Health-related quality of life in home care recipients after a falls prevention intervention: a 6-month follow-up

Abstract

Background: Falls in older adults are an increasingly important public health concern due to the expanding older population and contribute considerably to the global burden of disease. Home care recipients have a high incidence of falls and a low level of health-related quality of life (HRQOL). In this understudied group of older adults, exercise interventions could prevent falls, promote HRQOL and enable healthy ageing in the longer term. Methods:The study is a single-blinded parallel-group randomised controlled trial, lasting three months with a follow-up at six months, conducted in primary care. The objective was to explore the effects of a falls prevention exercise programme post-intervention at a six months follow-up in home care recipients 67+ years with a history of falls. The Otago Exercise Programme lasting three months was performed. The primary outcome was HRQOL measured by the Short Form 36 Health Survey (SF-36). Linear mixed regression models and structural equation models were employed.Results: At six months follow-up, the intervention group scored significantly higher on SF-36's physical component summary (PCS) compared to the controls; 3.0 points, 95% confidence interval (CI) = 0.4, 5.6. This effect was mediated by an increased probability of maintaining exercise in the post-intervention period; odds ratio = 2.3 (CI = 1.1, 5.1). Exercising was associated with a 7.1-point increase in PCS (CI = 3.2, 10.9). Conclusion:A falls prevention exercise programme can improve physical HRQOL in home care recipients post-intervention. The exercise programme also led to longer term changes in exercise behaviour mediating this effect.

The tensions between micro-, meso- and macro-levels: physiotherapists’ views of their role towards fall prevention in the community – a qualitative study

“…However, their impact on competence should not be disregarded. In addition, the perception of competence is closely linked to patient outcomes [15,16]. This link between perceptions of competence and patient outcomes could be explained by the general emphasis on the problem-solving competence by the professionals themselves, as shown in earlier research [57].…”

“…To answer the research question, we used a purposive sample, which are used when the opinion of experts in a particular field is the topic of interest [14]. The current study was conducted in six municipalities in Eastern Norway, where the participating PTs had earlier been involved in a randomised controlled trial evaluating a fall preventative exercise programme [15,16]. All informants had clinical experience in the area of fall prevention and working with older adults.…”

Associations with rates of falls among home care clients in Ontario, Canada: a population-based, cross-sectional study

“…A systematic review examining community-based exercise interventions found that these interventions are valuable for reducing the incidence of falls when these interventions focus on improving balance and include functional and resistance exercises [40]. A randomized controlled trial from Norway on exercise programs also found positive results with respect to improving physical health-related quality of life [41]. These findings demonstrate the value of exercise interventions for home care clients to reduce the incidence of accidental falls and improve patient safety in home care settings.…”

Enhancing existing formal home care to improve and maintain functional status in older adults: Protocol for a feasibility study on the implementation of the Care to Move (CTM) programme in an Irish healthcare setting

“…However, uptake and adherence to such interventions is often poor [11][12][13] . Home care is also an important arena to address falls prevention and QOL, but this vulnerable group of older adults is underrepresented in health research 14 . One recent study of a falls prevention exercise programme based on the Otago Exercise Programme (OEP) significantly improved physical function, Health Related Quality of Life (HRQOL) and balance in older adults receiving home care but was cost intensive 14 .…”

“…Home care is also an important arena to address falls prevention and QOL, but this vulnerable group of older adults is underrepresented in health research 14 . One recent study of a falls prevention exercise programme based on the Otago Exercise Programme (OEP) significantly improved physical function, Health Related Quality of Life (HRQOL) and balance in older adults receiving home care but was cost intensive 14 . Integrating strength and balance activities into daily life activities has shown better adherence but there are less studies in those receiving care 15 .…”