Does a Falls Prevention Program Impact Perceived Participation in Everyday Occupations? A Pilot Randomized Controlled Trial

Abstract

This study aimed to evaluate the effectiveness of a multi-disciplinary, client-centered, fall prevention program on the experiences of participation and autonomy in everyday occupations among community-dwelling older adults. In total, 131 older adults (65+) were included and randomly allocated into two groups. Intention-to-treat analysis was used. Results of this pilot study showed that the program had a limited effect on the subjective experiences of participation and autonomy in everyday occupations among the participants. However, a trend of increased perceived participation and a decrease in the experience of perceived problems with participation among the participants in the intervention group was shown. Perceived participation and autonomy seem to be subjective experiences, and they seem to vary depending on the individual. To properly understand the impact of fall prevention interventions on participation and autonomy, measurements that capture both subjective and objective experiences are essential to use.

Health-promoting and preventive interventions for community-dwelling older people published from inception to 2019: a scoping review to guide decision making in a Swedish municipality context

“…Qualitative findings on the experiences of participants also provide an understanding of why the intervention was effective by concluding that senior meetings were experienced as a "key to action" in empowering participants to engage in preventive approaches to improve health [76]. The benefits of senior meetings, albeit with other content, were also verified in the studies by Zingmark et al, [8] and Johansson et al, [37]. In the study by Zingmark et al, [8] two group-based formats of interventions (a discussion group and an activity group) were implemented by occupational therapists which both resulted in positive effects.…”

“…Of the 27 original studies, 12 focused specifically on fall prevention (looking primarily at fall-related parameters and fall risk factors, e.g. falls, fear of falling, balance performance, bone mineral density) [ 17 , 32 – 35 , 37 – 41 , 55 ]. Eight fall prevention interventions were single component and included only exercise [ 10 , 32 – 36 , 38 , 39 ], while five combined an exercise component with one or more different components, e.g.…”

“…Eight fall prevention interventions were single component and included only exercise [ 10 , 32 – 36 , 38 , 39 ], while five combined an exercise component with one or more different components, e.g. preventive home visits (PHV), discussion groups, nutrition, medication review [ 17 , 37 , 40 , 41 , 55 ]. Eleven studies had a health promoting approach.…”

“… Norway, Trondheim Setting: home-based and group format Older people ≥75 years ( n = 77) Inclusion and exclusion criteria: at least one fall during the last year, use walking aid either indoor or outdoor, not exercising more than once per week, no cognitive impairment, no terminal illness. Johansson et al 2015 [ 37 ] Fall prevention/multifactorial b Evaluate effectiveness/ efficacy on the experiences of participation and autonomy, risk of falls, fear of falling. Sweden, Stockholm Setting: primary healthcare unit Older people ≥65 years ( n = 131) Inclusion and exclusion criteria: one or more accidental fall during the last year and/or experienced fall incidents and/or experienced fear of falling, no cognitive impairments, no psychiatric problems, no considerable difficulties in understanding and speaking Swedish.…”

“…Senior meetings, one type of intervention investigated in four different studies, seems potentially effective in promoting general health and wellbeing among communitydwelling older people [8,37,43,44]. The study which provides the broadest evidence base is the "Elderly Persons in the risk zone"-study conducted in Gothenburg [43], which evaluated a four-sessions senior meeting intervention combined with a home visit.…”