Abstract
BackgroundImpaired balance and mobility are common among rehabilitation inpatients. Poor balance and mobility lead to an increased risk of falling. Specific balance exercise has been shown to improve balance and reduce falls within the community setting. However few studies have measured the effects of balance exercises on balance within the inpatient setting.The aim of this randomised controlled trial is to investigate whether the addition of circuit classes targeting balance to usual therapy lead to greater improvements in balance among rehabilitation inpatients than usual therapy alone.Methods/DesignA single centre, randomised controlled trial with concealed allocation, assessor blinding and intention-to-treat analysis. One hundred and sixty two patients admitted to the general rehabilitation ward at Bankstown-Lidcombe Hospital will be recruited. Eligible participants will have no medical contraindications to exercise and will be able to: fully weight bear; stand unaided independently for at least 30 seconds; and participate in group therapy sessions with minimal supervision.Participants will be randomly allocated to an intervention group or usual-care control group. Both groups will receive standard rehabilitation intervention that includes physiotherapy mobility training and exercise for at least two hours on each week day. The intervention group will also receive six 1-hour circuit classes of supervised balance exercises designed to maximise the ability to make postural adjustments in standing, stepping and walking.The primary outcome is balance. Balance will be assessed by measuring the total time the participant can stand unsupported in five different positions; feet apart, feet together, semi-tandem, tandem and single-leg-stance. Secondary outcomes include mobility, self reported physical functioning, falls and hospital readmissions. Performance on the outcome measures will be assessed before randomisation and at two-weeks and three-months after randomisation by physiotherapists unaware of intervention group allocation.DiscussionThis study will determine the impact of additional balance circuit classes on balance among rehabilitation inpatients. The results will provide essential information to guide evidence-based physiotherapy at the study site as well as across other rehabilitation inpatient settings.Trial registrationThe protocol for this study is registered with the Australian New Zealand, Clinical Trials Registry: ACTRN=12611000412932
Highlights
Impaired balance and mobility are common among rehabilitation inpatients
This study will determine the impact of additional balance circuit classes on balance among rehabilitation inpatients
Patients admitted to a general rehabilitation ward often present with poor mobility, impaired balance and reduced ability to carry out activities of daily living [1,2]
Summary
This trial will provide essential information to guide evidence-based physiotherapy at the study site as well as across other rehabilitation inpatient settings It will identify whether the addition of a two-week circuitclass balance program improves balance, mobility and function among rehabilitation inpatients. Decreased balance and its subsequent effects such as falls decreased mobility and functional within the inpatient setting is a significant and costly issue for the health system Despite this cost there has been very little research to date examining the effectiveness of exercise programs designed to improve balance in this setting. If shown to be effective, this balance program has the potential to improve the balance, mobility and function of future rehabilitation inpatients both at the study site and across other similar settings where this program is implemented.
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