Date of Award

2017

Document Type

Scholarly Project

Degree Name

Doctor of Physical Therapy (DPT)

Department

Physical Therapy

First Advisor

Meridee Danks

Keywords

Accidental Falls -- prevention & control; Aged; Risk Assessment; Risk Factors

Abstract

Background: The Timed Up and Go (TUG) is intended to predict fall risk through assessment of balance, functional mobility, and gait in community-dwelling adults age 65 and older. The Stepping On program aims toward fall prevention through education, exercise, and shared experiences among participants. Previous evidence has displayed positive, significant results for Stepping On and the TUG, indicating use of the assessment to track participants' progress in the program.

Objective: The purpose of this study was: 1) to determine if the Stepping On program decreases fall risk in community-dwelling elderly individuals as measured by the TUG test, 2) to distinguish if the TUG is an effective screening tool in assessing fall risk in program participants, and 3) to describe characteristics of Stepping On participants.

Methods: Two females and one male participant with an average age of 87.6 years (81- 93) were recruited from a local Stepping On program, and agreed to participate in additional functional screening. The CDC Fall Risk Checklist and Stepping On Baseline Questionnaire were administered on Week 1. The TUG was administered on Week 1 and Weeks 7 of the program. Subjects performed a two trials of the TUG, one of which was done at a comfortable pace, and other at a quick pace.

Results: Two of three participants completed the 7 week Stepping On program as well as the initial and final TUG assessment. The following results were obtained when the TUG was performed at Week 7 in comparison to Week 1: Subject 1 progressed at comfortable pace by 1.05 seconds (15.34--714.29 seconds; 6.85% improvement) but demonstrated a slower score at quick pace by 1.13 seconds (12.09-713.22 seconds; 9.35% decline), and Subject 2 demonstrated a slower score at comfortable pace by 2.18 seconds (11.88-714.06; 18.35% decline) as well as a slower score at quick pace by 1.21 seconds (10.07-711.28 seconds; 12.02% decline). These results classified Subject 1 as being 'moderate risk' for falls at both comfortable and quick pace, and Subject 2 as being 'high-risk' at comfortable pace and 'low-risk' at quick pace. On the Week 7 Stepping On Survey, both subjects indicated they had not experienced any falls since the start of the program.

Conclusion: The TUG displayed validity in appropriately classifying those experiencing recent falls at a fall risk. Ongoing data collection will be performed with 3- month recheck to analyze if categorized fall-risk based off of TUG performance times are directly related to reported falls (if any). With continuation of the Stepping On program, as well as a focus on increased age when testing, comes opportunity to further assess the effectiveness of the TUG as a screening tool for assessing fall risk in the community-dwelling elderly population.

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