Physical Therapy Rehabilitation Science

korean Academy of Physical Therapy Rehabilitation Science (물리치료재활과학회)
권호 표지
DOI QR코드

DOI QR Code

Effect of Fall Prevention Exercise Program on Fall Efficacy, Depression, and Quality of Life of Elderly in the Community

  • Sungbae Jo (Department of Physical Therapy, Graduate School of Sahmyook University) ;
  • Yang Rae Kim (Department of Physical Therapy, College of Health Science, Kyungdong University)
  • Received : 2022.11.07
  • Accepted : 2022.11.21
  • Published : 2022.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Objective: This study aimed to investigate the effects of fall-prevention exercise programs on fall efficacy, depression and health-related quality of life in elderly. Design: a randomized controlled trial Methods: A total of 57 participants over 65-years-old have been allocated to control and experimental groups. The experimental group received 8 weeks of fall-prevention exercises that included strengthening of lower extremities, balance and gait training. They received the exercises twice a week for 50 minutes as a group.Both groups were assessed using Modified Falls Efficacy Scale (MFES), Geriatric Depression Scale (GDS), and 36-Item Short-Form Health Survey (SF-36) prior and post to the intervention. The control group also received the same exercise program after the post evaluation. Results: The experimental group showed overall improvement in MFES, GDS, and physical components of SF-36 (p<0.05). The MFES was significantly increased in the experimental group after the intervention (p<0.05). The GDS was significantly decreased in the experimental group after the intervention (p<0.05). The SF-36, only physical Function, Role limitations due to physical health, general health, and energy and fatigue categories were improved in the experimental group after the intervention (p<0.05). Conclusions: The results showed 8 weeks of fall-prevention exercise programs can increase fall efficacy and physical related quality of life while reducing depression of elderly over 65.

Keywords

References

  1. Fiani B, Siddiqi I, Lee SC, Dhillon L. Telerehabilitation: Development, Application, and Need for Increased Usage in the COVID-19 Era for Patients with Spinal Pathology. Cureus. 2020;12:e10563. 
  2. Yamada M, Kimura Y, Ishiyama D, Otobe Y, Suzuki M, Koyama S, et al. Effect of the COVID-19 Epidemic on Physical Activity in Community-Dwelling Older Adults in Japan: A Cross-Sectional Online Survey. J Nutr Health Aging. 2020;24:948-50.  https://doi.org/10.1007/s12603-020-1501-6
  3. Cunningham C, R OS, Caserotti P, Tully MA. Consequences of physical inactivity in older adults: A systematic review of reviews and meta-analyses. Scand J Med Sci Sports. 2020;30:816-27.  https://doi.org/10.1111/sms.13616
  4. Willey JZ, Moon YP, Kulick ER, Cheung YK, Wright CB, Sacco RL, et al. Physical Inactivity Predicts Slow Gait Speed in an Elderly Multi-Ethnic Cohort Study: The Northern Manhattan Study. Neuroepidemiology. 2017;49:24-30.  https://doi.org/10.1159/000479695
  5. Gladyshev TV, Gladyshev VN. A Disease or Not a Disease? Aging As a Pathology. Trends Mol Med. 2016;22:995-6.  https://doi.org/10.1016/j.molmed.2016.09.009
  6. Seene T, Kaasik P, Riso E-M. Review on aging, unloading and reloading: Changes in skeletal muscle quantity and quality. Archives of Gerontology and Geriatrics. 2012;54:374-80.  https://doi.org/10.1016/j.archger.2011.05.002
  7. Inouye SK, Studenski S, Tinetti ME, Kuchel GA. Geriatric syndromes: clinical, research, and policy implications of a core geriatric concept. J Am Geriatr Soc. 2007;55:780-91.  https://doi.org/10.1111/j.1532-5415.2007.01156.x
  8. Klenk J, Kerse N, Rapp K, Nikolaus T, Becker C, Rothenbacher D, et al. Physical Activity and Different Concepts of Fall Risk Estimation in Older People--Results of the ActiFE-Ulm Study. PLoS One. 2015;10:e0129098. 
  9. Tinetti ME. Preventing falls in elderly persons. New England journal of medicine. 2003;348:42-9.  https://doi.org/10.1056/NEJMcp020719
  10. Tinetti ME, Williams CS. Falls, injuries due to falls, and the risk of admission to a nursing home. N Engl J Med. 1997;337:1279-84.  https://doi.org/10.1056/NEJM199710303371806
  11. Marottoli RA, Berkman LF, Cooney LM, Jr. Decline in physical function following hip fracture. J Am Geriatr Soc. 1992;40:861-6.  https://doi.org/10.1111/j.1532-5415.1992.tb01980.x
  12. Hamed A, Bohm S, Mersmann F, Arampatzis A. Follow-up efficacy of physical exercise interventions on fall incidence and fall risk in healthy older adults: a systematic review and meta-analysis. Sports Med Open. 2018;4:56. 
  13. Thomas E, Battaglia G, Patti A, Brusa J, Leonardi V, Palma A, et al. Physical activity programs for balance and fall prevention in elderly: A systematic review. Medicine (Baltimore). 2019;98:e16218. 
  14. Cheng P, Tan L, Ning P, Li L, Gao Y, Wu Y, et al. Comparative Effectiveness of Published Interventions for Elderly Fall Prevention: A Systematic Review and Network Meta-Analysis. Int J Environ Res Public Health. 2018;15. 
  15. Chodzko-Zajko WJ, Proctor DN, Fiatarone Singh MA, Minson CT, Nigg CR, Salem GJ, et al. American College of Sports Medicine position stand. Exercise and physical activity for older adults. Med Sci Sports Exerc. 2009;41:1510-30.  https://doi.org/10.1249/MSS.0b013e3181a0c95c
  16. Sousa N, Mendes R, Silva A, Oliveira J. Combined exercise is more effective than aerobic exercise in the improvement of fall risk factors: a randomized controlled trial in community-dwelling older men. Clin Rehabil. 2017;31:478-86.  https://doi.org/10.1177/0269215516655857
  17. Cao ZB, Maeda A, Shima N, Kurata H, Nishizono H. The effect of a 12-week combined exercise intervention program on physical performance and gait kinematics in community-dwelling elderly women. J Physiol Anthropol. 2007;26:325-32.  https://doi.org/10.2114/jpa2.26.325
  18. Zhuang J, Huang L, Wu Y, Zhang Y. The effectiveness of a combined exercise intervention on physical fitness factors related to falls in community-dwelling older adults. Clin Interv Aging. 2014;9:131-40.  https://doi.org/10.2147/CIA.S56682
  19. Liu JY. Fear of falling in robust community-dwelling older people: results of a cross-sectional study. J Clin Nurs. 2015;24:393-405.  https://doi.org/10.1111/jocn.12613
  20. Pata RW, Lord K, Lamb J. The effect of Pilates based exercise on mobility, postural stability, and balance in order to decrease fall risk in older adults. J Bodyw Mov Ther. 2014;18:361-7.  https://doi.org/10.1016/j.jbmt.2013.11.002
  21. Young WR, Mark Williams A. How fear of falling can increase fall-risk in older adults: applying psychological theory to practical observations. Gait Posture. 2015;41:7-12.  https://doi.org/10.1016/j.gaitpost.2014.09.006
  22. Faul F, Erdfelder E, Lang A-G, Buchner A. G*PowerG*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods. 2007;39:175-91.  https://doi.org/10.3758/BF03193146
  23. Cohen LJ. The Probable and The Provable: Oxford University Press; 1977 03 Oct 2011. 
  24. Hill KD, Schwarz JA, Kalogeropoulos AJ, Gibson SJ. Fear of falling revisited. Archives of Physical Medicine and Rehabilitation. 1996;77:1025-9.  https://doi.org/10.1016/S0003-9993(96)90063-5
  25. Brink TL, Yesavage JA, Lum O, Heersema PH, Adey M, Rose TL. Screening Tests for Geriatric Depression. Clinical Gerontologist. 1982;1:37-43.  https://doi.org/10.1300/J018v01n01_06
  26. Bae JN, Cho MJ. Development of the Korean version of the Geriatric Depression Scale and its short form among elderly psychiatric patients. Journal of Psychosomatic Research. 2004;57:297-305.  https://doi.org/10.1016/j.jpsychores.2004.01.004
  27. Ware Jr JE. SF-36 Health Survey. The use of psychological testing for treatment planning and outcomes assessment, 2nd ed. Mahwah, NJ, US: Lawrence Erlbaum Associates Publishers; 1999. p. 1227-46. 
  28. Han C-W, Lee E-J, Iwaya T, Kataoka H, Kohzuki M. Development of the Korean Version of Short-Form 36-Item Health Survey: Health Related QOL of Healthy Elderly People and Elderly Patients in Korea. The Tohoku Journal of Experimental Medicine. 2004;203:189-94.  https://doi.org/10.1620/tjem.203.189
  29. Ware JE, Jr., Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30:473-83.  https://doi.org/10.1097/00005650-199206000-00002
  30. Freiberger E, Blank WA, Salb J, Geilhof B, Hentschke C, Landendoerfer P, et al. Effects of a complex intervention on fall risk in the general practitioner setting: a cluster randomized controlled trial. Clin Interv Aging. 2013;8:1079-88. 
  31. Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson LM, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012;2012:Cd007146. 
  32. Herala M, Luukinen H, Honkanen R, Koski K, Laippala P, Kivela SL. Soft tissue injury resulting from falling predicts a future major falling injury in the home dwelling elderly. J Epidemiol Community Health. 2000;54:557-8.  https://doi.org/10.1136/jech.54.7.557
  33. Gomez F, Wu YY, Auais M, Vafaei A, Zunzunegui MV. A Simple Algorithm to Predict Falls in Primary Care Patients Aged 65 to 74 Years: The International Mobility in Aging Study. J Am Med Dir Assoc. 2017;18:774-9.  https://doi.org/10.1016/j.jamda.2017.03.021
  34. Gettens S, Fulbrook P. Fear of falling: association between the Modified Falls Efficacy Scale, in-hospital falls and hospital length of stay. J Eval Clin Pract. 2015;21:43-50.  https://doi.org/10.1111/jep.12226
  35. Murray KJ, Hill K, Phillips B, Waterston J. A pilot study of falls risk and vestibular dysfunction in older fallers presenting to hospital emergency departments. Disabil Rehabil. 2005;27:499-506.  https://doi.org/10.1080/09638280400018486
  36. O'Halloran AM, Penard N, Galli A, Fan CW, Robertson IH, Kenny RA. Falls and falls efficacy: the role of sustained attention in older adults. BMC Geriatr. 2011;11:85. 
  37. Pua YH, Ong PH, Clark RA, Matcher DB, Lim EC. Falls efficacy, postural balance, and risk for falls in older adults with falls-related emergency department visits: prospective cohort study. BMC Geriatr. 2017;17:291. 
  38. Delbaere K, Close JC, Brodaty H, Sachdev P, Lord SR. Determinants of disparities between perceived and physiological risk of falling among elderly people: cohort study. Bmj. 2010;341:c4165. 
  39. Rochat S, Bula CJ, Martin E, Seematter-Bagnoud L, Karmaniola A, Aminian K, et al. What is the relationship between fear of falling and gait in well-functioning older persons aged 65 to 70 years? Arch Phys Med Rehabil. 2010;91:879-84.  https://doi.org/10.1016/j.apmr.2010.03.005
  40. Tekin F, Cetisli-Korkmaz N. Effectiveness of a Telerehabilitative Home Exercise Program on Elder Adults' Physical Performance, Depression and Fear of Falling. Percept Mot Skills. 2022;129:714-30.  https://doi.org/10.1177/00315125221087026
  41. Aung TNN, Moolphate S, Koyanagi Y, Angkurawaranon C, Supakankunti S, Yuasa M, et al. Depression and Associated Factors among Community-Dwelling Thai Older Adults in Northern Thailand: The Relationship between History of Fall and Geriatric Depression. Int J Environ Res Public Health. 2022;19. 
  42. Iaboni A, Flint AJ. The complex interplay of depression and falls in older adults: a clinical review. Am J Geriatr Psychiatry. 2013;21:484-92.  https://doi.org/10.1016/j.jagp.2013.01.008
  43. Turcu A, Toubin S, Mourey F, D'Athis P, Manckoundia P, Pfitzenmeyer P. Falls and depression in older people. Gerontology. 2004;50:303-8.  https://doi.org/10.1159/000079128
  44. Jung YJ, Kim R, Yoo D, Han K, Lee J-Y. Late-life falling and depressive symptoms associated with the risk of Parkinson's disease: a nationwide cohort data analysis. BMC Geriatrics. 2020;20:284. 
  45. Justino Borges L, Bertoldo Benedetti TR, Zarpellon Mazo G. [The influence of physical exercise on depressive symptoms and functional fitness in elderly residents of south Brazil]. Rev Esp Geriatr Gerontol. 2010;45:72-8.  https://doi.org/10.1016/j.regg.2009.12.004
  46. Oh S, Lim JM, Kim Y, Kim M, Song W, Yoon B. Comparison of the effects of water- and land-based exercises on the physical function and quality of life in community-dwelling elderly people with history of falling: a single-blind, randomized controlled trial. Arch Gerontol Geriatr. 2015;60:288-93.  https://doi.org/10.1016/j.archger.2014.11.001
  47. Dias RC, Dias JM, Ramos LR. Impact of an exercise and walking protocol on quality of life for elderly people with OA of the knee. Physiother Res Int. 2003;8:121-30.  https://doi.org/10.1002/pri.280
  48. Liu CJ, Latham N. Can progressive resistance strength training reduce physical disability in older adults? A meta-analysis study. Disabil Rehabil. 2011;33:87-97.  https://doi.org/10.3109/09638288.2010.487145
  49. de Vries NM, van Ravensberg CD, Hobbelen JS, Olde Rikkert MG, Staal JB, Nijhuis-van der Sanden MW. Effects of physical exercise therapy on mobility, physical functioning, physical activity and quality of life in community-dwelling older adults with impaired mobility, physical disability and/or multi-morbidity: a meta-analysis. Ageing Res Rev. 2012;11:136-49.  https://doi.org/10.1016/j.arr.2011.11.002
  50. Sato D, Kaneda K, Wakabayashi H, Nomura T. Comparison of 2-year effects of once and twice weekly water exercise on activities of daily living ability of community dwelling frail elderly. Arch Gerontol Geriatr. 2009;49:123-8.  https://doi.org/10.1016/j.archger.2008.05.011
  51. Matsushita T, Matsushima E. Quality of life and lifestyle among city dwellers participating in the medical programs. Psychiatry Clin Neurosci. 2004;58:642-50. https://doi.org/10.1111/j.1440-1819.2004.01315.x