Date of Award

2016

Document Type

Scholarly Project

Degree Name

Doctor of Physical Therapy (DPT)

Department

Physical Therapy

First Advisor

Meridee Danks

Keywords

Accidental Falls ǂx prevention & control; Aged; Gait; Postural Balance; Risk Assessment; Risk Factors; Walking Speed

Abstract

Purpose: To identify fall risk and determine if the Stepping On program is effective at reducing the risk of falls in participants by increasing gait speed to greater than or equal to 1 m/s. Step and stride length were also compared to age related norms to determine if they correlated to fall risk. Gait speed of less than I m/s has been shown to increase the risk for falls in elderly.

Methods: Fourteen female participants over the age of 65 (mean age of 87) were recruited from a local Stepping On class conducted at an assisted living facility in order to assess gait speed. The Stepping On class included balance and strength exercises along with education on fall prevention strategies that were taught one session per week over a period of seven weeks. Gait speed, step length, and stride length were analyzed both at the first and seventh week of the class using the GAITRite walkway. Participants also filled out several surveys that were used to help with fall risk assessment and activity levels.

Results: Seven participants completed both the pre and post gait tests. Five of seven participants (71 %) were able to improve their gait speed along with step and stride length, with four (57%) increasing gait speed by greater than .05 m/s which has been established as the MCID. The average gait speed at Week 7 was 0.69 mls which was less than the cut off measure for being at risk for falls is 1.0 m/s.

Conclusion: Further research needs to he conducted to see if members of an assisted living facility can decrease risk of falls by increasing their gait speed after taking part in the Stepping On program. Possible limitations to this study include increased age of participants, exercise compliance, no incorporated walking program and multiple other tests performed on the same day. Future research could look at the relationship between balance confidence and gait speed or TUG scores along with testing at the three month follow-up session. Other correlations could be looked at between the 30 Second Sit to Stand Test, the Cognitive TUG, or the 4 Stage Balance Test.

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