Feasibility of a 6-Month Home-Based Fall Prevention Exercise Program in Older Adults with COPD

Abstract

Marla K Beauchamp,1– 3 Cindy Ellerton,1,3 Renata Kirkwood,1 Dina Brooks,1,3 Julie Richardson,1 Roger S Goldstein,3,4 Stewart Pugsley,2,5 Diana Hatzoglou2 1School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada; 2Firestone Institute for Respiratory Health, St. Joseph’s Healthcare, Hamilton, ON, Canada; 3Respiratory Rehabilitation, West Park Healthcare Centre, Toronto, ON, Canada; 4Department of Medicine, University of Toronto, Toronto, ON, Canada; 5Department of Medicine, McMaster University, Hamilton, ON, CanadaCorrespondence: Marla K BeauchampMcMaster University, School of Rehabilitation Science, 1400 Main Street West, Room 428, Hamilton, ON, L8S 1C7, CanadaEmail [email protected]: Older adults with chronic obstructive pulmonary disease (COPD) have a high risk and rate of falls. Home-based fall prevention exercise programs reduce falls in older adults and may be an alternative approach for people with COPD without access to hospital-based rehabilitation. Therefore, we aimed to determine the feasibility of a home-based fall prevention exercise program in older adults with COPD and to examine the effect of the program on fall-related outcomes at baseline, 3 and 6 months.Patients and Methods: Adults ≥ 60 years with COPD at risk for falls participated in a single group study. The intervention was a 6-month home-based fall prevention program which included 40 minutes of independent exercise three times per week, four physiotherapist home visits, bimonthly phone calls, and an optional booster session post-exacerbation. An independent assessor collected outcome measures at home at baseline, 3- and 6-months. Primary feasibility criteria were recruitment and retention rates (≥ 70%) and exercise adherence (≥ 60%). Functional outcomes included the Berg Balance Scale (BBS), the Balance Evaluation Systems Test (BESTest), the Activities-Specific Balance Confidence (ABC) scale, the repeated chair-stand test, self-reported function, and fall history.Results: Thirty-six patients (female 63.8%, mean age 74.4 ± 6.1 years; mean FEV1 45.0 ± 13.8% predicted) were enrolled. The recruitment rate was 46.8%, participant retention rate was 69.4%, and exercise adherence rate was 73.6%. Repeated measures ANOVA showed improvements at 3- and 6-months compared to baseline in the BBS (p= 0.001) and the BESTest total scores and sub-scores (p= 0.001).Conclusion: The home-based fall prevention exercise program met one of the three pre-specified feasibility criteria (exercise adherence), and improved balance-related measures of fall risk in older adults with COPD. Our findings highlight important opportunities for refinement of the study design prior to undertaking a full-scale trial.Keywords: COPD, balance training, exercise, falls prevention

Keywords

• copd
• balance training
• exercise
• falls prevention