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

• Published in: International journal of chronic obstructive pulmonary disease 2021-01, Vol.16, p.1569-1579
• Main Authors: Beauchamp, Marla K, Ellerton, Cindy, Kirkwood, Renata, Brooks, Dina, Richardson, Julie, Goldstein, Roger S, Pugsley, Stewart, Hatzoglou, Diana
• Format: Article
• Language: English
• Subjects: Balance; balance training; Chronic obstructive pulmonary disease; copd; Disease prevention; exercise; Falls; Falls (Accidents); falls prevention; Intervention; Lung diseases, Obstructive; Older people; Original Research; Patient satisfaction; Prevention; Retention; Validation studies; Validity
• ISSN: 1178-2005; 1176-9106; 1178-2005
• DOI: 10.2147/COPD.S309537

Purpose: 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 [greater than or equal to] 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 ([greater than or equal to] 70%) and exercise adherence ([greater than or equal to] 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 [+ or -] 6.1 years; mean [FEV.sub.1] 45.0 [+ or -] 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