J Korean Acad Nurs.  2011 Apr;41(2):165-174. 10.4040/jkan.2011.41.2.165.

Effects of a Fall Prevention Program on Physical Fitness and Psychological Functions in Community Dwelling Elders

• Kwon MS

• KMID: 1754157
• DOI: http://doi.org/10.4040/jkan.2011.41.2.165

Abstract

PURPOSE
This study was done to identify effects of a fall prevention program on physical fitness and psychological functions in community dwelling elders.
METHODS
A quasi-experimental study was carried out with a nonequivalent control group pre & post-test design. The program, which included exercises and education, consisted of a 12-week group program and an 8-week self-management program using a health calendar. An experimental group (32) and a control group (21) participated.
RESULTS
There were significant differences in SPPB (t=-3.92, p<.001), TUG test (t=4.94, p<.001), standing with right leg (t=-3.60, p=.001), standing with left leg (t=-3.74, p<.001), front and rear maximum step length test (t=-4.34, p<.001), right-left maximum step length test (t=-2.65, p=.011), and fall efficacy (t=-2.42, p=.019). Fall efficacy, fear of falling and depression showed significant differences following the 12-week exercise program and 8-week self-management program in the experimental group.
CONCLUSION
Study findings indicate that the fall prevention program is an effective nursing intervention to enhance physical fitness and psychological functions for elders. Using a health calendar, the self-management program was more effective for psychological functions compared to only the group program. Therefore, health providers should develop diversified fall prevention programs which include motivation plans to encourage clients in participating.

Keyword

Accidental falls; Physical fitness; Depression; Aged

MeSH Terms

Accidental Falls/*prevention & control
Aged
Aged, 80 and over
Depression
Fear
Female
Geriatric Assessment
Humans
Male
*Physical Fitness
Postural Balance
Program Evaluation
Stress, Psychological

Reference

1. Akyol AD. Fall in the elderly: What can be done? International Nursing Review. 2007. 54:191–196.

2. Choi JH. The effects of Tai Chi exercise on physiologic, psychological functions, and fall in fall prone elderly. 2002. Seoul: The Catholic University of Korea;Unpublished doctoral dissertation.

3. Choi JH, Moon JS, Sohng KY. The effects of Tai Chi exercise on physiologic, psychological functions, and falls among fall prone elderly. Journal of Rheumatology Health. 2003. 10:62–76.

4. Clemson L, Cumming RG, Kendig H, Swann M, Heard R, Taylor K. The effectiveness of a community-based program for reducing the incidence of falls in the elderly: A randomized trial. Journal of the American Geriatrics Society. 2004. 52:1487–1494.

5. Elley CR, Robertson MC, Garrett S, Kerse NM, Mckinlay E, Lawton B, et al. Effectiveness of falls-and-fracture nurse coordinator to reduce falls: A randomized controlled trial of at-risk older adults. Journal of the American Geriatrics Society. 2008. 56:1383–1389.

6. Feibel JH, Springer CJ. Depression and failure to resume social activities after stroke. Archives of Physical Medicine and Rehabilitation. 1982. 63:276–277.

7. Gu MO, Jeon MY, Kim HJ, Eun Y. A review of exercise interventions for fall prevention in the elderly. Journal of Korean Academy of Nursing. 2005. 35:1101–1112.

8. Guralnik JM, Ferrucci L, Simonsick EM, Salive ME, Wallace RB. Lower-extremity performance in persons over the age of 70 years as a predictor of subsequent disability. The New England Journal of Medicine. 1995. 332:556–561.

9. Hornbrook MC, Stevens VJ, Wingfield DJ, Hollis JF, Greenlick MR, Ory MG. Preventing falls among community-dwelling older persons: Results from a randomized trial. The Gerontologist. 1994. 34:16–23.

10. Jeon MY, Bark ES, Lee EG, Im JS, Jeong BS, Choe ES. The effects of a Korea traditional dance movement program in elderly women. Journal of Korean Academy of Nursing. 2005. 35:1268–1276.

11. Jung YM, Lee SE, Chung KS. Prevalence and associated factors of falls according to health status in elderly living in the community. Journal of the Korean Gerontological Society. 2006. 26:291–303.

12. 2005 Korean health and nutrition examination survey. Korea Centers for Disease Control and Prevention. 2006, December; Seoul: Author.

13. Liu MR, So HY. Effects of Tai Chi exercise program on physical fitness, fall related perception and health status in institutionalized elders. Journal of Korean Academy of Nursing. 2008. 38:620–628.

14. Mahoney JE, Shea TA, Przybelski R, Jaros L, Gangnon R, Cech S, et al. Kenosha county falls prevention study: A randomized, controlled trial of an intermediate-intensity, community-based multifactorial falls intervention. Journal of the American Geriatrics Society. 2007. 55:489–498.

15. Menz HB, Lord SR, Fitzpatrick RC. A structural equation model relating impaired sensorimotor function, fear of falling and gait patterns in older people. Gait posture. 2006. 25:243–249.

16. Nelson ME, Layne JE, Bernstein MJ, Nuernberger A, Castaneda C, Kaliton D, et al. The effects of multidimensional home-based exercise on functional performance in elderly people. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. 2004. 59:154–160.

17. Park EY. The effects of mixed exercise program on physical fitness and depression in the elderly. 2005. Seoul: Ewha Womans University;Unpublished doctoral dissertation.

18. Park SK. The effects of falls prevention exercise on functional fitness in elderly. 2008. Seoul: Kyunghee University;Unpublished master's thesis.

19. Rejeski WJ, King AC, Katula JA, Kritchevsky S, Miller ME, Walkup MP, et al. Physical activity in prefrail older adults: Confidence and satisfaction related to physical function. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences. 2008. 61:19–26.

20. Ryeom TH, Kim SY, So YK, Park SY, Lee JH, Cho HS, et al. The risk factors of falls in the elderly. Journal of the Korean Academy of Family Medicine. 2001. 22:221–229.

21. Salminen MJ, Vahlberg TJ, Salonoja MT, Aarnio PT, Kivela SL. Effect of a risk-based multifactorial fall prevention program on the incidence of falls. Journal of the American Geriatrics Society. 2009. 57:612–619.

22. Scott VJ, Votova K, Gallagher E. Falls prevention training for community health workers: Strategies and actions for independent living(SAIL). Journal of Gerontological Nursing. 2006. 32:48–56.

23. Sheikh JI, Yesavage JA. Geriatric depression scale (GDS), recent evidence and development of a shorter version. Clinical Gerontologist. 1986. 5:165–173.

24. Shin KR, Shin SJ, Kim JS, Kim JY. The effects of fall prevention program on knowledge, self-efficacy, and preventive activity related to fall, and depression of low-income elderly women. Journal of Korean Academy of Nursing. 2005. 35:104–112.

25. Shumway-Cook A, Silver IF, LeMier M, York S, Cummings P, Koepsell TD. Effectiveness of a community-based multifactorial intervention on falls and fall risk factors in community-living older adults: A randomized controlled trial. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. 2007. 62:1420–1427.

26. Tideiksaar R. Falling in old age-prevention and management. 1997. 2nd ed. New York: Spring Publishing Co.

27. Tinetti ME, Richman D, Powell L. Fall efficacy as a measure of fear of falling. Journal of Gerontology. 1990. 45:P239–P243.

28. Yoo IY. Effects of fall prevention program applying HSEP on physical balance and gait, leg strength, fear of falling and falls efficacy of community-dwelling elderly. Journal of the Korean Gerontological Society. 2009. 29:259–273.