Authors (including presenting author) :
Lau ST, Ip YY, Chan TKK, Tse KY, Chan WK, Fan HUS, Li PM, Ho CM
Affiliation :
Department of Occupational Therapy, Tai Po Hospital
Introduction :
In Hong Kong, falls are prevalent among patients with stroke or hip fracture,which impact their functioning. Lifestyle-integrated functional exercise (LiFE) (2010) is an evidence-based intervention aims at reducing falls and improving functioning by integrating balance and strength activities into daily tasks and routines. Daily Community LiFE program (DC-LiFE), is a modified program, aimed to develop individualized community skills and facilitate community reintegration.
Objectives :
To evaluate the effectiveness of the DC-LiFE program in patients with stroke or hip fracture by exploring functional ADLs, functional mobility, fall efficacy and community integration.
Methodology :
Participants were recruited at Tai Po Hospital with 1) diagnosis of stroke or hip fracture, 2) cut-off > 7th percentile in Montreal of Cognitive Assessment (MoCA), 3) Modified Barthel Index (MBI) >60, at least minimal assistance in ADL, 4) potential discharge home.
DC-LiFE includes 1) balance and strength activities during in-patient phase 2) community skills training within hospital indoor and outdoor environments prior discharge, 3) environmental assessment and modification through home visit along with HA Go and LiFE home program prescription. 4) referral to outpatient service including Geriatric Day Hospital (GDH) and community partner if indicated 5) 1-month post-discharge telephone follow-up on the latest functioning.
Outcome measures include 1)Modified Barthel Index (MBI), 2)Short Physical Performance Battery (SPPB), 3)Fall Efficacy Scale (FES), 4)Community Integration Questionnaire (CIQ), 5)Satisfaction survey post home visit.
Result & Outcome :
Four men and ten women were recruited with a mean age of 64.4 (SD 9.3). Wilcoxon Signed Ranks Test was conducted to analyze the data by comparing mean of the pre- and post-outcome measure.The results showed significant changes in MBI (Z=-3.18, p=0.001), SPPB (Z=-3.11, p =0.002), FES (Z=-2.81, p=0.005) and CIQ (Z=-2.03, p=0.043). In patient’s satisfaction survey and telephone follow-up, all participants agreed that DC-LiFE could enhance ADL performance, and increase confidence in community participation.
DC-LiFE has shown to be effective in improving ADL functioning, functional mobility, fear of falling and community integration among participants. It would be beneficial to continue the LiFE program in cooperation with community partners in the future.
