Proposed Topic (Most preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Authors (including presenting author) :
Poon A, Chan WC, Ip WM, Lau M
Affiliation :
Occupational Therapy Department, Shatin Hospital
Introduction :
The Lifestyle-Integrated Functional Exercise (LiFE) program is a promising approach and effective in improving strength, balance and preventing falls. Originally, the LiFE program is an effective but resource-intensive one to one format with limited feasibility for large-scale implementation. A recently developed group-based LiFE could enhance large-scale implement ability and decrease resource intensity. Although emerging evidence supports the group-based LiFE, there remains a lack of established service provision in local hospital settings. Addressing this gap could significantly improve the fall related functional outcomes and overall cost-effectiveness.
Objectives :
To explore feasibility & effectiveness of a group-based LiFE format for fall prevention in in-patient rehabilitation setting for medical and geriatric patient.
Methodology :
Medical & geriatric patient admitted to Shatin Hospital with HK-MoCA(5) above 7th percentile, activities of daily living with mild assistance and potential discharge home were recruited. Average 5 group-based LiFE sessions, each session lasted for 30 mins were practiced during hospital stay.
The effectiveness of group-based LiFE was measured by Modified Barthel Index, Fall Efficacy Scale, fall incidence at baseline, pre-discharge and 1 month post discharge. The feasibility of group-based LiFE was tested by quantitative questionnaire (7-point Likert scale) measuring safety, acceptability (1 = insufficient to7 = best) and adherence to the LiFE activities (1=least practice to 7=much practice).
Result & Outcome :
Total 19 moderate fall risk (Morse Fall Scale mean=42.8) patients were recruited from May to Nov 2023. The mean age was 77.6 years with 89.4% of female.
Repeated-measures ANOVA was used. Significant improvement was seen in Modified Barthel Index (F=33.6, P=0.01), Fall Efficacy Scale (F=34.1, P=0.00) and Fall incidence (F=37.6, P =0.00).
In feasibility of group-based LiFE format, patients rated as high in safety (mean = 6.8), acceptability (mean = 6.8) and adherence (mean=6.6).
Patients also perceived the group format and LiFE activities as positive and helpful for improving strength and balance capacity, no adverse events occurred during their practice and could recommend group-based LiFE to their friend.
Conclusion:
Group-based LiFE has showed to be feasible and effective in local in-patient rehabilitation setting. The program not only enhanced activities of daily living for medical and geriatric patients but also effectively reduced the fear of falling and lowered fall incidence. Moreover, the incorporation of social interaction and mutual role-modeling among patients enriched the program, highlighting the psychosocial benefits of group format.
Future development and broadening the impact of the LiFE program to address cognitive impaired patient groups and focusing on empowering carers could be considered for better fall prevention management.
