Screening for Preclinical Balance Limitations in Younger Older Adults: Time for a Paradigm Shift?

A seniors exercise park program for older adults with mild balance dysfunction - a feasibility study

PURPOSE

To evaluate the feasibility of a multimodal exercise program conducted at a Seniors Exercise Park among older adults with mild balance dysfunction.

METHODS

Participants (aged ≥65 years) with mild balance dysfunction underwent 18 weeks of gradual reduction of supervised training followed by six weeks of independent training at the Seniors Exercise Park. Feasibility and safety were assessed at baseline, 18 and 24 weeks.

RESULTS

Seventy-five participants expressed interest in the program. Of the 46 participants enrolled in the study, 36 (78.3%) completed the 18 week intervention, and 32 (69.6%) were followed-up at 24 weeks. The median adherence to supervised training was 90.9%, and independent practice was 26.3% (weeks 19-24). All the supervised training sessions were completed within 18 weeks. No falls, or adverse events occurred. All physical performance (e.g., balance, lower body strength, and mobility), psychosocial health outcomes (e.g., mental wellbeing) and quality of life improved significantly at 18 and 24 weeks.

CONCLUSIONS

This initially supervised Seniors Exercise Park program which progressed to independent practice is feasible, safe, and improved health outcomes in older adults with mild balance dysfunction. Strategies are needed to improve adherence to independent practice and minimise dropouts. Implications for rehabilitationGradually reduced supervision in a Seniors Exercise Park program progressing to independent practice is feasible and safe for older adults with mild balance dysfunction.Seniors Exercise Parks can assist older adults with mild balance dysfunction to improve their balance, lower body strength, mobility, and psychosocial health.There is a need for more Seniors Exercise Parks in community parks to enable greater access to this novel exercise approach by older people, including those with mild balance dysfunction.

A Physical Therapy Mobility Checkup for Older Adults: Feasibility and Participant Preferences From a Discrete Choice Experiment

PURPOSE

Physical performance measures, like walking speed, identify and predict preclinical mobility disability but are rarely used in routine medical care. A preventive model of care called Mobility Checkup is being designed to reduce mobility disability in older adults. This study had two purposes: 1) determine feasibility and outcomes of the Mobility Checkup, and 2) identify preferences of older adults regarding this model of care using a discrete choice experiment.

METHODS

Adults over 55 years of age were recruited from the community. In the study's first phase, participants completed a Mobility Checkup, with feasibility evaluated using 6 criteria. In the second phase, a new sample of older adults (>55 years old) were educated about the Mobility Checkup and then completed a discrete choice experiment to determine their preferences regarding 4 attributes of this care model: cost, visit duration, desired education topic, and style of educational graphic.

RESULTS

Each study phase was completed by 31 participants. Of the 6 feasibility criteria, 5 were met. Visit duration exceeded the 60-minute criteria for 13 of the 31 participants. Still, 91% of participants were very satisfied with the Mobility Checkup. Ability to transition positions identified preclinical mobility disability most frequently. A 30-minute visit with no out-of-pocket cost was deemed preferred.

CONCLUSIONS

Older adults value knowing what physical performance measurements predict about their general health. Transitions should be evaluated as part of a Mobility Checkup for older adults. Clearly conveyed cost of health care service is important to older adult consumers.