Article

OBJECTIVE: To evaluate measures of strength and balance and falls incidence in
participants attending fall prevention exercise classes taught by volunteer peer
leaders, paid professional (Age Concern Otago group), or a comparison class
(comparison group). DESIGN: Quasi-experimental evaluation with 12-month
follow-up. SETTING: Community. PARTICIPANTS: Older adults with increased fall
risk (N=118; mean age, 75.5 y; age range, 65-94 y), with 23% drop out at 12
months. INTERVENTION: Peer-led group (n=52) and Age Concern Otago (n=41) weekly
1-hour strength and balance classes adapted from a home-based nurse/physical
therapist-administered program and comparison group (n=25) 1-hour weekly seated
exercise classes. MAIN OUTCOME MEASURES: Timed Up and Go test, 30-second chair
stand, functional reach, step touch, Single Leg Stand, and balance confidence at
baseline, 10 weeks, and 6 and 12 months. Falls diaries collected monthly for 12
months. Continued exercise participation questionnaire at 6 and 12 months.
RESULTS: At baseline, the peer-led group achieved normative standards on most
tests and performed significantly better than the Age Concern Otago and
comparison groups (overall P<.05). The Age Concern Otago group reached normative
standards on most tests at 10 weeks. Functional improvements were similar in the
peer-led group and Age Concern Otago groups from 10 weeks to 12 months, and all
functional measures were significantly greater than in the comparison group
(overall P<.02). Poisson regression showed a tendency for a 27% decrease in falls
for the peer-led group compared with the comparison group (incidence rate ratio
[IRR], .73; 95% confidence interval, .48-1.1; P=.07). Continued participation in
strength and balance classes at 12 months was greater in the peer-led group and
Age Concern Otago groups compared with the comparison group. CONCLUSIONS: This
peer-led model maintained measures of strength and balance and was superior to
seated exercise. People in the Age Concern Otago group chose to continue these
classes over other activities, whereas the comparison group had discontinued
exercise classes by 12 months. Peer-led classes may decrease the fall incidence,
although larger studies are needed to confirm this finding.
CI - Copyright (c) 2011 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS