Article

OBJECTIVE: To investigate whether two additional home visits improve outcomes for
rehabilitation outpatients with balance impairments compared to usual care.
DESIGN: Randomized controlled trial. SETTING: Outpatient rehabilitation.
PARTICIPANTS: Fifty with balance impairments. INTERVENTIONS:
Both groups received
usual care including weekly group exercise over eight weeks. The intervention
group received two home visits to individualize home exercises. OUTCOME MEASURES:
Primary outcome measure was the Balance Outcome Measure for Elder Rehabilitation
(BOOMER) score, and secondary outcomes included force platform measures using the
NeuroCom Balance Master((R)), assessed at baseline, after intervention and
three-month follow-up. RESULTS: There was no between-group difference for BOOMER
score. There were significant between-group differences in favour of the
intervention group for limits of stability reaction time at week 9 (mean
difference (MD) -0.27, 95% confidence interval (CI) -0.44 to -0.09) and week 22
(MD -0.28, 95% CI -0.45 to -0.10) and for limits of stability maximal excursion
at week 9 (MD 8.66, 95% CI 1.67 to 15.65) and week 22 (MD 14.58, 95% CI 7.59 to
21.57). Significant between-group differences favoured the control group for
Clinical Test of Sensory Interaction of Balance at week 9 (MD 0.40, 95% CI 0.13
to 0.66) and week 22 (MD 0.45, 95% CI 0.18 to 0.72) and step quick turn time at
week 9 (MD 0.56, 95% CI 0.02 to 1.10). CONCLUSION: Two exercise-focussed home
visits improved some dynamic balance outcomes in older patients with balance
impairments. Some outcomes showed significant improvements with small effect
sizes in favour of the control group which may be chance findings or because they
completed a standard home exercise programme.

Langue : ANGLAIS