Citation

Taylor-Piliae RE, Chiu-Hsieh (Paul) H, Dolan H, Toosizadeh N, Mohler J (2019) A Novel Dual-Task Balance Challenge to Prevent Falls in Older Adults: A Randomized Pilot Study. J Geriatr Med Gerontol 5:075. doi.org/10.23937/2469-5858/1510075

Copyright

© 2019 Taylor-Piliae RE, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

RESEARCH ARTICLE | OPEN ACCESS DOI: 10.23937/2469-5858/1510075

A Novel Dual-Task Balance Challenge to Prevent Falls in Older Adults: A Randomized Pilot Study

Ruth E Taylor-Piliae, PhD, RN, FAHA1*, Chiu-Hsieh (Paul) Hsu, PhD2, Hanne Dolan, MSN, RN, PhD Student1, Nima Toosizadeh, PhD3 and Jane Mohler, NP-C, MPH, PhD4

1College of Nursing, The University of Arizona, USA

2College of Public Health, The University of Arizona, USA

3Colleges of Medicine and BioMedical Engineering, The University of Arizona, USA

4Colleges of Medicine and Public Health, The University of Arizona, USA

Abstract

Background

A Matter of Balance (MOB) is a national community-based fall prevention program focusing on cognitive restructuring to manage concerns about falling, though does not include a balance-training component. A dual-task balance challenge (DTBC) comprising weight transfer using fixed and random ordering of ankle-reaching balance tasks was added to MOB, to determine of this would lead to reduced fall risk. The study aims were to assess acceptance, satisfaction, safety and adherence to the interventions, examine changes in fall risk, and monitor incident falls for 3-months post-intervention.

Methods

A single-blind, two-group, randomized pilot study with community-dwelling older adults assigned to MOB (2-hours, twice/week for 4 weeks) with 15 minutes of social time or MOB plus DTBC (15 minutes of fixed and random ordering of ankle-reaching balance tasks). Acceptability and satisfaction obtained by self-report, safety and adherence monitored during class by study staff. Fall risk included objectively assessed balance and gait (LEGSys, BioSensics, LLC), and fear of falling (Falls Efficacy Scale International). Monthly fall calendars with phone follow-ups for incident falls.

Results

At high fall risk older adults (n = 16, mean age = 74 ± 8 years), mainly retired (95%), women (88%), with > 13 years education (81%), completed the study (drop-outs, n = 1). Acceptability and satisfaction (mean score = 9.0 ± 1.3, 1 = least, 10 = most) were high, no safety issues, and very high adherence rates (> 94%), regardless of group assignment. The MOB group (n = 7) had no within group changes in fall risk post-intervention (p > 0.05). Conversely, the MOB plus DTBC group (n = 9) had significant improvements in balance (p < 0.05) and gait (p < 0.05) with less fear of falling (p = 0.04) post-intervention, when compared to baseline.

Conclusions

Reducing fall risk factors and preventing falls are essential for older adults, to ensure that they continue to live safely and independently. The addition of DTBC to the nationally-used MOB curriculum may enhance both balance and gait, and lead to reduced fall risk.