Feasibility of a 6-Month Home-Based Fall Prevention Exercise Program in Older Adults with COPD

Purpose: Older adults with chronic obstructive pulmonary disease (COPD) have a high risk and rate of falls. Home-based fall prevention exercise programs reduce falls in older adults and may be an alternative approach for people with COPD without access to hospital-based rehabilitation. Therefore, we...

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Published inInternational journal of chronic obstructive pulmonary disease Vol. 16; pp. 1569 - 1579
Main Authors Beauchamp, Marla K, Ellerton, Cindy, Kirkwood, Renata, Brooks, Dina, Richardson, Julie, Goldstein, Roger S, Pugsley, Stewart, Hatzoglou, Diana
Format Journal Article
LanguageEnglish
Published London Dove Medical Press Limited 01.01.2021
Dove Medical Press Ltd
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Dove Medical Press
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Summary:Purpose: Older adults with chronic obstructive pulmonary disease (COPD) have a high risk and rate of falls. Home-based fall prevention exercise programs reduce falls in older adults and may be an alternative approach for people with COPD without access to hospital-based rehabilitation. Therefore, we aimed to determine the feasibility of a home-based fall prevention exercise program in older adults with COPD and to examine the effect of the program on fall-related outcomes at baseline, 3 and 6 months. Patients and Methods: Adults [greater than or equal to] 60 years with COPD at risk for falls participated in a single group study. The intervention was a 6-month home-based fall prevention program which included 40 minutes of independent exercise three times per week, four physiotherapist home visits, bimonthly phone calls, and an optional booster session post-exacerbation. An independent assessor collected outcome measures at home at baseline, 3- and 6-months. Primary feasibility criteria were recruitment and retention rates ([greater than or equal to] 70%) and exercise adherence ([greater than or equal to] 60%). Functional outcomes included the Berg Balance Scale (BBS), the Balance Evaluation Systems Test (BESTest), the Activities-Specific Balance Confidence (ABC) scale, the repeated chair-stand test, self-reported function, and fall history. Results: Thirty-six patients (female 63.8%, mean age 74.4 [+ or -] 6.1 years; mean [FEV.sub.1] 45.0 [+ or -] 13.8% predicted) were enrolled. The recruitment rate was 46.8%, participant retention rate was 69.4%, and exercise adherence rate was 73.6%. Repeated measures ANOVA showed improvements at 3- and 6-months compared to baseline in the BBS (p=0.001) and the BESTest total scores and sub-scores (p=0.001). Conclusion: The home-based fall prevention exercise program met one of the three pre-specified feasibility criteria (exercise adherence), and improved balance-related measures of fall risk in older adults with COPD. Our findings highlight important opportunities for refinement of the study design prior to undertaking a full-scale trial. Keywords: COPD, balance training, exercise, falls prevention
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ISSN:1178-2005
1176-9106
1178-2005
DOI:10.2147/COPD.S309537