Effectiveness of reality-simulated training in promoting fall efficacy and community reintegration in patients with fear of fall

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Abstract Description
Submission ID :
HAC55
Submission Type
Authors (including presenting author) :
Ho MW(1), Lau FCA(1)
Affiliation :
(1)Occupational Therapy Department, Pok Oi Hospital
Introduction :
Fear of fall limited patient’s performance in activities of daily living (ADL), social engagement and outdoor participation. To promote patient’s fall efficacy and community reintegration, KINE-SIM, a balance rehabilitation device with simulated real-life scenarios of community activities, was introduced into occupational therapy (OT) training in Pok Oi Hospital.
Objectives :
This study aims to compare the effectiveness of patients with fear of fall receiving the combined KINE-SIM and conventional OT training to those receiving conventional OT training only in ADL, instrumental ADL (IADL) and fall efficacy.
Methodology :
Altogether 23 patients with fear of fall, whose Falls Efficacy Scale-International (FES-I) score >28, were recruited to receive out-patient OT training weekly from January to May 2022. The experimental group (EG) with 13 patients received 15-minute KINE-SIM training and 45-minute conventional OT training while the control group (CG) with 10 patients received 60-minute conventional OT training. Pre- and post-assessments were completed for patient’s ADL function using modified Barthel Index (MBI), IADL using Lawton IADL scale and fall efficacy using FES-I. Post-program satisfactory survey for KINE-SIM was conducted for EG.
Result & Outcome :
Among the 23 cases, there were 12 males (52.5%) and mean age was 56.09. They received 14.96 treatment sessions on average. 18 of them were stroke cases, 1 was Parkinson’s case and 4 were orthopedics cases. The age, gender and treatment sessions were normally distributed.

There was significant increase in MBI within EG (p=0.014). Also, there were significant increase in Lawton IADL (EG: p=0.002; CG: p=0.028) and decrease in FES-I (EG: p=0.000; CG: p=0.000) within each group.

Between two groups, there were no significant difference in MBI, Lawton IADL and FES-I (p>0.05). However, the mean changes of assessment scores in EG were greater than in CG.

For the satisfaction survey, all patients in EG agreed that KINE-SIM can “realistically simulate community activities” and “promote confidence in taking public transport”. 92% patients agreed that KINE-SIM can “reduce fall risk”, “increase their confidence to outdoor activities” and “motivate them to return to community”.

Introduction of KINE-SIM in OT training is effective in further promoting patient’s ADL, IADL and fall efficacy. It can be an immersive and motivating approach in preparing patient for community reintegration.
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