test（FRT）,Single Leg Stance Test（SLST）,30 seconds ChairStand test（30s CST）,Modified Falls Efficacy Scale（MFES）,Activities-specific Balance Confidence scale（ABC）,the Physical Activity Scale for the Elderly（PASE）,and the 12-item Short-Form Health Survey（SF-12）.SPSS 24.0 was applied for the statistical analysis of the data.Results1.Implementation of the intervention program: Three participants dropped out of the study due to additional reasons during the 12 week-intervention,and the sample effective rate was 94.23%.The initial level assessment of daily physical activities was completed before the intervention.More than 70% of the participants in these three activities of tandem standing,tandem walking,and single-leg standing can only start from level 1.According to the records of the daily physical activity schedule,the compliance of participating in the life-based physical function exercise activities was as high as 87.5% during the follow-up period.2.Baseline data comparison results: There was no significant difference between the two groups in general demographic data such as age,gender,marital status,educational level,and the number of falls in the past year（P>0.05）.Meanwhile,the balance function,lower limb strength,fall efficacy,balance confidence,physical activity level,and quality of life between the two groups was no difference between the two groups（P>0.05）,which were comparable.3.Effectiveness of life-based physical function exercise on fall rates,balance function,and lower limb strength in older adults: After 12 week-intervention,the incidence of falls in the control group was significantly higher than that in the intervention group（P<0.05）.Compared with the control group,the TUGT time of the older adults in the intervention group was significantly decreased;the TST scores and30 s CST times were significantly increased（P<0.05）;but the FRT distance and the SLST time in the two groups were no significant difference（P>0.05）.Compared with the baseline,the results of the intra-group analysis showed that the TUGT time of the older adults in the intervention group was significantly decreased（P<0.001）;the TST scores,the SLST time,and the 30 s CST times were significantly increased（P≤0.001）.But the FRT distance did not change significantly（P>0.05）.4.Effectiveness of life-based physical function exercises on fall performance and balance confidence in older adults: Compared with the control group,the older adults in the intervention group had significantly higher MEFS scores than the control group,and the difference was comparable（P<0.001）,but the difference in ABC scores between the two groups was not comparable（P>0.05）after 12 week-intervention.The results of the intra-group analysis showed that the MFES score of the older adults in the intervention group was significantly increased（P=0.001）,but the ABC score did not change significantly,and the difference was not statistically significant（P>0.05）.5.Effectiveness of life-based physical function exercises on the physical activity level and quality of life in older adults: After the intervention,the comparison results between groups showed that the scores of SF-12 dimensions（except RE and BP dimensions）and PASE scores of the older adults in the intervention group were significantly higher than those in the control group（P<0.05）.Compared with baseline,the RE and BP dimension scores of SF-12 in the intervention group did not improve significantly（P>0.05）,but the scores of other dimensions of SF-12 and PASE scores were significantly increased（P<0.05）.Conclusion1.Twelve weeks of life-based physical function exercises can reduce the risk of falls,and improve balance and lower limb strength in older adults.2.Life-based physical function exercises can significantly improve fall efficacy,physical activity level,and quality of life in older adults.3.Life-based physical function exercises are integrated with daily life activities,which are deeply loved by older adults and have high compliance.As a personalized home-based exercise program,it can be popularized and practiced among seniors in China.