An intervention study for community-dwelling elderly fallers based on nonlinear causal resource analysis

Falls are a leading cause of injury, immobility, disability, and premature death in the elderly. Therefore fall prevention in the elderly is imperative. To prevent falls, the risk factors associated with falls need to be assessed to determine the limiting elemental resources responsible for impaired physical performance of higher level functional tasks.;Subjects completed an individualized program twice a week with supervision and an independent home exercise program a minimum of once a week. A repeated measures multivariate analysis (MANOVA) with followup univariate analysis was utilized to determine significant changes in the physical performance measures before and after the 12-week intervention. Changes in the impairment measures not targeted with interventions were compared to changes in the targeted limiting elemental resources with the Wilcoxon Signed Ranks test. Percent agreement was calculated to investigate changes in the targeted limiting elemental resources and the changes in the corresponding physical performance measures. Overall percent agreement was 76% when comparing changes between the targeted limiting elemental resources and the corresponding 10 physical performance measures.;These results support the utilization of NCRA to determine elemental resources limiting physical performance in subjects who have fallen. Clinicians can therefore develop individualized interventions targeting those limiting elemental resources to improve physical performance and hopefully prevent future falls in community-dwelling elderly. (Abstract shortened by UMI.).;In this study, Nonlinear Causal Resource Analysis (NCRA) was utilized to determine the limiting elemental resources for 17 community-dwelling elderly fallers. There were 14 females and 3 males with a mean age of 76.8 +/- 6.7. The subjects were tested using impairment and physical performance measures before and after a 12-week intervention. For each subject, NCRA identified the limiting elemental resources for each physical performance measures by developing a resource demand function curve for each combination of physical performance measure and elemental resources. Individualized interventions were targeted at those limiting elemental resources.