Effect Of Otago Exercise Programme On Fear Of Falling In Stroke Elderly Patients

Objective (1) To investigate the current status and influencing factors of fear of falling (FOF) among the stroke older patients. (2) To evaluate the effect of Otago Exercise Programme on fall-related efficacy, balance, mobility, fear of falling, and falls in stroke elderly patients.Methods The research consists of two parts.The first part was descriptive research.By convenient sampling,170 stroke elderly patients were investigated using questionnaire and assessments. The questionnaire and assessments were designed to collect information on demographic characteristics, stroke features, fear of falling, fall-related efficacy, balance and mobility of stroke elderly patients. In the second part,56 stroke elderly patients were randomly assigned into the intervention or control group,28 cases in each group.Participants in the intervention group were received Otago Exercise Programme (OEP) and regular telephone follow-up. Paticipants in the control group were received regular telephone follow-up only. The intervention period was 16 weeks. OEP includes two parts, the first part contains warm-up, strength exercises and balance exercises,30 minutes each time,3 times a week; the second part was walking, which takes 30 minutes each time,2 times per week. Participants were asked to complete OEP by themselves at home, and they could get OEP guided booklet and exercise calendar, which used to record the numbers of OEP, walking and falls weekly. During the intervention period, participants would conduct outpatient follow-up for 5 times. At each follow-up, reseacher developed the individualized OEP based on the participants’physical condition, and guided OEP for participants. In order to ensure the participants’OEP compliance, they were recived telephone follow-up from researcher twice a week. Regular telephone follow-up was provided information related to falls and stroke care. The time of regular telephone follow-up was same to make an appointment to outpatient time, which took every 4 weeks a time, totally 4 times,10 to 15 minutes each time. The time and content of regular telephone follow-up for the control group was same to the intervention group. After 16 weeks, researcher collected data for all participants and evaluated the effect.Results (1) 39.4% of stroke elderly patients reported FOF, and the scores of MFES between those with FOF and those without FOF were significantly different(78.21±21.88 VS 116.1’5±10.15, p<0.001).(2) Multiple logistic regression analysis indicated that good balance (OR=0.697) was the protective factor associated with FOF; impaired mobility (OR=1.180) and a previous history of falls in past six months (OR=2.728) were the risk factors associated with FOF, which could explain 41.8%,56.6% of variations. (3) 56 of 67 FOF participants were entered to the randomized cortrol trial finally. After 16 weeks, totally 51 participants completed the OEP,2 in the intervention group and 3 in the control group dropped out, and the drop-out rate between two groups was no statistical significant differences (p-1.000). (4) Exercise compliance rate of participants in the intervention group was 76.92%.(5) Significant statistical differences in MFES score and BBS score were found between the intervention and control groups after 16-week intervention p=0.040, p=0.039), but the differences of TUGT, number of FOF, and number of falls between two groups were nonsignificant (p=0.115, p=0.131,p=0.936). (6) Significant increase in MFES score and BBS score were found within the intervention group between baseline and 16 weeks (p=0.000,p=0.006), but no significant statistic changes were found in TUGT (p=0.116). Significant increase in BBS score were found within the control group between baseline and 16 weeks (p=0.001), but no significant statistic changes were found in MFES and TUGT p=0.081,p=0.191).Conclusion 39.4% of stroke elderly patients reported FOF. Good balance was the protective factor associated with FOF, but impaired mobility and a previous history of falls in past six months were the risk factors associated with FOF.OEP could improve the balance of stroke elderly patients, and it could also improve fall-related efficacy, which means alleviate the level of FOF of stroke elderly patients.