THE EFFECTIVENESS OF A NURSE-LED HOME EXERCISE PROGRAMME ON FALL PREVENTION AMONG COMMUNITY-DWELLING ELDERLY : A PILOT STUDY

Abstract

Background: With Singapore’s rapidly ageing society, monitoring elderly falls is increasingly important. Community nursing for one of the main healthcare organisation in Singapore was implemented in early 2018. A balance and strength home-based exercise programme was developed to help community-dwellers prevent falls more effectively. Aim: The aim of this study is to compare the effectiveness of a nurse-led home-based exercise programme with the current care carried out by community nurses on fall prevention among community-dwelling elderly. Methods: A cluster-randomised trial conducted with 58 community-dwelling elderly recruited from senior activity centres. After baseline evaluation, the exercise group (EG) went through 10-weeks of balance and strength training programme while the no-intervention control group (CG) continued with the usual care. Outcome evaluation was done 3 months after baseline taking. Primary outcomes include proportion of participants (POP) with falls and physical performance. Secondary outcomes include fear of falling (FOF), POP with near-misses, POP with fall-related hospitalisation and POP with emergency department (ED) visits. Results: At post-test, between-groups comparisons showed no significant results for physical performance (P=0.727), FOF (P=0.073), POP with falls (P=1.000), POP with near-misses (P=0.078) and POP with fall-related hospitalisation (P=0.318) and ED visits (P=0.318). For within-group comparisons, FOF score improved significantly (P=0.019) among the CG but not physical performance (P=0.862). No viii significant differences were found for the EG from pre-test to post-test for physical performance (P=0.633) and FOF (P=0.657). Conclusions: A home-based exercise programme to help reduce the rate and risk of falls for community-dwelling elderly in Singapore was developed. Despite insignificant results for the EG, researchers can use this study’s findings to improve future fall prevention studies. Related healthcare professionals can learn more about the motivating factors and barriers to exercising in the elderly to improve patient care.