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 -- prevention & control; Aged, 80 and over; Postural Balance; Risk Assessment; Risk Factors

Abstract

Background: The Timed Up and Go (TUG) test is a functional assessment that has been proven effective at identifying individuals at a risk for falls. The Stepping On program aims toward fall prevention through education, exercise, and shared experiences among participants. With previous evidence displaying positive, significant results for Stepping On and the TUG, a utilization of this assessment to track participants' progress in the course is indicated.

Objective: The purpose of this study was 1) to determine if the Stepping On program displays a decrease in fall risk through the application of the TUG and 2) if the TUG is an effective screening tool for a fall risk assessment with Stepping On participants. A separate part of the study also evaluated the effectiveness of the Stepping On program in fall risk reduction with: Cognitive TUG, 30 Second Chair Stand Test (30sCST), Gait Speed via the GAITRite, and the Four-Stage Balance Test (FSBT).

Methods: Fourteen female participants with an average age of 87.2 years (80-94) were recruited for the Stepping On program, and agreed to participate in additional functional screening. The Falls Risk Survey, the Activities-specific Balance Confidence (ABC) scale, and functional assessments were administered on Week 2 and Week 7 of the program. Week 7 and 3-month follow up surveys were also completed by the participants to monitor their confidence and perception of fall risk.

Results: Eight of the 14 participants completed both the initial and final TUG assessment to determine the effectiveness of the Stepping On program by utilizing this functional test. Of the eight individuals, three displayed improved scores. One of these individuals dropped below fall risk, and another into 'normal mobility' «11 sec) for their age group (80-89 years of age). Five of the eight were classified at a high fall risk (> 13 .5 sec). In determining the effectiveness of the TUG for fall screening, this study found seven of the 14 participants classified at a fall risk, four without previous falls to be without a fall risk, and three without previous falls at a fall risk. These results give the TUG a sensitivity of 100% and a specificity of 57% at determining a fall risk for this study.

Conclusion: Based on the results, the TUG displayed 37% participant improvement in the Stepping On program as an effective course in decreasing fall risk. However, due to a high average age (87.2) of the participants, a majority use of assistive devices, residency in an assisted living facility, and various co-morbidities, improvements in function over a seven week period may not be expected.

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