Balance Walking Groups Delivering Evidencebased Exercise to reduce

Balance & Walking Groups Delivering Evidence-based Exercise to reduce falls risk in Older Adults in Bradford. Phil Wright - Physiotherapy Coordinator

Bradford each year • 15, 000 people 65 yo fall • 3, 000 people 65 yo come to A&E after a fall • 1043 admitted • Majority > 75 yo (867) • 367 Hip fractures • 500 Colles fractures • 1700 individuals attend trauma and fracture clinic with low trauma fracture • Inpatient falls – 30% result in injury, 5% a #, majority of clinical incidents, complaints and litigation • Cost to Bradford £ 5, 000

Background • Falls in Older People = big problem in terms of cost and quality of life • Raised profile within healthcare - NSF Standard Six – “effective rehabilitation” • Evidence that falls can be reduced by 30% using a multi-factorial approach • NICE Guideline recommends individualised strength & balance training

The Challenge • To provide Evidence based exercise programmes to increasing numbers of older people at risk of falling referred to Physiotherapy Services within Bradford • Small teams of Community Physiotherapists = limited resources

Balance & Walking Groups • • 3 Centres across Bradford 9 Groups in total Patients attend 2 x week for 8 weeks Validated Assessment and Outcome Tools pre and post attendance – TUG, Tinetti gait & balance, timed sit to stand, Falls efficacy scale • Educational component on avoiding falls and coping strategies in the event of a fall

Exercises • Warm up – seated or standing • Strengthening - resistance either using body weight or theraband • Gait and Balance – adapted Tai Chi • Endurance • Adapted to the individual • Home exercise programme

Development • Group format and content has been developed and is monitored by experienced physiotherapists with postgraduate qualifications in falls management • All aspects subject to on going review

Results • • 303 patients attended in 2006 285 (84%) completed the programme 70% female. Average = 79. 5 yrs Outcomes – 80% of completed outcome measures showed improvement • 11% maintained, 9% deteriorated • Positive Satisfaction Questionnaires

Strengthening with theraband

Balance – group exercise

Teaching getting up from the floor using the backward chaining method

Summary • Evidence to reduce falls risk through individualised specific exercise programmes • Exercise can be delivered in a Group Format • Patients attending the programme demonstrate improvement in gait, balance and strength assessment

Questions? • Do patients who have attended the group have fewer falls? • Do patients continue to maintain their home exercise programmes?

Balance & Walking Groups –Delivering Evidence Based Exercises to reduce falls in Older People Phil Wright – Physiotherapy Coordinator Older People’s Services