Effects of a Home-Based Fall Prevention Program in Older Lower Limb Prosthesis Users: A Randomized Controlled Trial

Prawina  Sakulkosol; Pieter U  Dijkstra; Kazuhiko  Sasaki; Gary Guerra; Jutamanee Poonsiri

doi:10.33192/smj.v78i10.283047

Authors

Prawina Sakulkosol, M.Sc. Sirindhorn School of Prosthetics and Orthotics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Pieter U Dijkstra, Ph.D. Sirindhorn School of Prosthetics and Orthotics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
Kazuhiko Sasaki, Ph.D. Sirindhorn School of Prosthetics and Orthotics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
Gary Guerra, Ph.D. Department of Exercise and Sport Science, St. Mary’s University, San Antonio, Texas, USA
Jutamanee Poonsiri, Ph.D. Sirindhorn School of Prosthetics and Orthotics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand

DOI:

https://doi.org/10.33192/smj.v78i10.283047

Keywords:

Fall prevention, older adult, amputee, lower limb, prosthesis

Abstract

Objective: To analyze the effects of a home-based fall prevention program on dynamic and static balance and balance confidence in older lower limb prosthesis (LLP) users.

Materials and Methods: In this randomized controlled trial, 44 older LLP users were randomly assigned to either a control group receiving usual care or an intervention group receiving a fall prevention program consisting of education and 16 home-based exercises performed three times per week for eight weeks. Dynamic balance was measured using the Timed Up and Go (TUG) test, static balance using center of pressure displacement, and balance confidence using the Activities-specific Balance Confidence scale. Outcomes were assessed at baseline and post-intervention.

Results: Forty-one of 44 randomized participants completed the study. Among the 44 randomized participants, the mean age was 68.6 ± 6.7 years; 86% were male; 61% had transtibial amputations; 66% had traumatic amputation. The change in TUG time did not differ significantly between groups (median (inter-quartile range) change: −0.6 (−1.5, 0.4) seconds in the intervention group and −0.4 (−1.2, 0.3) seconds in the control group; p = 0.584, r = 0.09). No significant between-group differences were observed in static balance or balance confidence. No falls were reported during the study.

Conclusion: A combined fall prevention education and eight-week home-based exercise program did not result in significantly greater improvements than usual care in dynamic balance, static balance, or balance confidence among older LLP users with relatively high functional mobility. The findings should be interpreted with consideration of the unblinded outcome assessment.

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