ASSESSMENT OF FALL RISK FACTORS IN ELDERLY WOMEN BEFORE AND AFTER A PHYSICAL THERAPY INTERVEN-TION PROGRAM.

Abstract

Purpose/Hypothesis: Physical mobility is important for promoting good health and maintaining the well-being of all persons. Physical fitness determines the degree of independence and health care needs among the elderly. Functional independence is necessary to lead a normal life and hence it is a mean of assessing quality of life. The purpose of this study was to evaluate the effects of exercises on impairment and physical performance measures in elderly women residing in an assisted living facility with different functional levels. Number of Subjects: Participants were 20 elderly females (87.1 ± 3.8 years) in two groups according to their functional levels (a high and a low-functional level groups) Materials/Methods: Both high and low-functional level groups participated in a combined program of group and individualized home exercise programs for eight weeks. The outcome measures were: two impairment measures: average strength and habitual gait velocity; four timed tasks: 5-repetition sit-to-stand from a standard chair, 5-repetition step-up forward and step-down backward on a single 4-inch step, 50-foot walk, and up and go. A two-factor repeated measures Multivariate Analysis Of Variance (MANOVA) and a follow-up analysis of variance (ANOVA) were used. Results: There was an overall significant main effect of treatment (F6, 13 = 15.88, p < .001), significant main effect of group (F6, 13 = 3.24, p = .03) but no interaction of treatment by functional level (F6, 13 = 0.64, p = .7) for all the dependent variables used in the MANOVA with the Wilk's Lambda criterion. Results from the follow-up ANOVA showed significant improvement in standardized average strength (F1, 18 = 37.9, p < .001), habitual gait velocity (F1, 18 = 15.9 p = .001), 50-foot walk task (F1, 18 = 28.2, p < .001). Participants were able to perform 5-repetition sit-to-stand (F1, 18 = 39.3, p < .001) and 5-repetition step-up task (F1, 18 = 25.67 p < .001) significantly faster after the intervention compared to before the intervention. They also increased significantly the timed up and go task velocity (F1, 18 = 22.3, p < .001). Additionally, both groups (high and low functional levels) gained similar benefits from this combined group and individualized exercise programs. Conclusions: There was no serious adverse effects was reported in this 80 to 95 years old group which may indicate the ability of elderly females to tolerate moderate exercise programs if intensity increases gradually. The increase of habitual and fast gait velocities and the other timed tasks after the intervention may enable subjects to negotiate the environment more effectively and safely. Improvements in physical performance might partially explain a reduction in the risk for falling. Clinical Relevance: A moderate intensity eight-week combined exercise program may be effective in improving strength; habitual gait velocity; and performance on the timed measures in elderly females and hence reduce their risk for falls. The gained improvement may occur in individuals who have high or low functional levels.