Autor: Bruna Raquel Gouveia; Maria Helena de Agrela Gonçalves Jardim; Maria Manuela Martins; Élvio Rúbio Quintal; Duarte Luís de Freitas; José António Ribeiro Maia; Debra J. Rose

Revista “Journal of Nursing Studies”

OBJECTIVE: This study aims to assess the effect of a nurse-led rehabilitation programme (the ProBalance Programme) on balance and fall risk of community-dwelling older people from Madeira Island, Portugal. DESIGN: Single-blind, randomised controlled trial. SETTING: University laboratory. PARTICIPANTS: Community-dwelling older people, aged 65-85, with balance impairments. Participants were randomly allocated to an intervention group (IG; n=27) or a wait-list control group (CG; n=25). INTERVENTION: A rehabilitation nursing programme included gait, balance, functional training, strengthening, flexibility, and 3D training. One trained rehabilitation nurse administered the group-based intervention over a period of 12 weeks (90min sessions, 2 days per week). A wait-list control group was instructed to maintain their usual activities during the same time period. OUTCOME: Balance was assessed using the Fullerton Advanced Balance (FAB) scale. The time points for assessment were at zero (pre-test), 12 (post-test), and 24 weeks (follow up). RESULTS: Changes in the mean (SD) FAB scale scores immediately following the 12-week intervention were 5.15 (2.81) for the IG and -1.45 (2.80) for the CG. At follow-up, the mean (SD) change scores were -1.88 (1.84) and 0.75 (2.99) for the IG and CG, respectively. The results of a mixed between-within subjects analysis of variance, controlling for physical activity levels at baseline, revealed a significant interaction between group and time (F (2, 42)=27.89, p<0.001, Partial Eta Squared=0.57) and a main effect for time (F (2, 43)=3.76, p=0.03, Partial Eta Squared=0.15), with both groups showing changes in the mean FAB scale scores across the three time periods. A significant main effect comparing the two groups (F (1, 43)=21.90, p<0.001, Partial Eta Squared=0.34) confirmed a clear positive effect of the intervention when compared to the control. CONCLUSION: This study demonstrated that the rehabilitation nursing programme was effective in improving balance and reducing fall risk in a group of older people with balance impairment, immediately after the intervention. A decline in balance was observed for the IG after a period of no intervention. CLINICAL TRIAL REGISTRATION NUMBER: ACTRN12612000301864.

Gouveia, B. R., Jardim, H. G., Martins, M. M., Gouveia, É. R., de Freitas, D. L., Maia, J. A., & Rose, D. J. (2016). An evaluation of a nurse-led rehabilitation programme (the ProBalance Programme) to improve balance and reduce fall risk of community-dwelling older people: A randomised controlled trial. International journal of nursing studies, 56, 1-8.

http://hdl.handle.net/10400.13/1311

dx.doi.org/10/1016/j.ijnurstu.2015.12.004