Date of Award

5-2020

Document Type

Scholarly Project

Degree Name

Doctor of Physical Therapy (DPT)

Department

Physical Therapy

First Advisor

Meridee Danks

Abstract

Background: Every year millions of adults over the age of 65 experience a fall. Falls cost healthcare and individuals financial distress, decrease self-confidence, and can cause injuries. Balance and strength deficits contribute to increasing an individual's fall risk. Studies have shown the efficiency of community-based exercise and education programs on reducing the risk of falling. The Stepping On Program utilizes a group setting to educate on falls and risks, strength and balance exercises, home safety, vision, coping after a fall, and community mobility. Stepping On is an evidence-based fall prevention program that has been proven to reduce falls by 31 % in the community. It is aimed towards fall prevention through education, exercise, and shared experiences among participants. This 7-week program was developed in Australia by Lindy Clemson and Megan Swann, and it is now being implemented across the United States.

Objective: The purpose of this study was to determine whether participants in the 7- week Stepping On fall prevention program experienced an improvement in balance and confidence following completion of the program.

Methodology: Thirteen participants (9 females, 4 males) were assessed from the Stepping On fall prevention program at a local fitness center and completed both pre- and post- testing for this study. The participant's mean age was 76.4 years old. Participants attended the 7-week Stepping On program between January and March 2019, for one, 2 hour session each week. Participants completed surveys ( demographics, CDC Fall Risk Checklist, Activities-Specific Balance Confidence Scale, and activity level), Timed Up and Go (TUG) test, Four Stage Balance Test (FSBT), 30-second Sit to Stand (30sSTS), and IO-meter Walk Test (l0MWT).

Results: Overall, participants showed improvements in balance assessment scores indicating a potential decrease in fall risk. The 30sSTS showed a significant improvement in repetitions (p=0.006). There was also a significant increase in gait speed velocity among participants (p=0.029). The ABC Scale (p=0.069) and the sum of all fall risks (p=0.055) had a tendency to be significant. Participants also reported increased confidence in their balance at the completion of the program. At week 1, 46% of the participants were at in increased fall risk on the ABC Scale, with a score less than 68%, indicating their decreased confidence. When taken the same scale in week 7, the percentage dropped to 30% with increased confidence rates. Participants had positive comments about the Stepping On program. Each participant in the study attended at least 5 of 7 sessions of the program, indicating adherence to the program guidelines.

Conclusion: Participants who were involved in Stepping On demonstrated significant positive effects on balance activities (30STS, gait speed velocity). The ABC Scale and the sum of all fall risks trended towards a significant change in participants' balance confidence. Clinical Significance: Fall prevention programs have been on the rise with the increasing elderly population and increasing healthcare costs associated with falls. Programs such as Stepping On have shown to be an effective method in reducing fall risk and increasing confidence. Physical Therapists can play an integral role by combining education and exercise to community dwelling individuals to decrease the incidence of falls.

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