Authors (including presenting author) :
Tao SCA, Tang LWF, Wong WYE, Yu KMK, Cheung YS, Lai CHA
Affiliation :
Physiotherapy Department, Kwai Chung Hospital
Introduction :
Fall is a major cause of injury in older people and is associated with severe morbidity, institutionalization and mortality. Muscle weakness, gait and balance impairment are some of the well-established intrinsic factors leading to fall in elderly. Psychogeriatric patients have higher fall incidence than elderly without mental illnesses. They have additional fall risk factors including cognitive impairment, impaired executive dysfunction and drug-induced movement disorder etc. Therefore, program specifically designed to target at some of these modifiable risk factors may enhance the effect of fall prevention in these patients.
Objectives :
To evaluate the effect of a physiotherapy training program in preventing fall in psychogeriatric in-patients in Kwai Chung Hospital
Methodology :
A longitudinal study is designed. Data were collected from April 2021 to November 2021. Psychogeriatic in-patients having history of fall or near fall in the past one year and with MFAC≥3 were recruited. The program comprises an individualized, supervised exercise regime including muscle strengthening, balance and transfer training, gait re-education, cognitive-motor and dual-task training for 120 min/week for 4 weeks. Outcome measures include short Falls Efficacy Scale-International (FES-I), 30 Seconds Sit to Stand Test (30s STS), dual-task cost in 6 metre walk test, single leg stance time (SLS) and Timed Up and Go Test (TUGT). They were used to assess subjects’ fear towards fall, lower limb strength, dual-task performance, balance and functional mobility respectively. Measurements were done before and after the program. Paired t-test was used to detect any significant difference pre- and post-training.
Result & Outcome :
22 subjects finished the program. Mean age was 77.8±7.1. Patients showed statistically significant improvement (p< 0.01) in 30s STS (8.72±4.15 to 10.72±4.00), TUGT (20.45s±9.81 to 17.05s±6.01) and dual-task cost (59.03%±49.60 to 32.02%±22.78). Patients’ SLS time displayed an improving trend and was marginally significant for both left (3.91s±6.94 to 8.77s±13.8, p=0.052) and right (4.36±6.99 to 7.14±12.1, p=0.066) sides. However, there was no significant change in patients’ fear of falling (12.92±4.16 to 11.62±4.55, p=0.408). The findings suggested that this program may mitigate some physical fall risk factors and hence lower the risks of fall. The results proclaimed the efficacy of a physiotherapist-led in preventing falls in psychogeriatric in-patients. Looking forward to further expansion of the program to include psychiatric day patients in the future.
