Authors: (including presenting author): :
Wong CM(1), Chui KW(1), Mok YT(1), Wong YB(1), Kan WL(1), Leung YYC(1)
Affiliation: :
(1) Physiotherapy Department, Princess Margaret Hospital
Introduction: :
Fall is a common geriatric problem requiring multifactorial physiotherapy interventions aimed at reintegrating patients back to the community. An eight-week community fall prevention program is proposed for the fall patients recruited into Integrated Care Model (ICM) in PMH.
Objectives: :
1. To optimize physical mobility for fall prevention. 2. To increase the confidence of resuming outdoor activities. 3. To reduce unplanned readmission after discharge.
Methodology: :
Patients admitted to PMH due to fall under ICM physiotherapist as case manager were recruited into this program. An eight-week post-discharge home-based or GDH training incorporating theraband exercise, dynamic standing balance training, fall education, carer empowerment and on-site outdoor training were provided. Assessment was done before and after program using the following outcome measures: 1. Modified Functional Ambulation Classification (MFAC), 2. Elderly Mobility Scale (EMS), 3. Time Up and Go (TUG), 4. 30-second sit to stand test and 5. Activities-specific Balance Confidence (ABC). Wilcoxon Signed-Rank Test was used as the statistical analysis by SPSS.
Result & Outcome: :
Thirty-seven cases (72% female) with mean age of 78.5 ± 6.9 years old were recruited from July 2019 to Jan 2020. 55% of them attended GDH-based training and others received home-based training on weekly basis. After approximate eight-week training, both functional mobility (MFAC, EMS, TUGT) and outdoor activities confidence (ABC score) showed statistically significant improvement compared with premorbid. The mean MFAC significantly increased from category IV (assisted walker) to category V (supervised walker) (p=0.021). The proportion of outdoor walker (category VII) increased from 0% to 28% after training. Mean EMS score, TUGT and ABC score significantly improved by 26% (p< 0.01), 41% (p< 0.01) and 23% (p< 0.01) respectively. No statistically significant difference was found in 30-second sit to stand test (p=0.067). Moreover, no readmission to hospital and no more fall episode were reported in all recruited cases. Conclusion: Community fall prevention program was found to be effective in reducing the risk of fall and improving the confidence of patient in reintegrating into community. In view of the satisfactory result, this Program should be continued and promoted to the elderly.
